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Feeding outcomes in post-discharge feeding clinic for infants following cardiac surgery

Published online by Cambridge University Press:  26 July 2021

Courtney Jones Open the ORCID record for Courtney Jones [Opens in a new window] ,
Melissa Winder Open the ORCID record for Melissa Winder [Opens in a new window] ,
Zhining Ou ,
Thomas A. Miller ,
Lauren Malik ,
Moira Flannery  and
Kristi Glotzbach
Courtney Jones*
Affiliation:
Primary Children’s Hospital, Acute Care Therapy Services, Intermountain Healthcare, Salt Lake City, UT, USA
Melissa Winder
Affiliation:
Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
Zhining Ou
Affiliation:
Division of Epidemiology, Department of Epidemiology, University of Utah, Salt Lake City, UT, USA
Thomas A. Miller
Affiliation:
Department of Pediatrics, University of Utah, Salt Lake City, UT, USA Pediatric and Congenital Cardiology, Maine Medical Center, Portland, ME, USA
Lauren Malik
Affiliation:
Primary Children’s Hospital, Acute Care Therapy Services, Intermountain Healthcare, Salt Lake City, UT, USA
Moira Flannery
Affiliation:
Primary Children’s Hospital, Acute Care Therapy Services, Intermountain Healthcare, Salt Lake City, UT, USA
Kristi Glotzbach
Affiliation:
Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
*
Author for correspondence: C. Jones, MS-CCC SLP, Acute Care Therapy Services, 81 N. Mario Capecchi Dr. Salt Lake City, UT84113, USA. Tel: 801-662-4959. E-mail: courtney.jones@imail.org
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Abstract

Introduction:

The aim of this study was to describe the development and assess the usefulness of a feeding clinic to help infants with CHD tolerate the highest level of oral feeding while achieving growth velocity and supporting neurodevelopment.

Materials and methods:

This retrospective, cohort study assessed feeding outcomes for infants who underwent cardiac surgery at <30 days of age with cardiopulmonary bypass between February 2016 and April 2020. Diagnoses, age at surgery, hospitalisation variables, and feeding outcomes were compared between two cohorts, pre- and post-implementation of a specialised feeding clinic using Exact Wilcoxon signed-rank test, chi-squared, or Fisher’s exact test. The association between time to full oral feed and risk factors was assessed using univariable and multivariable Cox regression model.

Results:

Post-clinic infants (n = 116) surgery was performed at a median of 6 days of life (interquartile range: 4, 8) with median hospital length of stay of 19 days (interquartile range: 16, 26). Infants’ median age at first clinic visit was at 30 days old (interquartile range: 24, 40) and took median 10 days (interquartile range: 7, 12) after hospital discharge to first clinic visit. In the post-clinic cohort, the median time to 100% oral feeding was 47 days (interquartile range: 27, 96) compared to the 60 days (interquartile range: 20, 84) in the pre-clinic cohort (n = 22), but the difference was not statistically significant.

Discussion:

The cardiac feeding clinic was utilised by our neonatal surgery population and feasible in coordination with cardiology follow-up visits. Future assessment of cardiac feeding clinic impact should include additional measures of feeding and neurodevelopmental success.

Keywords

Oral feedingCHDfeeding difficultiesdysphagianeurodevelopmental delaysfeeding challengesfeeding clinic
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 4 , April 2022 , pp. 628 - 635
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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