Congenital heart defects are among the most frequent anomalies present at birth, representing a heterogeneous group of malformations, both in terms of pathogenesis and clinical significance of the lesion. Failure to grow is well documented in infants with complex congenital heart defects; the presence of associated chromosomal abnormalities, cyanosis, and cardiac failure adds to the complexity and challenge. Malnutrition etiology can be grouped into the following three categories: inadequate intake, inefficient absorption and utilization, and/or increased energy needs. The consequences of malnutrition are both short and long term, timely nutritional intervention being necessary in order to maintain an adequate nutritional state. Because there are several types of congenital heart defects and multiple mechanisms by which they produce failure to thrive, no single strategy will be adequate to treat all cases. Medical complications such as chylotorax, necrotizing enterocolitis, laryngeal and neurological dysfunction play a major role in the requisite nutrition therapy in infants with congenital heart defect; limited access to human milk and parenteral concerns, as well as stress about feeding are also factors that can contribute to poor outcomes concerning nutrition and growth. Protocols are being considered and designed, and a systematic approach is always needed. The quality of life for patient and family, as well as getting the child back on track for age-appropriate development are always at the fore-front of each care plan.
15. Anderson JB. Kalkwarf HJ Kehl JE et al. Low weight-for-age z score and infection risk after the Fontan procedure. Ann Thorac Surg. 2011;91:1460-1466.
16. Parrish CR. Nourishing little hearts: nutritiional implications for congenital heart defects. Practical Gastroenterology. 2011;11-34
17. Ehlers KH. Growth failure in association with congenital heart disease. Pediatr Ann. 1978;7:750-759.
18. Vaidyanathan B Kumar RK. What Determines Nutritional Recovery in Malnourished Children After Correction of Congenital Heart Defects? Pediatrics. 2009;124(2):e294.
19. Unger R DeKleermaeker M Gidding SS Christoffel KK. Calories count. Improved weight gain with dietary intervention in congenital heart disease. Am J Dis Child. 1992;146(9):1078-84.
20. Jackson M Poskitt EM. The effects of high-energy feeding on energy balance and growth in infants with congenital heart disease and failure to thrive. Br J Nutr. 1991;65(2):131-43.
21. Bougle D Iselin M Kahyat A Duhamel JF. Nutritional treatment of congenital heart disease. Arch Dis Child. 1986;61(8):799-801.
22. Hofner G Behrens R Koch A Singer H Hofbeck M. Enteral nutritional support by percutaneous endoscopic gastrostomy in children with congenital heart disease. Pediatr Cardiol. 2000;21(4):341-6.
23. Marino BL O'Brien P LoRe H. Oxygen saturations during breast and bottle feedings in infants with congenital heart disease. J Pediatr Nurs. 1995;10(6):360-4.
24. Mitchell IM Davies PS Day JM Pollock JC Jamieson MP. Energy expenditure in children with congenital heart disease before and after cardiac surgery. J Thorac Cardiovasc Surg. 1994;107(2):374-80.
25. Forchielli ML McColl R Walker WA et al. Children with congenital heart disease: a nutrition challenge. Nutr Rev.1994;52:348-353.
26. Owens JL Musa N. Nutrition support after neonatal cardiac surgery. Nutr Clin Pract. 2009;24:242-249.
27. Hagau N Culcitchi C. Nutritional support in children with congenital heart disease. Nutr Ther Metab. 2010;28:172-184.
28. Medoff-Cooper B Naim M Torowicz D et al. Feeding growth and nutrition in children with congenitally malformed hearts. Cardiol Young. 2010;20 Suppl3:149-153.
29. Giannone PJ Luce WA Nankervis CA et al. Necrotizing enterocolitis in neonates with congenital heart disease. Life Sci. 2008;82:341-347.
30. Cabrera AG Prodhanb P Bhuttab AT. Nutritional challenges and outcomes after surgery for congenital heart disease. Curr Opin Cardiol. 2010;25:88-94.
31. Sachdeva R Hussain E Moss MM et al. Vocal cord dysfunction and feeding difficulties after pediatric cardiovascular surgery. J Pediatr. 2007;151:312-315.
32. Skinner ML Halstead LA Rubinstein CS et al. Laryngopharyngeal dysfunction after the Norwood procedure. J Thorac Cardiovasc Surg. 2005;130:1293-1301.
33. Lessen R. Use of skim breast milk for an infant with chylothorax. Infant Child and Adolescent Nutrition. 2009;1:303-310.
34. McCray S Parrish CR. When chyle leaks: nutrition management options. Practical Gastroenterology. 2004;28:60.
35. Li S Krawczeski CD Zappitelli M et al. Incidence risk factors and outcomes of acute kidney injury after pediatric cardiac surgery: a prospective multicenter study. Crit Care Med. 2011;39:1493-1499.
36. Mertens L Hagler D Sommerville J et al. Protein losing enteropathy after the Fontan operation: an international multicenter evaluation. J Thorac and Cardiovasc Surg. 1998;115:1063-73.
37. Meadows J Jenkins K. Protein-losing enteropathy: integrating a new disease paradigm into recommendations for prevention and treatment. Cardiol in the Young. 2011;21:363-367.