Sternal Precautions for Infants (0-12 months)

After heart surgery, the skin and breastbone, or “sternum,” need time to heal. Usually, the skin incision takes 2-4 weeks to heal, and the breastbone takes 6 weeks to heal.  The medical team may adjust these timeframes if there were any issues with healing after surgery.  

What are sternal precautions? Sternal precautions are guidelines used to help protect the breastbone after open chest surgery.

During the first two weeks after chest closure:                                             

• Avoid placing your child on their stomach for tummy time

• Hold your child in an upright chest-to-chest position. This is important for bonding and building stronger neck and back muscles

• You may wear a device to carry your child is safe as long as you follow the device manufacturer’s guidelines and follow sternal precautions

Two weeks after chest closure, start doing tummy time with your child: The American Academy of Pediatrics recommends that babies sleep on their backs. “Tummy time” refers to awake supervised play on their stomach.

• Continue to hold your child in chest-to-chest position  

• Slowly, lean back with your child on your chest

• The goal is to work towards tummy time on a flat and firm surface

During the first six weeks after chest closure:

• Scoop your child when picking them up or helping them move by placing one hand behind their head and the other hand under their buttocks

  • Do not lift your child from under the arms

  • Do not pull your child by the hands into a sitting position

  • Scoop your baby in and out of the car seat. Refer to the manufacturer instructions on proper fit of straps.  Do not add extra padding between the chest and car seat straps

• Try to keep your child’s arms lower than shoulder height. If you are getting them dressed, move one arm at a time overhead.

  • If your child reaches up with both arms, try to use a toy to encourage them to bring their arms back down. Do not force their arms down  

• Burp your child in an upright chest-to-chest position or in a supported sitting position

• If your child was already reaching, rolling, sitting, crawling, or standing, they can continue to do these activities as long as you follow sternal precautions. Let your infant do what they are able. Infants will limit themselves as needed.

• After six weeks, your child may return to normal activity, unless otherwise directed by your child's cardiologist.

Reviewed on 7/29/2024 by Rebecca Hoffritz PT, DPT