{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T14:43:11Z","timestamp":1793544191911,"version":"4.5.0"},"reference-count":89,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,9,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Infants with single ventricle congenital heart disease undergo 3 staged surgeries\/interventions, with risk for morbidity and mortality. We estimated the effect of human milk (HM) and direct breastfeeding on outcomes including necrotizing enterocolitis, infection\u2010related complications, length of stay, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We analyzed the National Pediatric Cardiology Quality Improvement Collaborative (NPC\u2010QIC) registry (2016\u20132021), examining HM\/breastfeeding groups during stage 1 and stage 2 palliations. We calculated propensity scores for feeding exposures, then fitted Poisson and logistic regression models to compare outcomes between propensity\u2010matched cohorts. Participants included 2491 infants (68 sites). Estimates for all outcomes were better in HM\/breastfeeding groups. Infants fed exclusive HM before stage 1 palliation (S1P)\u00a0had lower odds of preoperative necrotizing enterocolitis (odds ratio [OR], 0.37 [95% CI, 0.17\u20130.84];\n                      <jats:italic>P<\/jats:italic>\n                      =0.017) and shorter S1P length of stay (rate ratio [RR], 0.87 [95% CI, 0.78\u20130.98];\n                      <jats:italic>P<\/jats:italic>\n                      =0.027). During the S1P hospitalization, infants with high HM had lower odds of postoperative necrotizing enterocolitis (OR, 0.28 [95% CI, 0.15\u20130.50];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and sepsis (OR, 0.29 [95% CI, 0.13\u20130.65];\n                      <jats:italic>P<\/jats:italic>\n                      =0.003), and shorter S1P length of stay (RR, 0.75 [95% CI, 0.66\u20130.86];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). At stage 2 palliation, infants with any HM (RR, 0.82 [95% CI, 0.69\u20130.97];\n                      <jats:italic>P<\/jats:italic>\n                      =0.018) and any breastfeeding (RR, 0.71 [95% CI, 0.57\u20130.89];\n                      <jats:italic>P<\/jats:italic>\n                      =0.003) experienced shorter length of stay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Infants with single ventricle congenital heart disease in high\u2010HM and breastfeeding groups experienced multiple significantly better outcomes. Given our findings of improved health, strategies to increase the rates of HM\/breastfeeding in these patients should be implemented. Future research should replicate these findings with granular feeding data and in broader congenital heart disease populations, and should examine mechanisms (eg, HM components, microbiome) by which HM\/breastfeeding benefits these infants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.030756","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T05:50:23Z","timestamp":1693288223000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Human Milk Feeding and Direct Breastfeeding Improve Outcomes for Infants With Single Ventricle Congenital Heart Disease: Propensity Score\u2010Matched Analysis of the NPC\u2010QIC Registry"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6559-0812","authenticated-orcid":false,"given":"Kristin M.","family":"Elgersma","sequence":"first","affiliation":[{"name":"University of Minnesota School of Nursing Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2032-0875","authenticated-orcid":false,"given":"Julian","family":"Wolfson","sequence":"additional","affiliation":[{"name":"Division of Biostatistics University of Minnesota School of Public Health Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2110-498X","authenticated-orcid":false,"given":"Jayne A.","family":"Fulkerson","sequence":"additional","affiliation":[{"name":"University of Minnesota School of Nursing Minneapolis MN USA"},{"name":"Division of Epidemiology University of Minnesota School of Public Health Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K.","family":"Georgieff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Minnesota Medical School Minneapolis MN USA"},{"name":"M Health Fairview University of Minnesota Masonic Children\u2019s Hospital Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4608-4898","authenticated-orcid":false,"given":"Wendy S.","family":"Looman","sequence":"additional","affiliation":[{"name":"University of Minnesota School of Nursing Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7316-6616","authenticated-orcid":false,"given":"Diane L.","family":"Spatz","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Nursing Philadelphia PA USA"},{"name":"Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavisha M.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Minnesota Medical School Minneapolis MN USA"},{"name":"M Health Fairview University of Minnesota Masonic Children\u2019s Hospital Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7303-7635","authenticated-orcid":false,"given":"Karen","family":"Uzark","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery University of Michigan Medical School Ann Arbor MI USA"},{"name":"C. 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