الفهرس 
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Abstract
Introduction: Congenital heart defects are classified into two broad categories: acyanotic and cyanotic. In acyanotic defects, congestive heart failure is the most common symptom. The most common acyanotic lesions are ventricular septal defect, atrial septal defect, atrioventricular canal, pulmonary stenosis, patent ductus arteriosus, aortic stenosis and coarctation of the aorta. In infants with cyanotic defects, the primary concern is hypoxia. The most common defects associated with cyanosis are tetralogy of Fallot and transposition of the great arteries. These nine lesions constitute 85 percent of all congenital heart defects.Te incidence of CHD may be up to12 to 14/1,000 live births. Conclusion: Congenital heart defects (CHD) are often associated with malnutrition and failure to thrive. The greatest severity of growth retardation is often found in infants with congestive heart failure. Even children born with an appropriate birth weight for gestational age soon fall off their birth percentiles for weight and/or height. Mechanisms linking CHD to malnutrition may be related to decreased energy intake and/or increased energy requirements. Most treatment strategies aim to facilitate catch-up growth by providing extra calories and protein that exceed the RDAs for age. Early attention to the correction of the cardiac defect supplemented by a balanced nutritional care will help children with CHD thrive better. Parenteral nutrition is indicated in infants with CHD when the projected time to establish adequate enteral support exceeds the infant‘s metabolic reserves. If enteral nutrition cannot be obtained in longer than 1 week, a central line should be obtained to maximize the dextrose and protein in the total parenteral nutrition (TPN) in addition to intralipids at 20% to prevent fatty acid deficiency and promote optimal nutrition. The use of formula or breast milk at a rate of 0.5 to 1.0 cc/kg/hr continuous drip uses the gastrointestinal tract and can lessen the risk for systemic bacterial infection by preventing complications related to intestinal mucosal atrophy and loss of the functional intestinal barrier. .Increasing caloric density of the formula may be necessary if tolerance to volume is a limiting factor in meeting caloric requirements. Enteral feeds may be best managed as a combination of oral (PO) and nasogastric tube (NG) feedings, allowing the infant to work on oral feeding skills but also receive the necessary energy required for catch-up growth. Nasojejunal (NJ) delivery of nutrients is an option when delayed gastric emptying or GER is present. Percutaneous endoscopic gastrotomy (PEG) is a safe method to deliver calories to children who are severely malnourished due to CHD. This method of feeding has the advantage that the child does not need to expend any energy to feed and therefore more is available for growth. It is a common misconception that breastfeeding is more difficult and requires more effort than bottle-feeding for infants with CHD. Studies carried to compare oxygen saturation during breast and bottle feeding they found that Saturations during breast feeding were higher and less variable than saturations during bottle feedings.