Breastfeeding infants with congenital heart disease

Trabulsi, Jillian C.Congenital Heart Disease (CHD) is the most common birth defect in the world and is the leading cause of infant mortality. Many infants with CHD have significantly poor growth which is concerning, since poor nutrition can affect length of hospital stay, immune function, wound healing, and neurodevelopment. Poor nutritional status likely stems from a multitude of reasons including feeding schedule interruption due to medical procedures and surgery, difficulties with feeding (poor suck, tiring out easily during a feeding), and increased energy expenditure prior to heart defect repair. In the past, it was recommended that CHD infants receive infant formula from a bottle, the thought being that breastfeeding was too physiologically taxing for the CHD infant. With that theory disproven, and with increasing knowledge of the nutritional benefits of breastmilk, breastmilk is recommended for all infants, healthy or with chronic disease/illness. Breastmilk is the gold standard of feeding for infants, but the course and success of breastmilk feeding/breastfeeding among infants with CHD throughout the first year of life is unknown. In this observational study, we sought to determine the incidence of breastmilk feeding/breastfeeding among infants with CHD throughout the first 12 months of life. Second, we sought to assess the exclusivity of breastmilk feeding/breastfeeding and factors that affect breastmilk feeding/breastfeeding. ☐ To date, a total of 43 of the target 75 mother-infant dyads were recruited to participate in this study from the Cardiac Intensive Care Unit at the Children’s Hospital of Philadelphia. Thirty-four of these infants completed the 3-month visit and 23 infants completed the 6 month-visit. We found that 95% of infants were reported to have been fed any breastmilk at 1 month, 73.5% at month 3, and 52.2% at month 6. In contrast, the incidence of infants receiving only infant formula increased over the 6 months, from only 5.1% at month 1 to 47.8% at month 6. There was no significant difference in duration or exclusivity of breastmilk feeding/breastfeeding in infants who were only hospitalized once versus infants who were re-hospitalized more than once. There was no significant difference in duration of breastmilk feeding/breastfeeding duration in infants who were fed via an enteral tube versus those who were not. As the study continues, we will have the data to examine other factors that may impact breastfeeding exclusivity and duration, such as weight gain and growth. The results presented in this thesis are preliminary and will be repeated when the data set is complete.University of Delaware, Department of Behavioral Health and NutritionM.S