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Updated: Jan 24, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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The association between feeding protocol compliance and weight gain following high-risk neonatal cardiac surgery

Jamie M Furlong-Dillard1, Benjamin J Miller2, Kathy A Sward2

  • 1Division of Critical Care, Department of Pediatrics,University of Louisville, Norton Children's Hospital, Louisville, KY,USA.

Cardiology in the Young
|May 29, 2019
PubMed

Insights

High-risk feeding protocol adherence in children with congenital heart disease improves weight gain. Focusing on adherence, not just nutrition delivery, is key for better outcomes.

Area of Science:

  • Pediatric Cardiology
  • Clinical Nutrition
  • Health Outcomes Research

Background:

  • Children with congenital heart disease (CHD) face significant malnutrition risks.
  • Standardized feeding protocols show potential in mitigating these risks.
  • Variability in institutional protocols and lack of adherence data necessitate analysis of protocol components.

Purpose of the Study:

  • To analyze the efficacy of adherence to and deviation from feeding protocols in high-risk CHD patients.
  • To assess the association between protocol adherence/deviation and clinical outcomes.
  • To determine the impact on weight-for-age z-score changes.

Main Methods:

  • Retrospective analysis of feeding protocol adherence and deviation in high-risk CHD patients (December 2015 - March 2017).
  • Evaluation of associations between adherence/deviation and clinical outcomes.
  • Primary outcome: change in weight-for-age z-score.

Main Results:

  • Increased adherence and decreased deviation from feeding protocol instructions significantly improved weight-for-age z-score changes from birth to discharge (p = 0.031).
  • No statistically significant differences in secondary outcomes (clinical severity markers, nutritional delivery) were observed between high and low adherence/deviation groups.
  • Weight gain was linked to adherence irrespective of nutritional delivery or caloric intake.

Conclusions:

  • Feeding protocol adherence in high-risk CHD patients is associated with improved weight gain.
  • Protocol efficacy assessment should extend beyond caloric delivery and illness severity to include adherence measures.
  • Future research should incorporate adherence and deviation metrics for comprehensive feeding protocol evaluation.
Abstract

Keywords:
Feedingcongenital heart diseaseprotocolweight-for-age z score

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