Heart murmurs in the newborn

Information for parents Neonatology

PROUD TO MAKE A DIFFERENCE SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST What is a ? The word murmur describes a swishing sound made as the blood flows through any of the heart's chambers or valves. It makes a sound like water rushing through a pipe. The murmur is an extra sound, in addition to the normal , which is heard when the doctor or nurse listens to the heart with a .

What causes murmurs in new born babies?

It is common for newborn babies to have heart murmurs in the first few days of life.

When babies are in the womb they have extra connections in the heart to enable them to get oxygen from the placenta (afterbirth). At birth the baby starts to breathe through their lungs, causing these extra connections to close. In some babies they close immediately. In other babies it can take days or weeks for these connections to close. If these connections are not completely closed blood is allowed to pass through the closing connections which results in an additional sound. Occasionally a heart murmur can be a sign of a problem within the heart. Common problems are narrowing of the valves in the heart or leaky heart valves. Also there can be narrowed blood vessels within the heart or holes in between the chambers of the heart.

If my baby has a heart murmur does that mean they have a heart problem? Not always. Most murmurs are due to the connections closing which were described earlier. But the most common murmur is called a “functional murmur” which is produced by a normal healthy heart. Typically they can come and go throughout childhood and they usually pose no health threat and as the child grows they disappear.

page 2 of 4 How will you decide if the murmur is more serious? Your baby will be examined daily by the doctor or nurse. They will also listen to your baby’s heart again with a stethoscope. They may ask you if your baby has been feeding well; whether they get tired or breathless whilst feeding. They will ask if you, your partner or other children (siblings) may have suffered with early childhood heart problems. If the murmur has disappeared, no further treatment is required. If the murmur persists an echocardiogram (scan of the heart) will be performed. This enables the medical staff to see the heart’s chambers, flow of blood, and vessels and valves and determine how well the heart is working. Does my baby need to come back to hospital to have the murmur reviewed? Yes. Your baby will be seen again if a cause was found on the echocardiogram. This will usually be up to 10 weeks after discharge. If a cause was not found on echocardiogram, we will inform your GP to reassess your baby at the routine 6 week newborn check. How do I know if my baby has a problem with his/her heart? Some of the signs to look for, which may indicate your baby has a heart problem, are given below: • becoming less active • more tired and disinterested in feeds • feeding poorly and becoming tired quickly during feeding • fast and his/her spaces between the ribs seem to be sucking inwards (often becoming worse during feeding)

page 3 of 4 • widening his/her nostrils to take a breath inwards • appears to be sweaty, pale or blue colour and has cold clammy skin. If you are at all concerned about your baby when you return home please contact your GP.

Please note: • Religious circumcision is not advised until your heart specialist says it is safe to do so. • If your child is admitted to hospital, always inform the doctor that your child is being monitored for a heart murmur, as some procedures require that the patient receives antibiotics prior to it being performed.

Further information can be found at: • Babycentre medical advisory board www.babycentre.co.uk/baby/health/heartmurmurs • Children's Heart Federation www.chfed.org.uk/how-we-help/information-service/heart-condi tions/ • British Heart Foundation help line 0300 330 3311 (charged at local rate) • Heartline 0330 022 4466 (charged at local rate) www.heartline.org.uk

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PD8878-PIL3779 v2 Issue Date: June 2021. Review Date: June 2024