Feeding your baby after heart surgery is an important part of their healing, growth and recovery. Every baby is different. Babies with heart problems often have problems with eating. Your baby’s heart surgery team has a plan to address feeding problems.
The main goal is to get your baby the right amount of calories and fluid to grow and heal. It may take some time before your baby is able to do this without help. After surgery, some babies take longer than others to start eating like they did before surgery. Some babies have not had very much experience eating before surgery and may take even longer.
Your baby will need more calories than they did before surgery. However, your baby will need to gradually increase their calories and volume to try to prevent feeding problems. It can take time to reach your baby’s calorie and feeding goals. These goals are different for each baby, but all babies need to gain weight with their feeding routine. Your baby may need IV (intravenous) nutrition while increasing their calories. This is a normal part of a feeding plan after heart surgery.
How Will My Baby Eat?
. Feeding by mouth
We will help your baby learn to eat by mouth as soon as it is safe. Think of eating by breast or bottle as exercise for your baby. It takes a lot of energy for babies to eat. Babies must limit the time they eat by mouth to 30 minutes at each feeding. Young babies need to eat every 3 hours even overnight. If it takes longer than 30 minutes to eat, your baby is using too much energy and burning too many calories. Your baby may need to limit eating by mouth to 10 or 15 minutes at a time. You and your baby may work with a feeding therapist (physical or occupational therapist) to learn to eat more efficiently.
. Feeding tube
After surgery, your baby may need a feeding tube called a nasogastric or “NG” tube. The tube goes in your baby’s nose down to their stomach. Every baby is different. Some babies only need this for a few days. Some babies need it for weeks to months.
The feeding tube allows your baby to get calories without the work that it takes to drink by mouth. This will help your baby gain weight faster. The feeding tube can be removed when your baby is able to take enough breast milk or formula by mouth to grow well. Nurses may also use the feeding tube to give your baby medicine.
What Should I Watch for During and After Feedings?
You and your nurse will watch your baby carefully during and right after a feeding. It is hard work for your baby to learn how to coordinate sucking, swallowing and breathing.
After surgery some babies may have trouble swallowing. If they do, they can get a small amount of milk down the wrong tube and into their lungs (aspirate). If they aspirate, it can cause breathing problems and, in some cases, can cause your baby to develop a lung infection (pneumonia). Tell your nurse if you have concerns about how your baby is feeding. You can help your nurses watch for these signs!
Signs that your baby may be aspirating include:
. Coughing while eating
. Choking while eating
. Noisy breathing after eating
Not tolerating feedings
Signs that your baby may not be tolerating feedings include:
. Increased diarrhea
. Blood in their bowel movements
. Stomach getting bigger
. Increased vomiting
. Coughing or choking when eating
. Fast breathing after eating
. Excessive fussiness
What If My Baby Is Having Trouble with Feedings?
. The ear, nose and throat (ENT) team may look to see if there are any problems with your baby’s vocal cords. Vocal cords help protect your baby from aspirating when they swallow.
. A swallowing study may be needed to take pictures of where the breast milk or formula goes when your baby swallows.
. A feeding tube that goes in your baby’s nose past the stomach, called a nasoduodenal tube or “ND” tube may be needed. If it is needed, your baby will have a small amount of milk always running through the feeding tube (continuous feed).
. Watch for signs of reflux (fussiness after feeding, arching or vomiting). Medicines and a special positioning wedge may help prevent or treat this. A small amount of spitting up is normal for babies. Your nurse and the heart surgery team will help you learn how much spit-up is normal for your baby.
What Do I Need to Learn Before We Go Home?
Before you go home, your nurse and heart surgery care team will teach you how to give your baby medical care at home. This may include:
. Learning about your baby’s feeding plan
. Learning how to give your baby medicines
. Learning how to use a feeding tube, if your baby needs one. This includes how to check that it is in the right place, how to place the feeding tube if your baby pulls it out, and how to use a feeding pump.
. Learning how to mix your baby’s formula or breast milk with extra calories (a fortifier).
. Learning about your baby’s plan to increase feeds at home as your baby grows.
About Iranian Surgery
Iranian surgery is an online medical tourism platform where you can find the best pediatric heart (cardiac) surgeons in Iran. The price of Pediatric Heart Surgery in Iran can vary according to each individual’s case and will be determined by an in-person assessment with the doctor.
For more information about the cost of Pediatric Heart Surgery in Iran and to schedule an appointment in advance, you can contact Iranian Surgery consultants via WhatsApp number 0098 901 929 0946. This service is completely free.