CHILDREN WITH CONGENITAL HEART-DISEASE - A NUTRITION CHALLENGE

Growth in children with congenital heart disease (CHD) is often compro mised. For several decades, investigators have tried to identify the f actors affecting growth in children with CHD. Cardiac malformations ar e undoubtedly responsible for malnutrition, which may range from mild undernutrition to severe failure to thrive (FTT). Malnutrition may the n significantly undermine the outcome of corrective surgical operation s and postoperative recovery. Mechanisms linking CHD to malnutrition m ay be related either to decreased energy intake and/or to increased en ergy requirements. Decreased energy intake can involve deficiencies of specific nutrients, or insufficient total caloric intake. increased r espiratory rate accompanying congestive heart failure may be responsib le for increased energy requirements. Different types of cardiac malfo rmations and consequent interventions may have different effects on gr owth and require diverse strategies. Most treatment strategies aim to facilitate ''catch-up'' growth, providing extra calories and protein t hat exceed the Recommended Dietary Allowance for age. However, there i s no generally accepted set of guidelines that define appropriate calo ric intake for catch-up growth. We attempt to identity the most import ant causes of malnutrition and highlight the most effective nutrition strategies for children with CHD.