Infants with congenital heart disease (CHD) are at risk for developing both benign hematochezia and necrotizing enterocolitis (NEC). Despite these risks there are very few studies that investigate modifiable risk factors such as feeding practices. It remains unclear what feeding practices should be avoided due to higher incidence of CHD-NEC. We aim to assess the feeding practices across three high volume tertiary centers to establish a relationship between various feeding practices and development of NEC. A multicenter retrospective review of feeding practices at the time of documented hematochezia event that occurred between 1/2019 and 1/2021 in infants with CHD who were less than 6 months of age. NEC was defined as Bells Stage 2 or greater. Age, weight, ventricular morphology, primary diagnoses, feeding route, feed change, and formula type were evaluated. 176 hematochezia events occurred in 121 patients, 72% of these events were considered benign hematochezia with the remaining 28% being true NEC. Single ventricle (SV) physiology (p < 0.05), younger age, < 45 days of life, (p < 0.001), and feeding route were statistically associated with true NEC (p < 0.01). Formula type and recent change in feed administration were not associated with NEC. The caloric density of feeds at the time of hematochezia was nearing significance. The majority of hematochezia events are benign in nature, however, there should be heightened awareness in patients who are SV, younger in age, and those who are post-pylorically fed. There may be some risk in using higher caloric density feeds (> 24 kcal/oz), however, additional research is needed to fully establish this relationship.

患有先天性心脏病（CHD）的婴儿有发生良性便血和坏死性小肠结肠炎（NEC）的风险。尽管存在这些风险，但很少有研究调查可改变的风险因素，例如喂养方式。由于 CHD-NEC 发病率较高，目前尚不清楚应避免哪些喂养方式。我们的目标是评估三个大容量高等教育中心的喂养实践，以建立各种喂养实践与 NEC 发展之间的关系。对 2019 年 1 月至 2021 年 1 月之间发生的 6 个月以下先天性心脏病婴儿记录的便血事件时的喂养做法进行了多中心回顾性审查。 NEC 被定义为 Bells Stage 2 或更高版本。评估年龄、体重、心室形态、初步诊断、喂养途径、饲料变化和配方奶粉类型。 121 名患者发生了 176 起便血事件，其中 72% 被认为是良性便血，其余 28% 被认为是真正的 NEC。单心室 (SV) 生理学 ( p  < 0.05)、年龄较小、出生 < 45 天 ( p  < 0.001) 和喂养途径与真实 NEC 具有统计学相关性 ( p  < 0.01)。配方奶类型和近期饲料管理的变化与 NEC 无关。便血时饲料的热量密度接近显着性。大多数便血事件本质上是良性的，但对于 SV 患者、年龄较小的患者以及幽门后喂养的患者，应提高警惕。使用较高热量密度饲料（> 24 kcal/oz）可能存在一些风险，但是，需要进行更多研究来充分建立这种关系。