The first days — between joy and worry
Your baby has arrived. For every parent, it's a miracle. But sometimes in the first hours or days after birth, doctors notice something that needs attention: a problem with the heart.
Hearing this is devastating. But here is what matters: modern medicine detects heart defects in newborns early — and in the vast majority of cases, treats them successfully.
In this article, let's go through what to look for — which signs are normal, and which ones need attention.
How common are heart defects in newborns?
Worldwide, about 1 in every 100 babies is born with a congenital heart defect. It is not rare.
Some defects are detected before birth on prenatal ultrasound. Others are found after — at the first examination, through the baby's behaviour, or by skin colour.
Early detection saves lives. That's why every parent should know these signs.
Normal signs — no need to panic
Let's start with what's normal — because many parents confuse normal newborn signs with something serious.
In the first 24–48 hours, it is normal to see:
— Bluish hands and feet (acrocyanosis) — peripheral circulation is still establishing itself;
— Rapid breathing — adapting to a new environment;
— Occasional trembling — temperature regulation.
If these signs pass within the first day or two — there is no need to worry. If they persist — contact your doctor.
Signs that need immediate attention
The following signs can indicate a congenital heart defect. If you notice any of these, contact a doctor immediately:
Cyanosis (bluish colour): bluish lips, tongue, or nail beds — especially during feeding or crying. Unlike blue hands and feet, blue lips and tongue are a serious sign.
Rapid breathing: more than 60 breaths per minute, visible pulling in between the ribs when breathing, flaring of the nostrils.
Tiring quickly during feeding: the baby cannot feed for more than 5–10 minutes, sweats heavily during feeds, takes frequent breaks.
Poor weight gain: the baby is feeding but not gaining the expected weight.
Lethargy and passivity: excessive sleepiness, difficulty waking, a weak cry.
Swelling: puffiness of the abdomen, face or limbs — may be a sign of heart failure.
Pulse oximetry — the newborn screening test
In modern maternity units, every newborn receives a pulse oximetry screening. A small sensor placed on a finger or foot measures the oxygen level in the blood.
If oxygen is below 95% — this may indicate a heart problem and requires further investigation.
The test is painless, without radiation, and takes just a few minutes. But not all defects are caught this way — which is why clinical observation remains essential.
Echocardiogram — the key investigation in infancy
At the slightest suspicion — whether clinical signs or a screening result — an echocardiogram (echo) is arranged immediately.
In newborns, echo is completely safe: no radiation, no pain. It can even be done while the baby sleeps.
The echo shows the heart's structure precisely — the type of defect, its size, its severity. This information is the foundation of the treatment plan.
The echo result must be reviewed together with a paediatric cardiac surgeon — who determines the type and timing of treatment.
When does treatment begin?
This depends on the type and severity of the defect.
Some defects require emergency intervention — within the first hours or days of life. These are so-called 'critical' congenital heart defects: TGA, hypoplastic left heart syndrome, severe pulmonary stenosis.
Others can wait a few weeks or months — large VSD, moderate ASD. During this time, the baby is monitored closely and weight gain is tracked.
Others need only observation — small VSDs, small ASDs. These often close on their own over time.
Timely intervention — even in infancy — gives children a completely healthy future. Outcomes of modern cardiac surgery in babies are excellent.
What should parents do?
If your baby shows any of the signs above — stay calm, but don't wait. Contact a doctor immediately.
If the doctor recommends an echo — make sure it happens. This test gives answers.
If a defect is found — arrange a consultation with a paediatric cardiac surgeon. A diagnosis is not a sentence. It is the beginning of treatment.
If you have questions or worries — reach out. Together we'll make the best decision for your baby's heart.