Hi, Thank you for your query, The second male kid probaly having some cyanotic congenital heart disease. The reddish lips and tongue is due to polycythemia which occurs in cyanotic congenital heart disease due to persistent stimulation of erythriod tissue because of low oxygen in the blood. Hydration to be maintained properly during the states of gastroenteritis. Iron deficiency should be treated with oral iron supplements. Cyanotic spells if present they should be managed promptly. Infective endocarditis prophylaxis should be indicated before any invasive procedures like dental , urogenital interventions. Hope I have answered your query.