Aims To assess the nutritional status of infants with congenital heart disease (CHD) who were managed jointly by the medical and dietetic teams and required either high calorie feeds or nasgastric feeding to optimise their growth.
Methods Infants with CHD requiring dietetic input between 2008–2011 were reviewed. Patients were identified from paediatric cardiac and dietitians databases. A retrospective case note and electronic clinic letter review was performed.
Results Thirty nine infants were studied: 15(39%) with cyanotic CHD and 24(61%) acyanotic CHD. In 12 (29%) cases CHD was part of a syndrome. 25(64%) were treated surgically, 8(21%) required transcatheter procedures and 6(15%) were managed medically. Surgery was performed in 9 (27%) within 1-month of their birth and 24(73%) within the first-year.10 (67%) of the cyanotic infants had their corrective surgeries in the first 6 months. All 6 (15%) managed medically were among the acyanotic infants, 19 (76%) of the acyanotic infants were on diuretics and 10(40%) were operated in the later half of the year. There were 4 (10%) deaths in this cohort.
The birthweight was less than the 2nd centile in 12% of infants and overall 67% had a birthweight less than 50th centile. In the pre-operative period, 14(41%) were nasogastric fed (NG). The majority of infants were on mixed feeds, 50% receiving some breast milk and 65% receiving Infatrini to maximise the weight gain. In the post-operative period, 10(30%) needed nasogastric feeds and 3(8%) with complex gut anomalies needed gastrostomy feeding tubes. The NG tubes were in place post-operatively for a median period of 2 months. At the end of 1 year, there was improvement in weight gain in 8(53%) of the cyanotic infants and 9(38%) of the acyanotic infants.
Conclusion Challenges persist in optimising the nutritional needs especially in children with CHD particularly those on prolonged diuretics. Collaboration with the dieticians is essential for optimising their growth prior to and after surgery.
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