Having a baby should be a happy moment in the lives of parents. However, if your baby experiences a hypoxic brain injury before, during or after birth, that happiness can quickly turn to fear and anxiety. Babies who experience oxygen deprivation can suffer from a condition called hypoxic ischemic encephalopathy (HIE).
What is HIE?
Also referred to as intrapartum hypoxia-ischemia or perinatal asphyxia, HIE is a condition that leads to cell damage within the brain and occurs in as many as 1 in 1,000 births. The cell damage associated with HIE is caused by restricted blood flow from a lack of oxygen.
When blood oxygen levels are insufficient for normal metabolism, the human body tries to compensate by increasing the blood flow to the affected area. However, ischemia (inadequate blood supply) to the affected area will prevent oxygen levels from rising.
HIE may not be noticed immediately. However, signs that a baby is experiencing a lack of oxygen can be identified before birth, during the neonatal period and in early childhood.
HIE signs before birth
Oxygen deprivation can occur before a child is born, and the signs can be seen when they’re still inside the womb. Often when these signs appear, it indicates that interventions, such as intrauterine resuscitation or a cesarean section (C-section), may be immediately necessary. The most common signs of oxygen deprivation include:
- Abnormal fetal heart rate
- Abnormal pattern to contractions
- Abnormally low or high weight gain (mother)
- Decreased fetal movement
- High blood pressure (mother)
- Severe cramping
- Vaginal bleeding
While these signs can be scary, it’s possible to stop a baby from developing HIE when these signs are caught early. If your physician recognizes any of these fetal distress signs, they should monitor you closely and assess your baby’s health to determine the best course of action. If your doctor fails to conduct proper prenatal testing or doesn’t appropriately respond, they can be held negligent.
HIE signs during the neonatal period
During the neonatal period (the first 4 weeks of life), there are also signs that indicate a lack of oxygen in a baby. These signs may include:
- Abnormal consciousness (hyperalert or lethargic)
- Abnormal light responses
- Acidemia (increased hydrogen ion concentration in the blood)
- Low Apgar scores at 5 or 10 minutes
- Breathing problems
- Coma
- Feeding problems
- Hypotonia (low muscle tone)
- Organ problems (failure or damage)
- Seizures
Just like before a baby is born, medical professionals should respond quickly if a neonate shows any of the above signs of oxygen deprivation. Newborns should be assessed quickly to determine whether they would benefit from treatments such as therapeutic hypothermia to prevent damage from reduced oxygen levels.
If a newborn has experienced an oxygen deprivation event, it’s important that doctors conduct tests to look for evidence of brain damage, such as brain imaging or an electroencephalogram (EEG), even if the newborn doesn’t exhibit signs of a hypoxic brain injury at birth. These tests can help detect brain injuries that might otherwise be overlooked and determine if further treatment for hypoxia in a newborn is necessary.
HIE signs during infancy and early childhood
In instances where HIE is mild or moderate, signs in the neonatal period may go unnoticed. Some signs of oxygen deprivation may not be present until later and can include:
- Delays in developmental milestones
- Growth delays
- Hearing and visual impairments
- Impaired motor functions
- Seizure disorders
Parents who notice signs of HIE during any stage of their child’s development should contact their child’s pediatrician or healthcare provider. If your child’s doctor diagnoses HIE, it’s vital to move quickly so your child can receive assistance to maximize their abilities.