1) What is the right age to get heart related tests in kids?
Not all kids need routine heart related tests. Kids should have regular health check-ups with their pediatrician, and if the pediatrician suspects a heart disease in the child, they are then referred to a Pediatric Cardiologist. The Pediatric Cardiologist will then assess the child in detail and do an echocardiogram to diagnose the heart defect and start the treatment.
The commonest heart defects in children are congenital heart defects, which the child is born with. Major congenital heart defects can be detected by fetal echocardiography during the pregnancy itself. After the baby’s birth, critical heart defects can be diagnosed and treated within a few hours of birth.
2) What are some tell-tale signs that a child’s heart health needs attention?
Symptoms and signs such as babies not feeding well, getting tired while feeding, having poor weight gain and excessive sweating are suggestive of congenital heart disease. Some babies and infants will have bluish discolouration of their lips, tongue and nails while crying. Older children may present with recurrent pneumonias, getting tired and having increased breathlessness on exertion.
3) Do you often see kids reporting heart issues?
As I am a pediatric cardiologist, I regularly see kids with heart conditions. However, in the general population, only around 8-10 babies out of 1000 live births are born with heart disease. So around 1% of all children have congenital heart disease. A small percentage of children have acquired heart conditions such as Kawasaki disease and Rheumatic Heart Disease, and in the last couple of years, post covid MIS-C which affects the heart.
4) What are the biggest mistakes or health mistakes that make kids prone to heart issues?
Congenital heart defects are developmental anomalies, and are usually not due to any health issues or mistakes during pregnancy. Heart disease in kids is not lifestyle related, unlike in adults. Hence, kids do not develop the heart disease due to any mistake of theirs or their parents. However, once the heart disease has been diagnosed, timely intervention is essential for good outcomes. And for this the patients need to consult a pediatric cardiac specialist and follow the treatment advice given.
Unfortunately, even today, we see children who have been diagnosed to have a hole in the heart in infancy and advised early surgery, and the parents have not brought the child for surgery because of their beliefs that the heart disease will resolve on its own or that the child is too young for cardiac surgery. And with this delay, the child develops late complications such as pulmonary hypertension and may even become inoperable.
5) What is the amount of exercise kids should do daily? Is there any age wise breakdown? Toddlers, pre-teens, teens etc
Kids should be encouraged to play outdoor sports and games, and their screen time and TV viewing time should be limited. There is no minimum or maximum hours or amount of exercise that is recommended, but 1-2 hours of daily outdoor activity is helpful in inculcating and encouraging a healthy lifestyle from early in life. Of course, the exercise and outdoor activity will need to be balanced with school work and studies as the child grows.
Children with heart disease may have restrictions on how much they can and should exert themselves, and this needs to be discussed with their pediatric cardiac specialist.
6) What is a heart healthy diet? Are there any foods that children should eat daily (or often)?
A heart healthy diet is the one that equips an individual to fight heart disease. It recommends that a child’s diet has food diversity with foods from a variety of food groups, including fruits, vegetables, whole grains, low-fat dairy, lean protein, nuts, legumes and vegetable-based oils. Such a diet helps to maintain healthy weight and stable metabolism while providing all the nutrients to meet a child’s daily requirement as per the RDA (recommended dietary allowance). Foods that are high in calories but low in nutrients, like cakes, doughnuts and sugary beverages, foods with saturated fat, trans fat and a large amount of sodium should be consumed in moderation or avoided.
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A child with congenital heart disease has high metabolism that causes faster burning of calories and therefore they need to be fed foods with high calories. Frequent feeds of calorie and nutrient dense meals helps to meet this increased requirement. High protein foods like milk or dairy, meat, pulses, sprouts and nuts should be included. For older kids it is best to avoid salty, fried, sweet and junk foods.
Omega 3 fatty acid containing foods have a protective effect so foods like fish, flaxseed and flaxseed oil, Walnuts, Canola, Soybeans and soybean oil, Chia seeds Green leafy vegetables should be included in the diet regularly.
Dr. Supratim Sen – Sr. Consultant (Paediatric Cardiology)
Ms. Roshan Kore – Sr. Dietitian and Nutritionist