Just as there are many different types of birth injuries. As a result, there are also many different symptoms that could be a sign that your child has been injured. Sometimes, the symptoms of a birth injury appear immediately, even while your baby is still in the hospital. Others, however, do not appear until your child develops through growth stages. Always consult with a physician before assuming your child has a birth injury.
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Birth Injury Indicators
Below, you will find more details about different birth injury symptoms that are commonly reported by healthcare providers and parents.
Arched Back While Crying
Although it is common for infants to cry, it is not always typical for them to exhibit an arched back while doing so. However, it is also not always something to be concerned about. Sometimes parents see this when toddlers cry and arch their back as a way of wriggling out of a mother’s grasp. Other times, it is a symptom of gas or another internal discomfort.
Yet, while this struggle is easily identified in toddlers who are defiant and trying to get away, it should not be seen in infants for no apparent reason. If your baby has an arched back while crying, it may be an indication of a medical problem. Arched back while crying can be indicative of:
An arched back while crying may be an indication of cerebral palsy. Since cerebral palsy is a neurological disorder marked by uncontrollable or spastic movements, infants may involuntarily arch their backs, with or without crying. An arched back alone, however, is not indicative of cerebral palsy. Other symptoms are usually present as well.
An arched back while crying is primarily symptomatic of pain. Arching the back doesn’t really do anything for the child (unless their muscles are also writhing, but that’s another symptom entirely), but instead, it’s a behavior that exhibits a kind of desperation. It is a movement that attempts to self-soothe. At this phase in your identification of the symptom, you should consider making an appointment with your pediatrician because sometimes the problem is not externally obvious.
If your child recently had or currently has jaundice and is exhibiting an arched back while crying, you should consult your doctor immediately. Arching the back while crying in conjunction with inadequately treated jaundice is a sign of kernicterus, a rare type of brain damage caused by excessive levels of bilirubin. Left untreated, kernicterus can lead to cognitive disabilities, hearing loss, and even death.
Other symptoms of kernicterus include an absent startle reflex, poor sucking or feeding, lethargy, a bulging soft spot on the head, or seizures. While an arched back while crying may appear like average uncomfortable crying for a new parent, it is not something to take lightly. It could be indicative of a birth injury and may mean something is wrong with your baby.
An arched back while feeding may be an indication of gastrointestinal reflux (also known as acid reflux), which may or may not be accompanied by crying. Fortunately, this problem is usually treatable by medication. It is still important to contact your physician to rule out any other problems.
Infant Apraxia, also known as childhood apraxia of speech (CAS), is a motor speech disorder in which common communication development is missing. CAS isn’t a muscle disorder in which the mouth muscles fail to communicate. Instead, it is a disorder in the brain that can be caused by brain injuries during birth.
It’s important to understand that not all babies and toddlers are the same. Therefore, each may exhibit a few of the signs of apraxia or several. In general, however, the most common signs include:
- Failure to coo or babble
- Says first word late or doesn’t say any words at all
- Understands only a few vowel and consonant sounds
- May have issues with feeding
Toddlers and Children:
- Difficulties in imitating speech
- Difficulties in saying long words (prefers short words)
- Words sound choppy or monotonous when speaking
- Says words incorrectly
- Excessive grunting and pointing
- Speaking mostly in vowels
Abnormal Positioning of the Limbs
Seeing your infant’s limbs in an abnormal position, such as the arm inward and towards the body, may be nothing more than the way they feel the most comfortable. However, if the abnormal posture seems consistent, it’s important to speak with a pediatrician as soon as possible to rule out a number of medical conditions associated with it.
Abnormal positioning of the limbs is a birth injury symptom that may be associated with the following injuries or conditions:
When a child has cerebral palsy, he or she may have abnormal positioning of the limbs. Cerebral palsy is a neurological disorder that is often misunderstood as a muscular disorder. Cerebral palsy is a neurological disorder that manifests itself through spastic or hypotonic muscles.
Erb’s palsy is also known as brachial plexus palsy as the nerve damage affects the brachial plexus nerves between the neck, collarbone and shoulder. If the brachial plexus nerves are damaged, overstretched or torn, the arm may not function as it should. This can lead to abnormal positioning of the upper extremity.
Other symptoms that characterize this birth injury could include paralysis to that arm, or intense pain or sensitivity to that arm. It can also cause the arm to be internally rotated with the wrist flexed (waiter’s tip abnormality).
Klumpke’s palsy is a more severe form of Erb’s palsy. With Erb’s palsy, the child has very limited movement of the affected arm and it is almost always turned in toward the body. Another characteristic symptom is that the arm is turned in toward the body and the affected hand is in a claw formation. Together, these symptoms are obvious and may indicate a birth injury.
Dyspnea or Shortness of Breath
Breathlessness and shortness of breath are both casual terms for dyspnea. It is something that can be experienced in all age groups, but it is often indicative of a medical condition. With infants, parents and pediatricians must be proactive when there is breathlessness or shortness of breath. There could be an underlying medical issue that requires immediate medical assistance. Some birth injuries and related conditions that can cause breathlessness include:
Group B Strep Infection
Breathing problems or breathlessness is one of the many symptoms associated with group B strep infection (GBS) when it has lung involvement, such as in GBS pneumonia. Sometimes mothers carry group B strep infection without even knowing it, which is called an asymptomatic carrier. They can then transmit it to their baby during childbirth. Doctors generally test women for GBS towards the beginning and towards the end of pregnancy. When doctors don’t, the mother may unknowingly carry the infection and transmit it to the baby. This is considered a birth injury because it causes undue harm to the baby.
Other GBS-related birth injury symptoms include fever, grunting sounds, bluish skin, seizures, limpness, stiffness, heart rate and blood pressure abnormalities, poor feeding, and fussiness.
Hypoxic Ischemic Encephalopathy (HIE), Hypoxia, or Anoxia
One of the most difficult, common and tragic birth injuries is hypoxic-ischemic encephalopathy (HIE). HIE occurs when the baby suffers from a lack of oxygen at birth. He or she may be hypoxic (lacking adequate oxygen) or anoxic (complete oxygen deprivation). If the baby is not breathing or has difficulty breathing immediately after delivery, this may be an indication of hypoxia. The doctor should work immediately to assist the child’s breathing to prevent brain damage.
