Heart conditions in babies and toddlers (especially congenital conditions) need to be addressed at the earliest. Children often start showing some obvert symptoms of heart complications which parents and elders fail to notice. “The signs and symptoms in a new-born baby will be different from that of adults, and they could be subtle or dangerous,” says Dr Tanuja Karande, consultant pediatric cardiologist, Kokilaben Dhirubhai Ambani Hospital, Mumbai.
Signs of heart complications
According to experts, some signs of heart conditions in toddlers include:
1. Baby blue syndrome
If the baby’s skin (especially the lips and tongue) turns blue, then it is an alarming sign. “It is observed on the lips, palate and tongue, not on the palms and soles,” says Dr Karande. It can be a sign of low oxygen level in the baby’s blood due to a congenital heart condition. Bluish discolouration can also be seen in older kids (three or four years old) along with unconsciousness, and they might also faint while running.
Dr Karande says if the child keeps crying despite being fed, it could be a sign of an underlying health complication, including heart conditions. She adds that if changing the diet does not bring any change in the child’s behaviour, then a doctor should be consulted at the earliest. Irritability could be a manifestation of other symptoms (of a heart condition) experienced by the child.
3. Rapid and abnormal breathing
Rapid breathing could be a symptom of heart conditions in babies and toddlers. “Continuous rapid breathing is seen in children who have a hole in their heart,” says Dr Suresh Joshi, director, cardiac surgery, Jaslok Hospital & Research Centre, Mumbai.
Dr Karande explains that rapid breathing should be observed over the stomach, since their chest will not move up and down like in an adult. Children use their nostrils and abdominal muscles to breathe harder. So, if the stomach is moving up and down faster than normal, and if the nostrils are flaring with each breath along with indrawing of the lower neck muscles, it could be a sign of a heart condition.
“If the child is tired, drowsy or falls asleep quickly and if it is difficult to wake them up even after three or four hours, it is a sign of a heart complication,” says Dr Karande.
Dr Joshi explains children often get tired and sweat while they are breastfed. The baby may stop to take a break as well.
Dr Karande adds that older kids (four or five years old) should be able to do whatever children their age normally do.
“Older children with heart conditions get tired easily and often have breathing difficulty on exertion,” says Dr Joshi. For instance, if the child is unable to run around and play or gets easily exhausted, it could be a sign of a heart condition.
5. Little or no weight gain
A heart condition could affect the baby’s ability to feed or gain weight normally. They may also have poor growth despite adequate nutrition. If the baby is not gaining as much weight as a neonate should despite feeding, it could be a sign of a heart condition. “The baby should gain 1 kg at the end of every month,” says Dr Karande.
“Parents should consult a pediatric heart specialist if they think their baby is experiencing any of these symptoms. A 2-D echo test should be done by a pediatric cardiologist,” says Dr Joshi.
Dr Karande adds that if a pediatrician hears a murmur (extra sound apart from the two heart sounds) while examining the baby, then the child has a cardiac issue.
Risk factors for heart conditions
Experts list the following risk factors that can cause heart complications in a baby:
- Structural defects: Dr Karande explains that the growth and development of a fetus’s heart can be affected if:
- The mother has a history of smoking or alcohol abuse.
- She has had fever with a rash (or any kind of febrile illness).
- She was on medication for seizures when the heart was being formed (during the second or third month).
- Advanced maternal and paternal age: If the mother or father is older in age, the baby could be at risk of developing a heart condition.
- Family history: If there is a family history of heart defects, it might lead to the baby developing a heart condition. In addition, diabetes in the mother or genetic and chromosomal abnormalities can also put the child at risk.
Dr Karande recommends mothers to get a fetal echo done between the fourth and sixth month of pregnancy. This is done to prepare the parents in case the baby has a congenital heart condition such as hypoplastic left heart syndrome, atrial septal defect and atrioventricular septal defect.