Children with CHD are at increased risk for feeding difficulties, yet the prevalence and predictors of paediatric feeding disorder in this population remain underexplored.

To evaluate the prevalence of paediatric feeding disorder and identify consistent predictors of feeding difficulties in children with CHD 18-<25 months of age.

A retrospective review was conducted on 159 children diagnosed with CHD. Paediatric feeding disorder was defined using consensus criteria encompassing nutritional status and feeding skill domains. Feeding outcomes were assessed at 18-<25 months, regardless of the method of feeding (oral or tube-fed). Medical history, growth, and neurodevelopmental status were analysed to identify predictors of paediatric feeding disorder.

At 18-<25 months, 58% of children met criteria for paediatric feeding disorder. Among exclusively orally fed children, 41% still qualified, indicating persistent dysfunction beyond tube dependence. Significant challenges were observed in nutrition and feeding skill domains. One-third relied on formula and overnight feeds, reflecting high energy needs and possibly inefficiencies. While 74% had transitioned to cup drinking, 21% struggled, particularly those born preterm or with neurodevelopmental delays. Texture progression was delayed: 29% had no table foods, and among those who did, 67% had chewing difficulties. Predictors of paediatric feeding disorder included medical/genetic comorbidities, low weight, prolonged hospitalisation, low maternal education, and delays in cognitive, language, and motor development.

Paediatric feeding disorder is highly prevalent in children with CHD, including those feeding orally. Early risk factors are associated with domain-specific feeding challenges, emphasising the need for individualised, developmentally informed feeding and nutrition care plans in this high-risk population.

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.

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.

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.

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.