Baby with bradycardia - AIBU?

[Hyperemesishell]

Currently in hospital with baby aged 7m who is being treated for sepsis, however luckily not unwell and has been caught very early.

Heart rate is dropping consistently during all periods of sleep - naps, overnight etc. Lows of 57/58 bpm but frequenting high 60’s/low 70’s all night. It does improve when baby is roused (and baby is consistently able to be roused) but AIBU to think this is not normal in a baby of 6 months old?

First night they spotted it they did an ECG which was ok but we are 7 nights in now and this is a consistent finding and actually probably happening more consistently than the first night where it would drop and bounce straight back to 80/90.

Some of the nurses seem quite concerned (saying it’s not normal etc as do a couple of doctors) but some are very nonchalant.

Does anyone have any experience please? FWIW baby was in hospital shortly after birth and this didn’t happen back then.

No it is not normal but that doesn't mean it's a bad thing.

It could be the medication they are giving your baby it could be 100 other things.

I don't want to scare you but when I was working in cardiology our youngest pacemaker patient was about 6-7 months.

Now that is a possibility but if it does happen it is a short procedure. In adults it is done under local anesthetic.

With a baby then they would use a general anesthetic and usually the pacemaker is put in the abdomen with a wire that goes in to the actual heart.

As I said it could be 100 things, talk tot he Drs and nurses.

Heart rate does drop when you are asleep, the fact the HR comes back up when the baby is awake is a positive thing.

You and baby are in the best place. Try not to worry, your baby is being monitored and treated.

Push for a echo / scan - pre the sepsis was there breathlessness or other symptoms you would be worried about?

They are so little at that age & so many things it could be as well as normal for them.

How is it during and post feeding?

I would ask for more tests before discharge. When the alarms go and the nurses next come, you can ask for a review and if you get the doctor that also feels concerned push for a review with the cardiologist or scan.

I am not a medic, but had a child with various things & took a lot of pushing for heart to be checked even with obvious symptoms. It got to the point when the doctors presumed basics had been done like X ray, scan etc so do remind them if no scans have been done.

Each time you see the doc you can say no X has been done, do you think he needs it?

Ask them directly what is causing it in their opinion? Ask why they haven't done a heart echo. Ask what other tests they plan to do. If they don't plan to investigate ask them to document, I front fo you, that you asked for additional tests and they have declined them and why.

Thanks everyone. No concerns pre the sepsis. All the other pjs are normal despite the infection.

it’s so difficult when you don’t see the same doctor twice. The nurse overnight was really concerned but doctor said he’d had a normal ecg so to just leave it. It just feels very light touch for something potentially so serious.

I will continue to advocate for him the best that I can and continue to raise it, ask questions etc.

@Hyperemesishell how are things now?

Thanks for checking in @2023readyornotherewecome we are still in and the heart rate is still doing the same. The Dr’s are saying it’s not ‘normal’ but ‘normal for her’. I have raised it with all of the various doctors we’ve seen over the course of the stay but nothing else has been done and no further investigations carried out. They say it’s totally unnecessary so we’re stuck really.

Echo won't tell you anything in relation to heart rate - it assesses structural problems. If the ecg has been dine during an episode of low heart rate and is normal you have nothing to worry about. Hypothyroidism can cause low heart rate with a normal ecg - but would expect it to be low all the time.

I think I'd ask for a meeting with the doctor and just ask them to explain why no further tests are needed. Maybe there is a simple explanation but you're her mum and need to know what it is. They can't just say 'normal for her' and not offer any reasoning when there are potentially serious reasons to rule out.

It's horrible when they're little and in hospital - had this twice with ds as a newborn. He's 16 now and towers over me but god they're so tiny and vulnerable when they're new and plus you're probably exhausted ♥️

@User613 ECG was done when awake and she only has the low HR when asleep so I’m not sure this is the case?
All made worse by the fact I heard the consultant telling someone she couldn’t believe the jr doctor had not done an ecg on a baby with HR of 65 (my baby) and that it was lucky the baby had woken up…..

@Hyperemesishell I am so sorry you heard that comment. I know it is hard when you are in there and May feel like everything is happening to you rather than with you.

I suggest as another poster said that you ask for a meeting or at ward round today, say you want further tests or referral to cardiology before discharge.

You could contact PALS or go & see them. When I have contacted them suddenly had results!

A low point for me, my now 4 year old was poorly at 8 weeks with heart symptoms, they said you can go home while we wait for GOSH but you need to watch a CPR video before you go home. In hindsight the basic tests should have been done etc etc - things seem to change when we turned up at A&E my husband was there & we called a meeting with the consultant.

Hope today goes well & baby is ok.