Though every parent dreams of a healthy and happy baby, some babies may have a problem with their heart's structure or the way it works due to a congenital heart defect (CHD). 

Congenital simply means 'present since birth' and CHDs are quite common, representing nearly 30 per cent of all birth defects. In India, it's estimated that nearly 2,40,000 babies, every year, are born with CHD and 10 per cent of infant deaths are attributed to the condition.

This Congenital Heartcare Awareness week, February 7-14, in order to spread awareness and expand upon the origin of these defects, Dr Krishna Kumar, Clinical Professor and Head of the Department of Paediatric Cardiology at the Amrita Institute of Medical Sciences and Research Centre, Kochi said, "The development of the heart is an extremely complex and precise process. It is completed within a few months of pregnancy. Anything that goes wrong with the development can result in the formation of a heart defect."

"An issue occurring early in the developmental process can lead to more serious defects whereas a problem happening slightly later may translate into a less complex CHD and can be fixed more easily," he added. Your baby's heart is divided into four chambers--the upper smaller ones called atria and the lower larger ones called ventricles. The two atria are separated by a thin wall called the atrial septum whereas the ventricles are similarly divided by the ventricular septum.

The flow of blood within the heart is controlled by four gates or valves. Foetal ultrasound at 18-20 weeks of pregnancy can help in the detection of CHD in an unborn child. There are several types of CHDs, depending upon the location of the defect (septa, valves, connecting blood vessels or a combination of these).

Heart Centre, Tirupati, elaborated on this, saying, "CHDs which occur within the structure of the heart include ventricular or atrial septal defects(hole in the atrial/ventricular septum) and patent ductus arteriosus or PDA (an abnormal connection between the two major blood vessels arising from the heart, aorta and pulmonary artery).

On the other hand, cyanotic CHDs (blue babies) are due to less blood flow to the lung and the commonest example of these is the transposition of great arteries where the major arteries arising from the heart are switched." The greater the CHD severity, the more visible are the symptoms. As a parent, the signs and symptoms in your newborn baby that you need to be alert about include recurring respiratory tract infections such as pneumonia, difficulty in feeding and absence of required weight gain.

Dr Nitin Rao, Chief paediatric Cardiologist, Star Hospital, Hyderabad, clarified, "Ideally, babies should gain 1 kg/month for the first few months followed by 0.5 kg monthly for the next few months. Inadequate weight gain, sweating while feeding and a 'suck rest suck cycle' of feeding where the baby tires easily, stops feeding, feel hungry and starts feeding again are a few pointers towards the presence of CHD."

Dr Krishna Kumar agreed and added, "Some parents notice that their baby is breathing with difficulty. Less commonly, a few may observe the blueness of the baby's fingertips, lips or tongue.

The baby may also turn noticeably blue when under stress, for example, while crying. However, in the case of less serious CHDs, symptoms may appear later in childhood where the child may have breathing difficulty or may be unable to play with other children or complain of rapid heartbeats. The parents need to be vigilant to such changes in their child."

Paediatric cardiac care has undergone enormous changes over the last few decades with the application of screening techniques coupled with advances in imaging, paediatric surgery and intensive care. Dr Krishna Kumar explained, "Simple screening measures such as pulse oximetry, which detects the level of oxygen in the baby's blood, along with a specific physical exam helps in the detection of CHDs in newborns. In the case of babies who need specific intervention, a team of skilled doctors from multiple specialities like cardiac surgery, intensive care and radiology work together to deliver the best possible care."

Dr Nitin Rao concurred, "The use of echocardiography, CT/MRI, improvement in surgical techniques, availability of state-of-the-art equipment and minimally invasive procedures have made the detection and treatment of CHD less complex. Surgical techniques and equipment have improved tremendously making operations in tiny babies possible, saving their lives. Minimally invasive procedures available today can help avoid surgery."

He continued, "Additionally, the recovery is faster and the child is home in 2-3 days. For PDA in premature babies, a small button-like device is now available which is inserted through a tiny incision in the baby's leg to seal the hole." Dr Srinath Reddy concluded, "The technological advances in India have brought us on par with the Western world and have drastically improved patient outcomes in babies with CHD."

On this reassuring note, improved screening and technologically advanced treatment methods for CHDs in our country have made the dream of an active and healthy baby an achievable one for most parents of such children.