Nutrition and Physical Activity

Infants

Proper nutrition for babies and children leads to good health. Babies born with congenital heart disease (CHD) may have special feeding needs in the beginning. They may be slow to suck, may tire quickly during feedings or may not be able to take breast milk or formula by mouth for periods of time. They may not gain weight the way they should and may need extra calories. The American Heart Association has made an excellent guide about Feeding Your Infant with Congenital Heart Disease and can help answer many of your questions. Your doctors and nurses can help you learn about feeding your baby in the hospital and at home. Your baby's growth chart will guide you and your doctors so that your baby gains enough weight but not too much.

Children and Teens

Children and teens are becoming overweight or obese at an alarming rate.

Overweight children or teenagers can have many physical and emotional health problems. For a child with CHD, the impact could be worse. As your baby becomes a toddler and then a young child, set up healthy eating habits early. Children who have repaired CHD sometimes continue to eat in ways that promote weight gain, such as eating high-calorie snacks, even when it is no longer required. Remember, proper nutrition means the right amounts and types of foods. If your child is growing normally, you do not need to do anything more than offer a variety of healthy meals and snacks. What your child wants to eat will vary from day to day. Urging children to "clean their plates" at meal times, therefore, is not necessary if growth is normal. It may even create harmful eating habits that can be difficult to change as children grow older.

How do I know if my child is at a normal weight?

Talk with your child's pediatrician and cardiologist about your child's weight and about proper nutrition as your child grows. Many parents have trouble telling if their child is overweight. One easy way to screen for fatness is a number called BMI or body mass index. It is calculated from knowing a child's weight and height, age and gender. Your doctor or nurse will usually measure and weigh your child at office visits and can tell you the BMI. If you want to find out your child's BMI, see the CDC's BMI calculator for Child and Teen.

How can I encourage my child to eat healthy?

It is important to teach your child to choose healthy foods, to eat balanced meals and avoid gaining too much weight. Good nutrition is a family affair. As a parent, you set the example by deciding which foods to have in your home and how meals will be organized. If you stock healthy snacks and serve balanced meals, your children will have many options for good nutrition. On the other hand, if you keep a lot of high calorie, low-nutrient foods on hand, like candy bars, sugary drinks (soda and fruit-flavored juices), potato chips and fried foods, the result will be poor nutrition and abnormal weight gain. Occasional treats like this can be something to look forward to during family celebrations, but shouldn't be daily fare. Some key points to consider:

• Include fruits and vegetables in breakfast, lunch, and dinner, and as many snacks as possible.
• Avoid sugary drinks, including fruit juice. Instead of drinking fruit juice, eat the fruit.
• Watch portion sizes, particularly of starchy foods, such as rice, potatoes, pasta, breads, bagels and crackers. Click here to see how much you know about the number of calories in today's portion sizes.
• Look for whole grain cereal, bread, bagels, crackers, and pasta. Cook brown or wild rice instead of white rice.
• Don't eat second helpings. To help with this, don't leave serving dishes on the table during meals.
• Avoid sugary cereals and packaged, snack foods.
• Limit eating out and ordering in. A good alternative to a "fast food" dinner is picking up a broiled chicken from the grocery store.
• Think about healthier ways to enjoy the foods you love, such as having vegetarian pizza with low- or no-fat cheese on a whole wheat crust.
• Become a nutritional detective. Learn how to read nutrition labels and what the fine print means.

Sometimes, it is tempting to try to comfort or reward your child with high-calorie snacks or treats, especially during particularly stressful times such as visits to the doctor or hospitalizations. Talking with your child, being physically close and offering support in other ways is not only healthier, but also can be more comforting. Non-food rewards can include games, books or stickers and children especially love a trip to the park, a play date with a friend or "special time" with parents or grandparents.

The National Heart, Lung and Blood Institute has developed We Can (Ways to Enhance Children's Activity and Nutrition) to give parents ideas for helping 8-13 year olds stay at a healthy weight. The site provides strategies for preventing overweight and obesity by making good food choices and increasing activity.

What can my child do to stay active?

As a parent of a child with CHD, you will want to talk with your pediatrician and cardiologist about physical activities that your child can participate in safely. Some children with CHD may be restricted from participating in certain sports or activities but can often engage in normal play. Ask many questions so you can understand clearly what your child may not do and why. It is important to remember that too much time spent in quiet activities like watching TV, using the computer, and playing video games, can lead to obesity and can have a bad effect on a child's ability to function. According to the American Academy of Pediatrics and We Can, health experts recommend that children spend less than 2 hours each day in "screen time".

How can I help my child to be more physically active?

As with family nutrition, you can also set the example here for your child as well as set the rules. And the rules should be the same for all family members! It won't help to have one set of rules for one child and another set and expectations for the rest of the family. Pick out activities everyone can do and enjoy to make family exercise a routine part of each day. Children will enjoy activities more when their parents participate with them. You might consider a family bike ride or a walk through the neighborhood after dinner. A visit to the park or swimming at the local pool on the weekends will offer a variety of choices for you and your child. Purchase toys, games and sports equipment that will encourage your child to be active. Explore options for sports, dance and other physical activities in your community or at your child's school. Speak to your pediatrician or cardiologist to be sure that the activities your child chooses are safe. And remember, children with active parents are more active as children AND adults.

How can I help my teen?

As children become teenagers, they will become more independent. You may find that you spend less time with your child in family activities and even at meal times and you will have less influence over food choices and physical activities. Remember that your child is still watching what you do and eat and responds more positively when a good example is set. Continue to stock nutritious foods in the refrigerator and pantry, limit screen time, offer encouragement and support for physical activity and work together as a family to maintain a healthy lifestyle for everyone.