Growth and stature of children with heart disease

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Learn about how growth and stature are affected by congenital heart disease.

Key points

  • Children with congenital heart disease may grow and develop more slowly than healthy children.
  • Good nutrition will need to be an essential part of your child's care if they are not reaching growth milestones.
  • After surgery, physiotherapists and occupational therapists may help ensure that children are reaching growth milestones and developing properly.
  • Many children with congenital heart disease display motor deficits, which can be addressed through physical or occupational therapy.

This page explains how a child with congenital heart disease can be expected to grow and physically develop as they get older. Physical and occupational therapists can work with children to overcome physical challenges.

How does congenital heart disease affect my child’s physical development?

Children with congenital heart disease tend to grow and develop a little more slowly than healthy children. They may also end up being a bit shorter than normal. This is particularly true of children with cyanotic CHD and congestive heart failure. They expend more energy, need boosted nutrition, and sometimes have trouble absorbing the food they eat. This may result in children looking a bit younger than their age or looking a little less robust. Young children may take more time reaching certain milestones in life, like crawling, sitting up, or mastering potty training.

The slower growth that may be seen in these children may be due to difficulty taking in enough food, either because of the condition itself or because of the high calorie requirements of children with a heart condition. Good nutrition (or the services of a dietician to overcome any feeding issues) will be an integral part of your child's care if they are not reaching their growth milestones. Getting enough calories is critical for children with CHD, since they need calories to support growth and energy needs. Some strategies may include energy boosting foods or organizing supplemental tube feedings.

To reach growth milestones and help ensure proper development, physiotherapists and occupational therapists may play a role in the period following a child's treatment. They will also show parents what they can do to help their children. The good news is that most of these children "catch up" in terms of growth and development by the time they reach adolescence.

The fine and gross motor function of children with CHD

A large percentage of children with CHD - especially those children with severe forms of CHD – display motor deficits. One study found that children with CHD have a risk of severe motor problems 11-times that of school-aged children without any known heart failure. Another study found that gross or fine motor deficits were seen in just under half of children with CHD 12 to 18 months after neonatal open heart surgery. Reduced motor coordination was seen in children with cyanotic heart diseases and children with transposition of the great arteries. Children with hypoplastic left heart syndrome tend to have weaker visual motor integration capabilities. Gross motor skills refer to a child's ability to control different parts of the body. Fine motor skills refer to the degree of coordination present when using different body parts. This means that they may have difficulty playing with toys or other objects, they may have weaker hand-eye coordination, or they may exhibit more difficulty in physical activity. Some children showed reduced muscle strength and impaired balance performance. Since some motor skills require a certain level of muscular strength and balance, those skills are difficult or impossible for some children with CHD without rehabilitative programs or strengthening exercises.

Therapy to improve motor skills

Health care providers need to perform routine screenings of motor competence in children with CHD at an early age in order to identify those children with developmental delays and to prescribe the proper therapy. A specially selected rehabilitation or physical therapy program can be of great assistance to a child’s physical development, in addition to their intellectual and emotional development. A physical or occupational therapist can work with children to overcome problems they may have in the motor skills area by guiding the child through physical challenges using a well-rounded movement experience. Parents, teachers, and health care providers should encourage the active integration of the child, socially, at home, and in the school regardless of their motor skill impairment.

Last updated: December 14th 2009