What does this research mean for the field?

For infants with critical congenital heart disease, human milk is used in the majority of first oral feeds, and its use is significantly increased by modifiable factors such as parent presence and feeding or lactation consults. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 28, 2026Open Access

Human milk and breastfeeding at the first oral feed for infants with critical congenital heart disease: a multi-institutional study

KEKristin M. ElgersmaUniversity of Minnesota CCCaelah ClarkChildren's Hospital Colorado NSNancy L. SlaterMinnesota West Community & Technical College

Key Points

The aim is to describe the type of nutrition received at the first oral feed for infants with critical congenital heart disease and identify factors influencing this.
Retrospective cohort study involving 1355 infants across 15 sites.
Adjusted regression analyses estimated associations between clinical and parental factors and the use of human milk or breastfeeding.
Human milk was utilized in 78.5% of first oral feeds, with 34.5% breastfeeding occurrence.
Presence of parents was associated with a higher likelihood of using human milk (OR: 5.32, p < 0.001).
Feeding/lactation consults were linked to increased human milk (OR: 2.49, p < 0.001) and breastfeeding rates.

Abstract

Abstract Objective Describe nutrition type/route at the first oral feed (FOF) for infants with critical congenital heart disease (CCHD); identify supportive/limiting factors. Study design Retrospective cohort; adjusted regression estimated associations between parental/clinical factors and human milk or breastfeeding at the FOF. Result For 1355 infants across 15 sites, human milk was used in 78.5% of FOFs, with 34.5% breastfeeding. Human milk was associated with parent presence (OR: 5.32, p < 0.001) and with feeding/lactation consults (2.49, p < 0.001). Private insurance predicted human milk (1.87, p < 0.001) and breastfeeding (1.82, p < 0.001). Younger age (<2 days; 2.23, p < 0.001) and preoperative status (3.66, p < 0.001) were associated with breastfeeding. Conclusion This is the first description of human milk/breastfeeding at the FOF in CCHD. Parent presence and feeding/lactation support were potentially modifiable factors.

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