What to Expect after the Child's Heart Surgery
Helpful Tips for Parents
o Rest when child is resting
o Accept help with other sibling’s activities
o Accept help with cleaning and meals from family and friends
o Limit social commitments for a while
During routine cleaning of the teeth or certain surgical procedures, there is a chance that bacteria (germs) may enter the bloodstream, travel through the body, and cause an infection of the heart. This infection is called Subacute Bacterial Endocarditis (SBE). SBE is a serious illness, but the potential risk can be reduced if these simple rules are followed once your child begins
routine dental visits:
• See that your child’s teeth are kept in the best possible condition by daily brushing/flossing and regular check-ups with your dentist.
• Inform your child’s dentist and any doctors involved with your child’s health care that your child had a heart problem and surgery to repair it.
• The dentist or doctor will prescribe the appropriate antibiotic for your child to take prior to and possibly after any dental procedure to prevent SBE.
• If emergency dental work needs to be done, call your hospital before to discuss prophylaxis for SBE.
• Wait six weeks after surgery to begin routine dental care including cleaning.
• Patients who have had heart surgery should continue to follow these rules throughout their lives.
• Please be sure to discuss SBE prevention with your child’s cardiologist.
When returning home, your child will not need to stay indoors or in bed. Your child’s energy level may be somewhat lower than normal following surgery, but it should improve every day. Your child will probably need to rest more often during the day and:
Your child may need less active play such as reading and board games. After about two weeks your child will probably have more energy and be able to be more active with his/her play.
Your child should steadily increase activity until he/she returns to normal or even increased activity four to six weeks after surgery.
An infection such as the flu or throat infection might slow down your child’s recovery. To help protect your child against infection your child should avoid crowded places and also close contact with any sick people.
Your child should not go to school for a while after coming home from the hospital. Usually a child can return to school one to two weeks after coming home.
When you visit your child’s heart doctor after surgery, this doctor will tell you exactly when your child can go back to school and when your child can go back to gym class.
Tell your child’s teachers of restrictions.
If your child had open-heart surgery the breastbone in the middle of the chest was cut. This bone takes about six weeks to heal.
• Carrying a backpack and heavy lifting also can hurt the chest so your child should not do this for the first two months after surgery.
• When lifting your baby/child it is important not to lift under their arms. Pick up the baby with one hand under the neck and head with your other hand underneath the buttocks. You should not pick up your child by lifting under the arms during the first six weeks after surgery.
• Your child will have to be careful and not take part in activities and sports that could cause injury to the chest. Rough play where the chest might be hurt should be avoided.
Immunizations are given to infants and children to protect them from serious illnesses such as Diptheria, hepatitis, whooping cough, polio, and others.
• The timely use of immunizations in children with heart disease is very important as it is for all children.
• For the most part, the usual guidelines apply and children with heart problems get the same immunizations at the same time as other children.
• Most children can continue their usual immunizations six weeks after surgery. Talk to your child’s pediatrician about this. Children can get their immunizations at the doctor’s office.
• It is best to postpone routine immunizations in children who have a fever or a severe respiratory infection.
Feeding / Nutrition
After heart surgery some babies while feeding will be more tired than usual and need to rest more often. Many babies do better if they are fed more often during the day. Many children do not eat very well while they are in the hospital. When the child returns home they usually feel better and begin to eat more food.
Most children can eat the same type of foods that they were eating before their surgery. As your baby recovers it is likely that he/
she will gradually eat more and start to gain weight. Your baby’s doctor will tell you if your baby needs any special food and will help you to watch how your baby is eating and growing.
Feed your child a nutritious diet, with a focus on including protein for better wound healing.
When your child comes home from the hospital you may see changes in behavior. Generally, these are nothing to worry about.
Some children become more demanding of attention. Some children may start behaving as if they were much younger. Some children may become quieter while others may show more anger towards other people.
Great importance is placed on hygiene and your child should have daily body washes ensuring the cleanliness of the wound. Regular hand washing and short fingernails are ideal. You may gently wash over the incision and steri-strips (white strips) with soap and water, then pat dry. Dressings are usually not recommended. The steri-strips and scabs will fall off in approximately
one to two weeks. Any remaining stitches need to be removed during your first follow-up visit.
Hand washing and general cleanliness are most important. Parents and caregivers need to always wash their hands before touching the wound. Keep your fingernails short and clean, bathe regularly, and wear clean
clothes when caring for the child. Showers are usually okay about one week after surgery but may depend on how the incision is healing.
Check with the medical team. Try to have water run more on your child’s back to avoid direct pressure to the incision. Tub baths are okay but do not soak the incision underwater completely until six weeks after surgery. Your child may sit waist-high in a tub until
that time. Lotions, creams, sunscreens, or ointments should not be applied to the incision for six weeks after surgery. Itching is a normal sign of healing. To reduce the risk of infection, keep a cotton shirt over the chest area and keep your child’s fingernails short. The incision may appear bumpy; this is temporary and will improve with time. Avoid exposing the incision to sun after surgery to prevent darkening of the scar.