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


RESULTS
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.


CONCLUSIONS
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.
School of Nursing, University of Pennsylvania, USA.
Barbara
B
Medoff-Cooper
Chitra
C
Ravishankar
D002648:Child; D002149:Energy Intake; D004750:Enteral Nutrition; D005183:Failure to Thrive / Q000209:etiology* / Q000503:physiopathology; D006330:Heart Defects, Congenital / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D044342:Malnutrition / Q000150:complications*; D058327:Norwood Procedures; D018529:Nutritional Support / Q000379:methods / Q000592:standards; D010290:Parents / Q000523:psychology; D011300:Preoperative Care; D012307:Risk Factors; D013315:Stress, Psychological