Inadequate nutrition support in the postoperative period in infants recovering from cardiac surgery can impact morbidity and growth. We sought t o determine postoperative nutrition support patterns and identify factors associated with rate of weight gain in infants <1 year. Data were collected from the medical records of 24 infants. The median age a t surgery was 2.7 months (range, 1 day to 9 months). The median overall daily weight change during the postoperative ward stay was -11 gld (range, -145 to +84 gld), with a net positive gain in 8 (36101, net loss in 14 (64%) and unknown in 2 infants. The rate of weight change by hospital discharge was related to feeding practice: bottle fed infants gained a median of 20 gld (range, -100 to +73 gld); breast fed infants who were supplemented with bottle feeds gained a median of 5 gld (range, -83 to +43 gld); and exclusively breast fed infants lost a median of 49 gld (range, -80 to -23 gld)(p = .04). Patients who were meeting a greater percentage of their energy requirements by the time of hospital discharge had higher rates of weight gain ( r = .78; p = .003). Rate of weight gain was not related to cardiac lesion or hospital length of stay. We conclude that weight gain after cardiac surgery in infants is sub-optimal and is related t o feeding practices. Greater attention to achieving energy requirements during postoperative recovery is necessary, especially in breast fed infants.In the last 30 years failure to thrive has been a concern in infants and children with congenital heart disease.' Although there is no uniform Correspondence and reprint requests: Brian RIcCrindle, RID, RIPH,
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