Meningitis is the inflammation of the fluid and membranes that surround your brain and spinal cord. It has many causes, such as bacterial, viral, etc. Meningitis can lead to difficulty breathing in infants. Infants can get meningitis if their mother transmits an infection, or if they develop an infection before, during or shortly after delivery. Other symptoms of meningitis to watch out for include fever, trouble eating, sensitivity to light, stiff neck, irritability, lethargy or seizures.
The vast majority of newborn bruising is merely a result of the physical stresses of labor and delivery. Newborn bruising can be the result of a long and arduous labor. Difficult labors are often the result of:
- Babies that are large for their gestational age
- Premature babies born before 37 weeks
- Cephalopelvic disproportion, which occurs when the infant’s head is too large to fit through the mother’s pelvis
- Breech births
In difficult deliveries, there is an increased risk that birth trauma may occur. All babies can experience birth injuries as a result of prolonged labor. In all deliveries, physicians must assist and monitor both the mother and newborn in order to ensure the delivery goes as smoothly as possible.
When the delivery is complicated by difficult labor, for example, physicians may need to assist in delivery, especially if there is fetal distress. In these situations, attending doctors may use instruments, such as forceps or vacuums, to deliver the baby. Though these medical tools are useful and solve many birth-related complications, they may cause birth injuries like bruising.
During childbirth, the mother’s pelvic bones and muscles within the birth canal exert pressure on the newborn. This can cause breakage in the capillaries and venules under the skin, and can form contusions. There are three types of contusions:
- Subcutaneous contusions occur under the skin (common).
- Intramuscular contusions occur within muscle tissue (less common).
- Periosteal contusions affect bones (very rare).
Contusions can also be caused by the use of medical instruments like forceps or vacuum extractors. Generally these bruises are superficial and require minimal, if any, medical treatment.
Caput succedaneum is a medical condition marked by swelling on an infant’s soft scalp tissue. It is often a result of difficult labor, especially after the uterine membranes break, It can, however, occur in normal deliveries also, especially for first-time mothers. Caput succedaneum is caused by pressure of the uterus or vaginal wall on the baby’s head.
The principal sign of caput succedaneum is a soft, puffy swelling of the scalp, particularly on the part of the head that emerged first. In many cases, the condition is accompanied by bruising to the scalp or face.
Cephalohematoma is an accumulation of blood underneath the bones of an infant’s skull. It is usually noticeable several hours after birth and appears as a lump on the top of the baby’s head. There may also be bruising, anemia or signs of jaundice accompanying the bulge. Such bulges generally occur on one side of the skull, usually at the point of most contact between the baby’s head and the mother’s pelvic bones.
Keep in mind that caput succedaneum and cephalohematoma are not brain injuries. They are caused by trauma outside of the baby’s skull.
Although most instances of bruising are a result of the natural physical stresses of childbirth, they can also be caused by birth trauma due to healthcare professionals. Although some incidents that lead to infant bruising are inevitable, some are the result of medical errors and poor judgment. Improper use of vacuum extractors or forceps may result in painful contusions or other injuries.
According to the National Institutes of Health (NIH), infants have developmental milestones according to age. Frequently missed developmental milestones may be an indication of a birth injury. In order to understand which milestones your child may be missing, it’s important to understand what development milestones are and the average age at which most children reach the milestones:
2 to 4 months old:
- Turns head when noises are heard
- Coos and smiles
- Follows people with eyes and recognizes faces
- Holds head up
- Can reach and grasp objects
- Pushes up on elbows if lying on stomach
6 to 9 months old:
- Brings objects to mouth
- Looks around easily at nearby objects
- Rolls over from back to front and front to back
- Can pass objects from one hand to the other hand
- Sits alone without assistance
- Can bounce when standing on the ground, with assistance
- Can pick up small things with fingers
- Begins to crawl
- Bears down weight on legs when standing, with assistance
1 year old:
- Explores and finds hidden objects
- May be able to walk or can walk while holding on to furniture
- Starts to say words
18 months old:
- Can scribble alone
- Stands and walks
- Eats with a spoon without assistance
- Drinks from a cup without assistance
- Can say a variety of single words
- Understands one-step instructions
- Points to objects they want to play with
2-3 years old:
- Knows body parts and is familiar with family members
- Begins to complete sentences and understand rhymes
- Can run and kick a ball
- Walks up and down stairs without assistance
- Can draw straight lines and circle shapes
- Knows and says name and age
- Can dress and undress without assistance
4-5 years old:
- Begins to cooperate with other kids
- Uses scissors
- Can hop and stand on one foot for short periods of time
- Retells favorite stories
- Understand basic grammar and songs
- Uses the toilet without assistance
- Climbs without assistance
If your child is behind in developmental milestones, it’s important to talk to your doctor. This is especially true if your child is also showing other birth injury symptoms. Consider the following information about important developmental milestones and possible related birth injuries.
Difficulty Sitting Up
One of the first delays in motor skill development to watch out for is sitting up. If the baby doesn’t sit up, it could be the first sign of cerebral palsy. Cerebral palsy is a neurological disorder that can alter muscular movement.
If your infant is still not sitting up by six to nine months, there is no need to panic. However, it’s always a good idea to alert your pediatrician. What age do babies sit up? That depends on your child, and you should address your concerns with your doctor.
A child that doesn’t walk normally could also be suffering from cerebral palsy. For example, if a child has muscle rigidity caused by cerebral palsy, it may cause them to drag their foot when they walk. This can be treated with Botox and other orthopedic devices. In addition, a child with cerebral may exhibit a lack of control over muscle movement.
In some instances, failure to walk may be an indication of a spinal cord injury, sometimes traced to spina bifida. If the child is suffering from nerve damage related to a spinal cord injury externally or a spinal cord injury internally (such as meningitis in the perinatal period), the child may have paralysis or difficulty walking attributed to mild nerve damage.
