After your infant has heart surgery, it is important that they avoid certain positions and activities, while still remaining active. This article outlines recommendations to follow in the days and months after heart surgery. It includes information on:
- Positioning and handling your child after surgery to promote recovery
- Encouraging tummy time with your baby
- Activities to promote fine motor and thinking skills
Positioning and handling your child after surgery
First 2 weeks after sternal closure
Activity restrictions
- Avoid lying or playing on the tummy
- Avoid lifting under arms
- Avoid pulling arms when moving to sitting position or while dressing
Activity recommendations
- Lift under head/neck and bottom
- Encourage play in all other positions (lying on side, supported sitting, up in caregiver's arms)
2 to 6 weeks after sternal closure
Activity restrictions
- Avoid lifting under arms
- Avoid pulling arms when moving to sitting position or while dressing
Activity recommendations
- Lift under head/neck and bottom
- Encourage play on tummy
- Encourage play in all positions, as above
More than 6 weeks after sternal closure
Activity restrictions
- No restrictions
Activity recommendations
- Encourage all typical developmental activities
Sleep and tummy time
To reduce the risk of sudden unexpected infant death (SUID), your baby should always sleep on their back. However, too much time on their back can lead to positional plagiocephaly (flattened head). To prevent positional plagiocephaly and promote healthy development, you should position your baby on their tummy (if two weeks following sternal closure), supported sitting or up in your arms throughout the day.
Tips to encourage tummy time with your baby
| Tip | Goal |
|---|---|
| Start by placing your baby on their tummy for short periods of time, 3-5 times throughout the day | Your baby gradually becomes familiar with this position |
| Roll your baby from their back on to their tummy | Your baby will feel less startled than when placed directly on their tummy |
| Use a firm, flat surface such as a play mat or the floor | Promotes upper body strength and mobility |
| Encourage weight shifting and reaching by placing toys within view/reach | Improves strength needed for future sitting, rolling and crawling |
| When your baby is awake, lay them on your chest (“tummy-to-tummy”) while you lie down. This does not replace tummy time on a firm, flat surface | Your baby will learn to enjoy tummy time when they are comfortable and close to you |
Recommended activities to promote fine motor and thinking skills
Birth to 3 months
Suggested activities
- Toys that make noise or are brightly coloured will draw attention and encourage your baby to look and reach in the direction of the toy
- Toys of different textures help your baby get used to how different things feel
3 to 6 months
Suggested activities
- Rattles and toys of different sizes and shapes will help your child learn how to grasp and hold objects
- Toys that make interesting sounds (rattles, shakers, musical instruments) will encourage your baby to explore the connection between sound and movement
- A play arch allows your baby to reach, kick and/or roll toward hanging toys
6 to 12 months
Suggested activities
- Toys that encourage imaginative thinking and building such as stacking and nesting toys, blocks and shape sorters, balls and cars
- Toys that promote balance, pre-standing or standing such as ride-a-long and push-toys
Monitoring your baby’s development
If you are concerned with your baby’s development, speak to your child’s family doctor or paediatrician. If you are unsure whether or not your baby’s development is progressing appropriately, the Nipissing District Developmental Screen (NDDS) is a developmental checklist for infants and children up to six years of age that can be completed by a parent or health/childcare professional. You can locate a free copy of this developmental checklist at https://lookseechecklist.com/en/.
If you or your baby’s doctors have a concern about your baby’s development, your baby may benefit from an assessment by an occupational therapist or physiotherapist. Your family doctor or paediatrician can make the appropriate referral to a therapist.