Physical activity- recommendation for children – what is needed and why? All you need to know

Physical activity promotes – growth and development, prevents obesity, hypertension and anxiety, improves quality of sleep

- It is recommended that

- Pre-school children 3-5yrs- need to be active throughout the day

- School age children and adolescents-6-17 years- moderate to vigorous activity for at least 60 minutes a day, everyday

- Activities should include- aerobic exercises ( walking, running), bone strengthening ( running, jumping ) and muscle building exercises (climbing, push-ups)

- Adults need- 150 minutes of moderate to vigorous activities per week!

During moderate activity your child will breathe hardand will feel heart racing. During vigorous activities breathing will be harder and heart beat still faster. For example- walking at a normal speed is considered moderate activity and playing a game of chasing a friend is vigorous.

Encourage indoor games, dedicate time to play active games with your child or encourage siblings to play together. Reduce time spent in front of TV or make it productive by encouraging children to do push ups or jumping jack during the commercial breaks. Plan short family trips to the local park after dinner or involve children in the household chores-are some examples of how you can keep your child moving throughout the day.

Generally , outdoor games with friends in an open field may be allowed. But children should have their mask on at all times.

please contact your child’s doctor to discuss what activity will be appropriate. Specifically, for children with congenital heart defects- all aerobic activities are allowed upto the extent of the child’s ability, and the golden rule is to allow them to take rest when they feel the need. There are some conditions when some specific kind of activity can lead to problem-these should be discussed with your cardiologist. But in general always encourage your child to be active


- Stay home

- Discourage visitors

- Wear mask at all times when out of house

- Wash hands with soap water/hand rub with at least 60% alcohol first thing after coming home/ after touching frequently touched surfaces

- A well fitted multilayered cloth mask, preferably two when going out of house

- You can also wear a surgical triple layer mask on top of the cloth mask

- The mask should fit well around mouth and nosewithout any gap

- Tie mask is preferred than loop mask.

- N95 mask is recommended to be used by the health care workers

- Home cooked light diet

- Daily exercise at home

- Do not touch face, nose, mouth, eyes without washing or cleaning hands when out of house

- Practice hand hygiene before and after touching mask

Children can have COVID- but in the majority it is a mild illness like a common cold. Common symptoms are- low grade fever, runny nose or blocked nose, cough, head ache,/body ache, nausea, vomiting. Loss of smell is not so common which is otherwise a well described symptom in adults. Children can be asymptomatic COVID positive. Children can spread the disease as much as adults even if they are asymptomatic, so isolation should be practiced.

- Congenital heart disease

- Asthma or other chronic lung diseases

- Childhood diabetes

- Children with cancer/undergoing treatment

- Children suffering from immunosuppressive conditions

Newborns may be affected from a COVID positive mother if the mother gets the disease within 2 weeks of delivery. The virus can affect the newborn at the time of labour or as a blood bourne infection.

It is advisable to continue breast feeding even if the mother is COVID positive, as breast milk is the best nutritionally rich food for the baby. Mother should wear a mask and practice hand hygiene at the time of feeding the baby. Babies face should not be covered with mask as there is risk of suffocation

Maximum infective period is from 2-3 days prior to symptom onset to 2-3 days after it. Person to person spread of the disease can be effectively controlled by wearing mask by the patient as well as by the caregiver as described earlier. A mask used by the patient if soiled should be changed every 6-8 hours or washed regularly. Alternatively they can be disinfected by immersing in 1% sodium hypochlorite solution. For mild disease home isolation for 14 days is adequate to control cross infection

The virus particles have been shown to remain active in air further than six feet distance from a source, in a closed space and so can infect others in an ill ventilated environment. Wearing mask can be protective.

- Ill fitting mask/no mask

- Not maintaining physical distancing norm

- Attending social gatherings

- Visiting restaurants, cinema hall etc

Vaccine only by itself will give partial protection. Even if vaccinated you should continue to wear mask and practice hand hygiene.