Dragging Leg When Walking
The moment has come when your baby has gone from crawling to walking, and you want to be overjoyed that the developmental milestone has been reached. It is understandable that any parent would be concerned if one leg is dragging while walking. This is one of the many symptoms of cerebral palsy, yet according to the National Institutes of Health (NIH), there are a variety of reasons while someone drags one leg while walking, including:
- Juvenile arthritis
- Foot abnormalities
- Infections and/or leg injury
- Different lengths in legs
In order to determine the reason your child is walking while dragging a leg, physicians will generally run a series of tests and exams. The types of tests performed will depend upon the results of an initial physical exam in which the legs, nervous system and bones are analyzed.
Delayed or Difficult Speech
Speech difficulties could be related to any form of brain damage. Sometimes oxygen deprivation at birth causes brain damage from anoxia, hypoxia or Hypoxic Ischemic Encephalopathy (HIE). These various forms of birth injury-related oxygen deprivation can cause:
- Brain hemorrhage
- Brain ischemia
- Cerebral palsy
All of these injuries can affect the child’s speech.
If a speech delay is the only developmental delay, the birth injury may be quite mild. Speech therapy may help with delays in speech when your child reaches school age.
Delay in Motor Skills
As an infant starts to develop motor skills, you may notice legs kicking, arms moving, and hands clasping together. As the infant gets older, fine motor skills start to develop, such as grasping a small object or holding a spoon.
Again, not all infants develop in the same manner and at the same age. If you notice your friend’s baby grabbing a small object and your baby has not, there is no need for alarm. Yet, if you notice that your toddler is not developing motor skills and is stalling in other developments, let your pediatrician know.
Lack of motor skills may be indicative of several types of disorders. A proper diagnosis of infant delay in development is the only way to determine if there is an underlying medical issue.
Not all symptoms of birth injuries are immediate. If an infant experiences hypoxia or anoxia (lack of oxygen at birth), turning blue is an immediate response. However, the human brain is an unusual, unpredictable organ that may take months or years to manifest symptoms from an injury. Some developmental abnormalities may arise as you’re watching your toddler grow, while others may surface immediately.
As a parent or loved one, it’s important to understand what infant developmental abnormalities are, when and how they surface and the treatment options available. Below, we discuss some conditions that are related to developmental abnormalities, including related birth injury symptoms.
Abnormal Neck Position
When infants involuntarily pull their necks back, it could be indicative of several issues. If it happens while you’re feeding your baby, this may indicate gastrointestinal reflux, or may just be that your infant feels the food and/or drink is too hot.
In some instances, infants are simply extremely tired and their necks will involuntarily pull back when falling asleep.
Medical conditions such as cerebral palsy and cervical torticollis are also common reasons for abnormal neck positioning. Treatment will typically consist of physical therapy, and in some instances, muscle-relaxant medications.
Exaggerated Reflexes or Absent Reflexes
When your pediatrician examines your baby at his or her well-check visits, the physical examination will include testing your child’s reflexes. If an exaggerated reflex, or hyperreflexia, is noted, your pediatrician may want to monitor this or perform more tests. Likewise, if an absent or diminished reflex, or hyporeflexia, is found on exam, your pediatrician will also need to evaluate this further. Abnormal reflexes in general may indicate a problem in the brain or spinal cord.
Difficulties with Sucking, Eating, and Swallowing
If your child has sucking, eating or swallowing problems, be sure to consult your physician immediately. Listed below are a few disorders that may cause difficult sucking, eating and swallowing. These may be birth injury symptoms, or may indicate another issue.
Problems with sucking, eating or swallowing is one of the many symptoms of cerebral palsy. Cerebral palsy appears to be a muscular disorder but is really a form of brain damage that interferes with the normal use of the patient’s muscles, and because of that, children with cerebral palsy often have a hard time using the muscle functions required to eat. Often children with cerebral palsy are malnourished because they have difficulty with sucking, eating or swallowing, and they have a hard time controlling their arms for fine muscle movement. This makes it very challenging for them to take food to their mouth, to begin with.
Difficulty sucking, eating or swallowing may be a result of a previous brain hemorrhage, which is a bleed in the brain. A hemorrhage occurs when there is an accumulation of blood in the brain as a result of a ruptured blood vessel. Other symptoms of a brain hemorrhage include lethargy, loss of consciousness, nausea or vomiting, weakness in one arm or leg and seizures. A brain hemorrhage can be diagnosed from a CT scan or an MRI.
Babies drool, particularly when they’re teething. Sometimes it’s hard to see how much they’re drooling, but when parents identify that their child is drooling excessively, it’s usually obvious and noticeable.
If you think your child may be drooling excessively, be sure to cross reference additional symptoms to rule out the possibility of a birth injury.
Excessive Fussiness or High-Pitched Crying
Babies cry, and it’s normal for some babies to be fussier than other babies. So how do you know if you have a normal, naturally-fussy infant or if the fussiness associated with your child is unhealthy? After all, fussiness and high-pitched crying can be a symptom of a few different kinds of birth injuries, some very serious.
Generally, health experts don’t underestimate your motherly intuition: if you think something is wrong with your baby, you should make an appointment with your physician so that your child’s fussiness can be ruled out as a symptom of a birth injury.
Determining Different Types of Cries
According to Medical News Today, a study performed on infant crying suggests that the frequency and the decibels of the cries can help determine neurological problems. Per Linda LaGasse, PhD, and Barry Lester, PhD, the characteristics of crying, including the high-pitch frequency, is different in infants with medical issues.
“The cry signal has enormous potential diagnostic value; for example, very high pitched cries can tell us that something may be wrong with the infant, so the cry signal can be an early warning that leads to further neurological testing,” Dr. LaGasse stated.
Babies who are at an increased risk of medical complications, such as those born prematurely, tend to have a higher-pitched cry than a normal cry, but yet at a lower amplitude. This often indicates that there may be undiagnosed neurological problems.
“Given the results of earlier studies relating cry characteristics to known neurological compromise, these findings suggest that at-risk infants have undetected neurological damage and that cry analysis may be able to identify these infants when no other symptoms are present,” added Dr. Lester.
Excessive fussiness or high-pitched crying can be a symptom of a variety of birth injuries, including:
Favoring One Side of the Body
We naturally favor a muscle group or limb that is not feeling great or is weaker, so when you see a child or infant favoring one side of the body, it may indicate that something is not right. Listed below are some conditions that may cause a child to favor one side of his or her body.
