Human Milk and Breastfeeding Outcomes in Infants with Congenital Heart Disease

Background: Although human milk (HM) is the recommended form of infant nutrition, the provision of HM feeding among infants with congenital heart disease in the cardiac intensive care unit is unknown. Therefore the aim of the study was to understand the prevalence of pumping initiation, HM feeding, and breastfeeding patterns of mothers and their infants born with congenital heart disease. Subjects and Methods: This was a prospective cohort study conducted a large children's hospital with a cardiac referral program and unit. All women with infants with congenital heart disease were approached for enrollment in order to document HM prevalence. Results: The majority of women (89%) initiated lactation via pumping for their infants. On average, mothers pumped five to six times per day, and mothers were able to achieve a milk supply of over 500 mL/day. Once infants received enteral feeds, over 70% of the infant diet was HM. Very few (13%) infants fed via direct breastfeedings; rather, they received HM via gavage or bottle. There was a significant difference in pumping initiation based on where the infant was born, with mothers delivering in the hospital having a significantly higher pumping initiation rate (96% born in this hospital, 67% born in an outside hospital). Conclusions: Mothers who have infants diagnosed with congenital heart disease should be encouraged to initiate pumping for their infants. Future research is warranted regarding the dose response of HM and specific health outcomes and the need for postdischarge services for these families.