Congenital heart disease (CHD) is the most common structural anomaly in live born infants. Infants with CHD are more likely to be born preterm and conversely, preterm infants are more likely to have CHD. The reason for this relationship is currently incompletely understood. Infants with CHD who are born preterm have increased morbidity, including necrotising enterocolitis (NEC) and mortality, compared to their counterparts who are born at term. NEC is a serious inflammatory intestinal condition. Furthermore, preterm infants who have CHD and subsequently develop NEC have a worse outcome than infants who have develop NEC as a consequence of prematurity alone.
Feeding practice, including nutritional content of enteral feeds as well the volume and rate of feed administered, can influence the occurrence of NEC in this patient population. Infants born preterm and/or at low birth weight often require interim or delayed cardiac procedures prior to their definitive CHD surgical correction. This increases the time period over which they receive enteral nutrition but are still unoperated and exposed to the adverse hemodynamic impact of uncorrected CHD. This is because definitive surgical intervention may not be possible in patients below a certain weight or gestational age due to immaturity of cardiac and cerebral tissues compounded by the technical difficulties associated with low birth weight.
This study attempts to describe the feeding regimes, rate of growth, and complications of feeding in this cohort who have the two independent risk factors, CHD and prematurity, for development of NEC. It will attempt to define any differences in the feeding experience of infants who remain well versus those who develop NEC. It will therefore help to direct and optimise the feeding practice in these infants and hopefully will be used to inform a national feeding strategy for preterm babies who have CHD.