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Parents have been sounding off to me with lots of questions about heart murmurs in their children.

Allow me to get to the heart of the matter and provide some information on this topic.

A heart murmur is simply a noise heard by a stethoscope between the beats of the heart due to the flow of blood through the heart. In fact, it sounds like water flowing through a hose.

While the term heart murmur may be scary to hear, for most children this is extremely common. It doesn’t mean anything is wrong — just that blood is whooshing through the pipes and chambers of the heart, and if the blood is rushing faster, the noise it makes is louder and is often the cause for a heart murmur.

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When do we worry about murmurs?

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¯ We worry most about infants at birth and in the first few months of life. This is because a murmur might be a signal that there is a congenital abnormality involving the heart. There may be an abnormal connection between chambers or problems with valves controlling blood flow in the heart or the major blood vessels coming from the heart.

¯ If a baby appears blue in the face and has a murmur. This occurs rarely. If it does, your infant’s health care professional will do other tests such as a chest x-ray and an electrocardiogram to diagnose whether a heart problem exists.

¯ If a problem is revealed they will refer your child to a pediatric heart specialist. The specialist will do an echocardiogram or ultrasound of the heart which will help to determine the diagnosis and further treatment approaches.

¯ When a child reaches preschool and school age and is noted to have a murmur, this is usually less cause for concern. By examining your child and listening to the sound, your child’s health care professional should be able to determine if further testing is needed, but most of the time it is not.

¯ If the murmur is just due to blood flowing noisily through the heart, treatment is not needed. However, a follow-up visit or two may be requested to make sure the sound is not changing or has gone away.

¯ If the flow is stronger because your child is anemic due to low iron and needs to make more red blood cells, iron therapy might be required. Otherwise, no therapy is indicated, and there needs to be no restriction from sports or other physical activities for what we call an innocent murmur due to noisy blood flow.

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When do we otherwise worry about a murmurin an older child?

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¯ Only if it is accompanied by rapid breathing, chest pain, or an older child being very tired or passing out — but these are very rare occurrences.

Hopefully tips like these will allow you to not miss a beat when it comes to knowing more about your child’s heart murmurs.

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Lewis First, MD, is Chief of Pediatrics at the Golisano Children’s Hospital at UVM Health and Chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and MyNBC 5.