Guide to birth injuries and claims

From the moment you discover you’re expecting a baby, you’ll begin to experience a rollercoaster of emotions. While it’s an eclectic mix of excitement and trepidation, most of these emotions are thankfully, happy ones.

As the anticipation of your baby’s arrival grows, you’ll be encouraged to think ahead and contemplate your birth choices and plan, including where you want to deliver, your pain relief options and who you want to be with you during this intensive period. What many of us don’t consider, however, is the possibility of complications.

Thanks to the advancement of medical practice and technologies, giving birth has never been safer. With both mother and child carefully monitored throughout the pregnancy and birth, most babies born in the developed world are delivered with no lasting complications to mother or child. Sadly, this isn’t the case for every birth.

Suffering from a birth-related injury can be devastating, especially if the injury has life limiting consequences for your baby or has seriously damaged the quality of life of the mother or baby. Some of these complications can be caused by a series of errors made throughout the pregnancy leading up to the birth, while others, despite experiencing an uncomplicated pregnancy, can occur in the delivery room. Missed windows for intervention, forgotten checks, mismanaged deliveries and the improper use of equipment can all make birth injuries more likely.

We’re here to help you if you or your baby has suffered from a birth-related injury or medical negligence.

Here you’ll find some of the most common birth injuries as well as information and support.

Pre-birth complications

Prior to your due date, you should be under the care of a registered midwife and receive advice, prenatal care, and be encouraged to attend regular appointments. It’s during this period that any potential complications or smaller issues that could develop into serious birthing difficulties can be addressed. Your medical history should be considered, and your concerns listened to. If anything is overlooked or correct procedures are not adhered to, then it could potentially pave the way for future complications.

Some of the most common pre-birth complications include:

Premature or Preterm Rupture of Membranes (PPROM)

What is it?

PPROM is when the waters of the amniotic sac prematurely rupture. One of the biggest complications of this event is the potential infection of the placenta called chorioamnionitis. This is extremely dangerous to both mother and baby. The earlier in the pregnancy PPROM occurs, the greater the risk of health complications for the baby. Once past 37 weeks, the prognosis is much more positive.

What is the cause?

It’s not easy to pinpoint, however some known causes include:

• Infection within the womb.
• Distension or a ballooning effect of the uterus and amniotic sac.
• External trauma.

Your medical team should be aware of any symptoms and potential trauma and act accordingly.

What Are The Symptoms?

• Amniotic fluid leaking from the vagina.

Chorioamnionitis

What is it?

This bacterial infection affects the outer membrane that protects the baby. If this infection is not closely monitored by medical staff, the greater the risk to the baby. Complications include infection such as meningitis (an infection of the brain and spinal cord lining).

What are the symptoms?

• A high or elevated temperature.
• A high or rapid heartbeat.
• Tenderness of the uterus.
• A discharge from the vagina which may be odorous or discoloured.

Pre-eclampsia

What is it?

Pre-eclampsia is a condition that reduces the blood flow from the placenta which can mean a lack of oxygen to the baby and other serious complications. 1 in every 200 women will develop this condition.

This birth complication is something that should be picked up on and looked for throughout pregnancy. Thankfully, most cases are picked up on early, and treated without serious medical intervention. If left untreated, symptoms can worsen leading to severe complications and even death.

What are the symptoms?

• Swollen face, hands, ankles and feet.
• Fluid retention.
• Intense headache.
• Problems with vision.
• Discomfort or soreness below the ribs.

Placental abruption

What is it?

Placental abruption is where the placenta starts to detach from the womb during pregnancy. This can result in the baby not getting enough nutrients or oxygen during the pregnancy and can lead to other complications. When you are presenting with symptoms of Placental Abruption, your midwife and medical team should intervene, usually with ultrasound and blood tests, as well as close monitoring of your baby. Failure to do so can lead to the baby being born too early, severe blood loss and can have fatal consequences.

What are the symptoms?

• Bleeding or spotting from the vagina.
• Blood in the fluid when your waters break.
• Soreness or pain in your stomach.
• Pain or discomfort in your back.
• Recurrent contractions, or a continuous contraction.
• The baby moves less.

Prolapsed umbilical cords

The prolapse of an umbilical cord is a life-threatening scenario for any unborn baby. Although rare, it’s a medical emergency that should be identified and acted upon as soon as possible.

