Explain Difficult Feeding and Poor Growth to recognition of congenital heart disease?

Difficult Feeding and Poor Growth: The parent of an infant with CHD may complain that the child has difficulty with feeds. This is usually a feature of an infant with congestive heart failure resulting from CHD. The history may be of slow feeding, small volumes consumed during each feed, tiring easily following feeds and requirement of periods of rest during feeds. Not infrequently, no history of feeding difficulty may be obtained, but exanimation of the growth charts will reveal that the Childs growth rate is not appropriate for age. A recent decline in growth rate (falling oft' the growth curve) or weight that is inappropriate for age (<5th percentile) may result from a large left to right shunt. Characteristically, growth retardation affects weight more that height.