A foam red heart and a stethoscope against a wooden background.
1 out of every 100 babies is born with a heart defect, such as congenital heart disease.

Congenital Heart Disease in Babies

According to the Centers for Disease Control and Prevention (CDC), there are 2 million adults and children in the U.S. who have congenital heart disease (CHD), also known as a congenital heart defect. About 1 out of every 100 babies is born with a heart defect. One quarter of those babies born with a heart defect have a critical case. Fortunately, however, over the past three decades, treatments for CHD have significantly improved. Although some children with CHD may require multiple surgeries and procedures; almost all children born with heart defects grow into adulthood.

What Is CHD?

According to the American Pregnancy Association, a fetus’s heart begins to form very early in the pregnancy, at about 28 days after conception. It’s during this critical period that the defects in the baby’s heart’s structure can occur.

The heart muscle is responsible for pumping blood throughout the body. The heart has four sections called chambers, with two chambers on both sides of the heart. Each chamber has a valve opening that directs blood flow through one way only.

Through this arrangement, the right side of the heart pumps blood to the lungs to obtain oxygen. The oxygen-rich blood flows from the lungs to the left side of the heart. Then, it is pushed by the heart out to the rest of the body. The body then uses up the oxygen, and oxygen-poor blood returns to the right side of the heart that is then pumped into the lungs for more oxygen.

Because the heart works through a complicated system of pipes, chambers, valves and ducts, a small abnormality or defect can disrupt the flow of blood. It can also cause changes in the direction and speed of blood flow. Any defect that occurs during pregnancy within the heart of the fetus is called congenital heart disease or defects (CHD). CHD is an umbrella term that includes numerous heart defects like atrial septal defect (ASD), Tetralogy of Fallot and aortic valve stenosis.

Causes and Risk Factors for Congenital Heart Disease in Babies

Most of the time, the cause of CHD is not known. However, there are some identified causes and risk factors, most pertaining to the mother, that can play a part in CHD.

Chronic Illnesses

Some chronic illnesses like diabetes in the mother may cause nutritional deficiencies that impact fetal development, causing CHD.

Viral Infections

According to the CDC, women should avoid becoming pregnant for one month after receiving the measles-mumps-rubella (MMR) vaccine. This warning is because women who become infected with rubella during the first trimester have an increased risk of having a baby with CHD.

Alcohol

Babies with fetal alcohol syndrome (FAS) often have heart abnormalities. Abstaining from alcohol during pregnancy is highly recommended due to a probability of issues like CHD.

Medication

Some medications taken by the mother can increase the risk of CHD. Blood pressure medications and drugs used to treat high cholesterol in the mother may cause CHD in babies. Medications also used for mood disorders (lithium) and some anti-seizure medications are examples of the types of drugs that women who are planning to get pregnant should be aware of. An expectant mother needs to consult with her obstetrician regarding her medications.

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Illegal Drug Use

Cocaine use during pregnancy by the mother, especially during the first month, can increase the risk of CHD in babies.

Genetic Factors

Genetics may play a large part in the formation of CHD in babies. Siblings of babies with CHD tend to have higher rates of heart defects. Children with Down syndrome are also prone to CHD.

What Are the Signs and Symptoms?

Detection of CHD is possible through the use of fetal echocardiography. Sound waves create an image of a baby's heart. The image can then be evaluated for any abnormalities. Early detection of CHD enables clinicians to prepare for any interventions, both within the womb or after birth.

Sometimes, CHD cannot be detected until a baby is born. Within the first months after birth, a baby with CHD may have the following signs and symptoms:

  • “Blue baby" look, which is a bluish tint to skin, mouth and nails
  • Shortness of breath
  • Fatigue and sleeping often
  • Difficult to wake up
  • Breathing quickly
  • Murmur in the heart
  • Poor feeding
  • Unable to gain weight

What Are the Treatment Options for Babies With Congenital Heart Disease?

With modern healthcare, most cases of CHD can now be corrected or improved with surgery, medication and medical devices. These medical devices include artificial valves and pacemakers for babies and children, enabling them to survive into adulthood. Many of these clinical interventions occur before the child becomes 2 years old.

The Future for Children With CHD

For a majority of CHD cases, children will not have any long-term effects from the defect or treatments. Most babies with CHD will grow and be able to participate in the joyful and fun activities that childhood brings.

Nevertheless, CHD can be challenging for parents to go through. For encouraging stories of infants and children who survived CHD, and for support systems, you can visit the CDC website.