Many people think that cerebral palsy is a muscular disorder, when in fact it is a neurological brain injury that manifests by sending abnormal signals to the muscle groups. To that end, when you see a child or an infant favoring one side of the body, it could be an indicator of cerebral palsy.
Cerebral palsy is a form of brain damage that doctors still don’t completely understand. There are plenty of mysteries surrounding the way that children’s brains react to cerebral palsy in relation to muscle groups, though doctors are fairly certain that if a child is favoring one side of the body, there is some kind of neurological injury.
Erb’s palsy is a kind of injury that describes damage to the Brachial Plexus nerves, a network of nerves connecting the shoulder, collarbone, and neck together. Sometimes Erb’s palsy is prevalent in children that have an above-average birth weight, and these children didn’t have enough room in the birth canal during delivery.
Sometimes the shoulder is snagged on the mother’s pubic bone causing this injury, and sometimes it’s because the position of delivery was such that it put undue pressure on that network of nerves. These nerves could tear or stretch resulting in abnormal positioning and use of the affected arm. When a child is favoring one side of the body, this could indicate more severe damage to those nerves, as it’s not merely the arm the child is favoring.
Many infants have minor food-related problems, including spitting up, avoiding new foods, or refusing to eat at certain times. These issues are usually normal and are not an indication that the baby is sick. Per the National Institutes of Health (NIH), 25 percent of normally developing infants and 35 percent of infants with neurodevelopmental disabilities are affected by some kind of feeding problem. Some, such as refusing to eat certain foods or being overly picky, are temporary and don’t pose any health risks.
However, problems such as food allergies, gagging, vomiting and consistently refusing foods and liquids may indicate an underlying medical condition. It can have adverse effects on an infant’s health and may require medical treatment.
Infant feeding disorders may include problems with grabbing food, holding liquids and foods in the mouth, sucking, and chewing. For instance, children who are unable to pick up food and get it to their mouths, or who are unable to close their lips to keep food and drink from falling out of their mouths, may potentially have a feeding disorder/issue.
Swallowing disorders, medically known as dysphagia, can occur at different stages during the infant’s swallowing process, and include:
- Oral Stage: The oral stage consists of sucking, chewing, and moving foods and/or liquids to the throat.
- Pharyngeal Stage: The pharyngeal stage is when the infant begins to swallow and move food down the throat, yet closes off the throat to prevent it from going into the airway, which prevents choking
- Esophageal Stage: The esophageal stage consists of relaxing and tightening the openings of the esophagus and pushing food into the stomach. This part is mostly involuntary.
Signs and Manifestations of Infant Feeding Problems and Disorders
Infants with feeding problems may exhibit a number of signs and symptoms, but keep in mind that signs and symptoms will vary according to each individual and the severity of the feeding issues. Common signs and symptoms of infant feeding problems include:
- Arching the back and body while feeding
- Irritability or lack of interest or alertness while feeding
- Persistently refusing to eat and drink
- Excessively long feeding times
- Chewing problems
- Difficulty with bottle and/or breastfeeding
- Coughing or gagging during feeding times
- Excessive drooling
- Difficulty in coordinating breathing with eating and drinking
- Increased nasal stuffiness during meals
- Hoarse, or breathy voice quality
- Frequent regurgitation of food or liquid
- Recurring pneumonia or respiratory infections
- Poor weight gain or growth
Infants with feeding problems may also be at risk for:
- Chronic lung disease
- Poor nutrition
Causes of Infant Feeding Problems
The following are some causes of feeding and swallowing disorders in infants:
- Traumatic birth injuries that lead to neurological disorders, such as cerebral palsy
- Cleft lip and/or cleft palate
- Neck and head abnormalities
- Premature birth
- Low birth weight
- Respiratory problems
- Heart disease
- Gastrointestinal disorders
- Medications that decrease appetite
Fever, also known as pyrexia, is a natural bodily reaction to an infection in the body. Generally a fever raises the body temperature from its normal level (usually by only a few degrees) in order to kill off invading viruses or bacteria. Fever can also be the body’s response to infection, releasing more white blood cells to fight whatever aggressive attack the body perceives. Often, an infant with a fever will go on to heal without any major medical issues, but it’s important to understand why it happened in the first place and rule out any other underlying medical conditions.
Chorioamnionitis is a bacterial infection of the amniotic fluid that surrounds the baby while inside the uterus. It is a maternal infection that is often accompanied by maternal fever near the time of delivery.
As the baby is born, the mildest symptom of chorioamnionitis is a fever. Other symptoms may follow, such as fetal tachycardia and fetal leukocytosis.
Group B Strep Infection
Another maternal infection, group B strep infection, is carried by one in every four women. If their physician hasn’t tested them at 37 weeks of pregnancy, they can pass the bacteria on to the infant as he or she passes through the birth canal.
Fever is one of the infant’s responses to bacterial exposure, but a fever alone is not indicative of group B strep. Other symptoms include breathing problems, grunting sounds, a bluish tint and/or pale skin, seizures, limpness, stiffness, heart rate and blood pressure abnormalities, poor feeding and fussiness.
Foul Smelling or Greasy Stool
Changing diapers usually isn’t the most fun part about caring for an infant. However, it’s not only a necessary part of caring for a baby, but it’s also a way to keep track of normal urination and stools. You need to know if your child is passing food normally, if there is anything abnormal about the state of the stool, and if so, what’s causing the issues. Abnormalities to look out for include blood in the stool and stool in various colors and consistencies.
One of the important things to look out for in your baby’s poop is whether it is foul-smelling (outside of the normal foul-smelling baby poop) and whether it is greasy. If either of these things match your baby’s stool, take a look at the other symptoms to see if your baby’s body is trying to warn you that something could be wrong. Greasy or thick stool can often indicate problems, such as poor fat absorption in the intestines.
Intestinal Blockage or Severe Constipation
If you’re changing your baby’s diaper and you notice a small, dark, pebble-sized stool, your baby may have constipation. Constipation can be painful, and can lead to more serious problems if your child cannot pass stool normally. Constipation may include symptoms like dehydration, inadequate fiber or excessive dairy product intake.
