Heart Murmur In Newborn Symptoms | Red Flags For Parents

Hearing “murmur” attached to your newborn can land like a brick. You picture something broken, and your brain races. Take a breath. A heart murmur is a sound a clinician hears with a stethoscope, not a diagnosis by itself. In many newborns it’s a short-lived flow sound as the circulation shifts after birth.

Still, a murmur can also be the first hint of a heart problem that needs attention. The tricky part is that the sound alone doesn’t tell you how serious it is. What guides the next step is the whole picture: how your baby looks, feeds, breathes, grows, and what the exam shows.

What A Heart Murmur Means In A Newborn

A murmur is extra noise during the heartbeat, often described as whooshing. It happens when blood flow turns turbulent. In a newborn, that turbulence can come from normal newborn transitions or from a structural issue inside the heart.

Right after birth, several “switches” flip. The lungs take over oxygen exchange, pressures change, and temporary fetal pathways start closing. During that handoff, flow can speed up in certain spots and create a murmur that fades as the circulation settles.

Innocent Versus Concerning Murmurs

Clinicians often separate murmurs into two buckets: innocent (also called normal or physiologic) and concerning. Innocent murmurs can show up even when the heart is built normally. The American Heart Association notes that innocent murmurs are common in children and harmless. American Heart Association: Heart Murmurs

Concerning murmurs may link to congenital heart disease or valve issues. Some babies with heart disease have a murmur, some do not. That’s why symptoms and exam findings matter as much as the sound.

Newborn Heart Murmur Symptoms And When To Call A Doctor

Most babies with an innocent murmur look and act like themselves. When symptoms show up, they usually relate to oxygen delivery or how hard the heart has to work to push blood. Mayo Clinic lists signs that can point to a more serious murmur-related condition, such as bluish skin, shortness of breath, poor growth, or swelling. Mayo Clinic: Heart murmurs—Symptoms & causes

Feeding Clues That Matter

Newborns do most of their “workouts” at the breast or bottle. A baby who tires out quickly while feeding, falls asleep after a few sucks, or needs long breaks to catch breath is telling you something. Watch for:

• Feeds that stretch far past the usual time because your baby keeps pausing
• Milk dribbling with frequent coughs or gagging
• Sweating on the forehead during feeds
• Fewer wet diapers because intake is low

Breathing And Color Changes

Breathing patterns can be noisy in newborns, so focus on trends. Red flags include fast breathing that doesn’t settle, ribs pulling in with each breath, flaring nostrils, or grunting. Color matters too: a gray or blue tone around the lips or tongue, especially with crying or feeding, needs prompt evaluation.

Circulation Signals You Can Spot

Some heart conditions affect blood flow to the body. Call your clinician right away if you notice:

• Cool hands and feet that stay cool even in a warm room
• Long capillary refill (press a toenail, color takes more than a couple seconds to return)
• Unusual sleepiness or hard-to-wake behavior that’s new for your baby

When It’s An Emergency

Go to urgent care or an emergency department the same day if your newborn has blue lips or tongue, pauses in breathing, severe trouble feeding, repeated vomiting with poor intake, or seems limp. Trust your gut. If something feels off, get eyes on your baby.

Heart Murmur In Newborn Symptoms: What Parents Notice

Parents often ask, “Can I hear it?” Usually you can’t. A murmur is heard with a stethoscope. What you can notice are the side effects when blood flow or oxygen levels aren’t where they should be. Think in three buckets: feeding, breathing, and color/energy.

Also pay attention to timing. A baby may look fine in the hospital, then struggle a few days later as fetal pathways close. Some serious heart defects declare themselves in that window.

How Clinicians Check A Newborn With A Murmur

A newborn exam is more than listening. The clinician checks pulses in the groin, compares oxygen readings, looks for liver enlargement, and watches breathing. Many maternity units use pulse oximetry screening to catch critical congenital heart disease.

Primary-care guidance stresses that infants with murmurs deserve careful assessment and, when indicated, referral for echocardiography rather than “watch and wait” alone. AAFP: Heart Murmurs in Children—Evaluation and Management

Questions You’ll Hear In The Exam Room

Expect questions that sound basic but give strong clues:

• Was your baby born early?
• Any family history of congenital heart disease?
• How many wet diapers per day?
• How long does a feed take?
• Any blue spells or noisy breathing?

Tests That May Be Ordered

Some babies need no testing at the first visit. Others get one or more of the following:

• Pulse oximetry: checks oxygen saturation in the hand and foot.
• Echocardiogram: an ultrasound that shows heart structure and flow.
• Electrocardiogram (ECG): maps the heart’s electrical rhythm.
• Chest X-ray: looks at heart size and lung blood flow.

If your baby is discharged with a murmur, some NHS maternity leaflets advise repeat listening and clear safety-net symptoms to watch for at home. Royal Free London NHS: Heart murmurs in babies

Common Reasons Newborns Have Murmurs

Parents often want a name for the cause. Sometimes you get one right away. Other times you get a plan: monitor growth and symptoms, then scan if the sound persists or the exam suggests a concern.

