Nutritional Management in Pediatric Congenital Heart Disease
Summary
Children with congenital heart disease exhibit unique nutritional challenges driven by increased metabolic demand, inefficient cardiac output and feeding difficulties. Chronic undernutrition, manifested as impaired weight gain, stunting and wasting, is common and correlates with disease severity. Early assessment of nutritional status using anthropometric measurements and z-scores is essential to identify growth failure and guide interventions. Management strategies encompass tailored energy intake, optimisation of feeding modalities and micronutrient supplementation. Preoperative nutritional stabilisation reduces perioperative morbidity, while structured postoperative programmes support catch-up growth. Multidisciplinary teams integrate paediatric cardiology, dietetics, speech therapy and nursing to implement individualised feeding protocols, including breastmilk promotion, fortification and, where necessary, enteral tube feeding. Consensus pathways and standardised clinical algorithms have emerged to harmonise practice, with ongoing efforts to refine guidelines and bridge resource gaps globally.
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Nutritional Management in Pediatric Congenital Heart Disease publication trend
The graph below shows the total number of articles in nutritional management in pediatric congenital heart disease across all publications each year (not limited to Nature Index journals).
Technical terms
Anthropometric measurement: Quantitative assessment of body size and composition using metrics such as weight and height.
Z-score: A statistical measure indicating how many standard deviations a value is from the population mean, used to assess growth relative to reference standards.
Enteral feeding: Delivery of nutrition directly into the gastrointestinal tract via feeding tubes or oral routes.
Feeding intolerance: Inability to digest or tolerate enteral nutrition, manifesting as vomiting, abdominal distension or delayed gastric emptying.
Energy expenditure: The amount of energy utilised by the body over a defined period, often increased in children with complex cardiac lesions.
References
- Moderate and Severe Congenital Heart Diseases Adversely Affect the Growth of Children in Italy: A Retrospective Monocentric Study. Nutrients (2023).
- The Impact of Pre-operative Nutritional Status on Outcomes Following Congenital Heart Surgery. Frontiers in Pediatrics (2019).
- Enteral Nutrition in Term Infants with Congenital Heart Disease: Knowledge Gaps and Future Directions to Improve Clinical Practice. Nutrients (2021).
- The development of a consensus-based nutritional pathway for infants with CHD before surgery using a modified Delphi process. Cardiology in the Young (2018).
- Current Strategies to Optimize Nutrition and Growth in Newborns and Infants with Congenital Heart Disease: A Narrative Review. Journal of Clinical Medicine (2022).
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