A Multi-Interventional Nutrition Program for Newborns with Congenital Heart Disease

Current Strategies to Optimize Nutrition and Growth in Newborns and Infants with Congenital Heart Disease: A Narrative Review

“…In centers where feeding protocols have been developed for infants with CHD, the observed benefits include improved postoperative enteral feeds, reduced parenteral nutrition (PN) use, fewer placements of nasogastric and gastric tubes, and improved weight and outcomes such as NEC onset, hospital stay and mortality [ 8 , 45 , 46 , 47 , 48 ].…”

“…A minimum protein intake of 1.5 g/kg/day is recommended by both European and American guidelines, to prevent a cumulative negative protein balance [ 24 , 56 ]. A standard protein requirement of up to 3 g/kg/day should be ensured in critically ill infants aged <2 years [ 8 , 11 , 47 ], especially those requiring mechanical ventilation [ 56 ].…”

“…Breast milk has been demonstrated to be protective in term, preterm and infants undergoing surgery and therefore should be encouraged in the CHD population [ 47 , 72 , 73 ]. Unfortunately, infants with CHD are less breastfed compared to their healthy peers, both for their clinical conditions and for long periods of mother–infant separation.…”

Nutritional Management of Patients with Fontan Circulation: A Potential for Improved Outcomes from Birth to Adulthood

“…In addition, the numerous surgical interventions and hospitalizations cause abrupt interruptions of a delicate phase of growth and neuromotor development, including the oral-motor learning and training parts [ 48 ]. Early nutritional management is controversial, primarily because of the association between early enteral feeding and necrotizing enterocolitis (NEC) in newborns with CHDs [ 49 ], notably those with SV physiology and/or shunt-dependent pulmonary blood flow [ 50 , 51 , 52 ]. The risk of NEC has often led to a prohibitive approach to enteral nutrition (EN) (mean time to the initiation of EN is 6 days, and 84% of infants not receiving any EN preoperatively) [ 37 ], significant differences in feeding practices, and the emergent necessity of a standardization of the latter.…”

Commentary: The growing problem in congenital heart surgery

“…Postnatal poor growth in patients with congenital heart disease has been well studied, and preoperative and postoperative interventions that address growth and nutrition have improved outcomes after congenital heart surgery. 6,7 The fetal environment introduces additional complexities, however. Maternal health status and nutrition, 8 as well as the placenta's ability to deliver appropriate nutrition, impact growth.…”