Nutritional Considerations for the Neonate With Congenital Heart Disease

Area of Science:

• Pediatric critical care nutrition
• Congenital heart disease (CHD) management
• Neonatal intensive care unit (NICU) nutrition protocols

Background:

• Growth failure and malnutrition are prevalent in infants with CHD, stemming from multifactorial causes like increased metabolic demands and nutrient malabsorption.
• Existing nutrition guidelines for infants with CHD lack high-quality evidence, leading to inconsistent clinical practices.
• Critical illness in infants with CHD necessitates tailored nutritional strategies to improve health outcomes.

Approach:

• This review synthesizes evidence to establish best practices for nutritional support in infants with CHD.
• Recommendations focus on infants under 6 months admitted to ICU or inpatient wards.
• The nutrition subgroup of the Neonatal Cardiac Care Collaborative developed these evidence-based guidelines.

Key Points:

• Addresses energy needs, nutrient requirements, enteral nutrition, feeding practices, and parenteral nutrition.
• Highlights the multifactorial etiology of growth failure in infants with CHD.
• Emphasizes the need for individualized nutrition plans based on patient-specific factors.

Conclusions:

• Standardized, evidence-based nutrition practices are essential for critically ill infants with CHD.
• Future efforts should focus on quality improvement and personalized perioperative nutrition management.
• Optimizing nutrition is foundational for improving short- and long-term health outcomes in infants with CHD.