Breastfeeding infants with congenital heart disease
Date
2018
Authors
Journal Title
Journal ISSN
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Publisher
University of Delaware
Abstract
Congenital heart disease (CHD) is the most common birth defect in the United States. Infants with CHD are known to have a high incidence of feeding challenges, which compromise nutritional intake and contribute to compromised growth. Historically, it was recommended that infants with CHD be bottle fed, because breastfeeding was considered physiologically laborious. Research demonstrated otherwise, and this, paired with the known nutritional benefits of breastfeeding has led to the recommendation that infants with CHD be breastfed/receive breast milk (BM). What is not known is the course of breastfeeding/feeding BM in this population in the first year of life and its effects, if any, on growth outcomes. The data herein are part of an on-going, observational study of breastfeeding in infants with CHD. A total of 46 infants have been enrolled and completed through 4 months of age. With respect to exclusivity and duration of breastfeeding/feeding BM, at two weeks of age, the majority of infants were fed BM exclusively (N=29, 63%), 11 infants (23.9%) were fed a mix of BM and formula, and six infants (13.0%) were fed formula exclusively. By four months of age, the number of infants receiving exclusively BM decreased to 14 (31.1%), six infants (13.3%) were fed BM fortified with powder formula, 16 infants (35.6%) received a mix of BM and formula, and nine infants (20.0%) were fed formula only. With respect to the within subject breastfeeding/feeding BM pattern over time, we identified three feeding patterns: “principally BM” for infants who received BM as the only source of nutrition for first four months of life, “BM/Mix” for infants that received breast milk from birth up to 1 month of age, then changed to a mix of breast milk and formula for the next three months”, and “BM/Mix/Formula” to define infants who received breast milk at birth, then a mix of breast milk and formula, and then exclusive formula feeding for the next three months of life. We next examined the influence of these feeding pattern on trajectories of Z-scores over the first four months of life. We found no significant group × time interactions in weight for age Z-scores (WAZ; p=0.385), length for age Z-scores (LAZ; p=0.755), or height for age Z-scores (HCZ; p=0.918), indicating these growth trajectories did not differ over time by feeding group/pattern. There was however a significant group × time interaction for WLZ (p=0.035); infants in the principally BM feeding pattern tended to be leaner at four months compared to those in the BM/Mix and BM/Mix/Formula categories. The data presented in this thesis are from an interim analysis, all data analyses will be repeated when the study is complete (n=75 infants).
Description
Keywords
Health and environmental sciences, Breastfeeding, Congenital heart disease, Infants