Signs of Severe Neonatal Brain Damage Parents Should Not Ignore

Welcoming a new baby into the family is an event that parents happily plan with the expectation of a lifetime of joy ahead. Tragically, in a small but significant number of cases, joyous expectation turns to distress and an uncertain future for a child who suffered brain damage during delivery. 

Knowing the signs of neonatal brain damage is crucial for parents, so they can seek the earliest possible medical intervention for their baby. Families may benefit from a review by an experienced Arizona medical malpractice attorney to determine whether the injury could have been prevented with proper care.

Immediate Symptoms of Neonatal Brain Injury After Birth

Recognizing the signs of brain injury in the immediate moments after birth can be difficult, especially for first-time parents who may not know what to expect. Common signs of a brain injury exhibited soon after birth include the following:

• Floppiness or stiffness (signs of abnormal muscle tone)
• Apnea, or long pauses in breathing
• Swelling of the head or forehead
• High-pitched, persistent crying
• Crying with an arched back
• Extreme lethargy or unresponsiveness
• A bulging fontanelle (soft spot)
• Seizures
• Twitching or jerking movements
• Weak reflexes
• Poor suck, swallow, breath rhythm, or difficulty feeding
• Poor eye tracking or repetitive eye movement

If a complication arose during delivery, such as signs of fetal distress, shoulder dystocia, or the use of forceps or a vacuum extractor, parents should be especially alert to the above signs of neonatal brain injury.

What to Do If Your Newborn Shows Signs of Neonatal Brain Injury

Depending on the circumstances, the delivering doctor or neonatal care team may identify signs of a brain injury during the post-birth assessment process, or Apgar scoring, which typically takes place within five minutes after the birth. Apgar stands for Appearance, Grimace, Activity, and Respiration. The Apgar score addresses the infant’s heart rate, breathing effort, reflexes, skin color, and muscle tone. If the medical providers note a low Apgar score or signs of distress, they may order an MRI or other imaging tests to determine if the child has suffered a brain injury.

In other cases, the immediate assessment does not identify a brain injury. For example, Hypoxic Ischemic Encephalopathy (HIE) develops gradually during a six-hour “window” after birth as a lack of oxygen during the delivery causes energy depletion in the brain, which leads to swelling and cell damage. During the window between restoring oxygen to the brain after birth and cell death, parents may begin to observe some of the above-described signs of severe neonatal brain damage.

Alerting the Medical Team of Suspected Neonatal Brain Damage

While newborns once spent their early hours primarily in neonatal units, the more modern effort to maximize mother-infant bonding and breastfeeding means they now spend their early hours after birth with their parents. If a parent suspects that their child has suffered a brain injury, it’s crucial that they alert the hospital’s neonatologist and request an immediate assessment of their child. The neonatologist should perform a comprehensive evaluation and medical imaging to determine the cause and extent of the injury.

An early assessment and diagnosis help to minimize the damage and improve the outcome for some types of neonatal brain damage. For instance, therapeutic hypothermia (“cooling treatment”) for infants with HIE can prevent massive brain cell death when applied within the first six hours after birth.