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Nutrition After Cardiac Surgery for Infants With Congenital Heart Disease

Boctor, Dana L., Pillo-Blocka, Francy, McCrindle, Brian W.
Nutrition in clinical practice 1999 v.14 no.3 pp. 111-115
breast feeding, congenital abnormalities, energy requirements, heart diseases, hospitals, infants, medical records, morbidity, patients, surgery, weight gain
Inadequate nutrition support in the post-operative period in infants recovering from cardiac surgery can impact morbidity and growth. We sought to determine postoperative nutrition support patterns and identify factors associated with rate of weight gain in infants <1 year. Data were collected from the medical records of 24 infants. The median age at surgery was 2.7 months (range, 1 day to 9 months). The median overall daily weight change during the postoperative ward stay was -11 g/d (range, -145 to +84 g/d), with a net positive gain in 8 (36%), net loss in 14 (64%) and unknown in 2 infants. The rate of weight change by hospital discharge was related to feeding practice: bottle fed infants gained a median of 20 g/d (range, -100 to +73 g/d); breast fed infants who were supplemented with bottle feeds gained a median of 5 g/d (range, -83 to +43 g/d); and exclusively breast fed infants lost a median of 49 g/d (range, -80 to -23 g/d)(p = .04). Patients who were meeting a greater percentage of their energy requirements by the time of hospital discharge had higher rates of weight gain (r = .78; p = .003). Rate of weight gain was not related to cardiac lesion or hospital length of stay. We conclude that weight gain after cardiac surgery in infants is sub-optimal and is related to feeding practices. Greater attention to achieving energy requirements during postoperative recovery is necessary, especially in breast fed infants.