The Case of the Cranky Baby

Each year, about 7,000 American babies less than a year old die of inborn heart defects. "Eighty percent of these infants could be saved by surgery," says Baylor University's Pediatrician Dan G. McNamara. The trouble is, Dr. McNamara told an international meeting on the heart and circulation of the newborn, that not enough physicians are trained to detect the sometimes subtle signs that a "cranky" baby may actually have severe deformities of the heart or major blood vessels.

Most of the preventable deaths, said Dr. McNamara, occur in the first three months of life. That is usually too early for obvious symptoms to develop--such as blueness of the extremities and lips, which would alert many a parent and any physician. Blueness and significant heart murmurs are almost certain not to appear until later.

The earliest signs are deceptive because they are so common, and rarely indicate serious disorders. Even then, heart disease may be misdiagnosed as pneumonia. But a baby may be colicky and irritable, or have spells of rapid breathing, or be a feeding problem and fail to gain weight from a variety of benign causes. "It is not in the thinking of most doctors that a feeding problem has anything to do with heart disease," said Dr. McNamara. But in these thousands of cases every year, it should be.

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