Heart Health Questions for Your Baby at UPMC Magee-Womens in Central Pa.

Prenatal checkups can be both exciting and overwhelming, with so many questions to ask and so much information to understand. At some point, prenatal checkups may also seem routine and uneventful. As your baby develops in utero, you may assume no news is good news if your obstetrician does not find reason for concern. If nothing alarming presents during a check-up, everything should be on track, right? Not necessarily!

We encourage expectant moms to ask about their baby's heart health whenever an ultrasound is performed, typically between 18 to 22 weeks.

The reason? At least half of all babies born with a heart condition are not diagnosed during pregnancy. Congenital heart disease is one of the most common birth defects. According to the Centers for Disease Control and Prevention, birth defects affect one in every 33 children born in the United States each year. The good news is that early detection could mean earlier treatment for such babies.

What type of heart defects can babies have?

There are many types of congenital heart defects. Some are not life-threatening and can even resolve on their own such as holes in the heart. Common defects usually affect the heart muscles, separating the chambers or the heart valves. There are, however, rare and serious defects. These include conditions where the heart's main pumping chamber is missing, or where the heart is twisted along with abnormal arrangement of liver, spleen and stomach.

Pennsylvania law requires all newborns to undergo a non-invasive, painless test called pulse oximetry. This checks newborns for critical heart defects before they leave the hospital. A special clip is placed on the hand and foot to measure oxygen levels. Specifically it checks how much hemoglobin in the bloodstream is oxygen attached and determines the saturation level. (Normally, more than 95 percent of the hemoglobin in the body has oxygen attached to it.)

Not all heart conditions reveal themselves immediately at birth, but they do exist. This can make the baby critically ill over the first week or so of life. These types of screenings can help you and your baby’s doctor get ahead of the majority of heart problems.

We can't say for certain what causes heart defects in babies. Some research has indicated that they are a result of damaged chromosomes or genes that prevents a baby's heart from developing normally. Studies also have shown that there may be an association between a mother's diet before and during her pregnancy. Women who consume fish, nuts, fruit and vegetables, as well as who take supplements such as folic acid to reduce other birth defects, have a lower risk of their baby being born with at least some specific types of heart defects.

I recommend a healthy diet in preparation of pregnancy. This is also good advice for during and after pregnancy since the benefits for you and your baby numerous. It can make a difference in everything from energy levels, moods and weight control, to brain and body system development. Eating well is one more factor that empowers moms and helps their growing babies in utero and in life.

Questions to Ask at Your Ultrasound Appointment during Pregnancy

As you prepare for your ob-gyn visits or your next ultrasound, be sure to ask your doctor the following questions. Then you'll be prepared for any obstacles your baby may be facing.

• Do you see four chambers of my baby's heart?
• Are there two valves adequately formed controlling flow from the upper chambers to the lower chambers?
• Are there two main blood vessels exiting the heart in a crossing fashion?
• Is the heart on the correct side of the body?
• Is the heart the correct size?
• Are both sides of the heart approximately equal in size?

If there are any doubts about heart anatomy or if there is a high-risk condition in the mother, your OB physician may refer you get a specialized scan of baby's heart during pregnancy. This is called a fetal echocardiogram.If everything appears normal during your pregnancy, but after birth, your baby is experiencing any of the following symptoms, talk to your doctor about your baby's heart health. Your doctor may refer you to a pediatric cardiologist or other specialist.

3 Signs of Heart Defects

1. Heart murmur

During your child's well-visits, a pediatrician uses a stethoscope to listen to your baby's heart. He or she checks for beats per minute, strength of the heart and often hears a whoosh sound, indicating normal blood flow. However, if the pediatrician hears an abnormal pitch or intensity in the sounds a heart defect may be suspected. An ultrasound test of the heart, called echocardiogram, can confirm this.

2. Problems with feeding or growth

Part of the reason for your child's well-visits is to make sure he or she is growing appropriately. When a defect occurs, it places a lot of strain on the heart. This can, cause the heart to beat much faster or harder than normal in order to pump enough blood around a baby's body. If that happens, babies need a lot of calories just to keep the heart pumping. Think about a car needing gas to run. If it is always running, you need more gas to keep it going. If your child is not gaining weight, but eating often and a lot, this may signal a heart problem. Your pediatrician will determine if it is metabolic or cardiovascular in nature.

3. Breathing, choking and coughing trouble

Shortness of breath or your child's skin color turning blue indicates he or she is lacking oxygen. In this event, they should be immediately seen in the emergency room. Many infants have congestion and coughs. There are times, however, when a serious heart defect is responsible for a child's breathing difficulties. If your child appears winded or struggles to breathe, tell your pediatrician. They will make sure your baby's lungs and heart are functioning properly.

Lastly, all babies are known to spit up or gag at times. If this is more the norm rather than the exception, your pediatrician will need to check for acid reflux, allergies and other problems which may include a heart defect. There are instances where blood vessels from the heart become tangled and wrap themselves around the breathing tube (trachea) or feeding tube (esophagus) thereby squeezing and constricting those areas, causing breathing or feeding trouble.

In the end, it is important to remember that most babies have a perfectly normal heart. But armed with the right knowledge, you can help prepare for your newborn before and after birth.

For more information about how to prepare for your baby's birth and overall health, talk to your ob-gyn or visit our website for additional resources and support for expecting and new moms.