Systematic survey of breastfeeding practices in mothers of infants with congenital heart disease undergoing cardiac surgery in a tertiary care center in India.

Background: Breastfeeding is recognized as optimal for infants with congenital heart disease (CHD). We sought to evaluate breastfeeding practices among mothers of infants with CHD and identify key modifiable barriers to breastfeeding.

Methods: Initially, a cross-sectional telephone survey was conducted among 100 mothers whose infants had undergone cardiac surgery in the past year. Based on the results of this survey, a structured interview questionnaire was designed and administered to 50 mother-infant dyads who were prospectively recruited from the inpatient population and followed postoperatively.

Results: Fifty infants were included (median age: 4.5 months [interquartile range (IQR): 2-7]; weight: 4.01 kg [IQR: 3.5-5.1]). Before surgery, 40 mothers (80%) were breastfeeding, whereas ten mothers (20%) were not. Notably, 17 mothers (34%) had stopped breastfeeding at some point before surgery, primarily due to perceived inadequate milk supply (82%). Additional reasons for the interruption of breastfeeding included difficulties with infant sucking or latching (35%), the belief that breast milk alone was insufficient (23%), and sore or cracked nipples (17%). Postoperatively, 39 mothers (78%) resumed breastfeeding after 3 days (IQR: 2-4). A postoperative feeding delay, defined as a delay in resuming breastfeeding beyond the anticipated timeframe of 4 days (as determined by the initial telephonic survey), was observed in 8 (16%) cases.

Conclusion: This study identifies the gaps and challenges in breastfeeding practices among mothers of infants with CHD. Targeted interventions are needed to support and sustain breastfeeding practices in these infants, addressing challenges and promoting continued breastfeeding during the postoperative period and beyond.