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Feeding your baby does more than provide nutrition. It’s also a special time to show love, hold your baby close and connect. When your baby gains weight and seems happy and healthy, it can feel reassuring and rewarding.

Babies born with congenital heart disease (CHD), however, may not gain weight as quickly as other babies, even when you’re doing everything you can. This can be frustrating at times. 

How does CHD affect growth?

Many healthy babies double their birth weight by 3 to 4 months of age. Babies and children with CHD often gain weight more slowly.

A common reason is that they may not get enough calories or nutrients. Some babies with CHD get tired during feedings and stop eating sooner. Even if your baby seems to drink enough breast milk or formula, they may still gain weight slowly because their body needs more calories than usual.

Your baby’s pediatrician or cardiologist will check their weight at each visit. These weight checks help show how well your baby is growing.

How to feed your baby

Breast milk is the best source of nutrition for most babies. It can also lower the risk of some health problems for both the mother and baby. Still, it’s important to stay flexible about how and when you feed your baby.

Some babies with heart disease may need extra calories added to breast milk or formula. Others may need feedings through a soft tube placed in the nose.

Babies with CHD often do best with smaller, more frequent feedings. They can get tired easily while eating, so feeding more often may help. Some babies may need to feed as often as every one to three hours. You may also need to wake your baby at night to feed until they can tolerate a larger volume of milk. 

Breastfeeding your baby

If your baby has CHD, you may not be able to breastfeed right after birth. That’s OK. You can start by pumping your breast milk.

• Try to start pumping within the first six hours after delivery.
• Many parents are encouraged to pump about eight times in 24 hours.
• Pump as often as your baby feeds to help keep your milk supply steady.

An electric pump can make this easier at home. If your baby needs surgery or can’t nurse for a while, you can keep pumping to maintain your milk supply. Be sure to clean your breast pump parts after each use, following the manufacturer’s cleaning directions.

Every baby is different, but here are general guidelines on how often babies feed:

• In the first few days: Every one to three hours
• In the first weeks and months: About every two to four hours
• Most babies feed eight to 12 times in 24 hours

If you have questions or need help with pumping or breastfeeding, a lactation consultant can help. Before you leave the hospital, they can:

• Watch a feeding
• Help with latching
• Answer questions

Feeding your baby formula

Formula feeding can offer more flexibility, especially if your child remained in the hospital after birth. It also lets other family members help with feeding.

Store-bought formulas are safe and regulated by the Food and Drug Administration. Your baby’s healthcare team can help you choose the best one for your baby. When preparing formula:

• Wash your hands and bottles
• Follow the mixing directions carefully

In the first few days:

• Many newborns take about 1 to 2 ounces every two to three hours. Your healthcare team can help you decide how much and how often to feed your baby.

As your baby grows:

• Offer more at each feeding
• Feed about every three to four hours

Your healthcare team will help make sure your baby is getting enough nutrition and calories.

There are many types of bottles and nipples. You may need to try a few to see what works best for your baby. An occupational therapist, nurse or feeding specialist can:

• Watch how your baby feeds
• Suggest a feeding schedule
• Recommend the right nipple type

Tube feeding for extra nutrition

Some babies with CHD may not get enough calories from breastfeeding or bottle-feeding alone. They may need extra help with feeding.

One option is a nasogastric (NG) tube. This is a soft tube that goes through your baby’s nose and into the stomach. Formula or breast milk goes through the tube. This can make feeding easier and help your baby gain weight.

Other types of tube feeding include:

• Gastrostomy tube (G-tube): Placed through the abdomen into the stomach
• Jejunostomy tube (J-tube): Placed through the abdomen into the intestine

These tubes are placed during a procedure or surgery. Your child’s healthcare team will help choose the best type of feeding and schedule for your baby.

Other liquids

Do not give your baby water, juice or other liquids unless your healthcare team recommends it. Breast milk or formula should continue to be the main source of nutrition even after solids are introduced.

Starting solid food

Your doctor can help you decide when to start solid foods. This is usually around 6 months of age.

You don’t need to follow a set order. You can start with soft foods, including:

• Fortified cereal
• Vegetables and fruits
• Lean proteins
• Whole grains
• Low-fat or fat-free yogurt and cheese

These foods can be good options as your baby learns to eat solids.

This is also a great time to help your child build healthy eating habits. Talk with your baby’s health care team about the best foods based on your baby’s growth.

Heart medication and feeding

Many babies with CHD need medications. They usually don’t affect feedings. Follow your health care team’s instructions about when to give medications. It can help to:

• Some medication may be easier to give before a feeding
• Give it directly into your baby’s mouth using a syringe or dropper
• Avoid mixing medication into a bottle since your baby may not finish it

If your baby throws up after taking medication, wait until the next scheduled dose unless your baby’s doctor tells you otherwise.

Call your baby’s healthcare team if your baby:

• Seems sick
• Is feeding poorly
• Throws up often (more than two to three feedings a day)

They may need to adjust your baby’s medication or formula, if not breastfed.

Making progress with feeding

Feeding takes time and patience. You are doing important work.

Even if your baby doesn’t eat much, being close during feeding helps build a strong bond. Try to keep feeding a calm and positive time. Let your baby show you when they are full.

If you have concerns about your baby’s feeding or growth, talk with their healthcare team.