Many infants with complex congenital heart disease (CHD) do not develop
the skills to feed orally and are discharged home on gastrostomy tube or
nasogastric feeds. We aimed to identify risk factors for failure to achieve full
oral feeding and evaluate the efficacy of oral motor intervention for increasing
the rate of discharge on full oral feeds by performing a prospective study in
the neonatal and cardiac intensive care units of a tertiary children’s
hospital. 23 neonates born at ≥ 37 weeks gestation and diagnosed with
single-ventricle physiology requiring a surgical shunt were prospectively
enrolled and received oral motor intervention therapy. 40 historical controls
were identified. Mean length of stay was 53.7 days for the control group and
40.9 days for the study group (p=0.668). 13/23 patients who received
oral motor intervention therapy (56.5%) and 18/40 (45.0%)
controls were on full oral feeds at discharge, a difference of 11.5%
(95% CI −13.9% to 37.0%, p=0.378).
Diagnosis of hypoplastic left heart syndrome, longer intubation and duration of
withholding enteral feeds, and presence of gastroesophageal reflux disease were
predictors of poor oral feeding on univariate analysis. Although we did not
detect a statistically significant impact of oral motor intervention, we found
clinically meaningful differences in hospital length of stay and feeding tube
requirement. Further research should be undertaken to evaluate methods for
improving oral feeding in these at-risk infants.
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