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Feeding Variation Among Infants in Acute Care Cardiology Units
Adam L Ware1, Courtney Jones2, Alaina K Kipps3
1Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, 81 N. Mario Capecchi Dr, Salt Lake City, UT, 84113, USA. adam.ware@hsc.utah.edu.
Pediatric Cardiology
|June 22, 2024
Summary
Infants with heart disease often need specialized nutrition and tube feeding at discharge. Feeding practices vary significantly across pediatric acute care cardiology centers, highlighting a need for standardized approaches.
Area of Science:
- Pediatric Cardiology
- Neonatal Nutrition
- Clinical Practice Variation
Background:
- Infants with congenital heart disease (CHD) face significant risks of feeding difficulties and related complications.
- Current feeding practices in acute care cardiology units lack standardization, leading to inconsistent care.
- Understanding discharge feeding strategies is crucial for optimizing outcomes in this vulnerable population.
Purpose of the Study:
- To describe the feeding practices for infants at the time of discharge from Pediatric Acute Care Cardiology Collaborative (PAC3) centers.
- To assess and quantify practice variation in discharge feeding strategies among participating PAC3 centers.
Main Methods:
- Analysis of discharge encounters from the PAC3 registry (February 2019 - October 2021).
- Descriptive statistics and modified bump plots used to summarize nutrition type and feeding routes.
- Funnel plots employed to evaluate center-specific variation in feeding practices.
Main Results:
- Over 15,000 encounters across 24 centers revealed diverse discharge nutrition: 54% standard formula, 41% human milk, 21% elemental formula.
- 80% of feeds were fortified to ≥24 kcal/oz.
- Supplemental tube feeding was utilized in 48% of encounters, with variations in continuous vs. bolus methods.
Conclusions:
- Infants with heart disease frequently require high-calorie nutrition and supplemental tube feeding upon discharge.
- Significant variability exists in discharge feeding strategies across PAC3 centers.
- Collaborative efforts are essential to establish evidence-based best practices for infant feeding in pediatric cardiology.
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