My Child Has a Heart Condition. What Should I Do?

Updated on Feb 9, 2025 | Children's Health, Heart Health, Your Health

Becoming a parent is exciting, sometimes nerve-wracking, and comes with a heap of responsibility for the health and well-being of your child. And if your child has been diagnosed with a heart condition, anxiety can ratchet up due to the uncertainty of what the condition may mean for their future.

Robert H. Pass, MD, Chief of the Division of Pediatric Cardiology at the Icahn School of Medicine at Mount Sinai and co-Director of the Mount Sinai Kravis Children’s Heart Center, answers common questions that parents may have about diagnosing a pediatric heart condition and explains the safe, minimally invasive treatments that are now available.

How do I know if my child has a heart condition?

Many heart problems in children are obvious nearly from the moment of birth. In fact, the most common types of heart disease in children are congenital heart diseases, which are birth defects that affect how the structure of the heart as well as how the heart functions. Congenital heart disease is the most common birth defect, affecting a little less than one percent of the population.

One of the most common signs of heart disease among newborns is cyanosis, which is when a child has a low oxygen level, which lends a bluish tint to the skin and mucous membranes. Additionally, some newborns have symptoms such as poor feeding or sweating as they feed. Heart problems can also cause poor growth.

Still other concerns—like heart murmurs—are identified only through a physical examination or sonogram. Heart murmurs can be signs of a problem, or they can be what we call “innocent,” which means there’s actually nothing wrong. Some studies suggest that if a doctor listens closely enough, nearly half of all kids have murmurs. Fortunately, though, only a very tiny fraction of this group actually has a heart problem.

How are congenital heart diseases diagnosed and treated?

Most congenital heart conditions are diagnosed either on physical examination or ultrasound and increasingly can be diagnosed prenatally on ultrasound.

Depending on the diagnosis, there are a variety of surgical and non-surgical treatments for congenital heart disease. Non-surgical treatment or the “wait and see approach,” may be the best option for problems such as small holes in the heart and some forms of abnormal heart rhythm which can resolve spontaneously. If your child has a condition that needs surgical intervention, options range from open heart surgery to the use of catheter-based therapies.

What are catheter-based therapies?

Catheter-based treatment is a minimally invasive alternative to traditional open heart surgery in which small tubes are inserted into the blood vessels and allow for diagnosis and treatment of many heart problems. Among many conditions that can be addressed in this way, we use these procedures to close holes between the upper two heart chambers—called atrial septal defects. In the past, we routinely treated this condition with surgery. Now we manage about 75 percent using catheter-based treatments.

During a catheter-based procedure the thin, flexible catheter is inserted through the child’s groin into a blood vessel and up to the heart. A device is then introduced through the catheter to seal the hole. With open heart surgery, the child would spend two to four days in the hospital and another six weeks recuperating at home. Using this minimally invasive approach, most patients are in the hospital only one evening and then back in school within three or four days.

What makes the Mount Sinai Children’s Heart Center special? 

Our Children’s Heart Center stands apart due to the integration among our services throughout the expanded Mount Sinai Health System. Our cardiology team works closely with our surgical team, and we seamlessly transition our pediatric patients into our very large and always growing adult congenital heart program headed by Ali N. Zaidi, MD, Professor of Medicine (Cardiology), and Pediatrics; Director of the Adult Congenital Heart Disease Center; and Director of Pediatrics to Adult Transition of Care Program, at Icahn Mount Sinai. We view our work as a team sport, with many players working together to achieve the best possible outcome.

We develop individualized treatment plans for children with a wide range of heart problems, always taking into account the needs of our patients and their families. While there are outstanding cardiologists in many of the major centers in New York City, I have never worked with a group where every single physician is outstanding. It is inspiring for me and keeps me on my toes. Our patients inspire us every day.

Learn more about the Mount Sinai Kravis Children’s Heart Center
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How Is the Omicron Variant Affecting Children?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

The Omicron variant is the latest strain of COVID-19 that is causing concern. While far more contagious than earlier variants, there are indications that it causes less serious disease—especially in the vaccinated.

