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

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.