Growth failure and malnutrition are common in neonates with congenital heart disease, and inadequate caloric intake is a major factor. In this issue, Schwalbe-Terilli et al describe their feeding protocol and evaluate caloric intake in these infants. Children with heart defects may need as much as 50% more calories than normal children to achieve normal growth.
The feeding protocol dictates the following:
Infants with ductal-dependent lesions on prostaglandin, and/or with umbilical arterial lines, are not fed.
Total parenteral nutrition is typically initiated on the 2nd postoperative day and discontinued once enteral feeding of 100 mL/kg per day is achieved.
The authors also found the following:
A caloric intake of 100 kcal/kg was achieved in 48% of feeding days, and 120 kcal/kg was achieved in 20% of feeding days.
Enteral feedings were temporarily discontinued on 21% of feeding days.
Inadequate caloric intake in the...
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