Sometimes constipation is unavoidable, but it can be a signal that your baby isn’t processing the foods appropriately. Below, we list some of the conditions that may be associated with constipation.
Cerebral palsy is a neurological disorder that affects the coordination and communication between the muscles and the brain. A series of other signs and symptoms are usually present. As the digestive tract is composed of a series of organs, which are made from muscles, children with cerebral palsy occasionally experience digestive problems as the muscles in that system also receive incorrect signals from the brain. One of these incorrect signals could manifest in the form of constipation.
Sometimes constipation can be a side effect of medication regulating the symptoms of cerebral palsy. These medications often address the hydration of the child as children with cerebral palsy often have trouble drooling and with urinary incontinence.
Infant Lack of Control of Muscles
Infant lack of control of muscles can indicate a number of things. Possibilities range from mild problems or temporary health issues to more serious problems that require long-term care. If your baby is experiencing muscle problems, you should always consult with a physician as soon as possible to determine how serious the issue may be, and to uncover any underlying medical issues.
Exaggerated Reflexes and Spasticity
Absent reflexes or exaggerated reflexes or spasticity generally indicates a neurological or muscular problem. If your child reflects exaggerated reflexes or spasticity, this could be characteristic of cerebral palsy.
Cerebral palsy is a neurological disorder often caused from oxygen deprivation at birth. When the brain is deprived of oxygen for too long, the neurons become damaged and begin to die. This destroys the normal neural pathways between the brain and the muscle groups. Children with slight versions of the disability may still experience muscle rigidity, exaggerated reflexes and spasticity.
Children with more severe forms of this disability may experience seizures, muscle spasms over all of the muscle groups (not just the limbs) and intellectual disability. In rare instances, infants who have exaggerated reflexes may have a condition known as dystonia, a disorder marked by:
- Jerking movements
- Abnormal arching of the head
- Exaggerated reflexes
- Difficulties in breathing
Writhing movements are another way of infants with abnormal movements losing control over their muscles. It is often difficult to define writhing movements, but they may present as slow, seemingly calculated movements of undulating muscles. However, they are not calculated. Infants with writhing muscles do so with little to no control.
Why does this happen? This is another symptom common among children with cerebral palsy. This injury manifests as a muscular injury transmitted from the brain. It overrides all of the commands that the child may try to control his or her muscles.
Because cerebral palsy overrides the commands of the brain and its control over certain muscle groups, another characteristic of cerebral palsy could be uncontrollable blinking. And often, there is uncontrollable blinking due to another neural override command.
Sometimes a child may exhibit signs of both cerebral palsy or dystonia disorder. The uncontrollable blinking may be stronger in the diagnosis of dystonia disorder than it is of cerebral palsy. Other possible reasons for uncontrollable blinking may include:
- Bell’s Palsy
- Habit Spasms, also known as facial tics
Infant lack of control of muscles may also be an indication of hypotonia. According to the National Institutes of Health (NIH), babies with hypotonia may have a rag-doll type appearance. That means they may have lack of head control and have floppy limbs. Hypotonia can occur for a variety of reasons, including:
- Brain damage stemming from oxygen deprivation at birth
- Muscular dystrophy
- Genetic disorders
Infant Limpness or Weak Movement
While you’re pregnant, you often worry about the movement of the baby. As your pregnancy progresses, your baby’s movements change. Sometime around 18-22 weeks you will start to feel “butterflies” or flutters. By week 24, you may notice hiccups, or jerking movements. Toward the end of your pregnancy, you will feel the baby move several times a day – often at particular times when the baby is not sleeping. By around 40 weeks, there is not much room left for the baby to move around, so you may notice less frequent “big” movements.
When the baby is born alive and well, there’s less of a focus on the activity of your child – your expectation is to simply monitor executive functions. But what if your child starts acting with more limpness? Or what happens if your child’s movements appear weaker? Is this a developmental milestone, or is this symptomatic of something else?
Sometimes limpness or weak movement can be indicative of a birth injury. Some possible examples include:
Group B Strep Infection
If you weren’t testing for group strep B infection during pregnancy, there is a chance that you could have passed it on to your baby without even knowing it. In many instances, babies may appear weak and limp as a result of the body attempting to fight off the infection. However, limpness and weak movements alone are generally not indicative of group strep B infection without other symptoms present.
Perinatal asphyxia occurs when an infant is deprived of an adequate amount of oxygen, typically during difficult, stressful childbirth. When a baby experiences a decrease in oxygen intake, limpness and/or weak movements may follow. In addition, the infant may have a bluish tint to the skin, rapid breathing, low heart rate and amniotic fluid that’s stained with meconium.
Meconium Aspiration Syndrome
Did you experience a difficult labor? During stressful labor and deliveries, an infant may defecate while still in utero (called meconium), and breathe in a mixture of the fetal matter and amniotic fluid. Although it is considered a rare condition, meconium aspiration syndrome is a serious, life-threatening issue, marked by slow heart rate and a low Apgar score. Due to distress, you may also notice limpness and/or weak movements.
In extreme cases of spina bifida, the nerves may be so severely damaged that the child has weak movements in the affected areas of the body. Spina bifida occurs when the vertebrae does not enclose the spinal column entirely, leaving raw, exposed nerves to external harm.
Sometimes spina bifida can worsen if an infant has been exposed to meningitis (an infection that manifests in the layer around the spinal column) or if the child has group B strep infection (which leads to meningitis).
Vacuum Extractor Injuries
Physicians use certain tools to help aid in a healthy delivery, however these tools are occasionally misused and end up causing birth injuries. Your child’s weak movement may be a result of a vacuum extractor injury, as the vacuum extractor needs to be placed on a certain part of the baby’s skull. Misplacement can lead to brain damage, thus altering your baby’s normal muscle movement.
Because cerebral palsy is a neurological disorder that affects the muscle groups in the child’s body, one of the more common symptoms is weak muscles that may go from limp to rigid. If children can’t move their muscles properly, as in the case of weakness or limpness, this could be an indication of neurological damage as the proper electrical signals are not being communicated from the brain to the muscle groups.
