Infant Brain Damage

In 2016, a Georgia jury awarded $30.5 million to the family of a young girl who suffered from infant brain damage at birth. The mother, who gave birth to the baby in 2012, claimed the medical staff was negligent during the last few days of pregnancy and during the birthing process, and that doctors gave sub-standard care even when tests indicated the fetus was under stress. She alleged that because of this negligence, her daughter was born with severe brain damage, resulting in cerebral palsy.

This is just one many infant brain damage lawsuits that have been successful in court. The medical malpractice lawyers at Chaffin Luhana are currently investigating cases in which doctors failed to take the proper safety precautions either before or during a baby’s birth, resulting in injury to the child. If your child suffered from infant brain injury, you may be eligible to file an infant brain injury lawsuit.

What is Infant Brain Damage?

According to a report from the Neonatal Encephalopathy and Neurologic Outcome, brain injuries affect about 3 in every 1,000 babies born full-term in the U.S., and about half of those cases are linked to oxygen deprivation during labor and delivery. Infant brain damage occurs when something injuries or damages the brain. The trauma may range from mild to severe, with short or often long-term consequences to the child and his or her family.

When the brain is damaged, the cells in the brain may be destroyed or may suffer from an injury that causes deterioration over time. Affected infants may be born with some connections between the brain cells malfunctioning or destroyed so that the brain can’t operate as it normally would. Though there are many things that can cause brain damage, including a blow to the head, tumor, illness, or an infection, the most common in infants is a lack of oxygen.

What Causes Infant Brain Damage?

Infant brain damage that occurs immediately prior or during the birthing process may be caused by one of the following:

Oxygen deprivation: Also called “birth asphyxia,” this occurs when a baby’s brain and other organs do not get enough oxygen before, during, or right after birth. Oxygen deprivation traumatizes the cells so they can’t work properly, and waste products result that cause cellular damage. The amount of damage generally depends on how long the baby goes without oxygen, how low the oxygen level is, and how quickly the baby receives appropriate treatment. If the deprivation is mild or even moderate, babies may recover completely. Babies may be able to withstand a short period of time without oxygen, but even a mild deprivation can result in damage down the road. Research published in 2014 showed that newborns suffering even from mildly low oxygen levels at birth had learning or behavioral issues at five years old, including speech delay, autism, and attention deficit disorder. Those who were oxygen deprived for a longer time—a brain without oxygen for minutes, for example—may suffer from more severe brain damage.
Infant jaundice: Infant jaundice is a condition that causes the baby’s skin and eyes to take on a yellow hue. It’s caused by an excess of bilirubin in the blood. Bilirubin is a normal part of the pigment released from the breakdown of used red blood cells. Immediate treatment usually solves the issue, but if treatment is delayed, levels of bilirubin may increase, which can cause jaundice brain damage, or “kernicterus.” This condition, in turn, can cause cerebral palsy, hearing loss, and intellectual disabilities. Premature birth and significant bruising during birth can both increase the risk of jaundice.
Birth trauma: Birth trauma occurs if tissues and organs are damaged in a newly delivered baby. Usually, this is the result of excess physical pressure or trauma during childbirth. Examples include broken bones, cuts and lacerations, or injuries sustained because of the use of instruments like forceps or vacuums. This sort of trauma can cause brain damage and lasting cognitive difficulties.
Infections: If the mother has an untreated infection during pregnancy or close to birth, the baby may suffer from brain damage. Infections that may affect the fetus include herpes, rubella, varicella, yeast infections, cystitis, and more.
Bleeding: If an injury occurs that causes bleeding inside the brain, it can lead to brain damage. Babies that are born prematurely are more at risk for this sort of injury. Oxygen deprivation can also cause brain hemorrhages. This can be a difficult injury to detect, as the baby may not exhibit symptoms for a while.

When Brain Damage Results in Cerebral Palsy

Infant brain damage can lead to cerebral palsy, which is a physical disability affecting movement and posture. The Centers for Disease Control and Prevention (CDC) states that cerebral palsy (CP) is the most common motor disability in childhood, and affects 1.5 to 4 per 1,000 births in the U.S. It results from brain injury or brain malformation, sometimes because of complications during the birthing process.

CP can affect the arms, legs, and face, sometimes damaging only one limb and other times affecting more than one. Symptoms may include muscle tightness or rigidness, trembling, shaking, and writhing. The disorder may also cause problems with balance, posture, and coordination, so that simple daily tasks like walking, sitting, tying shoes, and grasping objects may be more difficult.

