Between the excitement of meeting your new baby and the pain that comes with delivery, the process of having a baby can be emotional. When there are complications during childbirth, it can get even more stressful.
Hypoxic-ischemic encephalopathy (HIE) is a broad category of birth injuries that can affect your baby's brain affecting both cognitive and motor function. Many situations leading up to and during delivery that can cause HIE and lead to irreversible brain damage.
Some of the effects of HIE are immediate, but others may take weeks or years to notice. This is what you should know about the short and long-term impact of HIE.
The chain of events
During the HIE incident, the oxygen deprivation and lack of blood flow to the brain cause cells in the brain to die. In addition to the immediate consequence of losing these brain cells, as the cells die, they release toxins that continue to affect the brain. This is the beginning of a chain reaction that can continue for hours or days after birth leading to extensive brain damage.
While some babies may have minimal damage from HIE, if the medical team does not notice what is happening right away, they may miss the opportunity to control some of the damage with therapeutic hypothermia. There is a narrow window, between six and 24 hours after birth, to begin therapeutic hypothermia. During therapeutic hypothermia, the medical team will cool the baby below the “normal” range for about 72 hours to slow the brain-death chain reaction.
By starting therapeutic hypothermia early after an HIE incident, medical staff can help prevent further damage and inflammation in the brain. This therapy can significantly reduce death and disability rates.
Initial effects of HIE
Often, there are indicators during delivery that your baby may have suffered from oxygen deprivation and lack of blood flow to the brain. Even when there are no obvious signs during delivery, a baby suffering from HIE will show symptoms, including:
- Slow heart rate
- Very pale or blue skin tone
- Slow or irregular breathing
In the time that follows the initial brain trauma, there will be other observable effects of HIE. When evaluating for HIE or the extent of the damage from known trauma, medical staff will look for signs such as:
- Diminished muscle tone
- Overactive or decreased stretch reflexes
- Level of consciousness
- Digestive tract issues
Doctors may also take images of your baby’s brain and cord blood gas levels to figure out the level of brain damage.
How HIE effects your baby’s brain long-term
While there may be some immediately noticeable effects from HIE, it can take much longer to realize the full extent of the damage to your baby’s brain. It can be complicated to get a grasp of all the effects of the brain damage caused by HIE in a newborn.
Unfortunately, it becomes a process of evaluating when your child reaches certain developmental milestones. Still, checking for incomplete milestones is difficult since every child develops at a slightly different rate. Eventually, when the age range for a milestone has long passed, it may be caused by the brain death that happened because of HIE.
In general, children with HIE tend to have problems with attention, memory and appropriate behavior when compared to their peers. As children with HIE develop, their struggle with these issues becomes more pronounced, especially as they approach the late-toddler and early-school age range. Depending on how severe the damage was at birth, HIE can lead to other delays and disorders as well.
Coping with HIE
While the birth of your baby may not have gone the way you planned, eventually you will develop a sense of routine and normalcy for life with the newest member of your family. While you may have hesitations about asking for help, try to keep people around you who can support you through this critical change.