Caring for Your Child After Heart Surgery"©, Copyright 2000 NewYork-Presbyterian Hospital

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Table of Contents

Activities

Congratulations! You are ready to take your child home. Here are some guidelines for your child’s activity at home. Children recover in their own time. For the first two to three days at home your child may want to nap several times a day. Encourage a slow increase in exercise. Going outside is helpful for you and your child.

The breastbone (sternum) needs time to heal during the first 6 weeks after surgery. Your child should not be involved in rough play or activities such as bicycling, climbing, skateboarding, or contact sports. Avoid activities which would put pressure on the child’s chest or cause a blow to the chest.

Make sure your child always wears a seat belt, or is placed correctly into a car seat. Protect the incision by making sure it is covered by the child’s clothing or a cloth diaper.

For the first two weeks, when you pick up your child, hold your child under the buttocks, while supporting the back. Avoid pulling up or picking your child up under the arms.

Avoid crowds

Children are welcome to have family and friends over to see them after surgery. But avoid using day care, sending your child to school, or going to crowded places such as malls and churches for the first two to three weeks after surgery.

Some children have trouble sleeping for 1 to 2 weeks after surgery. Your child may also want to cling to you more than usual. Being positive and calm with your child will help to get your child back to usual behavior.

Handwashing

It is very important for everyone to wash their hands before caring for your child. This will prevent your child from picking up germs from others.

Your child should wear loose, soft clothing. Girls should wear a soft bra (without underwires) to help support incisions.

Most children who are pink before surgery will not have blueness of the skin, lips, or tongue after surgery. Most children who are blue before surgery may be blue after surgery. This depends on their heart defect and the surgery that was performed. The blue skin color may increase during feeding, playing, or crying.

Your child may continue to have mild pain after going home. Acetaminophen (Tylenol®) or Ibuprofen (Motrin®) can be given for discomfort, unless your doctor tells you otherwise. Call your doctor if the pain becomes worse or if the medicine does not help.

It may be several days after you go home before normal bowel habits return.

Call your nurse or doctor if you have any questions about this.

When to call your doctor

Call your doctor for any of the following:

• Temperature above 101 F, or above 38.3 C
• Increased sweating
• Vomiting
• Puffy eyelids
• Grunting, noisy breathing
• Rattling in the chest that’s felt when placing your hand on your child’s chest
• Difficulty waking your child
• Child doesn’t "act right"
• Increased tiredness
• Poor appetite
• Not wetting diapers
• New cough
• Change in incision: color of drainage, redness, swelling
• Incision opens
• Increased pain

Most children can continue their usual immunizations about 2 months after surgery. Talk to your child’s pediatrician about this.

Routine dental care should be delayed 4-5 months after surgery whenever possible.

Diet and Nutrition

Most children who have had heart surgery may return to their normal diet with no changes when they go home. In general, a low salt, lower fat, balanced diet is best for everyone.

Some children with cardiac problems get tired easily. Some children need more calories and/or smaller more frequent feedings. They may take longer to eat. For those infants, let them rest for short periods during the feeding time.

Usually, infants can be fed within one half hour. Burp your infant often (every one to two ounces with formula feedings, or every five minutes if breast feeding). Follow the directions given to you by your infant’s physician.

These play ideas can help your child at home. Play can help to reduce anger and fear. Here are some examples of helpful play items or activities for your child.

The infant and toddler may play with rattles, music and musical toys, pacifier, blanket, mobiles, bubbles, videos, and books. A soft touch is also helpful.

It can be helpful for the pre-schooler to play with coloring books, Colorforms®, puzzles, playdough, legos, and glue projects with magazine pictures and construction paper.

School age children can from read books, listen to books on tape, music, videos, using handheld video games, puzzles, board games, magazines, playdough, legos, puppet play, paper and markers, card games, and beading.

Preventing heart infection

Some children with cardiac problems need to take antibiotics for dental work, surgery, or when they have a large cut. This is done to prevent an infection in your child’s heart. Tell your dentist and doctor that your child has had heart surgery. Antibiotics to may be needed to prevent a heart infection. It is very important to talk about this with your cardiologist.

You will need to make appointments with the cardiologist, the cardiac surgeon, and your pediatrician as needed.

• Cardiologist: Newborns will need an appointment one week after discharge. All other children will be told when to see the cardiologist.
• Cardiac surgeon: You will be given information about when to make the appointment with the surgeon.
• Pediatrician: Call your pediatrician and ask when the doctor would like to see your child.

You can obtain a bracelet or necklace with information about your child’s health printed on it. Call toll-free:1-888-633-4298, or contact Medic-Alert on line at www.medicalert.org

You can get a note for your child’s school from your doctor’s office or from the cardiothoracic nurse. The note will explain what kind of activity limits your child may have, as well as whether any medicine needs to be taken during school hours.