Neonatal Diet Type and Associations With Adverse Feeding Outcomes in Neonates With Critical Congenital Heart Defects.
Jessica A Davis, Kelley Baumgartel, Tracy Baust and 4 others
PMID 38236148WHAT IT FOUND
Human milk alone did not improve feeding tolerance or growth in neonates with heart defects.
However, more days of direct chest or breastfeeding were associated with fewer signs of gut distress and fewer bloody stools.
Key findings
01Higher percentage of human milk feeds was not associated with reduced feeding intolerance, NEC, or malnutrition in this cohort.
02Increased days of direct chest or breastfeeding were associated with fewer signs of gastrointestinal distress and fewer bloody stools.
03Only 23% of the cohort received an exclusive human milk diet, which may explain the lack of observed benefit compared to previous studies.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was single-center and retrospective, limiting generalizability. There was high variability in human milk use, with only 23% receiving an exclusive human milk diet, which may have masked potential benefits seen in studies with stricter diets. Feeding intolerance and NEC diagnoses relied on subjective clinical documentation and nonspecific signs like agitation. The analysis was limited to the first 28 days of life, potentially missing adverse outcomes that occur later. Quality improvement initiatives (lactation support and standardized feeding protocols) occurred during the study period, introducing temporal confounders.
Declared interests
No specific conflicts of interest or funding sources were declared in the provided text.
The easy way to misread this
Do not conclude that human milk is ineffective for CCHD neonates. The null findings for human milk may be due to the low rate of exclusive human milk diets in this cohort, as only 23% received human milk without formula supplementation or fortification.