Introduction

Congenital heart disease (CHD) occurs in 1% of newborns each year. It is the most common major congenital defect, comprising 13% of all major congenital defects. It is well known that infants with hemodynamically significant CHD have an increased rate of malnutrition and growth failure compared with healthy infants. In the early 1900s, William Osler described children with CHD as “rarely thriving and often displaying lethargy of body and mind.” Unfortunately, in the modern era, this description may still be accurate for some infants and children with CHD.

The neonatal period is a critical time for organ growth and development that is adversely affected by malnutrition associated with CHD. Many infants and children with CHD will need surgical correction of their congenital defect, with more than half requiring surgery during infancy. Although no data are available in infants undergoing cardiac surgery, data in adults indicate that improved preoperative nutritional status results in decreased postoperative morbidity. Therefore, it is imperative that early nutritional intervention is begun in infants with CHD, both to avoid long-term consequences of malnutrition during this period of rapid growth and development and to improve the metabolic response to surgery in those infants who require early surgical intervention.

There are few data regarding nutritional metabolism and growth in the neonatal period in infants with CHD.