{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:55:40Z","timestamp":1790769340914,"version":"4.1.0"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951126124287_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Feeding neonates with CHD is clinically and emotionally challenging. Although human milk improves outcomes\u2014including reduced necrotising enterocolitis, sepsis, and neurodevelopmental delays\u2014its use remains suboptimal. Prior studies have focused on clinical endpoints, with limited attention to modifiable maternal or prenatal influences on feeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126124287_as2\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate how maternal expectations, prenatal counselling, and early lactation behaviours affect feeding outcomes in infants with prenatally diagnosed CHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126124287_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a prospective cohort study of 49 mother\u2013infant dyads with prenatally diagnosed CHD in a tertiary neonatal ICU and paediatric cardiac ICU. Mothers completed structured surveys during hospitalisation. Feeding outcomes were assessed through chart review over six months post-discharge. Primary outcomes included human milk volume at day of life 14, feeding type at discharge, and direct breastfeeding. Multivariable logistic regression and CHD risk stratification were used for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126124287_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Direct breastfeeding during hospitalisation predicted oral feeding at discharge (77% vs. 28%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0006) and ongoing human milk use. Early milk exposure (&lt;72 hours) increased likelihood of human milk use at discharge (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0158). Strong maternal intent and prior breastfeeding experience were linked to sustained lactation. Prenatal counselling (reported by 68%) was not associated with outcomes. Higher Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery scores correlated with delayed achievement of 500 mL\/day by day of life 14 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0405).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126124287_as5\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Direct breastfeeding, early milk exposure, and maternal intent are key modifiable drivers of feeding success in neonates with CHD. Standard prenatal counselling alone is insufficient. Targeted, risk-informed lactation support is needed to optimise outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951126124287","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:02:42Z","timestamp":1790766162000},"page":"1-6","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["In-hospital direct breastfeeding is linked to improved oral feeding and human milk intake at discharge and beyond in neonates with CHD"],"prefix":"10.1017","author":[{"given":"Lara","family":"Nicolas","sequence":"first","affiliation":[{"name":"University of Florida College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siena","family":"Vadakal","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Kaidyn","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Valcarce","sequence":"additional","affiliation":[{"name":"The University of Alabama at Birmingham Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie A.","family":"Parker","sequence":"additional","affiliation":[{"name":"University of Florida College of Nursing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desiree","family":"Machado","sequence":"additional","affiliation":[{"name":"Instituto D\u2019Or de Pesquisa e Ensino- IDOR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alissandre","family":"Eugenie","sequence":"additional","affiliation":[{"name":"University of Florida College of Nursing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanzhi","family":"Gao","sequence":"additional","affiliation":[{"name":"University of South Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9508-5507","authenticated-orcid":false,"given":"Diomel","family":"de la Cruz","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3269-9122","authenticated-orcid":false,"given":"Nicole T.","family":"Cacho","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05rrcem69","id-type":"ROR","asserted-by":"publisher"}],"name":"University of California Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"S1047951126124287_ref13","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-018-0077-z"},{"key":"S1047951126124287_ref21","first-page":"1","article-title":"Human milk, breastfeeding, and early neurodevelopmental outcomes for infants with critical CHD","volume":"13","author":"Elgersma","year":"2024","journal-title":"Cardiol 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}