Patterns of Growth and Nutrition From Birth to 6 Months in Infants With Complex Congenital Cardiac Defects.
Deborah K Steward, Nancy Ryan-Wenger, Tondi M Harrison and 1 others
PMID 32569101WHAT IT FOUND
Infants with complex congenital heart defects had lower mean weight and length scores at discharge than at birth.
Mean scores were higher at 6 months than at discharge, but 28% developed failure to thrive, and tube-fed infants had lower scores.
Key findings
01Mean weight-for-age and length-for-age z-scores were lower at discharge than at birth, and higher at 6 months than at discharge.
02By 6 months, 28% of infants developed failure to thrive, and orally fed infants had higher mean weight-for-age and length-for-age z-scores than tube-fed infants.
03None of the infants changed from tube-only or oral-plus-tube feeding to oral-only feeding between 2 and 6 months, and 19.2% changed from oral-only or oral-plus-tube feeding to tube-only feeding.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was only 28 infants, so many comparisons are unstable and the study was not powered to detect differences. It was a pilot feasibility study, and the intervention and usual-care groups were combined for most analyses, so it cannot show that the nurse-led intervention changed growth. Hospital and community records were not linked for all infants, and missing data affected growth analyses. Growth data were abstracted from records and assumed accurate; errors would affect z-scores and nutrient calculations. Nutrition diaries were missing for some infants and could not be calculated for exclusively breastfed infants, so intake findings are incomplete. The study reports associations over time, not proof that feeding mode or surgery timing caused growth differences. The reported proportion with failure to thrive differs between the results (28%) and discussion (29%).
Declared interests
The authors report no conflicts of interest. The article is listed as supported by NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that the nurse-led intervention or tube feeding improves growth. The intervention and usual-care groups were combined because they differed only in failure-to-thrive proportion, and tube-fed infants had lower mean weight and length z-scores at 6 months.