Congenital heart defect (CHDs) is the most common birth defect worldwide, affecting millions of babies each year. In India, the incidence of CHDs is 8-10 per 1,000. Many are detected during pregnancy or soon after birth, but some slip quietly under the radar. Early signs of CHDs are often mistaken for normal infant behaviour, feeding issues, or minor infections. International Congenital Heart Defect Awareness Day serves as a poignant reminder that awareness is a vital tool in saving lives. When parents know what to look for, they can seek timely care and dramatically improve outcomes.
A baby’s first year is full of rapid changes. Sleep patterns shift, feeding habits evolve, and growth spurts come and go. Hence, early symptoms of heart defects can often be overlooked. Some babies with CHDs appear completely healthy at birth because their bodies temporarily compensate. Others show signs that mimic common childhood concerns such as poor feeding, slow weight gain, or frequent colds.
Subtle signs parents often overlook
Difficulty feeding or taking too long to feed: Feeding is a baby’s first “exercise.” A healthy infant usually feeds steadily and gains weight. Babies with CHDs may:
Tire quickly during feeds
Sweat on the forehead while feeding
Take more than 30 minutes to finish a bottle or breastfeed
Struggle to coordinate sucking and breathing
Persistent difficulty deserves attention.
Poor weight gain
If a baby is feeding well but not gaining weight as expected, the heart may be working harder than it should. Because CHDs increase the body’s energy demands, calories are burnt faster. Slow or stagnant weight gain, despite adequate feeding, is a red flag worth discussing with a pediatrician.
Rapid breathing or shortness of breath
Fast breathing even at rest
Visible effort while breathing
Flaring nostrils
Chest retractions (skin pulling in between ribs)
These can be mistaken for a respiratory infection, but if they persist or occur without fever or cold, they may point to a heart issue.
Excessive sweating
Unusual sweating, particularly during feeding or minimal activity, can signal that the heart is under strain.
Bluish skin or lips (Cyanosis): A bluish tint around the lips, tongue, or fingernails can indicate low oxygen levels. Sometimes it appears only during crying or feeding, but it should never be ignored.
Repeated chest infections: Frequent pneumonia or persistent cough may be linked to increased blood flow to the lungs, a feature of certain CHDs. If infections keep returning despite treatment, visit a doctor.
Unusual fatigue or low activity: Every baby has a unique temperament, but extreme sleepiness, low activity, or lack of interest in play can be early signs of reduced oxygen supply.
Parents can help doctors notice patterns in the child’s activities. Speaking up early can make a world of difference. If you observe any combination of the signs above, especially if they persist, it’s wise to consult your pediatric cardiologist. A minimal examination or a non-invasive test like an echocardiogram can provide clarity.
Many congenital heart defects are treatable. Advances in pediatric cardiology mean that children with CHDs can grow up to lead full, active lives. Early detection allows for timely interventions, better growth, and fewer complications. Awareness is not about creating fear; it’s about empowering families. When parents know what to look for, they become strong advocates for their child’s health.
By Dr Koushik Kannan, consultant cardiothoracic surgeon, Prashanth Hospitals, Chennai