Infant brain damage is a serious condition that affects millions of babies each year. Although there are a myriad of causes, the end result usually means that the baby may experience long-term, permanent neurological problems and a wide range of physical problems. To better understand infant brain damage, it’s important to educate yourself on how these types of infant brain injuries occur, the symptoms to look out for, how they are diagnosed, and ultimately, which best treatment methods may be employed.
Infant Brain Damage Causes
Infant brain damage can be caused by a variety of ways, including oxygen deprivation, infant jaundice, physical trauma suffered during labor and delivery, and infections perinatal infections. The resulting damage to the baby’s brain ranges widely in severity and can lead to various disabilities and psychological issues.
Oxygen Deprivation (Birth Asphyxia)
Oxygen deprivation, also known as birth asphyxia, occurs in about four of every 1,000 full term births. Premature babies are a higher risk of being injured by oxygen deprivation. Shortly after delivery, infants begin to breathe on their own. If they are deprived of oxygen, there is only a small window of time that physicians have in order to treat the problem. Even a few minutes of oxygen deprivation can lead to lifelong brain damage and disorders such as cerebral palsy, autism, attention deficit hyperactivity disorder, impaired vision.
There are several reasons in which infants can be deprived of oxygen, including umbilical cord problems, problems with the mother’s blood pressure, constricted airways, the baby has anemia at birth, the placenta separating too early from the uterus, and getting stuck in the birth canal during delivery. However, these problems may be prevented if the healthcare provider is diligent in monitoring and treating fetal distress in a timely manner.
According to the Seattle Children’s Hospital, two stages of injury can occur in cases of oxygen deprivation, the first stage involves brain cell damage that occurs within the first few minutes due to lack of blood flow and oxygen. The second stage, reperfusion injury, occurs after the flow of blood and oxygen is restored. Reperfusion injuries may last for periods that range between a few days and several weeks.
Infants with mild or moderate oxygen deprivation often have complete recoveries, especially if they receive prompt medical assistance and physical therapy. Babies whose brain cells were deprived of oxygen for a longer period are more likely to suffer permanent damage to their brain, cardiovascular system, respiratory system, digestive organs, kidneys, and more.
In extreme cases, oxygen deprivation can lead to complete organ failure and death.
Infant jaundice is a common condition, especially in premature babies. It is a yellowish staining of a baby’s skin and eyes. Jaundice is caused by an excessive amount of bilirubin, a yellow pigment in red blood cells, in the baby’s blood.
If infant jaundice is treated immediately, there usually isn’t a reason for concern. However, if left untreated, bilirubin levels in the baby’s circulatory system increase. These higher levels of bilirubin cause a condition called kernicterus. Kernicterus is a form of brain damage marked by lethargy, high-pitched screaming, a high fever, and abnormal arching of the back.
Bilirubin is toxic to the delicate cells in the brain. In addition to kernicterus, high levels of bilirubin in a baby’s brain can cause a more serious condition called acute bilirubin encephalopathy. Acute bilirubin encephalopathy is triggered by severe cases of untreated infant jaundice
Symptoms of kernicterus may vary, but may include:
- Poor feeding
- High-pitched crying
- Absence of certain reflexes
Moderate to severe cases include diminished muscle tone and/or opisthotonus (head and heels bent backwards and body bowed forward).
According to the University of California, San Francisco (UCSF) School of Medicine, birth related brain injuries are the leading cause of cerebral palsy and intellectual disabilities in the United States. Babies are most at risk of suffering brain injuries during the birth process, especially if they are premature.
During labor and delivery, a host of medical mistakes and other forms of physical harm may lead to infant brain damage. For instance, if a doctor doesn’t use birth-assisting tools properly, it may lead to brain damage due to improper placement and use of the tools, such as forceps or vacuums, on the infant’s head. Physical trauma can also occur if the delivery is performed too quickly and rapidly.
Other examples of physical trauma include a protracted, difficult delivery which may lead to head and brain trauma as the baby’s head is constantly hitting against the mother’s pelvic bone, and if the attending doctor does excessive twisting and pulling during a difficult labor.
Infections in the Mother
It’s important for physicians to monitor and detect maternal infections as soon as possible during pregnancy. If left untreated, infections such as rubella, herpes, varicella, and syphilis may lead to neonatal brain damage.
Other types of maternal infections include:
- Vaginal yeast infections
- Venereal warts
- Coughs that last more than one week
Per a Danish clinical study, babies of women with maternal infections may also be at higher risk of developing childhood epilepsy, cognitive issues, and schizophrenia.
Maternal infections may also lead to premature birth, which in turn heightens the risk of infant brain damage and cerebral palsy. In fact, an estimated 30-40 percent of all premature births in the United States have been associated with intrauterine infections. Premature infants with low birth weights have an increased risk of developing brain damage and various other disabilities and physical limitations.
For additional in-depth information on brain damage causes, refer to our article Brain Damage Causes.
Symptoms of Infant Brain Damage
The types of symptoms as well as the severity will vary according to how the brain damage occurred. Some of the symptoms will be immediately noticeable while others may not surface until the infant shows signs of developmental delays. Common symptoms include:
- Abnormal Temperament: Although is normal and expected that infants cry after birth, excessive crying and high-pitched wails, combined with other abnormal behavior such as refusing nourishment and being extremely fussy may be a sign of brain damage.
- Physical Appearance: Although there are instances in which an infant with brain damage looks physically fine, in many instance an abnormal physical appearance is a sign of brain damage. For example, infants with brain damage may have unusually small skulls, have difficulty focusing their eyes, deformed facial features, a deformed spinal cord, and an abnormally large forehead.
- Delays in Development: As mentioned earlier, sometimes brain damage isn’t detected until an infant is slow in developmental delays. For instance, some babies may not crawl, smile, or crawl appropriately for their age. However, it’s important to keep in mind that all babies do not hit developmental milestones at the same time. Only a physician will be able ascertain if your infant’s developmental delays are a result of brain damage.
For additional details and more in-depth information on brain damage symptoms, refer to our article Symptoms of Brain Damage.
Infant Brain Damage Treatment Options
Treatment will depend upon the seriousness of the injury. For instance, an infant who experiences mild brain damage may not benefit from surgery, but physical therapy, occupational therapy, and medication may be be the best option. Yet, infants who experience traumatic brain injuries may need surgery to decrease swelling and intracranial pressure, and repair damaged blood vessels.
A relatively new treatment option for infant brain damage, hypothermia therapy, has shown positive results if administered immediately after birth. Hypothermia therapy works by cooling the infant’s body temperature to between 33.5°C and 34.5°C for at least three days immediately after birth.
According to the National Institutes of Health (NIH), hypothermia therapy not only increases an infant’s chance of survival, but also the decreases the chances of long-term, permanent brain damage and physical impairment.
Infant Brain Damage Prognosis
If attending physicians identify the damage-causing injury and start treatment immediately, infants may survive the traumas of brain, but more than likely will have to deal with a host of psychological, physical, and cognitive issues as they grow older.
For instance, according to the Simon’s Foundation Autism Research Initiative (SFARI), infants who experience brain injuries are at high risk for developing autism. Attention deficit disorders, emotional outbursts, and physical disabilities have also been associated with brain damage. However, children with these health issues can go on to live productive lives if they are active in physical and occupational therapy.
It’s important to note that the prognosis of brain damage will worsen with more severe injuries. It also depends on what area of the brain the damage occurred. For example, an infant with subdural hematoma is at high risk for mortality, especially if treatment doesn’t start immediately. Yet, an infant who suffered mild brain damage may have slight disabilities but can otherwise lead a normal life.
For more detailed information on infant brain damage prognosis, refer to our article Brain Damage Prognosis.