Introduction
Congratulations on the birth of your newborn.
Many parents are understandably worried and upset when they are told their newborn baby has a heart murmur. We hope this leaflet will help address some of your concerns.
What is a “heart murmur”?
All babies have their heart examined as part of the newborn examination. When a doctor, midwife or advanced nurse practitioner listens to your baby’s heart, they might tell you they can hear “a murmur”. This is an added sound that can be heard between your baby’s heart beats. Heart murmurs are common in the newborn period.
What causes a heart murmur?
The structure of a baby’s heart and vessels in the womb will change after birth. These changes can take place over the first days to weeks of life. While things are changing the sounds of the heart may also change, including murmurs starting or disappearing. There are a number of possible causes for a heart murmur, including:
- Fast blood flow in the heart – this is normal in newborns
- Blood flowing through a small hole in the heart
- A narrowed valve or blood vessel or a leaky heart valve
Should I be worried about a heart murmur?
In most cases a heart murmur can be normal in newborn babies, in which case it won’t cause any problems and the murmur will likely disappear in time. If the murmur doesn’t go away or your baby displays any symptoms linked to their heart, this will need to be investigated by a specialist cardiologist to work out whether any treatment is needed. Only a small number of murmurs can sometimes be a sign that there is a problem with the heart.
What happens next once a murmur has been identified?
If the health professional who examined your baby feels that your baby requires immediate attention, they will need to remain in hospital. They may either stay with you on the maternity ward or be transferred to the Neonatal Unit. The reasons for this and a plan of care will be explained to you.
If your baby is otherwise well, they will be discharged home with you but will be seen in the paediatric outpatient clinic within a few weeks. If at the outpatient appointment the murmur is no longer heard, they will be discharged back to your general practitioner (GP).
If a murmur is still present we will arrange for your baby to have a heart ultrasound scan called an echocardiogram. You will be given an appointment for this to come back on a different day. If they need a cardiology review following on from this, then this could be in either Leeds or local hospital depending on the advice of the cardiologist.
What is an echocardiogram?
An echocardiogram is a similar sort of ultrasound scan to those used during pregnancy. It is painless and looks at the structures of the heart and how well it is functioning. It will be able to identify what is causing the heart murmur and whether any treatment or procedures are needed.
When I go home, should I watch out for anything?
Most babies discharged home with a murmur will remain well. However, we ask that you pay particular attention to the following:
You should get your baby reviewed urgently by a health professional if you notice any of the following symptoms:
- Poor feeding compared to normal and poor weight gain
- Becoming breathless whilst feeding
- Becoming less active
- Sucking in their ribs or flaring their nostrils while breathing
- Becoming sweaty, pale, mottled skin or blue colour of hands, feet and lips.
- Also, tell them you have been given this leaflet
These symptoms don’t necessarily mean your baby has a heart problem but you should still get your baby assessed urgently.
What treatment procedures might my baby need?
In many cases your baby will not need any treatment at all. Any treatment or further monitoring that your baby might need will be fully explained to you by a cardiologist and you will have the chance to ask questions before you decide how to go forward. Treatments for heart murmurs vary according to the cause.
If you have further questions or you are worried
Before discharge from hospital, if you have any concerns please do not hesitate to speak to a doctor or a nurse or midwife.
After discharge home, if you are concerned that something is not right speak to your GP, midwife or contact NHS 111
Adapted from the Neonatal leaflet written by Dr E A Gouta, Dr A Westripp in May 2021