Babies with better attention before cardiac surgery likely to have good feeding outcomes

Neonates with higher attention scores before undergoing cardiac surgery are more likely to have better postoperative feeding outcomes, a recent study has found.

Researchers retrospectively assessed 124 neonates (median age at surgery, 7.0 days; 40 percent male) scheduled for cardiac surgery. Perioperative evaluations were performed using the Neonatal Intensive Care Unit Network Neurobehavioural Scale (NNNS), which assesses infants’ capability to orient and fixate on stimuli.

At discharge, majority of the neonates were taking <50 percent of their feeds orally; almost 40 percent were not feeding at all. The median time to achieve full oral feeding was 32 days for those with preoperative NNNS assessments, and 36 days for infants with postoperative evaluations. By 100 days after surgery, around 70 percent of the neonates were being fed completely orally.

Univariable analysis of the zero-inflated beta-regression model showed each additional day a neonate spent on ventilator was associated with an increase in the likelihood of zero-percent oral feeding (odds ratio [OR], 1.38, 95 percent CI, 1.09–1.73; p=0.01) and, conversely, with decreased chances of achieving full oral feeding by discharge (OR, 0.84, 0.73–0.97; p=0.02).

Similarly, better preoperative scores on the NNNS attention domain correlated with a shorter time to achieve full oral feeds (hazard ratio [HR], 1.4, 1.0–2.0; p=0.045). The same was true for older age at surgery (HR, 1.8, 1.3–2.6; p=0.001). On the other hand, infants who spent more days on ventilator took longer to achieve full oral feeding (HR, 0.8, 0.7–0.9; p=0.003).