Despite this sliver of good news, reports of increased pediatric hospital admissions has many parents and guardians worried that this variant may be more dangerous for children. Pediatric infectious disease specialist Roberto Posada, MD, Professor of Pediatrics and Medical Education, at the Icahn School of Medicine at Mount Sinai, dispels that belief and explains how to protect yourself and your family. The key takeaways: if eligible, get vaccinated; wear a high-quality face covering while indoors; and practice social distancing.

Is the Omicron variant more of a risk to infants and toddlers than older kids and adults? What are the symptoms?

The Omicron variant is very widespread and it affects people of all ages. That includes infants, toddlers, school-age kids, adolescents, and adults. It does not discriminate by age—everybody is at risk.

For the vast majority of children, symptoms of this variant are very similar to other common illness of childhood. This includes fever, a runny nose, cough, congestion, a sore throat, and/or difficulty swallowing. Some kids also complain about abdominal pain and diarrhea.

My child has COVID-19. How can I treat them at home?

Treatment depends on how ill your child is but the vast majority can be treated at home using over-the-counter medications. For instance, children who are experiencing minor symptoms, like fever and body aches, can be treated with acetaminophen (Tylenol) or ibuprofen.

However, if you think that your child is sicker than you can handle at home or if they are having difficulty breathing or eating so little that you are worried about dehydration, call your doctor right away.

How can we protect children from the Omicron variant?

Vaccination goes a long way toward protecting children—and adults—from the Omicron variant, and a booster shot provides additional defense against the virus. So, if you (or your child) are eligible for a booster but have not received one, I encourage you to schedule an appointment. By protecting yourself, you are protecting your child.

In addition to getting vaccinated, wearing a mask and maintaining social distance are very important. Since COVID-19 is circulating at very high levels, try to avoid crowded places. Also, make sure that your child understands the importance of washing their hands frequently, either with soap and water or an alcohol-based sanitizer.

If your child happens to feel sick, keep them home from school so that you can prevent an infection from spreading to others. If you think somebody in your family has COVID-19, reach out to your doctor about testing for the virus. If your child attends a daycare or school, you might need to alert them as other close contacts of your child may need to get tested. Be sure to follow whatever directives their daycare/school has outlined.

My child is not yet eligible for vaccination. How can I protect them from contracting COVID-19?

Unfortunately, the vaccine is not available yet for kids who are younger than 5 years of age. In that case, it’s even more important for parents, older siblings, and whoever else lives at home to be fully vaccinated and to get a booster shot. In addition, all household members should diligently follow the rules we have followed throughout this pandemic: avoid crowded places, wear a face covering, maintain social distance, and wash your hands frequently.

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Why Vaccination Is Critical to Protect Your Child From COVID-19

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

Young child getting vaccinated

As we see an uptick in pediatric hospitalizations for COVID-19, it is important to reemphasize the significance of vaccination.

“Most of the children that we’re seeing in the hospital with COVID-19 have not received a vaccine—or have only received one dose,” says Roberto Posada, MD, Professor of Pediatrics and Medical Education, at the Icahn School of Medicine at Mount Sinai.

In November 2021, the U.S. Centers for Disease Control and Prevention (CDC) endorsed COVID-19 vaccination for children ages five and up. But, if you have been hesitant to schedule an appointment for your child, Dr. Posada explains vaccine safety and why vaccinating—and, if eligible, boosting—your child is a critical step in avoiding COVID-19.

Should all children ages five and older get the COVID-19 vaccination? What if my child had, and recovered from, the virus?

Yes, the CDC recommends that everyone age five and up get vaccinated. The vaccines are very, very effective at both preventing serious disease caused by COVID-19 and keeping people out of the hospital if they do get the virus. The vaccine is extremely safe and has been tested in patients of all ages. Serious side effects are very, very rare.

Vaccination is recommended even if you have had COVID-19. This includes children who are eligible to receive all the doses of the vaccine, including the booster. Why? Because vaccination offers higher protection than previous infection.

