Home-Based Appetite-Guided Weaning of Enteral Nutrition of Infants with Congenital Heart Disease: A Preliminary Clinical Observation

Abstract

Infants with a critical congenital heart defect are at high-risk for feeding difficulties, often necessitating feeding tube placement. Enteral nutrition (EN) support is initiated to meet nutritional requirements and promote growth pre- and post-operatively. Tube-fed infants with congenital heart disease (CHD) who achieve stable health status post-operatively are at risk of becoming feeding tube dependent (FTD). We report a clinical observation for infants with CHD based on survey results from Growing Independent Eaters (GIE), a company that utilizes a home-based, appetite-guided method to transition infants and children from FTD to oral eating. GIE surveyed families who participated in a GIE-led wean from June 2018 to December 2018 for program evaluation, quality improvement, and outcomes measurement. The cohort of 14 infants (ages 0-12 months) was categorized as: CHD only, CHD plus other diagnoses, and no CHD plus other diagnoses. Median wean duration for infants with CHD only (Mdn = 18.0 days, IQR = 9.5-38.5) was similar to infants with CHD plus other diagnoses (Mdn = 25.0 days) but shorter than infants with medical conditions other than CHD (Mdn = 63.0 days, IQR = 28.0-90.0). Mean loss of body weight during the wean was similar for all groups. These observations highlight that the GIE method of enteral weaning provides FTD infants with and without CHD the necessary support to successfully wean off EN, albeit faster for those infants with a diagnosis of CHD. Further studies are now required using a larger cohort of infants to support these promising preliminary findings.