Related Experiment Video
Updated: Jun 13, 2026
A Neonatal Heterotopic Rat Heart Transplantation Model for the Study of Endothelial-to-Mesenchymal Transition
Published on: July 21, 2023
Enteral feeding of neonates with congenital heart disease
Girija Natarajan1, Sreedhar Reddy Anne, Sanjeev Aggarwal
1Department of Pediatrics, Wayne State University School of Medicine, Detroit, Mich, USA. gnatara @ med.wayne.edu
Insights
Enteral feeding practices in neonates with congenital heart disease (CHD) are crucial. Many infants with CHD require gavage feeding at discharge despite early postoperative enteral nutrition, highlighting the need for improved feeding strategies.
Area of Science:
- Neonatology
- Pediatric Cardiology
- Surgical Outcomes
Background:
- Limited data exists on enteral feeding practices for neonates with congenital heart disease (CHD).
- Understanding these practices is vital for improving post-operative outcomes in this vulnerable population.
Purpose of the Study:
- To analyze feeding patterns in neonates with CHD before and after surgical repair.
- To determine the incidence of feeding-related morbidities and identify associated risk factors.
Main Methods:
- Retrospective review of neonates with CHD undergoing surgical repair within the first month of life.
- Statistical analysis using SPSS software (version 17) with a significance level of p < 0.05.
Main Results:
- Most neonates (92.5%) initiated enteral feeds pre-surgery, with 70.1% achieving 100 ml/kg/day.
- Postoperative feeds were initiated in 98.5% of infants, reaching 100 ml/kg/day within 5 days.
- 40.3% of infants required gavage feeding at discharge; cardiopulmonary bypass and pre-surgery full feed attainment were linked to death/discharge gavage needs.
Conclusions:
- While many neonates with CHD achieve moderate enteral intake pre- and post-surgery, a significant proportion still require gavage feeding at discharge.
- Early initiation of postoperative enteral feeds does not eliminate the need for prolonged gavage support in many cases.
- Developing evidence-based feeding strategies is critical for optimizing outcomes in neonates with CHD.
Background:
Despite their putative impact on post-operative outcomes, there is paucity of data on enteral feeding practices of neonates with congenital heart disease (CHD).
Objectives:
To examine feeding patterns among neonates with CHD before and after surgical repair and determine the incidence of and to identify risk factors associated with feeding-related morbidities.
Methods:
Retrospective data review of neonates with CHD who underwent surgical repair within the first month of life. SPSS software (version 17) was used for analyses and p < 0.05 taken as significant.
Results:
The median (range) gestational age of our cohort (n = 67) was 39 weeks (32-41) and birth weight 3,100 g (1,615-4,280). Ductal-dependent lesions were diagnosed in 52 infants (77.6%). Prior to surgery, feedings were initiated in 62 infants (92.5%) at a median age of 2.5 days (1-18); 100 ml/kg daily intake was achieved in 47 infants (70.1%) at 5 days (1-20) and full feeds in 22 infants (32.8%). Postoperative enteral feeds were started 3 days (1-20) after surgery in 66 infants (98.5%) and intake of 100 ml/kg/day was reached in 64 infants at 5 postoperative days (1-29). Four infants (5.9%) died; 27 (40.3%) were on at least partial gavage feedings at the time of discharge home. NEC was diagnosed in 2 infants. On regression analysis, cardiopulmonary bypass (p = 0.024) and age at which full feeds were attained prior to surgery (p = 0.039) were significantly associated with death and/or gavage at discharge.
Conclusions:
The majority of infants with CHD achieve moderate enteral intake prior to surgery, even while on prostaglandins. Despite this and the early initiation of postoperative enteral feeds, many infants need gavage feeds at discharge. Evidence-based feeding strategies for this high-risk population are critical to improving outcomes.
Related Concept Videos
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
01:26Enteral Nutrition I: Orogastric and Nasogastric Feeding
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:14Fetal Circulation
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
01:28Mitral Regurgitation IV: Nursing Management
01:27Mitral Stenosis IV: Nursing Management