Enteral Nutrition in Term Infants with Congenital Heart Disease: Knowledge Gaps and Future Directions to Improve Clinical Practice

Nutrients

Silvia Martini¹  Mariarosaria Annunziata¹  Silvia Galletti¹  Isadora Beghetti¹  Luigi Corvaglia¹  Arianna Aceti¹  Andrea Donti²  Luca Ragni² 

[1] Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;Pediatric Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;

关键词: congenital heart disease;    enteral nutrition;    term infants;    perioperative feeding management;    human milk;    necrotizing enterocolitis;   

DOI  :  10.3390/nu13030932

来源: DOAJ

【 摘 要 】

Optimal nutrition is essential to improve short- and long-term outcomes in newborns with congenital heart disease (CHD). Nevertheless, several issues on nutritional management and concerns about the potential risk of complications related to enteral feeding exist. This narrative review aims to summarize and discuss the available literature on enteral feeding in term infants with CHD. A wide variability in feeding management exists worldwide. Emerging approaches to improve nutritional status and outcomes in infants with CHD include: implementation of a standardized enteral feeding protocol, both preoperative and postoperative, clearly defining time of initiation and advancement of enteral feeds, reasons to withhold, and definitions of feeding intolerance; early minimal enteral feeding; enteral feeding in stable term infants on hemodynamic support; evaluation of enteral feeding in term infants with umbilical arterial catheters and during prostaglandin infusion; assessment and support of oro-motor skills; and promotion and support of breastfeeding and provision of mother’s own milk or donor milk when mother’s own milk is not available. As evidence from term infants is scarce, available observations and recommendations partially rely on studies in preterm infants. Thus, well-designed studies assessing standardized clinically relevant outcomes are needed to provide robust evidence and shared recommendations and practices.

【 授权许可】

Unknown