What is it?

It is where the umbilical cord comes out through the cervix with (or before) the presenting part of the baby. There are two types of prolapsed umbilical cord scenarios:

1. Overt: Umbilical cord protrudes beyond the baby.
2. Occult: Cord has slipped alongside the baby but has not gone beyond the presenting part.

What are the symptoms?

• The heartrate of the baby will suddenly drop and does not quickly improve.
• The umbilical cord is visible or can be felt on vaginal examination.

Screening during pregnancy

Screening is offered to all pregnant women to test for Down’s, Edwards’ and Patau’s syndromes. The screening tests are offered between 10 and 14 weeks of your pregnancy. The mother can choose not to have the test or opt to test for one or more of the syndromes. The test is a combination of a scan and a blood test and indicates the likelihood or not of the baby carrying one of these conditions. If there is a high risk, the mother will be offered a diagnostic test (chorionic villus sampling or amniocentesis) which will confirm whether the baby has Down’s, Edwards’ or Patau’s syndrome.

Down’s syndrome 

Although not specifically a ‘birth injury’ down’s syndrome is a condition that can be identified during pregnancy. 

What is it?

Down’s syndrome is a genetic condition caused by the presence of an extra copy of chromosome 21 in the baby's cells. A baby with Down’s syndrome will usually have a learning disability, although this varies greatly from baby to baby. As part of your routine appointments during pregnancy, you have the option to be screened to see the likelihood of your baby having Down’s syndrome.  If the initial screening indicates your baby may have the condition, further tests can be carried out to confirm the diagnosis.

What are the symptoms?

• The baby will usually have a learning disability.
• The baby will have certain physical characteristics (although these are different for each baby) and include low muscle tone, eyes that slant upwards and outwards and a small mouth with a protruding tongue.
• The baby is more likely to suffer with other health conditions.

Edwards’ syndrome

Edwards’ syndrome is not specifically a ‘birth injury’ but as with down’s syndrome, it is a condition that can be identified during pregnancy. 

What is it?

Edwards’ syndrome is a serious genetic condition caused by an additional copy of chromosome 18 in some or all of the cells in the baby’s body. As part of your routine appointments during pregnancy you have the option to be screened for Edwards’ syndrome between 10 and 14 weeks of pregnancy.  Further diagnostic tests are offered if the screening indicates a high risk of the baby having the condition.

Most babies with Edwards’ syndrome are either miscarried, or stillborn. If they do survive then the chances of them living beyond their first birthday is remote. However, there have been some rare incidences of people living into their 20’s.

What are the symptoms?

• A small, abnormally shaped head.
• A small jaw and mouth.
• Long fingers that overlap, with underdeveloped thumbs and clenched fists.
• Low-set ears.
• Smooth "rocker bottom" feet (with a rounded base).
• A cleft lip and palate (a gap or split in the upper lip and/or the roof of the mouth.
• Feeding and breathing problems.
• An exomphalos (where the intestines are held in a sac outside the tummy).

Turner’s syndrome

Turner’s syndrome is not specifically a ‘birth injury’ but as with down’s syndrome and edward’s syndrome above, it is a condition that can be identified during pregnancy. 

What is it?

Turner’s syndrome is a genetic condition that only affects girls (and is present in 1 in every 2,000 baby girls). It is caused by a missing chromosome. As part of your routine appointments during pregnancy you have the option to be screened for turner’s syndrome between 10 and 14 weeks of pregnancy.  A girl born with turner’s syndrome only has one ‘x’ chromosome rather than the usual two. Most girls diagnosed with Turner’s syndrome lead relatively normal lives and although there is no cure, the symptoms can be managed. 

What are the symptoms?

• Swollen and puffy hands and feet.
• Short stature.
• Infertile (the ovaries do not function).
• Skeletal abnormalities.
• Heart defects.
• High blood pressure.
• Kidney problems.

Injuries sustained during birth

While giving birth is an overwhelming experience, your medical team is there to provide care, support and medical intervention if required. Their primary focus should be the mother and the baby, with regular monitoring, tests and checks taking place throughout each stage of labour. Concerns and the wishes of the mother should be listened to and teams should work well together to ensure mother and baby are safe during delivery.

When teams aren’t cohesive, when the mother’s medical history is ignored, if they fail to notice the baby is in distress, or if the medical team is too slow to act then serious complications can arise.

