Transitioning Newborns With Heart Problems from ICU to Home – Care Instructions

Your newborn was treated in the intensive care unit (ICU) for a heart (cardiac) problem. Your baby is now eating and breathing normally and can go home. Here is the information about how to care for your baby after the cardiac procedure. Your baby’s health care provider may also give you more specific instructions. If you have problems or questions, contact your baby’s health care provider.

How to care for your baby at home:

Recovery time can take 3–6 weeks, depending on the procedure. While your baby is recovering, follow instructions from his or her health care provider.

Feeding

• Feed your baby as told. Your baby’s health care provider can give you instructions on breastfeeding or formula feeding or both. Your baby may need extra nutrition to heal and grow. A nutrition specialist (dietitian) can help you.
• Your baby’s health care provider may ask you to keep track of:
  • The number and amount of feedings.
  • How much and how often he or she urinates.
  • How often he or she passes stool.

Medicines

• Give over-the-counter and prescription medicines only as told by your baby’s health care provider. Always check with your baby’s health care provider before giving over-the-counter or alternative medicines.

Incision care

• Follow instructions from your baby’s health care provider about how to take care of the incisions. Make sure you:
  • Wash your hands with soap and water before you change your baby’s bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your baby’s dressing as told by your baby’s health care provider. Give your baby gentle sponge baths with mild soap and water.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your baby’s health care provider tells you to do that.
• Check your baby’s incision areas every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Keep the area of the incisions clean and dry. Avoid bathing your baby for up to 2 weeks, or for as long as told by your baby’s health care provider.
• Make sure siblings and animals are gentle around your baby. Keep your baby from getting bumped, rubbed, or hugged tightly until incisions heal.

Preventing infection

• Wash your hands often to avoid spreading germs to your baby. Use soap and water. If soap and water are not available, use hand sanitizer.
• Keep your baby away from crowds. Keep people who are ill away from your baby during recovery.

Rest and comfort

• Keep a calm, quiet environment. Allow your baby to rest and sleep often.
• Soothe your baby to avoid long periods of crying. Try skin-to-skin contact to soothe your baby.
• Put your baby to sleep on his or her back.

General instructions

• You may place your baby on his or her tummy 2 weeks after the procedure, or when your baby’s health care provider says it is okay. This is important for normal development.
• Dress your baby in loose-fitting clothing. Change your baby’s clothing whenever it becomes damp. This is especially important in places where it touches the incisions. Try not to pull on your baby’s arms when changing clothes.
• Avoid lifting your baby under the armpits. This can put pressure on the incision areas. Lift your baby up gently under the buttocks, back, and shoulders.
• Keep all follow-up visits as told by your baby’s health care providers. This is important. You will need to make appointments with your baby’s cardiologist, surgeon, and primary care physician. Your health care providers will examine your baby and check how well his or her heart is working.

Contact a health care provider if:

• Your baby has a fever.
• Your baby has redness, swelling, or pain around the incisions.
• Your baby has fluid or blood coming from the incisions.
• Your baby’s incisions feel warm to the touch.
• Your baby has pus or a bad smell coming from the incisions.
• Your baby is not feeding well.
• Your baby vomits.
• Your baby has a cough.
• Your baby’s heartbeat is irregular.
• Your baby is restless.
• Your baby is irritable.

Get help right away if:

• Your baby who is younger than 3 months has a temperature of 100°F (38°C) or higher.
• Your baby is crying continuously.
• Your baby’s breathing is not normal.
• Your baby’s breathing is fast.
• Your baby has episodes of not breathing for more than 20 seconds (apnea).
• Your baby’s skin looks blue or gray or both.

Summary

• This sheet gives you information about how to care for your baby at home after he or she has had a cardiac procedure. Recovery time can take 3–6 weeks, depending on the type of procedure your baby had.
• Feed your baby as told. Your baby’s health care provider can give you instructions on breastfeeding or formula feeding or both.
• Give over-the-counter and prescription medicines only as told by your baby’s health care provider.
• Check your baby’s incision area every day for signs of infection.
• Keep all follow-up visits as told by your baby’s health care providers.