Facts and Numbers


Diagnoses with high or low likelihood of needing dietetic intervention (1):



Variable presentation or risk


*Cyanotic lesions

Reasons for malnutrition

  • Increased heart rate
  • Difficulties in emptying a heart cavity
  • Pain
  • Operations and periods in intensive care
  • Lengthy periods between the operations with symptoms
  • Changes to the family situation
  • The heart muscle is affected
  • The liver is enlarged and presses the stomach
  • A swollen abdomen, leaving not enough room for the stomach
  • Poor blood circulation
  • Nausea
  • Tiredness
  • Poor absorption of nutrients from the digestive tract
  • Difficulties with swallowing
  • Decreased oxygen in the blood

Energy intake for children with congenital heart defects

Children aged 0–1 years

High need:
Energy130–150 kcal/kg per day
Protein 3 g/kg per day
Very high need:
Energy 150–200 kcal/kg per day
Protein 4 g/kg per day

Children older than 1 yearEnergy 120–150 % of NNR (which identifies the nutrient-to-calorie ratio of foods) (1).
Children with complicated congenital heart defect, 0-4 years:
Energy 126 kcal/kg per day, which is 140% more than that recommended for the age. (2)
Compared with peers (NNR)0–2 years: 93–85 kcal/kg per day
3–17 years: 79–42 kcal/kg per day

Some lesions that lead to malnutrition

  • Ventricular septal defect (VSD): VSD occurs when the hole in the heart is big and leads to excessive blood flow from the left to the right pumping chamber. The energy expenditure is higher, and the strength is lower.
  • Truncus arteriosus communis: Children with truncus are often born prematurely and they sometimes have a syndrome (such as CATCH). Newborn babies with truncus arteriosus need an operation. However, problems with circulation can remain after the operation.
  • Hypoplastic left heart: This lesion leads to a large expenditure of energy, reduced strength and needs several operations. Circulation might not be recovered after these operations.


(1) Hopkins, David The Cardiothoracic System, Chapter 13 in Margaret Lawson/ Vanessa Shaw, Clinical Paediatric dietetics, Great Ormond Street Hospital for Children and, Institute of Child Health, Blackwell Publishing 2007

(2) Ördén, Heléne. Feeding problems amongst children with congenital heart disease. Masters thesis, Uppsala university, 2006

Author(s): Ulrika Hallin
Last updated: 2008-09-22