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Feeding difficulties in neonates following cardiac surgery: determinants of prolonged feeding-tube use

Published online by Cambridge University Press:  23 January 2017

Elissa B. McKean ,
Nadine A. Kasparian ,
Shweta Batra ,
Gary F. Sholler ,
David S. Winlaw  and
Jacqueline Dalby-Payne
Elissa B. McKean
Affiliation:
Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia Department of General Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
Nadine A. Kasparian
Affiliation:
Heart Centre for Children, The Sydney Children’s Hospitals Network (Westmead and Randwick), Sydney, New South Wales, Australia Discipline of Paediatrics, School of Women’s and Children’s Health, UNSW Medicine, The University of New South Wales, Sydney, New South Wales, Australia
Shweta Batra
Affiliation:
Department of General Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
Gary F. Sholler
Affiliation:
Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia Heart Centre for Children, The Sydney Children’s Hospitals Network (Westmead and Randwick), Sydney, New South Wales, Australia
David S. Winlaw
Affiliation:
Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia Heart Centre for Children, The Sydney Children’s Hospitals Network (Westmead and Randwick), Sydney, New South Wales, Australia
Jacqueline Dalby-Payne*
Affiliation:
Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia Department of General Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
*
Correspondence to: J. Dalby-Payne, Department of General Medicine, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. Tel: +61 2 9845 0000; Fax: +61 2 9845 0074; E-mail: jacqueline.dalbypayne@health.nsw.gov.au
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Abstract

Aim

The aims of this study were to examine the prevalence and potential correlates of feeding difficulties in infants who underwent cardiac surgery in the neonatal period and to investigate resource utilisation by infants with feeding difficulties.

Methods

All neonates who underwent their first cardiac surgery at the Heart Centre for Children, The Children’s Hospital at Westmead, between January and December, 2009 were included. Demographic, preoperative, intraoperative, and postoperative data were collected via electronic medical records. For the purpose of this study, feeding difficulty was defined as the requirement for ongoing tube feeding at the time of discharge home or transfer to another hospital.

Results

Out of a total of 79 neonates, 24 (30%) were discharged home or transferred to another hospital with a feeding tube. Feeding difficulties were associated with the presence of a genetic syndrome (p<0.0001), assisted feeding preoperatively (odds ratio (OR)=4.4, p=0.03), and having a palliative procedure before biventricular repair (OR=5.1, p=0.02). Infants with feeding difficulties had significantly more reviews by speech pathologists (M=5.9, SD=7.9), dieticians (M=5.9, SD=5.4), and cardiac clinical nurse consultants (M=1.2, SD=1.4) compared with those without feeding difficulties.

Conclusions

This study identified factors that can be used in the early recognition of infant feeding difficulties, to help guide the direction of limited health resources, as well as being focal points for future research and clinical practice improvement.

Keywords

CHDcardiac surgeryfeedingneonatehealth services
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 6 , August 2017 , pp. 1203 - 1211
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Copyright
© Cambridge University Press 2017 

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