Lara Adejoro
A Consultant Paediatric Cardiologist at the Lagos State University Teaching Hospital, Ikeja, Dr. Omolola Lamina-Alaaya, says what parents do before and during pregnancy can have a significant influence on the child’s heart.
Dr. Lamina-Alaaya says a healthy heart starts in childhood and a bad health habit before and during pregnancy can predispose a child to have cardiovascular diseases, diabetes, obesity, and heart attacks in adulthood.
Experts say congenital heart disease is a problem that occurs with the baby’s heart while the baby is still developing.
According to online portal, Heart, the baby’s heart begins to form immediately after conception and is complete by eighth week of gestation.
“The heart begins as a tube shaped structure that twists and divides to form the heart and heart valves.
“A congenital heart defect usually occurs because the heart does not twist or divide normally.
“Some mothers wonder if drugs, alcohol or medications contributed to their child’s heart defect. In most cases, we don’t know why these defects occur.
“Although, some heart defects can run in families or be related to a disease the mother has, such as diabetes mellitus, for example.
“Congenital heart defects range from mild to very severe. Some require surgical repair in the newborn period and some may resolve on their own with time,” Heart says.
The United Kingdom National Health Service notes that in most cases, no obvious cause of congenital heart disease is identified.
However, NHS warns, some things are known to increase the risk of the condition, including Down’s syndrome; the mother having certain infections, such as rubella, during pregnancy; the mother taking certain types of medicine during pregnancy, including statins and some acne medicines; the mother smoking or drinking alcohol during pregnancy; the mother having poorly controlled type 1 diabetes or type 2 diabetes; or other chromosome defects, where genes may be altered from normal and can be inherited.
Again, United States nonprofit organisation that works to improve the health of mothers and babies, March of Dimes, states that congenital heart defects are the most common types of birth defects.
“The most serious congenital heart defects are called critical congenital heart defects (also called critical CHDs).
“Babies with critical CHDs need surgery or other treatment within the first year of life. Without treatment, critical CHDs can be deadly,” March of Dimes states.
Continuing, the nongovernmental organisation warns that, “If you’re pregnant or trying to get pregnant, don’t smoke or drink alcohol. Doing these things can increase the chances of your baby having a CHD.”
Speaking in an interview with Reportr Door HealthWise, the expert said alcohol, drugs like vitamin A, and antimalarials are also known to affect the foundation of the heart.
“Basically, problems in the heart starts even before the child is born. From the first month of pregnancy, usually about three weeks before the mother misses her first period, the heart starts to form and some issues start from that time.
“As much as possible, we encourage mothers to stay away from anything that can affect the formation of the heart.
“So, there is a need to prepare for the pregnancy. As soon as the mother notices she is pregnant, she is advised to see her Obstetrics & Gynaecology doctor for medical check, a detailed history, and monitoring of the mother and the child.
“Alcohol, drugs like vitamin A, and antimalarials are also known to affect the foundation of the heart. We encourage the mother to stay away from herbal concoctions because you do not know which one will affect the foundation of the heart.
“In other cases, if the mother is diabetic and it’s not well controlled, it can also affect the baby. The overall health of the mother has to be sound before and during pregnancy and she has to be watchful of what she puts in her mouth,” she said.
She added that if a member of the mother’s family has a history of heart disease or the mother has had a history of abortion, it can predispose the unborn child to have heart disease.
“The mother needs to maintain a healthy lifestyle. She should eat healthy foods and take her routine vitamins as prescribed,” Lamina-Alaaya counselled.
According to her, congenital heart problems start when the heart is forming in the womb; while acquired heart diseases develop from other factors that may come up after birth, ranging from infections, diet, and the child’s weight.
She noted that heart diseases may not manifest until a child’s first or second decade.
“There are congenital heart diseases often referred to as a ‘hole in the heart,’ and the troubles you find with the heart start from inside the womb when the heart is forming.
“However, there is another part which we call the ‘acquired heart disease.’ These are the issues that happen after the child might have been born and it can start from as early as possible once a child is born.
“For the congenital heart diseases, those have to do with the structure of the heart, the way the heart is formed and you have various holes in the heart, which will not manifest until the child is born.
“Some manifest immediately the child is born, some may take about a month or six weeks after the child is born before you see the manifestations.
“The acquired heart diseases can stem from nutrition to how the child is fed or if the child is obese, which we are beginning to see these days because a lot of people have this idea that the more they feed their child, or the chubbier the child looks, the society accepts that the child is healthy.
“However, these are issues that also affect the heart and they begin to mount on but the clinical manifestation will be when the child begins to develop serious symptoms in the first or second decade.
Lamina-Alaaya said congenital heart diseases can be hereditary as well.
“We have a group of diseases we call cardiomyopathy — they are hereditary but they don’t show symptoms until much later in life.
“If a member of the family has particular heart disease, the mother needs to tell the doctor so that the child can be screened, it may not manifest as early as possible but if we catch them early, we can begin to watch out and treat and make sure that the disease does not progress as fast as possible.
“Before the mother gets pregnant, if she knows that there is a family history of heart disease or she has had a child before that died or had a previous history of abortion, she needs to inform her doctors so that the person knows what to do,” she said.
The paediatric cardiologist said once the child is born, he is examined by a doctor to know his health status.
“If the child is found fit and sound and nothing suggesting of heart defect, the child can go on regular breastfeeding, no need for medication, just regular feeding, not overfeeding or underfeeding and the regular immunisation.
“If the child is born and while examining, the doctor finds anything abnormal in the heart, the child will be referred to the paediatric cardiologist to conduct the regular examination and investigation.
“If there are heart defects, treatment will commence so that it doesn’t progress to severe ones. If there are severe ones needing treatment, then the child will be taken for appropriate treatment.
“Parents need to know that there are heart diseases that can start as early as when the mother is pregnant.
“There is also a need to examine the child once he is born. If the child is certified healthy by a paediatrician, ensure he/she is properly fed, ensure he is not overweight or underweight because all these factors can contribute to the development of acquired heart diseases,” Lamina-Alaaya said.
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