Other more serious complications of CP may include vision and hearing loss, as well as intellectual impairment and seizures.

What are the Symptoms of Infant Brain Damage?

Symptoms of infant brain damage depend on the type and severity of the injury, and may include:

Difficulty breathing immediately after birth
Impaired reflexes
Loose or stiff movements
Sluggishness (lethargy)
Poor feeding
Unexplained seizures
Excessive crying or screaming or other abnormal behaviors
Difficulty focusing the eyes
Deformities, like a small skull or abnormally large forehead, or distorted facial features
Trouble sleeping
Death (in most severe cases)

As the child gets older, other symptoms may become noticeable:

Developmental delays; missed milestones
Problems with attention and concentration
Difficulty controlling impulses
Trouble remembering things or understanding things
Hearing and vision problems

When Medical Staff May be to Blame

If the medical staff doesn’t follow proper protocols when caring for the mother and delivering the baby, infant brain damage may occur. Risk for infant brain damage increases when the birth is difficult, or when the following risk factors are present:

Premature birth
Problems with the placenta separating from the womb
Long or difficult delivery
High blood pressure in the mother
Large infant weight and size (also called “fetal macrosomia)
Breech delivery
Use of instruments to extract the baby (like forceps or a vacuum)
Baby’s airway is not formed properly, or becomes blocked
Umbilical cord problems

Medical professionals are trained to assess the risks and to follow standard protocols of care, but sometimes mistakes are made. Delays may occur that shouldn’t have occurred, or healthcare personnel may fail to take the appropriate steps to be sure mother and baby are cared for properly. Staff may not be properly trained; there may be poor communication between staff members, particularly during a shift change; or there may be insufficient staffing levels at the medical center.

The Royal College of Obstetricians & Gynaecologists (RCOG) assessed birth injuries occurring in the United Kingdom in 2015 that resulted either in death or severe brain injury, and found that three quarters of those babies might have experienced a different outcome with different care. Below are some of the most common causes of infant brain damage, when not handled correctly:

Use of forceps or vacuum extraction: Both of these tools may become necessary if the baby gets stuck somehow in the birth canal. This may occur for a number of reasons, and it’s dangerous to leave the baby there, as that presents risks to both the baby’s and the mother’s health. Forceps are designed to be placed on each side of the baby’s head so the doctor can gently pull the baby out, but the right pressure and placement must be used. If the doctor uses too much force, it can cause trauma to the skull and spinal cord, which can result in brain damage. Vacuum extraction uses suction to pull the baby out, but if not used correctly, it can apply too much pressure to the baby’s head, causing bleeding in the brain.
Umbilical cord issues: The umbilical cord provides the baby with oxygen-rich blood from the mother until birth. If it becomes wrapped around the baby’s head, becomes knotted, or otherwise malfunctions, it can cause oxygen deprivation and brain damage.
Preeclampsia: This is high blood pressure that occurs during pregnancy. Without treatment, it can limit blood flow to the baby during birth, resulting in oxygen deprivation. It can also cause placental abruption, where the placenta separates from the inner wall of the uterus. This also affects oxygen flow to the fetus.
Shoulder dystocia: The infant’s shoulder becomes lodged in the birth canal, usually because of large infant size or awkward positioning during birth. If the baby remains there too long, he or she may suffer from lack of oxygen. If the baby is pulled from this position too forcefully, brain damage may also result.

There may also be problems after birth that doctors either don’t notice or don’t treat properly. These may include low blood sugar levels, jaundice, and bleeding on the brain. If the baby isn’t breathing at birth, doctors must resuscitate immediately and apply treatment.

How is Infant Brain Damage Treated?

There is a fairly new way of treating brain-injured babies called “Neonatal Therapeutic Hypothermia,” which means “infant cooling.” The idea is to lower the baby’s body temperature which may help prevent oxygen deprivation from causing severe brain injuries. Scientists have found that these injuries take time to develop, and involve a gradual cascade of injury, damage, and death to the cells.

Slowing the baby’s metabolism through cooling can help prevent brain cell death, stopping the brain from experiencing any further degradation. It cannot reverse any damage that was done before the cooling was started, which is why immediate and swift treatment is critical. The doctors need to be aware of the issue, and ready to treat quickly.

Other than cooling, treatment methods depend on the severity of the injury. Surgery is generally reserved only for the most serious cases. Medications, physical therapy, and occupational therapy are commonly used to help baby and family to cope with the challenges brain injury presents.

If surgery is needed, it usually involves reducing swelling, repairing fractures, stopping bleeding, and preventing blood clots.