Lactation Outcomes and Experiences Among Mothers of Infants with Congenital Heart Disease: A Scoping Review.

Abstract

Background: Infants with congenital heart disease (CHD) are at high risk for feeding difficulties and neurodevelopmental delays. Exclusive mother's own milk (MOM) reduces the risk of feeding intolerance and morbidity, yet feeding infants with CHD is complicated by decreased gastrointestinal perfusion, need for caloric fortification, and challenges in providing MOM by pump-dependent mothers. Lactation outcomes and support for pump-dependent mothers of infants with CHD are not well understood. Methods: We conducted a scoping review of original research identified in MEDLINE and Cumulative Index of Nursing and Allied Health Literature through November 2024 to identify key concepts, theories, and gaps in the literature on lactation support, outcomes, and experiences of mothers of infants with CHD. Studies were excluded if they were unavailable in English or were quality improvement projects, single case reports, or literature reviews. Results: Fourteen articles met the inclusion and exclusion criteria, of which 10 (71.4%) were quantitative. Results were grouped into five categories: (1) lactation outcomes, (2) lactation support, (3) lactation experiences, (4) barriers to breastfeeding and human milk (HM) feeding, and (5) predictors of breastfeeding and HM feeding. Conclusions: Mothers of infants with CHD can produce recommended MOM volumes by one month postpartum; however, breastfeeding and MOM feeding rates remain low in the first year. This review highlights barriers including inadequate support and mixed messaging from health care providers, emphasizing the need for further research, quality improvement measures, and health care provider education to address these challenges.