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A preoperative standardized feeding protocol improves human milk use in infants with complex congenital heart disease

Journal of Perinatology volume 41, pages 590–597 (2021)Cite this article

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Abstract

Objective

To evaluate the hypothesis that implementation of a preoperative standardized feeding protocol increases human milk use in infants with complex congenital heart disease (CHD).

Study design

Single-center, quasi-experimental study of infants with complex CHD. A cohort of 546 infants pre protocol was compared to 55 patients post protocol. Feeding regimen and peri-operative outcomes information were collected.

Result

Human milk use increased significantly (58.4% versus 100%, p < 0.01) and there was no formula use post protocol (18.7% versus 0%, p < 0.01). Preoperative necrotizing enterocolitis occurred in 18/546 (3.3%) infants pre protocol versus 1/55 (1.8%) post protocol, p = 1.00. Days to full feeds and length of hospital stay in both cohorts were not significantly different.

Conclusion

Successful implementation of a preoperative standardized feeding protocol can increase human milk and decrease formula use in infants with complex CHD without significant adverse outcomes. A larger study is needed to evaluate the association of human milk use with peri-operative outcomes.

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Fig. 1: Algorithm of preoperative feeding protocol for infants with congenital heart disease.
Fig. 2: Flowchart of infants in retrospective and prospective cohorts.

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Funding

Evie Whitlock Grant—Texas Children’s Hospital.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Texas Children’s Hospital, Houston, TX, USA

    Jasmeet Kataria-Hale, Dantin Jeramy Roddy, Patrice Hochevar, Jill Zender, Paige Sheaks, Scott Osborne, Kristina Tucker, Nancy Hurst, Joseph Hagan & Amy Hair

  2. Section of Neonatology, Texas Children’s Hospital, Houston, TX, USA

    Jasmeet Kataria-Hale, Patrice Hochevar, Scott Osborne, Kristina Tucker, Nancy Hurst, Joseph Hagan & Amy Hair

  3. Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA

    Jasmeet Kataria-Hale, Dantin Jeramy Roddy, Patrice Hochevar, Jill Zender, Paige Sheaks, Scott Osborne, Kristina Tucker, Nancy Hurst, Joseph Hagan & Amy Hair

  4. Section of Pediatric Critical Care Medicine, Texas Children’s Hospital, Houston, TX, USA

    Dantin Jeramy Roddy, Jill Zender & Paige Sheaks

  5. Lovelace Women’s Hospital, Albuquerque, NM, USA

    Acacia Cognata

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  1. Jasmeet Kataria-Hale
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Contributions

JK-H: conceptualized and designed the study, collected the data, drafted the initial manuscript, and approved the final manuscript as submitted. DJR: contributed to the study design, reviewed and revised the manuscript and approved the final manuscript as submitted. AC: contributed to the study design, collected the data, reviewed and revised the manuscript and approved the final manuscript as submitted. PH: contributed to the study design, collected the data, reviewed and revised the manuscript and approved the final manuscript as submitted. JZ: contributed to the study design, collected the data, reviewed and revised the manuscript and approved the final manuscript as submitted. PS: contributed to the study design, reviewed and revised the manuscript and approved the final manuscript as submitted. KT: contributed to the study design, reviewed and revised the manuscript and approved the final manuscript as submitted. NH: contributed to the study design, reviewed and revised the manuscript and approved the final manuscript as submitted. JH: carried out the statistical analyses, reviewed and revised the manuscript and approved the final manuscript as submitted. AH: mentored the primary author in study design, supervised data collection, and critically reviewed the manuscript and approved the manuscript as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Amy Hair.

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Kataria-Hale, J., Roddy, D.J., Cognata, A. et al. A preoperative standardized feeding protocol improves human milk use in infants with complex congenital heart disease. J Perinatol 41, 590–597 (2021). https://doi.org/10.1038/s41372-021-00928-8

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