When it comes to raising children, there’s a lot to keep up with: recitals, dentist appointments, soccer practice, wellness visits, and the list goes on. Your brain never keeps track of what’s most important first. Then, there are things on the list, whether you know about them or not, like your child’s heart health. You know you want your child’s heart to be in tip-top shape, and you assume it is, but how do you know if it’s not?

Thankfully, you’re not in this alone. Director of pediatric cardiology at Boston University School of Medicine, Dr. Sharon E. O’Brien, says pregnant women have a fetal screen ultrasound is to find congenital heart disease. Depending on the ultrasound and test sensitivity, these screenings can detect anywhere from 65 percent to 95 percent of congenital heart disease.

However, not all heart disease begins in utero. There are also acquired heart issues that don’t develop until early childhood or beyond. Here are some red flags to look out for when it comes to your child’s heart health and advice on keeping their heart healthy, so they don’t have issues during adulthood.

Poor weight gain and excessive sweating.

If your child sweats profusely, regardless of the weather, that could be a warning sign for heart problems. It’s imperative to pay attention to newborns doing this. If the sweating is to the point where you frequently change their clothes, that’s something you should be concerned about.

Slow weight gain due to poor feeding could also signal problems, especially if they fall asleep while breastfeeding or on the bottle immediately after they start eating, which stops them from getting the calories they need. Dr. Achiau Ludormirsky, another pediatric cardiologist, says that you may also notice your baby huffing and puffing for a while after eating. This huffing and puffing are referred to as tachypnea, a high respiratory rate.

The combination of these symptoms and a rapid heart rate could mean your child has intracardiac shunting or irregular blood flow pathways that put the heart in volume and pressure overload. The hospital will monitor your newborn after birth, but if you get home and notice your baby has blue lips or extremities, this could be cyanotic heart disease, resulting in low blood oxygen.

Chest pains or other strange feelings.

The same criticism that rings warning bells for adults regarding their hearts can be problematic when children start complaining about it too. However, remember that children express pain differently than adults. It can be challenging for younger children to discern what’s happening. It’s typical for heart rates to change based on what’s happening, like running versus sleeping. However, sometimes heartbeats can be unusually fast when they shouldn’t be.

Parents should be mindful of chest pain, which could be real pain or palpitations, coupled with other symptoms like inability to keep up with their friends, exercise intolerance, or being tired all the time. For example, a child that has to be carried in the grocery store when other children their age can walk with no problems. If your child has fainted, that’s another red flag that needs immediate attention.

Family history.

Sometimes, you can find signs that heart problems could be an issue for your child on paper through their family history. In some cases, there’s a family gene called hypercholesterolemia, which is high cholesterol of 600 or more. In these cases, it’s best to set your child up with a cardiologist to help stop early coronary heart disease. If you have family members who’ve had a heart attack at an early age, need a pacemaker, or have any other cardiac problems, it’s best to bring this up with your pediatrician. Hence, the pediatrician is aware and can assess appropriately.

Skin problems.

A child with a fever, rash and dry lips that crack and bleed could be a sign of Kawasaki disease. This condition, which affects the blood vessels, typically develops in children between six months and five years old. Kawasaki disease could go away on its own within 12 days without treatment, but it can lead to serious side effects, like heart disease.

How to prevent heart disease in children.

When specialists talk about and evaluate heart disease in children, there are two primary buckets: congenital issues and acquired. However, there’s also a third bucket: preventative. When you talk about heart disease and adulthood, people assume that things like heart attacks, strokes and high blood pressure can only happen to adults. Still, these conditions can start in early childhood if proper preventative measures aren’t taken.

The first preventative measure you can take is recognizing when your child’s weight for their height isn’t average. It would help if you stayed on top of your child’s wellness visits because the pediatrician will log their growth chart. A body mass index above 85 percent is considered overweight, and 95 percent is classified as obese. Another preventative measure is joyful movement. Even when the weather doesn’t permit going outside, try to get your child moving around the house. You could do anything, like playing Twister, making TikTok videos, or getting them to help you clean.

You should also do your best when balancing your child’s meals. Try to get as many vegetables and fruits into their diet as possible. Frozen is a healthy substitute when fresh fruit or vegetables aren’t available. However, it would be best to skip canned fruits and vegetables because they contain a lot of sugar and salt. It would help if you also practice portion control. An easy way to do so is to serve your child’s meals on a salad plate. Children don’t need to be, and shouldn’t be, eating the same portion sizes as adults yet.

Raising children comes with numerous responsibilities. You have to keep up with their after-school activities and everything else they do. However, the most important thing you have to keep up with is your child’s health, particularly their heart health. Children have the same symptoms as adults but handle pain differently, so pay close attention to their behavior.