Discharge Instructions: After Your Child’s Heart Surgery

Your child just had surgery to treat a heart problem. This surgery required a cut (incision) down the chest or breastbone (sternum) or between the ribs. This sheet gives you general guidelines to care for your child at home after heart surgery. Each child's recovery is different. It depends on your child's age, health, type of surgery, and other factors. Your child’s healthcare staff can answer questions and give you more detailed information for your child's recovery. Make sure you understand and can follow the healthcare team's instructions as directed.

Caring for your child’s chest incision

• Don’t lift your child under the arms for at least 4 weeks after surgery. Lifting stretches the chest and can cause pain at the incision site. It may also impair healing of the incision.

• Keep the incision clean and dry.

• Don’t submerge your child's incision in bath water for at least 2 weeks after surgery, or until your child's healthcare provider says it's OK. It’s OK to clean and wash the incision. Gently pat it dry.

• Check the incision site every day for redness, fluid leaking, swelling, or edges that pull apart. Watch your child for signs of pain. Itching is normal. But call the healthcare staff right away if you see any signs of infection. These include increased pain, redness, fluid leaking, or swelling.

• Keep your child in loose-fitting clothing. This is to prevent rubbing against the incision.

• Don’t let your child lift any heavy objects for at least 6 to 8 weeks, or until your child's healthcare provider says it's OK.

• Keep your child from rough play or contact sports for 2 to 3 months. Ask your child's healthcare team when it’s safe to play again.

• If your child is a teen with a driver’s license, don’t let them drive for at least 6 weeks, or as directed by your child's healthcare provider.

Other home care

• Your child may feel pain while recovering at home. It’s important for your child’s healing to control the pain. Give your child over-the-counter or prescribed pain medicines as directed by your child’s healthcare provider.

• Most children return to a normal diet while they are still in the hospital. Infants or newborns recovering from heart surgery may have a harder time with feeding. Give your child breastmilk or formula as directed by your child’s healthcare provider.

• Protect your child from infections during healing. You should wash your hands often with soap and water. So should anyone else who takes care of your child. Limit contact with visitors. Stay away from crowded public areas. If people in the household are ill, try to limit their contact with your child.

• Your child will need to rest at least 1 to 2 weeks at home before going back to normal physical activity or returning full-time to school. It’s important not to push your child until they are ready to return to a normal routine. But have your child get up and walk several times during the day. This is good for your child’s recovery.

• Your child has just gone through a stressful experience and may be unhappy or moody after heart surgery. It’s important to be patient and support your child during this time.

Follow-up care

You’ll need to make an appointment with your child’s cardiologist and surgeon. Your child may need follow-up tests. These are done to check how well your child’s heart is working. Ask how to contact your healthcare provider after business hours and on weekends.

When to call your child's healthcare provider

Call your child's healthcare provider right away if your child has any of these:

• Increased pain, redness, fluid leaking, swelling, or bleeding at the incision site

• Fever (see Fever and children, below)

• Increased tiredness

• A poor appetite

• Drinking less fluid

• Nausea and vomiting that doesn't stop

• A cough that won’t go away

• No signs of getting better

When to call 911

Call 911, or get medical care right away at the nearest emergency department if any of the following occur:

• Fainting

• New, different, or worsening chest pain or shortness of breath

• Heavy bleeding, or bleeding that is not quickly controlled

• Fast or irregular pulse

• A seizure caused by the fever

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider