The human brain, as complex and resilient as it is, is vulnerable to injury. That is particularly true of babies' developing brains. Unfortunately, some children with birth injuries will have to live with brain damage for the rest of their lives, and the implications can be devastating.
Causes of brain injuries during birth
Hypoxic Ischemic Encephalopathy (HIE) - This is a general term for a lack of oxygen in the baby's brain during the labor and delivery process. Hypoxia can be caused by problems with the umbilical cord, uterine rupture, or other factors. Doctors need to monitor the baby's heart rate in order to identify signs of hypoxia and immediately intervene to minimize brain damage.
Infections and Sepsis - Sometimes, during pregnancy or during childbirth, infections can be transmitted to the baby's body from the mother's body. If an infection enters the bloodstream, the baby may go into septic shock, which severely restricts blood flow and can cause damage to the brain or spinal cord. Untreated infections can also cause meningitis - that is, swelling in the membranes surrounding the brain - which again can lead to permanent brain damage. Doctors need to take steps to prevent infections from being transmitted and to immediately treat any infections that could harm the baby.
Bilirubin Encephalopathy (Kernicterus) - Many newborns develop jaundice, which is a yellowing of the skin and whites of the eyes. Jaundice is caused by a buildup of a chemical called bilirubin in the baby's bloodstream. This is a treatable medical condition that should not cause long-term harm if it is caught right away. Untreated jaundice, however, can lead to kernicterus, a serious complication in which the buildup of bilirubin causes brain damage.
Hypoglycemia - The developing brain needs glucose (sugar) because that is the only source of energy it can use. Hypoglycemia is low blood sugar. Again, if caught in time, this is easily treatable, either by giving the baby a drink of breast milk or formula, or in serious cases, giving the baby glucose through an intravenous (IV) needle. Untreated hypoglycemia can cause brain damage.
Birth Trauma - Because newborns' skulls are not fully developed, their brains are particularly vulnerable to traumatic brain injuries during the labor and delivery process. For example, misuse of forceps or vacuum extractors can cause skull fractures that also injure the baby's brain.
Brain injuries can result in a broad range of medical conditions that range from mild to severe. Perhaps the most common medical condition caused by birth injuries to the brain is cerebral palsy. Other children with brain damage develop seizures and epilepsy. There is no such thing as a truly minor brain injury; even seemingly minor damage can have long-term consequences for the child's quality of life.
Diagnosing and treating brain injuries
One of the first indications that a baby may have an injury is his or her score on the Apgar test, a diagnostic tool used one minute and five minutes after birth. Apgar scores consist of five components, each scored 0-2, for a total score ranging from 0-10. Generally, an Apgar score of 7 or higher means the baby is healthy, 4-6 is cause for some concern, and 0-3 is cause for immediate concern.
The main purpose of the Apgar test is to determine whether the baby needs immediate medical intervention. Low scores at the five-minute mark are correlated with brain damage. Often, if a baby has a low Apgar score at the five-minute mark, the test will be repeated at 10, 15 or 20 minutes; if the low score persists, a brain injury is likely. That said, not all low Apgar scores are a result of brain damage, and not all babies with brain injuries have low Apgar scores. It's a red flag, not definitive proof.
Other diagnostic tests can likewise identify some warning signs of a brain injury; for example, a general movements assessment (GMA) is performed around the three-month mark to diagnose signs of cerebral palsy. The only way to definitively diagnose a brain injury, however, is with an MRI or CT scan that looks directly at the baby's brain.
There is no cure for brain damage, but treatments and therapies can help children who are living with brain injuries become more independent and improve their quality of life. While the underlying brain injury won't get better or worse over time, symptoms may change as your child grows and develops. It's important to work with medical professionals and care planning experts to create a comprehensive and dynamic life care plan for your baby.
Unfortunately, many brain injuries are the result of negligence or carelessness on the part of medical providers. If you believe something went wrong as a result of a medical mistake during your child's delivery, you have legal recourse. An attorney in your state can explain your options in a free consultation.