The brachial plexus nerves between the shoulder, neck and collarbone are nerves that can be torn, moved, displaced or even broken when the baby is pulled too aggressively out of the mother’s body, or when the baby’s shoulder snagged on the mother’s pubic bone. If your child has Erb’s palsy, it’s likely that he or she may have limpness or weak muscle movement in the affected arm. Keep in mind, however, that it’s typically only the affected arm that has weakness or limpness, not the entire body.
Hypotonia is a medical condition marked by weak and/or limp movements, and is often referred to as “floppy infant” syndrome. According to the American Academy of Pediatrics (AAP), infants can develop hypotonia in a number of ways, including:
- Birth injuries and trauma
- Metabolic disorders
- Acute and/or chronic illnesses
- Abnormalities in the nervous system
- Genetic disorders
Infant Loss of Feeling, Absent Reflexes and Paralysis
It can be difficult for a parent to determine if an infant has a loss of feeling in a muscular group. After all, you can’t tell if your infant is experiencing numbness. So how do you know? There are a number of signs to look for, such as weak or absent reflexes, or even paralysis. It’s important to have your baby properly diagnosed, as absent reflexes, paralysis and loss of feeling are almost always indicative of an underlying medical issue – many of which may cause permanent damage, especially if not detected and treated as soon as possible.
Since Erb’s palsy, a brachial plexus injury, involves nerve damage between the shoulder, neck and collarbone area, even mild forms of the injury involve loss of feeling or paralysis in the affected area. In most instances, Erb’s palsy will clear up on it’s own within a few months. Physical and occupational therapy may be recommended, and in severe cases, surgery may be recommended.
Klumpke’s palsy is another type of brachial plexus injury, marked by damage to the lower portion of the brachial plexus nerves, which generally occurs due to a traumatic birth injury. Children suffering from Klumpke’s palsy often have an arm turned in toward the body and may from absent movement or reflexes in the wrist flexors.
If Klumpke’s palsy doesn’t heal on its own, physical therapy, occupational therapy, and/or surgery may be required.
Spinal Cord Damage
Whether your child has spina bifida, an injury from blunt force trauma to the spinal cord, or meningitis, spinal cord damage is marked by the loss of feeling in certain muscles, absent or weak reflexes in arms or legs, or paralysis. The spinal cord is the highway in which messages are communicated from the brain to the muscular groups. If any damage has occurred, the messages may fail to signal the body.
Cerebral palsy is a neurological disorder that’s generally marked by spastic, uncontrollable muscle movements. However, children with spastic diplegic cerebral palsy often exhibit a period of limpness and hypotonia, followed by spastic movements in the lower limbs. Quadriplegic cerebral palsy is marked by total loss of normal muscle movement, affecting every limb in the body.
Infant Low Heart Rate or Palpitations
The heart rate is one of the most important elements of yours or your baby’s health. Blood pressure numbers are something that gives a quick picture of what is generally going on with the patient’s health. Infant low heart rate or palpitations could be a sign of a serious medical condition. Some possible causes for low heart rate or palpitations include:
Group B Strep Infection
Group B strep infection is a bacterial infection that if left untreated, can be passed along to an infant during childbirth. Most pregnant women don’t even know they are carrying the infection as they are asymptomatic carriers. However, if infants develop group B strep infection, the signs and symptoms may include:
- Abnormal heart rate
- Abnormal blood pressure
- Poor feeding
- Limp, weak muscles
- Bluish tint to the skin
- Difficulties with breathing
Hypoxic Ischemic Encephalopathy (HIE)
Hypoxic ischemic encephalopathy (HIE) is a formal term for oxygen deprivation, a serious medical condition that can lead to brain damage. One of the symptoms of HIE is a low heart rate. Otherwise, the symptoms include poor muscle tone or reflexes, not breathing or weak breathing, seizures, bluish or pale skin and too much acid in the blood. Generally, patients are evaluated on whether they have mild, moderate, or severe symptoms of HIE. Doctors moderate care for each baby from there.
Infant Nausea, Dizziness or Vomiting
All healthy babies have gag reflexes. They spit up and burp. In fact, parents and caretakers are encouraged to help the baby burp by patting their back. This helps relieve gas and support digestion. But there is a difference between a baby burping normally and infant nausea, dizziness or vomiting.
Sometimes it’s hard to know when your infant experiences dizziness. After all, you can’t ask your infant if he or she is dizzy (or at least ask them and expect an answer). Also, you can’t observe your infant’s balance or posture as he or she walks because he or she is just an infant. So how do you determine if your child is dizzy?
Take a look at your child’s eye movement. Sometimes infants who are dizzy demonstrate that through circular eye movements, or from eye movements that resemble moving backward and forward. If you observe this happening in your child, it’s important to let your physician know as soon as possible. It’s also possible that your child may be experiencing dizziness without reflecting that in his or her eye movements, but there is no way to know.
Infant Brain Damage
Brain damage can happen from oxygen deprivation at birth (a result of the child not breathing for long minutes). Or, sometimes brain damage can happen from blunt force trauma to the baby’s head. Brain damage can also be the consequence of a forceps delivery injury or a vacuum extraction injury. These tools assist in the delivery of the child, and though it is rare, can cause injury.
Some infants who have brain damage experience nausea and vomiting. Other symptoms of brain damage include lethargy, lack of consciousness, seizures, weakness or inability to move limbs.
Infant Brain Hemorrhage
A brain hemorrhage occurs when a blood vessel in the brain bursts causing the blood to flood the brain and kill other blood vessels. When this happens to a child, the death of neurons leads to brain tissue damage which can cause lethargy, lack of consciousness, seizures, occasional paralysis or inability to move arms or legs.
If you believe your child has an active (acute) brain bleed, you should seek emergency medical attention. If you believe your child has experienced a brain hemorrhage in the past, be sure to consult your pediatrician for an evaluation. While brain damage cannot be reversed, there are several symptoms of brain damage that can be treated, making your child a little more comfortable. Treatment may also stop brain damage before it gets any worse.
Infant Lack of Consciousness or Lethargy
Every baby is different. When baby books tell you that newborns sleep on an average of 16-18 hours a day for the first few weeks or months, take this as a guide. But refrain from panicking if they sleep a little longer or a little less. An unexpected sleep schedule doesn’t mean there are problems. Infant lack of consciousness or lethargy is far more than just sleeping a little longer than expected.
