Breastfeeding the infant with congenital diaphragmatic hernia post extracorporeal membrane oxygenation

Area of Science:

• Neonatal Medicine
• Pediatric Surgery
• Lactation Science

Background:

• Congenital diaphragmatic hernia (CDH) frequently necessitates extracorporeal membrane oxygenation (ECMO) in neonates.
• Infants on ECMO often endure prolonged periods of nil per os (NPO), relying on parenteral nutrition.
• Post-ECMO infants require nutritional support to mitigate common morbidities.

Purpose of the Study:

• To highlight the importance of human milk for initiating enteral feedings in infants post-CDH repair and ECMO.
• To emphasize the critical role of lactation support for mother-infant dyads.
• To demonstrate the feasibility of successful breastfeeding in high-risk infants.

Main Methods:

• Review of clinical practice for feeding initiation in infants after CDH repair and ECMO.
• Emphasis on the benefits of human milk for immunological, developmental, and nutritional support.
• Presentation of three case studies illustrating successful breastfeeding transitions.

Main Results:

• Human milk is crucial for providing essential protection to high-risk infants post-ECMO.
• Adequate lactation support is key to maintaining milk supply and enabling breastfeeding.
• Case studies show that breastfeeding success is achievable even in vulnerable neonates.

Conclusions:

• Human milk feeding should be prioritized for infants after CDH repair and ECMO.
• Comprehensive lactation support is essential for optimizing outcomes in these infants.
• Breastfeeding can be successfully established in high-risk infants with appropriate interventions.