Children ages 12 and older get the same dose as adults. Children ages 5 to 11 get a lower dose of the same vaccine. Currently, only the Pfizer vaccines have been approved for children ages 5 to 11.

Does the vaccine give children full protection against COVID-19?

Children who have been vaccinated for COVID-19 have a high level of protection against the disease; but it is not 100 percent. People who’ve gotten the vaccine are much less likely to get sick. But if they do contract the virus, it’s much less likely that they’re going to get severely sick from it.

Also, we are beginning to see the significance of booster doses of the COVID-19 vaccine. Research shows that protection starts to decrease a number of months after the second COVID-19 vaccine dose. A booster dose provides an added layer of defense against the virus, including protection against the Omicron variant.

Are children eligible for a COVID-19 booster dose?

Everyone over age 12 is eligible to receive the COVID-19 booster dose five months after their last shot. Since children over 12 have been eligible for the COVID-19 vaccine since May 2021, some may be ready for their booster dose. If they are, I highly encourage parents to book an appointment to administer the shot.

Children ages 5 to 11 are not yet eligible for boosters but they just became eligible for the COVID-19 vaccine in October 2021, so they would not need a booster at this point.

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Is Your Child Afraid of Getting a Shot From the Doctor? Here’s How to Help Them

Nov 9, 2021 | Children's Health, COVID-19, Featured, Vaccines, Your Health

A trip to the doctor is a common childhood fear. But when kids are afraid of needles, even a simple checkup can cause problems for children and their parents or guardians alike. With the proper preparation and planning, you can help make your next doctor’s visit as smooth as possible, and that’s more important than ever for those getting a COVID-19 vaccine.

In this Q&A, C. Anthoney Lim, MD, the Director of Pediatric Emergency Medicine for the Mount Sinai Health System and the Medical Director of the Pediatric Emergency Department and Pediatric Short Stay Unit at Mount Sinai Beth Israel, explains how you can help calm your child’s fears and ease their anxiety about the doctor’s office and needles. And if needed, how you can talk with your doctor in advance about key issues, including medications that can help reduce the pain. Certified child life specialists and music therapists will also be present at the Mount Sinai vaccination pods to help support children of all ages using play, preparation, distraction and relaxation strategies.

“We have plenty of experience with children who are afraid of injections, so we can work with you and your child to ensure they get immunized in a safe and comfortable manner,” says Dr. Lim, who recently gave his own seven-year-old son the vaccine. “We are creating a very family-friendly space for the COVID-19 vaccine because you will need to bring them back in three weeks for their second shot, so it’s especially important that your child has a positive experience.”

How common is it for kids to be afraid of needles?

 It is a very common fear. We see it among children who may have been hospitalized or have chronic illnesses and are in the doctor’s office a lot. But a healthy child without any medical problems is equally prone to needle-phobia.

 How can I talk to my child who is afraid of needles?

There are many things you can do to help normalize the process, and it’s important to prepare. A lot of it is knowing your child and if they are at an age that we can talk about their fears. Then, prepare them by having a conversation in advance, letting them know what is going to happen at the doctor’s office and explaining what the process may look like. It can help quite a bit. Not all kids want to talk about it. But they are generally pretty smart, and they will know they are going to the doctor and what they are going for. It’s also worth remembering: Kids will often follow your lead. So if you are prepared and calm, your children will more likely be prepared and calm

Anything more specific?

For younger kids, play can be a really helpful way to prepare for a doctor visit. It provides children the opportunity to approach the event with a sense of control while creating a safe environment to express feelings and to practice coping strategies. One option for younger kids is showing them with their stuffed animal or having them play doctor to get used to what happens when you get your vaccine. For instance, when we were teaching kids how to use masks, we had them make a mask or put a mask on their teddy bear so they can see what it looks like. This is a similar process.

What about bringing something to distract my child?

You can bring a toy to distract them or a doll or plaything they can squeeze really hard. Tablets or smart phones are fine, so make sure your devices are charged. You can bring a cold pack because sometimes that will numb the area a little bit and that is often helpful. There are special cold packs for kids that also include a vibrating tiny bee that can help soothe and distract young children.

