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Nutrition and growth in congenital heart disease: a challenge in children

Medoff-Cooper, Barbaraa; Ravishankar, Chitrab

Current Opinion in Cardiology: March 2013 - Volume 28 - Issue 2 - p 122–129
doi: 10.1097/HCO.0b013e32835dd005
PEDIATRICS: Edited by Victoria L. Vetter

Purpose of review Growth failure secondary to feeding problems after complex neonatal cardiac surgery is well documented, but not well understood. The purpose of this review is to describe feeding and growth pattern in children with congenital heart defects.

Recent findings Nearly half of the infants with univentricular heart defects require supplementation with nasogastric or gastrostomy tube at discharge from neonatal surgery. Feeding challenges contribute to parental stress, and persist beyond infancy. These infants are ‘stunted’ with both weight and height being below normal. Nearly a quarter of these infants meet the definition of ‘failure to thrive’ in the first year of life. Short stature is a significant problem for many of these children, and has an impact on neurodevelopmental outcomes. A structured nutritional program can have a positive impact on growth in the interstage period prior to the superior cavopulmonary connection.

Summary Optimizing nutritional intake has been targeted as a key component of the National Pediatric Cardiology Quality Improvement Collaborative. This initiative has enabled the development of best practices that have the potential to mitigate poor growth in children with congenital heart defects.

aSchool of Nursing, University of Pennsylvania

bDepartment of Pediatrics, The Children's Hospital of Philadelphia, USA

Correspondence to Chitra Ravishankar, MD, MRCP (UK), The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. Tel: +1 215 590 2200; fax: +1 215 590 4620; e-mail:

© 2013 Lippincott Williams & Wilkins, Inc.