Impact of breast milk composition on nutritional status of term neonates with congenital heart defects: A prospective study

Figure 1 Study design. A: Group formation flow chart; B: Timepoints of observation and sample collection. Operation day of life is presented as median (interquartile range). BM: Breast milk; NICU: Neonatal intensive care unit; DOL: Day of life; POD: Postoperative day; V1: Colostrum; V2: Transitional milk; V3: Mature milk.

Figure 2 Types of enteral feeding substrates in operated and non-operated term neonates with congenital heart defects during hospitalization. Mixed feeding combines breast milk and formula. DOL: Day of life; POD: Postoperative day.

Figure 3 Colostrum, transitional milk, and mature milk composition in mothers of operated and non-operated term neonates with congenital heart defects and mothers of healthy neonates. A: Fat concentrations; B: Total protein concentrations; C: True protein concentrations; D: Carbohydrate concentrations; E: Total kilocalories (kcal). P values are presented from Kruskal-Wallis tests. V1: Colostrum; V2: Transitional milk; V3: Mature milk.

Figure 4 Enteral feeding volume and total (enteral and parenteral) nutrition trajectories in term neonates with congenital heart defects, comparing operated and non-operated groups during hospitalization. A: Enteral feeding volumes; B: Breast milk feeding volumes; C: Total fat intake; D: Total protein intake; E: Total carbohydrate intake; F: Total kilocalorie intake. DOL: Day of life.

Figure 5 Enteral feeding volume and total (enteral and parenteral) nutrition profiles in operated neonates with congenital heart defect, compared by hypotrophy status at discharge. A: Enteral feeding volumes; B: Breast milk feeding volumes; C: Total fat intake; D: Total protein intake; E: Total carbohydrate intake; F: Total kilocalorie intake. DOL: Day of life; POD: Postoperative day.

Figure 6 Dynamics of the weight-for-age z score in term neonates with congenital heart defects during hospitalization and at discharge. A: Hospitalization; B: Discharge. DOL: Day of life; POD: Postoperative day; OP: Operated group; NOP: Non-operated group; WAZ: Weight-for-age z score.

Figure 7 Spearman correlation analysis of relationships between maternal breast milk macronutrient content and growth parameters in neonates with congenital heart defects. A and B: Correlations for colostrum are presented separately for operated and non-operated neonates; C and D: Mature breast milk are presented separately for operated and non-operated neonates. Color scale indicates Spearman's r; ^aP < 0.05, ^bP < 0.01.