February is a month where paper hearts abound, but making sure our children’s actual hearts are strong and healthy is a year-round responsibility that begins during pregnancy. Congenital heart disease is the most common birth defect, and your child’s risk is connected to your family’s health history. According to Paul Kantor, chief of the Division of Cardiology and co-director of the Heart Institute at Children’s Hospital Los Angeles, children born to parents with a congenital heart defect or who have a sibling with a congenital heart defect are at greater risk of having one themselves. In the U.S., 60 to 80 of every thousand children born have a congenital heart defect. About 10 to 20 per thousand are born with one serious enough to be life threatening.
Prenatal ultrasound is vital to early detection. “Every woman should have a prenatal ultrasound where some basic screening views of the heart are done,” Kantor says. Unfortunately, not all ultrasound technicians are equally skilled, and detection rates for heart anomalies can vary from over 80% to as low as 30%. Kantor advises parents to make sure their OB-GYN has a good relationship with their ultrasound provider, “and that the results are carefully scrutinized by a radiologist or an obstetrician gynecologist who is familiar with the appearance of any abnormality which could indicate a possible congenital heart defect.”
Once your child is born, ask your healthcare provider about pulse oximetry screening, a noninvasive test where a device is placed on the finger or toe to measure oxygen levels in the blood. It isn’t available everywhere, but it is a useful tool in detecting congenital heart defects.
About 80% of congenital heart defects are identified within the first three months of life, and parents have a role to play. If your baby seems pale or has a dusky color, is lethargic or unresponsive, or has trouble breathing or feeding, seek medical attention right away. “Those are some of the earliest signs that there is a problem with blood flow to the lungs or the body, which is often associated with a congenital heart abnormality,” says Kantor.
You should also, of course, make sure your child has regular medical checkups. “The parents, however, are the best people to look for signs of undetected abnormalities in their children by monitoring their activity levels at home and during school sports and other activities,” Kantor says. If you notice that your child becomes breathless with mild effort, complains that their heart is racing or faints during or immediately after exercise, have them evaluated.
“These are very, very important warning signs that there could be an underlying heart problem.” This is especially important for high school athletes or others participating in competitive sports.
Parents can also protect their children’s hearts by leading heart-healthy lifestyles themselves. “Heart health for children begins with the example of their parents,” says Kantor. This means not smoking, building healthy eating habits and healthy levels of physical activity – which tends to decline as kids reach adolescence. “We need to get to children when they are younger by emphasizing how important it is that they not spend most of their time using a device inside on a couch,” Kantor says. Keeping kids’ weight healthy and keeping them active is the best way to prevent coronary artery disease, which Kantor says is starting to show up at younger and younger ages. “We now encounter, not infrequently, adults in their 30s who have had their first heart attack,” he says.
Parents – and even kids as young as 12 – can also learn to save a life by learning hands-only CPR. A CPR-training kiosk installed in the lobby at Children’s Hospital Los Angeles in February 2018 has already been used as many as 10,000 times. The kiosk features a touch screen that shows a how-to video for the procedure, which involves chest compressions but not rescue breathing. It also includes a rubber practice torso where users can practice in real time and receive feedback about how effective they are. “It would be wonderful to have younger teenagers learn how to do this,” Kantor says.
With prenatal and infant screening, careful observation, healthy habits and CPR training, your family can build healthy hearts that share love for a lifetime.