Breast/Chestfeeding Your Baby with Congenital Heart Disease

Important information:

Babies diagnosed with congenital heart disease can benefit from breast/chestfeeding or being fed expressed human milk.

If your baby is diagnosed with a congenital heart defect, you may not be able to breast/chestfeed your baby right away. You will need to begin pumping within the first few hours after birth. The sooner you begin pumping and the more often you pump, the sooner you will have milk for your baby.

How will breast/chestfeeding help my baby?

• Breast/chestfeeding provides closeness and comfort. It helps you and your baby bond. Your milk contains the right nutrients for your baby.

• Your milk changes to give your baby exactly what they need.

• Breast/chestfeeding protects your baby against common childhood illnesses such as diarrhea and ear infections and protects against SIDS.

• Breast/chestfeeding reduces the risk of obesity, asthma, and diabetes.

How do I get started making milk if my baby isn’t able to breast/chestfeed?

• You can use a double electric pump to provide the stimulation you need to make milk.

• Start pumping as soon as possible after the birth, ideally in the first hour.

• Pump every 2-3 hours or at least 8 times in a 24-hour period.

• Wake up to pump 1-2 times at night.

• Try not to sleep more than 6 hours without pumping.

• Use your hands to gently massage your breasts/chest and express more drops of milk.

• You will get very small amounts of the early milk called colostrum in the beginning. Save every drop! This milk is important to protect your baby from infections.

• Talk to your baby’s nurse about oral care. Use a cotton swab or small syringe to collect colostrum to insert inside their cheek. The nutrients will be absorbed into their blood stream to protect them even if they aren’t able to drink your milk yet.

• It can take several days before you start to fill up bottles with your milk.

• Hold your baby skin to skin to help make more milk.

• Self-care and relaxation are also important.

What if my baby was breast/chestfeeding at home before their surgery?

• Your baby will likely not be eating for a period of time before and after surgery.

• You will need to use a double electric breast pump to express milk when your baby cannot breast/chestfeed.

• Pump on a similar schedule as to when your baby usually fed.

• You can resume breast/chestfeeding when your baby has recovered from the surgery and can be held comfortably.

Is breast/chestfeeding too much work for my baby’s heart?

• The “work” of breast/chestfeeding is actually less than the “work” of bottle feeding.

• Your baby can coordinate sucking, swallowing, and breathing better while breast/chestfeeding than when bottle feeding.

• Your baby’s oxygen saturation will likely be better and their heart rate more normal during breast/chestfeeding than bottle feeding.

Once my baby is breast/chestfeeding, how can I tell if they are getting enough?

• Your baby is nursing 8-12 times in a 24-hour period.

• Your baby is latching well, and you hear swallowing.

• Your baby has at least 3 soft, yellow stools and at least 6 wet diapers in a 24-hour period.

• Your baby is gaining an average of 1 ounce per day during the first 3 months.

• You can obtain pre and post weights to measure how much your baby drinks when breast/chestfeeding. Weigh your baby in diaper and clothes before feeding and again in the same diaper and clothes after feeding. Use a special scale to get accurate weights. The difference between the before and after weight is the amount of milk your baby drank.

What if my baby needs extra calories?

• Some babies with CHD struggle to gain weight and grow.

• You can express milk after your baby breast/chestfeeds. This milk will have more fat and calories and can be used as a supplement.

• You can increase the fat and calories in your milk by making some changes to the way you pump. Ask to speak with a registered dietitian or a lactation consultant to learn more.

• You can allow the fat to rise to the top of a bottle of expressed milk in the refrigerator and then collect the cream with a spoon to add extra calories to other bottles of pumped milk.

• Some babies need extra calories (fortification) by adding formula to expressed human milk. Your baby’s medical team will provide guidelines on how to do this.

Breast/chestfeeding your baby with CHD can be a wonderful and satisfying experience. A mother of a baby with hypoplastic left heart syndrome (HLHS) told us, “As a mother to a child with a congenital heart defect you feel helpless and may sometimes even feel that there is nothing you can do for your baby at this critical time. Well, here is something you can do for you and your baby.”  

If you have questions about milk production or breast/chestfeeding, ask to speak with a provider who specializes in lactation support.

Reviewed June 2024 by Meghan Devine BSN, RN, IBCLC