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Patterns of Growth and Nutrition From Birth to 6 Months in Infants With Complex Congenital Cardiac Defects
Deborah K Steward1, Nancy Ryan-Wenger, Tondi M Harrison
1Deborah K. Steward, PhD, RN, is Associate Professor Emeritus, The Ohio State University College of Nursing, Columbus. Nancy Ryan-Wenger, PhD, RN, FAAN, is Professor Emeritus, The Ohio State University College of Nursing, Columbus. Tondi M. Harrison, PhD, RN, FAAN, is Associate Professor, The Ohio State University College of Nursing, Columbus. Karen F. Pridham, PhD, RN, FAAN, is Helen Denne Schulte Professor Emerita, University of Wisconsin-Madison School of Nursing.
Insights
Infants with complex congenital heart defects (CCHD) show growth issues. Enteral nutrition did not improve outcomes, suggesting current intake may not meet catch-up growth needs.
Area of Science:
- Pediatric Cardiology
- Neonatal Nutrition
- Growth and Development
Background:
- Infants with complex congenital heart defects (CCHDs) experience significant growth alterations post-surgery.
- The precise roles of nutritional intake and feeding methods in CCHD infant growth remain unclear.
Purpose of the Study:
- To characterize growth trends in infants with CCHD during their first six months of life.
- To analyze nutritional intake patterns in infants with CCHD within the first six months.
Main Methods:
- Secondary analysis of growth and nutritional data from a pilot study.
- Collected anthropometric data, nutritional intake via 24-hour diaries, and oral-motor skills.
- Utilized descriptive statistics, correlation, and group difference analyses.
Main Results:
- 28 infants analyzed; WAZ and LAZ decreased from birth to discharge, then increased by 6 months.
- One-third received enteral nutrition; many developed failure to thrive.
- Oral feeding was associated with better growth (WAZ, LAZ) at 6 months compared to enteral feeding.
Conclusions:
- Infants with CCHD exhibit persistent growth faltering in early infancy.
- Enteral nutrition alone did not enhance growth outcomes.
- Nutritional intake may be insufficient to support catch-up growth in these infants.
Background:
Infants with complex congenital heart defects (CCHDs) experience alterations in growth that develop following surgical intervention and persist throughout early infancy, but the roles of nutritional intake and method of feeding require further exploration as their roles are not fully explained.
Objectives:
The purpose of this study was to characterize trends in growth and nutritional intake during the first 6 months of life in infants with CCHD.
Methods:
We conducted a secondary analysis of growth and nutritional data from a pilot study designed to test the feasibility of nurse-guided participatory intervention with parents of infants with CCHD. Measures included demographic data, anthropometric data at birth, hospital discharge, and 6 months of age, nutritional intake at 2 and 6 months of age from parent-completed 24-hour nutrition diaries, and assessment of oral-motor skills between 1 and 2 months of age. Descriptive statistics and correlation and group differences were examined.
Results:
Data for 28 infants were analyzed. Infants demonstrated a decrease in weight-for-age z score (WAZ) and length-for-age z score (LAZ) from birth to hospital discharge and an increase in WAZ and LAZ by 6 months of age. Many of the infants developed failure to thrive. Across the study period, one third of the infants were receiving enteral nutrition. Infants who were orally fed had better growth WAZ and LAZ at 6 months of age when compared to infants who were enterally fed.
Discussion:
Infants with CCHD exhibit growth faltering throughout early infancy. Reliance on enteral nutrition did not improve growth outcomes in these infants. Findings suggest nutritional intake may not be enough to meet the nutrient requirements to stimulate catch-up growth.
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