Normal Newborn Transitions

Two common transition-related sources are:

• Closing ductus arteriosus: a fetal vessel that normally closes in the first days after birth.
• Peripheral pulmonary stenosis of infancy: mild turbulence in branches of the pulmonary arteries that can fade as vessels grow.

Structural Heart Findings

Some murmurs come from openings or narrowings inside the heart. Examples include ventricular septal defect (VSD), atrial septal defect (ASD), valve stenosis, or coarctation of the aorta. The management ranges from simple follow-up to medicine or procedures, based on the specific finding and your baby’s symptoms.

Symptom Patterns And What They Often Point To

Symptoms can overlap across conditions, so this is not a home-diagnosis tool. It can help you communicate clearly when you call the clinic.

Table 1: Broad + in-depth, 7+ rows, max 3 columns

What You Notice	What It Can Suggest	What To Do Next
Blue lips or tongue	Low oxygen level or mixing of blood	Same-day urgent evaluation
Fast breathing at rest	High work of breathing; heart or lung causes	Call clinician; urgent care if severe
Ribs pulling in with breaths	Breathing distress	Same-day evaluation
Tiring during feeds	High effort to circulate blood	Ask for prompt assessment
Sweating during feeds	Higher workload on the heart	Call clinician within 24 hours
Poor weight gain	Low intake or higher calorie burn	Book weight check and exam
Weak or hard-to-find groin pulses	Reduced blood flow past the aorta	Same-day evaluation
Cool legs with warmer arms	Circulation imbalance	Call clinician promptly
Extreme sleepiness or limp tone	Low oxygen, low blood sugar, infection, other causes	Urgent evaluation

What Happens After You Leave The Hospital

At home, your job isn’t to judge the sound. It’s to watch your baby’s basics: feeding, breathing, color, diapers, and wakefulness. If you’re tracking anything, keep it simple:

• Feed start and finish times
• Wet diapers per day
• Any blue or gray spells and what was happening right before
• Breathing rate when calm (count for 30 seconds, double it)

Practical Home Checks That Don’t Get Weird

You don’t need gadgets beyond what you already have. A phone timer helps with breathing counts. A scale can help if your clinician asks you to track weight, but don’t buy one just because you’re anxious. If you do weigh, do it at the same time each day with the same setup.

Sleep, Crying, And Reassurance

Newborns sleep a lot, so look for a change from your baby’s baseline. If your baby wakes to feed, makes eye contact when awake, and settles after feeds, that’s a good sign. If the cry is weak, the baby is hard to rouse, or breathing looks labored, that’s a different story.

How Murmurs Get Followed Over Time

Many newborn murmurs fade as the ductus arteriosus closes and the lungs fully take over. When the murmur persists, the plan usually involves a repeat exam and, if needed, a heart ultrasound.

If an echocardiogram shows an innocent finding, your clinician may tell you there’s no restriction on feeding, tummy time, or normal baby activity. If a structural finding is present, you’ll get specific guidance on follow-up visits and what to watch for between them.

Table 2: After ~60%, max 3 columns

Test Or Check	What It Shows	When It’s Often Used
Pulse oximetry (hand/foot)	Oxygen level and a clue about blood flow patterns	Newborn screening and sick-visit triage
Four-limb blood pressure	Differences that can hint at aortic narrowing	When pulses feel uneven
Echocardiogram	Heart anatomy, valve motion, direction of blood flow	Persistent murmur or concerning exam
ECG	Rhythm and signs of chamber strain	When rhythm issues are suspected
Chest X-ray	Heart size, lung blood flow patterns	Breathing symptoms or poor growth
Blood tests	Infection clues, anemia, metabolic issues	When symptoms could be non-cardiac

Feeding And Weight Gain Tips While You Wait For Follow-Up

If your baby is feeding well and the clinician isn’t worried, you can stay with normal routines. If feeds are a struggle, small changes can help while you wait for the next visit:

• Keep feeds calm and unhurried; pause to burp when breathing looks fast.
• Offer smaller, more frequent feeds if your baby tires out.
• Track wet diapers; it’s a simple window into intake.

If your baby is losing weight or not gaining, call your pediatric team quickly. Newborn weight can swing in the first days, but ongoing slow gain needs hands-on review.

Questions To Ask At The Next Appointment

Appointments can feel rushed. A short list keeps you on track:

• Does this murmur sound innocent or does it need a scan?
• Were oxygen readings normal in both hand and foot?
• Are pulses equal in the groin?
• What symptoms mean I should seek same-day care?
• When do you want the next weight check?

A Simple Checklist For Your Notes App

Parents often feel calmer when they have a clean plan. Copy this into your phone and update it once a day:

• Feeds: number and average length
• Wet diapers: count
• Breathing: calm rate (optional)
• Color: any blue or gray spells
• Energy: easy to wake for feeds, yes/no

If everything stays steady, you’ll likely hear the same phrase many parents hear: “We’ll recheck it, and it may fade.” If things shift, you’ll have clear details to share, which speeds up care.