Any other techniques?

There are many relaxation strategies that children of all ages can use when feeling anxious and worried. One example is deep breathing—taking deep breaths right before the shot, and then breathing out as the shot is being delivered, can help minimize the discomfort. For younger kids, there are specific positioning techniques you can use, basically a big hug that exposes their arm for the nurse to administer the shot.

What about medications?

Most of the time, approaches that do not involve medications work really well in kids. Prescription medications require a visit or a discussion with your doctor beforehand. There are prescription products, like EMLA or ELA-Max, which are creams that contain a local anesthetic we sometimes use for children for some injections and vaccines. You put the cream on your child’s arm before you go to the doctor’s office because it takes about an hour to kick in. Over-the-counter topical creams are also available.

Is it okay to take over-the-counter pain relievers?

We recommend pain relievers like Motrin or Tylenol but only if your child experiences muscle pain or fevers after they receive the shot, and not beforehand.

How is Mount Sinai helping to make the vaccination process easier for young kids?

At our hospitals, we are setting up special areas for vaccinations for young children. We want to make it a child-friendly, family-friendly environment. We want to make sure that they have a great experience

What should I do if I have more questions?

 There are some great resources online, such as from the American Academy of Pediatrics and from the Meg Foundation, an organization that helps families with pain management. A conversation with your pediatrician is very valuable.

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What You Need to Know About COVID-19 Vaccines for Children Ages 5 to 11

Oct 28, 2021 | Children's Health, COVID-19, Vaccines, Your Health

The moment many parents have been waiting for is approaching: Federal regulators are expected to decide soon whether to authorize COVID-19 vaccines for children ages 5 to 11. Vaccines for kids ages 12 to 15 were authorized in May.

The Food and Drug Administration (FDA) first authorized COVID-19 vaccines for adults in December 2020, and the safety and efficacy of vaccines has been widely discussed ever since. But those with young children still have many questions.

In this Q&A, Roberto Posada, MD, a pediatric infectious disease specialist in the Jack and Lucy Clark Department of Pediatrics at Mount Sinai Kravis Children’s Hospital and Professor of Medicine (Infectious Diseases), and Medical Education, at the Icahn School of Medicine at Mount Sinai, answers some of the questions most commonly asked of pediatricians and explains why the vaccines are extremely safe and highly effective.

How effective is the new Pfizer vaccine for children ages 5 to 11?

The new vaccine is highly effective at protecting children from severe COVID-19 disease. The studies, which included more than 4,000 children, showed children developed essentially the same level of antibodies that result in 90 percent or higher protection in adults.

 How safe are they?

The vaccines are extremely safe, the same as with adults. There were minor side effects, such as pain at the site of the injection, fatigue, and headache. Importantly, there were no serious adverse events at all related to the vaccine among the more than 4,000 children that were part of the studies.

What about concerns about rare cases of heart inflammation in young men and boys?

Myocarditis is an inflammation of the heart, and a side effect that has been seen very, very rarely, mostly in young adult males. It was not seen in the recent studies of young children; there were no cases, and although the studies were too small to estimate what the rate might be in the general population of children, we expect it to be lower than in adolescents.

Will children experience any side effects from the vaccine? What can I do about that?

It is very likely that children who receive the vaccine, just like adults and older children, will experience pain at the site of the injection or headache. Those are expected to go away within a day or so. Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be very helpful in managing the symptoms. Parents should follow the guidance of their pediatrician as to how to administer those medications to their children.

If my child had COVID-19, do they still need to get a vaccine?

Anyone who already had COVID-19 should still get the vaccine. That’s because cases of a second COVID-19 infection can happen in people who already had a first infection. The vaccine provides more protection against subsequent infections for people who already had COVID-19.

What are the benefits of vaccinating children ages 5 to 11 against COVID-19?

