Experts from Johns Hopkins Children’s Center participated in various sessions and presentations during the 2022 Pediatric Cardiac Intensive Care Society Annual International Meeting. In this video, Dennis Delany highlights key points from his nutrition session presentation on re-introducing feeds for newborns and infants with bloody stools, which is a comorbidity of congenital heart disease. Hello. My name is Dennis Delaney and I'm a pediatric cardiac intensive at the johns Hopkins book, classic thomas, pediatric and congenital heart center in the upcoming pediatric cardiac intensive care society conference will be part of a panel on nutrition support in a session called When is it Safe to reintroduce Phoebe's? I would I will be joined by pia schaeuble's registered dietitian at Children's hospital colorado and dr Aaron Gordon at the University of texas Southwestern to discuss the challenging topic of bloody stools and infants and Children with congenital heart disease. Bloody stools, specifically necrotizing colitis or neck is a co morbidity of congenital heart disease that can lead to prolonged hospitalizations, difficulty gaining weight and decreased ability to feed by mouth, leading to a need for feeding tube at discharge, most remarkably occurrence of neck after the stage one Norwood operation increases the risk of death with an odds ratio of 5.6 and one single center study this topic is difficult for a number of reasons. There are multiple ideologies that can lead to neck or bloody stools which vary across ages and lesions To this day. Most of the literature is focused on neck in premature infants, which has a different path of physiology. Additionally, there is a great variation and work up diagnosis and management across heart centers with limited evidence to support a single approach. The goal of our panels to explore this variation. Review what we know from the available literature and offer some suggestions for standardizing approach to bloody stools here at johns Hopkins Heart center. We have a multidisciplinary feeding work group made up of dieticians, nurse practitioners, nurses, speech therapists and physicians to review the available evidence and develop standardized protocols for feeding infants. Our goal is to safely optimize nutrition ideally by mouth while avoiding feeding complications such as neck or aspiration, while every patient requires an individualized care plan. The feeding protocols give the medical team guidance to safe feeding practices and advancement. As a work group. We audit the team's compliance with feeding protocols and provide additional feeding support is needed. I'm excited to be part of the P. C. I. C. S. Nutrition panel to share our work at JOHNS Hopkins and learn from the other panelists and the audience members experience. It offers are especially the chance to create some uniformity or standardization, which will improve our available data and continue to build upon an evidence based approach to decreasing neck while improving growth and ability to feed by mouth. Thank you.