Neurodevelopmental Intervention Strategies to Improve Oral Feeding Skills in Infants With Congenital Heart Defects

Purpose Full-term infants with congenital heart defects (CHD) are at high risk for developmental and feeding difficulties secondary to a complex combination of immature neurological structures, early surgical intervention, postsurgical complications, and disruption in typical care. Infants with CHD often present with neurobehavioral immaturity that resembles that of premature infants, resulting in difficulties in achieving stability in the physiological and behavioral subsystems. This results in poor arousal, muscle tone abnormalities, and poor state regulation, which affect their ability to achieve oral feeding readiness and progress in their oral feeding skills. In fact, a significant number of infants with CHD require supplemental tube feeding upon hospital discharge to meet their nutritional needs. However, despite these unique barriers, the feeding experience for infants with CHD is frequently overlooked and the focus tends to be on higher level oral motor and swallowing skills and volume intake. Conclusion Given the growing evidence of neurological immaturity and subsequent neurodevelopmental delays in this population, it is crucial for therapists to recognize neurobehavioral stability as a foundation for a complex neuromotor activity such as oral feeding. This article will discuss how to utilize infant neurobehavioral intervention as part of feeding treatment for children with CHD to help develop appropriate neural pathways for oral feeding.