Abstract
Infants and children with congenital heart diseases (CHDs) are especially susceptible to malnutrition. The pathogenesis of nutritional disorders in this population reflects a multifactorial balance between increased metabolic demands, reduced dietary intake, and altered nutrient absorption. This narrative review summarizes current knowledge on the prevalence, risk factors, and underlying mechanisms of malnutrition in paediatric CHDs. It also discusses available tools for nutritional assessment, practical strategies for dietary management, and perioperative considerations. Early identification through screening, combined with individualized nutritional support and multidisciplinary care, is essential to optimize growth and enhance clinical recovery. Special attention is given to feeding difficulties, micronutrient imbalances, and the contribution of human milk and energy-dense feeding approaches in promoting growth. Integrating nutrition into cardiac management is essential to improve both short- and long-term outcomes. Future research should focus on the development of standardized, evidence-based protocols and the implementation of precision nutrition in paediatric CHDs.