First of all, vaccinating young children protects them from getting seriously ill from COVID-19. We know that children have a lower risk for developing severe COVID-19 infection compared to adults, but that doesn’t mean they cannot develop severe COVID-19 infection. In fact, as an infectious disease specialist, I have seen children in the intensive care unit with complications of COVID-19. In addition, we know that even if children don’t get very sick themselves from COVID-19, children who have COVID-19 can pass it on to other people—to their parents, their siblings, their grandparents, and to kids and other people at school. So vaccinating children can also protect our community at large, including people that are at higher risk from COVID-related complications.

What if my child is afraid of injections?

It is not uncommon for children to be afraid of injections. Pediatricians have been giving vaccines for decades. Our staff are experienced in working with children who are afraid of injections. They will work with you and your child to make sure your child can get immunized in a safe manner.

Can the vaccine affect the fertility of my child?

It’s a very common misconception that the COVID-19 vaccine can affect fertility. There’s no evidence at all that the COVID-19 vaccine has that effect.

My child is 11 and about to turn 12. Should I wait and get them the adult vaccine?

We recommend that children get vaccinated at the first opportunity. Studies show that children age 11 responded very well to the pediatric formulation of the vaccine.

How do I get more information?

Parents who want to get more information about the COVID-19 vaccine for their children should contact their pediatrician for specific advice.

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How Do I Keep My Kids Safe When They Return to School In Person?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

As the Delta variant surges, and the timeline for vaccinating children under 12 remains uncertain, concerned parents are wondering how to keep students safe. But there are smart strategies for school children of all ages that can help protect them in the classroom.

In this Q&A, Roberto Posada, MD, a pediatric infectious disease specialist in the Jack and Lucy Clark Department of Pediatrics at Mount Sinai Kravis Children’s Hospital and Professor of Infectious Diseases and Medical Education at the Icahn School of Medicine at Mount Sinai, shares the best ways to help keep kids safe from COVID-19.

Given the current concerns about COVID-19, should parents be worried about sending their kids back to school?

I think it’s important for kids to go back to school not only for their education, but also for socialization and healthy development. But it’s also important to take precautions to make sure they return to the classroom in a safe way. If in-person learning is done safely, the benefits will outweigh the risk. According to the Centers for Disease Control and Prevention, children have been less affected by COVID-19 compared with adults. But kids can develop serious illness, especially those with underlying medical conditions, such as obesity, diabetes, and asthma; those with certain genetic, neurologic, or metabolic conditions; or those with congenital heart disease. In general, the best way to protect children is to make sure adults in the household are vaccinated.

What advice can you give to worried parents about keeping their kids safe at school?

It’s important to continue the things we’ve been practicing for the last year and a half: The main thing is that children over the age of two should wear a mask when they go to school. Children should also be encouraged to wash their hands, either with soap and water or with alcohol-based sanitizer frequently. Children should be encouraged to practice respiratory etiquette, which means coughing or sneezing into their elbow and washing their hands after coughing or sneezing. And they should be taught to maintain a safe distance at all times.

In addition, parents shouldn’t send their kids to school if they have a fever, cough, abdominal pain, or any symptom whatsoever of an illness, including COVID-19.

How worried should people be right now about the increasing cases of COVID-19?

The number of COVID-19 cases has been going up for the last several weeks in the United States, mostly due to the Delta variant. Vaccination is very important. Every child aged 12 and older should be vaccinated. The vaccine is safe, and in some cases it fully protects against COVID-19; in some cases people who are vaccinated may still get COVID-19, but usually it’s a much milder disease.

Is there any guidance for older vaccinated kids that you would recommend to parents?

What I want to stress is that even people who are fully vaccinated should be wearing a mask whenever they’re inside, whether they’re in school, on public transportation, in a store, or anywhere indoors. That applies to adults, as well. The reason is that even people who are fully vaccinated may have breakthrough infections, and they can still pass on the infection to other people. So by wearing a mask—in addition to getting the vaccine—you’re helping decrease cases in your area, which is what we all want.

When do you think the vaccine will be available for children 11 and under?

The original timeline was for this to be available in the fall. So let’s hope that’s going to be the case.

Is there anything else people should know about keeping their kids safe from COVID-19?

Any parent who has a particular concern about their child due to a chronic medical condition medical condition should talk with their pediatrician to come up with an individualized plan.

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