Abstract 14053: Problematic Feeding is Common and Related to Gastroesophageal Reflux in the First 6 Months After Neonatal Cardiac Surgery

Abstract

Introduction: Feeding problems are often reported in infants after cardiac surgery. To date, no studies have followed the development of feeding after cardiac surgery using valid and reliable measures. Purpose: To describe feeding problems and the relationship between feeding and gastrointestinal tract symptoms in infants over the first 6 months (mos) after neonatal cardiac surgery. Methods: Parents of neonates requiring cardiac surgery were invited to complete surveys when their infant was 2, 4, and 6 mos old. The survey included the Neonatal Eating Assessment Tool (NeoEAT), Infant Gastroesophageal Reflux Questionnaire – Revised (I-GERQ-R), and Infant Gastrointestinal Symptoms Questionnaire (IGSQ). Scores on the NeoEAT subscales ( Infant Regulation, Energy & Physiologic Stability, Gastrointestinal Tract Function, Sensory Responsiveness , and Compelling Symptoms of Problematic Feeding) were categorized as problematic (≥ 90 th percentile) or not problematic (< 90 th percentile) based on reference data. Percent of the sample with problematic feeding at each time point was determined. Bivariate correlations were calculated between the NeoEAT, IGSQ, and I-GERQ-R. Results: 27 parents completed the surveys, reporting on 6 infants with single ventricle and 21 with two ventricle conditions. Problematic feeding scores were common at all times and in both cardiac conditions. Problematic scores were reported on Compelling Symptoms of Problematic Feeding for 52% of the sample at 2 mos, 36% at 4 mos, and 22% at 6 mos. Problematic scores occurred in Gastrointestinal Tract Function for 22% at 2 mos, 10% at 4 mos, and 39% at 6 mos. Problems occurred in Sensory Responsiveness in 17% at 2 mos, 24% at 4 mos, and 33% at 6 mos. Energy & Physiologic Stability problems occurred in 13%, 10%, and 22%, respectively. None reported problems in Infant Regulation . Symptoms of gastroesophageal reflux (I-GERQ-R) were significantly correlated with the NeoEAT ( p < .05), but gastrointestinal symptoms (IGSQ) were not. Conclusions: Problematic feeding is common in the first 6 mos after neonatal cardiac surgery and is related to gastroesophageal reflux symptoms. Some areas of feeding improved over time, while others worsened, likely related to developmental and disease-related changes.