There are some serious medical problems that may cause your child to experience severe lethargy or a lack of consciousness. Below, we discuss some of these conditions.
Anoxia or Hypoxia
Anoxia and hypoxia both describe oxygen deprivation to your child’s brain and body. Both are bad for your child’s brain health. Anoxia means that there is no oxygen at all. Hypoxia means that there is little oxygen. Anoxia and hypoxia are disappointingly common in difficult labors (long labor, delayed labor or an umbilical cord kink or prolapse). Fortunately, your doctor should take a measure of your baby’s blood at birth to determine oxygen saturation levels.
Some physicians have developed more acceptable methods of hyperbaric oxygen therapy, the process of putting the baby in a chamber and exposing him or her to 100 percent oxygen. Often, this can reverse oxygen deprivation, preventing further harm.
Another form of brain damage is brain ischemia. Instead of the brain being flooded with blood (brain hemorrhage), brain ischemia occurs when the brain doesn’t have enough blood flowing to certain blood vessels or certain parts of the brain. The symptoms of brain ischemia are similar to that of a brain hemorrhage, as both can cause abnormal muscle movements.
Infant Muscle Rigidity or Stiffness
Overall limpness or stiffness may indicate an underlying medical problem. Some possible medical conditions that may lead to infant muscle rigidity or stiffness include the following:
Muscle stiffness is common in certain types of cerebral palsy. In addition to stiffness, children with cerebral palsy often have muscle spasticity, marked by involuntary muscle spasms in the arms, legs and neck.
Klumpke’s palsy is an injury to the brachial plexus, a network of nerves between the shoulder, neck and collarbone. These nerves can be stretched or torn during difficult labor, thus rendering the muscle group stiff. Many infants with Klumpke’s palsy cannot move their arm or wrist flexor nearly at all, and their hand may be malformed into a claw-like formation.
Hypertonia in a baby is a condition marked by excessive muscle tone in a muscle group, resulting in stiffness and muscle rigidity. This condition is a result of damaged signals to the spinal cord and brain, which can occur after a traumatic birth injury or infant stroke.
Kernicterus is a rare form of brain damage that results from inadequately treated jaundice. Jaundice is somewhat common in newborns since the mother’s body is no longer processing bilirubin for the baby. However, if bilirubin levels become excessive, bilirubin may be deposited into the brain, which causes brain damage. Muscle stiffness may be noted in infants with kernicterus.
Seizures are medical conditions that occur when brain cells disrupt the normal electrical signals of the brain. Because of the amount of infants who experience them, seizures are considered common. However, infant seizures may be an indication of a minor underlying medical problem or a more severe problem.
Seizures are often an expression from the brain that something is wrong. Seizures are uncontrollable electrical activities between neurons in the brain. This causes temporary abnormalities in movement, behavior, sensation and consciousness. But sometimes the seizure is an indication of an element of brain damage that already exists.
Some of the brain-related injuries that result in seizures include traumatic brain injuries. Seizures can also result from oxygen deprivation as a result of:
- Anoxia (No oxygen to the brain)
- Hypoxia (low oxygen to the brain)
- Hypoxic Ischemic Encephalopathy (HIE is the medical term which is a generalized term for the injury related to oxygen deprivation)
- Birth asphyxia
- Perinatal asphyxia (low oxygen environments before, during, or just after delivery)
Additionally, a seizure may happen when the brain is flooded with blood (brain hemorrhage) or when the brain doesn’t have enough blood (brain ischemia).
Group B Strep Infection
One in every four women have group B strep colonization without even realizing it. Because of that, it is important that physicians examine their pregnant patients at 37 weeks to make sure that the mother doesn’t pass the bacteria on to the child. The most common symptoms of Group B strep infection include:
- Trouble breathing
- Grunting sounds
- Pale appearance
- Unstable body temperature
Seizures can be an extreme manifestation of these symptoms.
Kernicterus can be a very severe problem. It starts as jaundice and develops as a result of excessively high bilirubin levels. Seizures are often a sign that bilirubin has reached the brain, which can cause brain damage. Seizures can be a complication of kernicterus. If so, your child needs immediate attention before your child suffers from a debilitating injury.
Group B strep infection can lead to meningitis if bacteria invades cerebrospinal fluid. Meningitis is often more serious than group B strep infection. Meningitis affects the child’s spinal fluid and brain activity, and may have lifelong consequences. Seizures may indicate a more serious infection. If you suspect meningitis, you should consult your doctor immediately.
Epilepsy is a known and somewhat common side effect of cerebral palsy. Sometimes infants who have seizures actually help diagnose cerebral palsy. But generally epileptic seizures are a common side effect of more severe forms of cerebral palsy. Sometimes doctors prescribe anti-epileptic medications to help control seizures. Medications can help, but epilepsy is often a permanent condition. Cerebral palsy is an injury that happens in the brain before it affects the various muscle groups. Infant seizures are a form of brain damage in the context of cerebral palsy.
Inflamed Nasal Passages
Although inflamed nasal passages are typically nothing more than the common cold or allergies, it’s important to rule out any underlying medical issues. Infants with inflamed nasal passages, in most instances, will go on to heal and breathe normally. However, it’s also a good idea to understand why this type of medical condition happens and symptoms of more severe complications to look out for.
Skin Color and Texture Abnormalities
As a new parent, you might be worried if your infant is exhibiting different skin color and texture. While this is often normal shortly after childbirth, it may also be indicative of an underlying medical issue.
Anemia or Paleness
Cephalohematoma causes bleeding between the brain and the membrane underneath the skin, causing blood to pool. Because the blood is pooling, it’s natural for the rest of the blood in the system to respond, causing anemia from the blood supply being concentrated in one place. Other symptoms of this injury could be jaundice, infection and soft bulges on the head.
If Your Infant is Blue in Color
If your baby is blue in color, it’s extremely important to get medical help immediately. When an infant has a blue appearance, it may indicate that there is a problem with oxygen deprivation at birth, meaning that the oxygen supply is reduced. The baby can withstand this for only a few minutes before brain damage occurs.
