A new publication highlights how human milk improves outcomes for infants with congenital heart defects (CHD). This state-of-the-science article concludes that mother’s milk should be considered a medical intervention for infants with CHD.
Diane L. Spatz, PhD, RN-BC, FAAN
“Numerous factors contribute to poor feeding and growth outcomes in infants with congenital heart defects,” said Diane L. Spatz, PhD, RN-BC, FAAN, Nurse Researcher and Director of the Breastfeeding and Lactation Program at Children’s Hospital of Philadelphia (CHOP) and senior author of the paper, published January 30, 2019, in Advances in Neonatal Care. “Human milk is a valuable resource for all infants, and is truly a lifesaving intervention in babies with CHD.”
Spatz co-authored the Evidence-based Practice Brief with Jessica Davis, BSN, RN, IBCLC, from Children’s Hospital of Pittsburgh.
The benefits of human milk for preterm and healthy infants are well documented, but information about the benefits that human milk plays in improving outcomes for neonates and infants with congenital heart defects (CHD) is limited.
CHD is the most common birth defect, with an estimate of 1 in 120 born with heart disease each year in the U.S. Infants with CHD are at an increased risk for complications related to necrotizing enterocolitis (NEC), chylothorax, feeding difficulties and growth failure.
In infants with CHD, NEC (a serious intestinal illness) causes a very high risk of mortality and morbidity, which can be substantially reduced by human milk. Human milk promotes the growth of healthy bacteria in the infant gut, promotes gastric motility and maturity of the digestive tract, minimizes intestinal membrane permeability, and has an anti-inflammatory effect on the digestive tract. An exclusively human milk diet can reduce the incidence of NEC by 50 percent in premature infants. “Human milk has an essential role in reducing the incidence and severity of NEC,” added Spatz.
Chylothorax, a rare complication of thoracic surgery, typically characterized by the presence of lymphatic drainage in the pleural cavity, may also occur in infants with CHD. It raises an infant’s risk of growth failure, electrolyte losses and protein malnutrition. Although infants with chylothorax are often transitioned to formulas for the duration of treatment, Children’s Hospital of Philadelphia has been making skim milk for these infants for over five years since opening the Human Milk Management Center. In consuming the skimmed milk, infants are able to receive all the immunobiological and developmental benefits of a human milk diet.
Using her 10-Step Model for Breastfeeding Vulnerable Infants, based on more than a decade of research demonstrating improved outcomes for vulnerable infants, Spatz lays out a model to ensure that infants with CHD receive human milk.
“This new manuscript highlights the importance of direct breastfeeding as an intervention to improve feeding outcomes in infants with CHD,” added Spatz.