Babies born with a congenital heart defect (CHD) usually require advanced medical care to stay alive. This makes them vulnerable to various cognitive impairments, and factors such as cardiac arrest, length of hospital stay, prematurity, etc. influence the development of these cognitive delays. However, the role of feeding method and proper growth has never been investigated with regard to these newborns.

A research team led by University of Pennsylvania School of Nursing recently looked into the matter and found that infants born with CHD, aged up to three months, and requiring device-assisted feeding had a higher risk of developing neurodevelopmental delays at six and 12 months.

The Prospective Newborn Feeding, Observational, Cohort Study

Researchers observed the one-year growth and development of infants having undergone neonatal cardiac surgery during their first month of being born. A total of 72 infants who had CHD at six and 12 months were evaluated. Anthropometric (measurement and study of human body) data was collected at six, nine and 12 months and was analyzed.

The method of feeding – bottle or breast milk, bottle or breast along with tube-assisted feeding, or only tube-assisted feeding – was documented at three months and at the time of discharge. Of the 72 infants with CHD, 38 (53 percent) were exclusively orally fed at hospital discharge, while the other 34 (47 percent) needed device-assisted feeding along with oral feeding.

What The Results Revealed

The findings showed a significant association between growth parameters and newborn feeding method, and neurodevelopmental outcomes within the first year of an infant’s life. The parameters recorded at three months were significantly associated with cognitive as well as motor functions, at six and 12 months.

Another unique finding was the association between newborn feeding method and the risk of neurodevelopmental delays. Newborns that required device-assisted feeding at the time of hospital discharge and at three months had the highest risk of cognitive impairment.

“Newborns with complex CHD face many challenges early life, particularly those requiring device-assisted feeding”, explained principal investigator, Barbara Medoff-Cooper, PhD, RN, FAAN, the Ruth M. Colket Professor in Pediatric Nursing. “These infants are unable to ingest the optimal amount of calories needed for proper growth and development at their age. A device-assisted supplemental feeding regime might prove to be an effective predictor for overall infant health status”.

Newborn Feeding: Implications And Prospects

The inability of an infant to feed might indicate immature feeding skills, suggesting the requirement of early device-assisted feeding. The latter has been found to be significantly associated with abnormal brain development, lower weight, head circumference and weight at three months. Moreover, this practice also leads to impaired neurodevelopmental outcomes at six and 12 months.

These results highlight the importance of closely monitoring feeding skills and growth parameters of infants that are at a significant risk of suffering from developmental delays. The findings can be found in The Journal of Pediatrics.