Perinatal Asphyxia is a term marked by an infant being deprived of oxygen anytime during the perinatal period – that is, any time before, during or after delivery. The skin can also be waxy in appearance, communicating that there is not a sufficient amount of oxygen.
Bruises or Lacerations
Bruising may look harmless and it’s usually common after delivery, but in some cases, it may mean that there is an underlying medical condition. In other instances, however, your physician may have misused tools that are intended for safe delivery:
- Forceps delivery injury: Sometimes when the doctor uses forceps, he or she can bruise or lacerate the skin around the baby’s head and neck. Bruises and lacerations can sometimes be indicative of other problems, such as skull fractures or brain damage. Another symptom of a forceps delivery injury is soft bulges on the head.
- Vacuum extraction injury: Because a vacuum extraction doesn’t involve using metallic tools, some parents believe that it’s safer. Sometimes it is –and sometimes a vacuum extractor can be improperly placed on the baby’s head, causing the soft, underdeveloped plates in the baby’s skull to move or to put undue pressure on the baby’s brain, thus causing a brain injury. There may not be lacerations in this case, but there may be bruising.
- General delivery injury: Mothers and babies may have cuts or lacerations in various places from a delivery. Mothers may have vaginal lacerations and the babies may have lacerations in other places such as arms and legs. These are considered a birth injury just as much as bruises from dropping the baby, mishandling the baby, or any accidental blunt force trauma to the baby.
If Your Infant Has Yellow Skin
It’s generally acknowledged that jaundice in the first few days after birth can be normal to an extent. In utero, the umbilical cord carries off the baby’s excess bilirubin levels to be broken down by the mother. However, once the umbilical cord is cut, the baby’s system is in charge of breaking down bilirubin. Oftentimes, bilirubin reaches abnormally high levels because of increased breakdown of red blood cells in the first few days after birth, which releases bilirubin into the blood, causing jaundice.
- Newborn Jaundice: Watch out for jaundice as it can quickly turn into a birth injury. Even though it’s pretty normal, be sure to consult your doctor immediately so that he or she can observe your child. There shouldn’t be any other symptoms than yellow skin. If there are other symptoms, then the jaundice may have developed to kernicterus.
- Kernicterus: This is a rare but extremely dangerous form of brain damage that happens if the levels of bilirubin climb so much that they start flooding the brain.
Infant skull fractures are generally minor and usually do not result in long-term brain damage. However, the prognosis will depend on the extent of the fracture. Skull fractures can happen for a variety of reasons during childbirth, and in many instances, could have otherwise been prevented with diligent and careful medical care.
Vacuum Extraction Injury
A vacuum extractor is a tool that physicians use to help deliver an infant, typically during a difficult, stressful delivery. In many instances, physicians claim that a vacuum extractor is safer than the use of traditional forceps because no metal pieces touch the baby. However, a vacuum extractor comes with its own set of risks if it is used improperly.
The mouth of the vacuum is placed on the baby’s head on the aspect that is visible. Then, the baby’s head/scalp is suctioned in the cup to assist the baby out of the birth canal. However, Infant heads are not one complete skull, but instead are a few different skull plates that will eventually form into one skull. Because of the construction of a newborn’s skull, injuries can happen when the vacuum is placed too roughly on any one plate, or if too much pressure is applied on the area between the plates. This can cause the membrane between the skin and the brain to swell with blood (medically known as cephalohematoma).
When blood pools between the periosteum and the skull, it can look like a bump on the baby’s head. It may look like a soft bulge that is generally easy to identify. In addition, vacuum extraction injuries may also cause skull fractures, but will require a CT scan or an MRI to identify it.
Forceps Delivery Injury
Another tool created for the safe delivery of a baby, the forceps were invented in the 16th century. You might intuit that childbirth hasn’t changed much over the course of human history, but keep in mind that in the 16th century, the mortality rate was much higher. That being said, this antique tool, though used a lot less frequently than in the past, is still used.
Forceps may occasionally cause skull fractures and cephalohematoma, but they are more likely to cause scalp or facial lacerations when the physician uses too much pressure while the forceps are on the infant’s head.
When your child has cephalohematoma or a skull fracture, other symptoms you may observe include anemia, infection and jaundice. A skull fracture may or may not be a form of traumatic brain injury (TBI). If it is, your baby may exhibit signs of brain damage such as behavioral changes, irritability and sensitivity to light and sound.
Weight Gain Problems
Weight is important for your baby – in fact, one of the first things they do when your child is born is weigh the baby. Furthermore, they monitor his or her weight through the next few years of life. Infant weight gain problems can indicate a birth injury or underlying medical condition, which is why monitoring it is important.
Sometimes children who are born prematurely or at a lower birth weight are prone to certain birth injuries, while others who are born at a higher birth weight are prone to other birth injuries.
Your child’s weight at birth may have little to do with how he or she will gain weight in the future. However, weight is still an important factor in your child’s health early on. A baby who does not gain weight properly may have an underlying medical condition.
Take a look at a few of the conditions that weight gain problems may be a symptom of:
Preeclampsia is one of the leading causes of premature birth and low birth weight. Most often, children are born between 32 and 36 weeks. Weight gain among infants affected by preeclampsia is extremely important because preeclampsia is a risk factor for low birth weight.
Cerebral palsy is another birth injury which is more common among infants with a low birth weight compared to those with “normal” birth weight. Often mistaken for a muscular disorder, cerebral palsy is actually a neurological disorder. Often, children with cerebral palsy have infant weight gain problems because they have a hard time with nutrition. Sometimes their digestive tract is one of the affected muscle groups and works abnormally. Also, sometimes children have a hard time gaining weight because they can’t feed themselves or swallow properly.
Your baby may have a hard time properly gaining a healthy amount of weight because there may be something happening neurologically that prevents him or her from processing food properly. If your child didn’t breathe for up to six minutes at the time of birth, it’s possible that oxygen deprivation at birth could have caused brain damage. Brain damage can damage normal neurological pathways and communications that make your child process food normally. Your child may have other symptoms of brain damage including intellectual disability, weak muscle movement, the feeling that they’re just “not there” or even something as extreme as seizures.