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Did Your Newborn Suffer Cerebral
Palsy or Another Brain Injury Before
or During Labor and Delivery?

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Our Birth Brain Injury Resource Guide

the guide

Get a FREE guide of resources available throughout Ohio to children and families of children who were born with brain injuries.

Our guide can help you build a foundation of knowledge and tools that will help you help your child
now and in the future.

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Cooling Therapy for Newborns with Hypoxic Ischemic Encephalopathy (HIE)

Infants who suffer from loss of oxygen during labor or delivery will experience mental disabilities or other problems such as seizures or cerebral palsy. HIE is a serious condition with symptoms that range from mild mental challenges to lifelong disabilities. Unfortunately, some children do not survive.

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Those who do may be severely impaired. Treatment for HIE has been very traditional until just the last several years. Cooling therapy for newborns with HIE can improve the outcome for some children.

Hypoxic Ischemic Encephalopathy

Hypoxic ischemic encephalopathy, HIE, is caused by lack of blood flow to the infant’s brain. It could occur during labor, birth, or soon after birth. Lack of blood flow can be caused by a number of things including a ruptured uterus, trauma or shock in the mother, umbilical cord problems, or a prolonged or difficult birth. Sometimes the exact cause is not known.

The length of time the infant was without oxygen is the most important factor when determining the prognosis. Every case is different, and the outcome can be quite unpredictable. There are several stages or severities of hypoxic ischemic encephalopathy.

Elk & Elk

Mild – Stage 1
Considered mild, the newborn may be hyper-alert but with normal activity and no seizures. They may have poor feeding habits and could be extremely sleepy or cry excessively. These symptoms may normalize over the first few days of life.

Moderate – Stage 2
The newborn may be lethargic and could develop seizures. The child has poor muscle tone and may suffer from periodic breathing or apnea and a slow heart rate.

Severe – Stage 3
The most serious of those with HIE, the newborn may be comatose, suffer with seizures, and have no spontaneous activity. The infant may require ventilation and does not have normal reflexes.

The doctors and medical team will assess the newborn to determine the severity of HIE. A neurological exam is done to determine the severity of the infant’s condition.

The exam checks these major areas and assigns a point value of 1 to 3 to each. 1 point indicates normal activity while 3 is the most serious impairment.

  • Level of Consciousness
  • Spontaneous Activity
  • Posture
  • Tone
  • Primitive Reflexes
  • Respiration, Pupils, Heart Rate
  • Seizures (yes or no)
  • Sedated / Paralyzed (yes or no)

Once a determination is made as to the severity of HIE, treatment can begin. Most infants diagnosed with HIE are candidates for cooling treatment. However, some infants should not be given cooling treatment. Infants with a birth weight of less than 1800 grams, those with known chromosomal abnormalities, and those who are in extremely critical condition should usually not be given cooling therapy.

Benefits of Cooling Therapy

There are thought to be some potential benefits to the use of cooling therapy for newborns with HIE. It may help to stop further damage from occurring as the brain normalizes after receiving full oxygen levels again. Infants who were cooled could have a better long-term prognosis. While more research must be done, preliminary results have found that those who receive cooling treatments are more likely to function at a higher level and have a lower mortality rate.