- Stay home

- Discourage visitors

- Wear mask at all times when out of house

- Wash hands with soap water/hand rub with at least 60% alcohol first thing after coming home/ after touching frequently touched surfaces

A pediatric cardiologist is a physician who has received extensive training in diagnosis and treating children’s cardiac problem. Evaluation and treatment may begin with the fetus since heart problem can now be detected before the birth. He/she is also trained to look after adults who were born with heart problems. When a pediatrician suspects a heart problem, he or she may ask a pediatric cardiologist to investigate further. Common causes for a referral to the pediatric cardiologist includes heart murmurs, chest pain, dizzy spells or palpitation. Initial evaluation may result in-patient and his/her parents being reassured that there is nothing to worry about. A pediatric cardiologist is trained to perform and interpret procedures such as echocardiograms and exercise test. In case of more significant heart disease, a pediatric cardiologist may perform a cardiac catheterization in order to diagnose or treat child’s heart problem. If the child needs to be hospitalized, the pediatric cardiologist & pediatric cardiac surgeon work together in planning cardiac surgery, when needs. However, in all cases the pediatric cardiologist is there every step of the way.

On most occasions you will get results from the physician immediately.

Typically new patients visit last approximately 40-60 minutes.

It is always advisable to take prior appointment to save your waiting time. However in case of other emergency or operation being performed, you may have to wait longer.

No, but most are. There are generally three categories of possible childhood heart problems: structural defects, acquired damage and heart rhythm disturbances. These defects are usually – but not always – diagnosed early in life. Rarely, childhood heart problems are not congenital, but heart damage may occur during childhood due to infection. This type of heart disease is called acquired; examples include Kawasaki disease and rheumatic fever. Children also can be born with or develop heart rate problems such as slow, fast, or irregular heartbeats, known as “arrhythmias”.

Anyone can have a child with a congenital heart defect. Out of 1,000 births, nine babies will have some form of congenital heart disorder, most of which are mild. If you or other family members have already had a baby with a heart defect, your risk of having a baby with heart disease may be higher.

Most of the time we do not know. Although the reason defects occur is presumed to be genetic, only a few genes have been discovered that have been linked to the presence of heart defects. Rarely the ingestion of some drugs and the occurrence of some infections during pregnancy can cause defects.

Virtually all children with simple defects survive into adulthood. Although exercise capacity may be limited, most people lead normal or nearly normal lives. For more complex lesions, limitations are common. Some children with congenital heart disease have developmental delay or other learning difficulties.

Successful treatment requires highly specialized care. Severe congenital heart disease requires extensive financial resources both in and out of the hospital. Children with developmental delay also require community and school-based resources to achieve optimum functioning.

The presence of a serious congenital heart defect often results in an enormous emotional and financial strain on young families at a very vulnerable time. Patient/family education is an important part of successful coping.

Treatment depends on the type and severity of the condition. Some children won’t require any treatment, while others may need medication or heart surgery. There are also other new techniques and procedures that, in some cases, can be done instead of surgery. Fetal Cardiology: Ultrasound scanning of pregnant women with suspicion of, or known congenital heart disease in the unborn child

Why do it? About 8-10 per 1000 live births are complicated by heart disease in the babies. 50% of still births are caused by heart disease in babies. 50000 babies die every year in our country before their first birthday due to their untreated heart disease. Many of heart disease are completely curable and parents get the time to prepare for the problems

When to do it? Tran abdominal or external fetal echo can be done any time, ideally between 16-18 weeks of pregnancy

1. Elderly mothers > 35 years.

2. Having previous child with heart disease.

3. Mothers getting viral fever, rash, joint pain in the first 3 months of pregnancy.

4. Routine ultrasound showing other malfunctions of fetus.

5. Routine ultrasound showing very high very slow heart rates in fetus.

6. Unexplained repeated abortions

7. Unexplained early child deaths.

8. Family having history of heart disease.

Usually pediatric cardiologists or fetal medicine specialist. A pediatric cardiologist not only does the echo but also explains you about the type of heart problems, the treatment for it, & treats the child after delivery.

no, it is painless without any no side effects on baby and mother.

1. It allows parents to understand the heart problems in unborn baby and prepares them psychologically at the time of delivery.

2. In extremely complicated cases termination of pregnancy is advised.