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A preoperative standardized feeding protocol improves human milk use in infants with complex congenital heart disease
Jasmeet Kataria-Hale1,2,3, Dantin Jeramy Roddy1,3,4, Acacia Cognata5
1Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA.
Insights
Implementing a standardized feeding protocol significantly increased human milk use and eliminated formula use in infants with complex congenital heart disease (CHD). This approach improved feeding outcomes without adverse effects.
Area of Science:
- Pediatric Cardiology
- Neonatal Nutrition
- Surgical Outcomes
Background:
- Infants with complex congenital heart disease (CHD) often face feeding challenges.
- Optimizing nutrition is critical for managing these vulnerable patients.
Purpose of the Study:
- To assess if a preoperative standardized feeding protocol enhances human milk utilization in infants with complex CHD.
- To evaluate the impact of the protocol on feeding regimens and peri-operative outcomes.
Main Methods:
- A quasi-experimental study comparing 546 infants before a feeding protocol to 55 infants after its implementation.
- Data collection focused on feeding regimens and peri-operative outcomes.
Main Results:
- Human milk use increased from 58.4% to 100% (p < 0.01).
- Formula use decreased to 0% (p < 0.01).
- No significant differences in necrotizing enterocolitis, time to full feeds, or hospital stay were observed.
Conclusions:
- A preoperative standardized feeding protocol effectively increases human milk use and reduces formula intake in infants with complex CHD.
- The protocol appears safe, with no significant adverse peri-operative outcomes.
- Further research is warranted to explore the link between human milk intake and peri-operative results.
Objective:
To evaluate the hypothesis that implementation of a preoperative standardized feeding protocol increases human milk use in infants with complex congenital heart disease (CHD).
Study Design:
Single-center, quasi-experimental study of infants with complex CHD. A cohort of 546 infants pre protocol was compared to 55 patients post protocol. Feeding regimen and peri-operative outcomes information were collected.
Result:
Human milk use increased significantly (58.4% versus 100%, p < 0.01) and there was no formula use post protocol (18.7% versus 0%, p < 0.01). Preoperative necrotizing enterocolitis occurred in 18/546 (3.3%) infants pre protocol versus 1/55 (1.8%) post protocol, p = 1.00. Days to full feeds and length of hospital stay in both cohorts were not significantly different.
Conclusion:
Successful implementation of a preoperative standardized feeding protocol can increase human milk and decrease formula use in infants with complex CHD without significant adverse outcomes. A larger study is needed to evaluate the association of human milk use with peri-operative outcomes.
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