Nutritional Challenges in Pediatric Congenital Cardiac Care

It is well documented that malnutrition significantly contributes to morbidity in children with congenital heart disease (CHD), which is influenced by type of cardiac lesion, malabsorption, hypermetabolism and poor nutrient intake. Most of the congenital heart diseases are present at birth but diagnosed and treated late due to poor resource availability in developing countries. Children with congenital heart defects may experience poor weight gain and linear growth due to several factors like increased work of breathing, increased energy demand, at the same time decreased overall calorie intake. These children need caloric supplementation before and after surgical/medical management of their cardiac condition to achieve catch up growth. So with improved supplementation of calorie, protein and side by side treating their heart failure medically and correcting their pathology surgically would be the holistic approach to deal with the situation. There are lacunae of randomised controlled trials to specify the nutritional need and feeding protocol about how to initiate and advance enteral feeding among these infants, so it is important to understand the challenges to fulfil their nutritional requirements. The purpose of this review is to discuss the nutritional challenges during preoperative and postoperative period, initiation of enteral feeding and current feeding practices among these children