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Human Milk and Infants With Congenital Heart Disease

A Summary of Current Literature Supporting the Provision of Human Milk and Breastfeeding

Davis, Jessica A. BSN, RN, CCRN, IBCLC; Spatz, Diane L. PhD, RN-BC, FAAN

Section Editor(s): Gephart, Sheila

doi: 10.1097/ANC.0000000000000582
Evidence Based Practice Brief

Background: Human milk is a life-saving medical intervention. Infants with congenital heart disease are at an increased risk for necrotizing enterocolitis, chylothorax, feeding difficulties, and growth failure. In the absence of evidence-based care, their mothers are also at risk for low milk supply and/or poor breastfeeding outcomes.

Purpose: Summarize the role of human milk and clinical outcomes for infants with congenital heart disease (CHD). Summarize methods of ideal breastfeeding support.

Methods/Search Strategy: PubMed, Cochrane Library, and CINAHL were the databases used. The terms used for the search related to CHD and necrotizing enterocolitis were “human milk” and “necrotizing enterocolitis” and “congenital heart disease.” This resulted in a total of 17 publications for review.

Findings: Infants receiving exclusive human milk diet are at a lower risk for necrotizing enterocolitis and will have improved weight gain. Infants with chylothorax who receive skimmed human milk have higher weight-for-age scores than formula-fed infants. Maternal breastfeeding education correlates with decreased risk of poor breastfeeding outcomes.

Implications for Practice: Human milk is the ideal source of nutrition for infants with CHD and should be encouraged by the care team. Evidence-based lactation education and care must be provided to mothers and families prenatally and continue throughout the infant's hospitalization. If a mother's goal is to directly breastfeed, this should be facilitated during the infant's hospital stay.

Implications for Research: Evaluate the role between human milk and the incidence of necrotizing enterocolitis, feeding difficulties, and clinical outcomes in the population of infants with CHD.

UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania (Ms Davis); Helen M. Shearer Professor of Nutrition, University of Pennsylvania School of Nursing, Philadelphia (Dr Spatz); Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania (Dr Spatz); and Children's Hospital of Philadelphia's Mothers' Milk Bank, Philadelphia, Pennsylvania (Dr Spatz).

Correspondence: Diane L. Spatz, PhD, RN-BC, FAAN, Helen M. Shearer Professor of Nutrition, University of Pennsylvania School of Nursing, 418 Curie Blvd, Office 413, Philadelphia, PA 19104 (

The authors disclose no competing interests in relationship to this manuscript.

© 2019 by The National Association of Neonatal Nurses