DIET AND FEEDING

For children with a chronic medical condition, such as cardiomyopathy, good eating habits and adequate nutrition become even more important for maintaining proper growth and development. According to recent studies, growth failure is a common problem in children with cardiomyopathy, with nearly one-third exhibiting some degree of growth failure during their illness.

Calorie Intake

A child with cardiomyopathy requires more energy or calories to function since the heart is not working at its optimal level. Poor weight gain and slow growth may be the result of not getting sufficient calories or nutrients in their diet. Some children with cardiomyopathy have poor appetites because their symptoms cause them to get tired while eating.

The goal is to provide more calories than the average child requires in an appropriate and realistic manner. Smaller, more frequent meals, increased calories per meal, and nutritional supplements can help boost daily calories.

For babies not gaining enough weight, a nutritionist or doctor may recommend gradually introducing a concentrated or higher calorie formula. Other ways to increase calories include adding iron-fortified baby cereal to the formula and mixing corn oil in milk for older babies. It may take time for a baby to adjust to a new taste and to determine if there are side effects. Possible signs of intolerance include vomiting, diarrhea, rash or gas.

It is best to be flexible when determining feeding methods and schedules to maintain positive eating habits. For additional guidelines about nutrition for children with cardiomyopathy download the “Nutritional Guidelines for Children with Cardiomyopathy” fact sheet from CCF Connect.

Breastfeeding and Bottle Feeding

Babies with cardiomyopathy can be breastfed or bottle fed, but they may not be able to tolerate a large amount of milk in one feeding. Since they may tire quickly, frequent "on-demand" feedings tend to work best. Consistent weight gain is a good gauge of health and sufficient milk intake. On average, a full-term baby should gain about an ounce (30 grams) per day until 3 months of age and 0.67 ounces (20 grams) per day between 3 and 6 months of age.

Breastfeeding is considered less work for babies with a heart condition because it is easier for them to coordinate sucking, swallowing, and breathing. The amount of oxygen is greater and the baby's heart rate and breathing are more normal during the feeding process. For bottle-fed babies, they may have difficulty feeding from a regular nipple or may change their nipple preference if they have been hospitalized.

Fluid Intake

Children with a heart condition like cardiomyopathy are at a higher risk for heat exhaustion or heat stroke because the heart cannot quickly adjust to changes in the body during extreme heat. To prevent dehydration, adequate fluid intake is important during hot weather or while engaging in exercise. If your child is taking a diuretic that rids the body of excess water and salt, your doctor may recommend a potassium supplement or an electrolyte solution like Pedialyte.

Changes in Appetite

If your child experiences a noticeable loss of appetite, contact your child's cardiologist to determine whether his/her heart condition is contributing to the change. A gastroenterologist or feeding specialist may become involved. In severe cases, tube feedings may be recommended as a temporary measure to increase your child's weight.

Feeding Tubes

If a child is failing to thrive and not meeting their weight gain goals through daily diet, a feeding tube may be recommended. There are different types of feeding tubes such as nasogastric (inserted through the nostril), gastric (inserted surgically into the stomach) and jejunostomy (inserted surgically into the intestine). Feeding pumps can be hooked up to a nasogastric tube to allow milk or nutritional supplements to be pumped into a child continuously or at specific times. For a longer-term arrangement, a gastrostomy or jejunostomy tube may be recommended. Your child’s doctor will determine which feeding tube, feeding plan, and schedule is right for your child.