Some of the most common injuries sustained during birth, include:

Obstetric fistula

What is it?

“An obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labour”

(source: Fistula Foundation)

Obstetric fistula (or vaginal fistula) is almost entirely preventable. It is a condition that occurs after a traumatic and prolonged childbirth where a hole (fistula) develops between the vagina and bladder or the rectum and vagina. It tends to occur during a Caesarean section, particularly if performed in an emergency. The injury can be treated with surgery in some instances. However, it can leave women with urinary and rectal incontinence as well as difficulty and pain during sex.

Although the injury is very rare in Europe and America, it’s not unheard of. Therefore, being aware of the symptoms can help you recognise this painful birth complication and get the medical treatment you need.

What are the symptoms?

• Ongoing flatulence.
• Odorous vaginal discharge.
• Recurring urinary or vaginal infections.
• Vaginal pain or irritation, including during sex.

Broken bones and fractures

The idea of your baby being harmed during childbirth and experiencing broken bones or fractures is incredibly distressing. Usually, these incidents occur where there has been a mis-managed delivery of the baby.

Reasons why fractures occur can include a large baby who struggles to pass through its mother’s cervix called cephalopelvic disorder (CPD); or a midwife or doctor may apply too much force or use the wrong technique when trying to deliver the baby, particularly if using forceps which can increase the risk of injury to the mother and baby.

Furthermore, a mis-managed delivery can result in a baby developing nerve injuries such as brachial plexus injuries. This type of injury can be avoided by performing an emergency caesarean.

What are the symptoms?

Signs on your baby to look out for, include:

• The area may be swollen and painful.
• There may be signs of bruising, redness and / or inflammation.
• The baby may not be able to move the fracture.
• The affected limb may seem deformed.

Skull fractures

You may be aware that when your baby is born their skull isn’t fully formed. You’ll find a soft spot on the top of their head where, over time, the plates of their skull will move and fuse together. Unfortunately, this leaves them susceptible to skull fractures and serious injuries.

There are four types of skull fracture that can occur during a mismanaged birth. In most instances, these skull fractures are spotted by the medical team involved, however if these skull fractures are overlooked then they can lead to fatal complications such as bleeds on the brain. The four types of skull fracture are:

1. Linear fractures: Causes minimal harm. This type of break doesn’t move and can usually resolve itself without medical intervention
2. Diastatic skull fractures: Occurs along the suture lines of the skull or where the bones will eventually fuse together. These suture lines will continue to widen until they finally heal and fuse together.
3. Depressed skull fractures: Incredibly serious. A depressed skull fracture can occur without displaying any signs of broken skin or scalp. This fracture means that the skull is sinking into the brain and can cause serious damage. Surgery is the only option.
4. Basilar skull fracture: This fracture occurs at the base of the skull. If the covering of the brain is damaged, there may be clear fluid leaking from the baby’s nose or ears.

Why does this happen?

During birth there is a huge amount of pressure around the baby’s head whilst in the birth canal. This can sometimes lead to fractures. However, they can also be the result of improper use of forceps or ventouse suction cup.

What are the symptoms?

The presenting symptoms will differ depending on the type of fracture; however, they can include:

• Bruising to the face.
• Pain and sensitivity to the fractured area.
• Bleeding or clear liquid from the nose and/or ears.

Oxygen deprivation (asphyxia)

What is it?

You may already be familiar with the term asphyxia. It occurs when the brain is starved of oxygen, and during birth this can lead to other complications and in extreme cases, death of the baby. In many cases, asphyxia can be picked up by midwives and doctors monitoring a baby’s heartbeat to check oxygen levels and to ascertain if the baby is coping or in distress.  A lack of oxygen to the brain can result in mild to severe brain damage.

Asphyxia can be profoundly serious if midwives and doctors are not quick enough to recognise it and do not intervene. It is estimated that 80% of surviving babies with severe birth asphyxia will develop serious long-term complications.

What are the symptoms?

• The baby’s breathing is very weak, or they are not breathing at all.
• The colour of the skin is pale or bluish.
• Low heart rate.
• Weak reflexes and poor muscle tone.
• The blood is too acidic and there is meconium staining (first stool) in the amniotic fluid.

Forceps delivery and vacuum extraction injuries

What is it?

Sometimes, mothers and their baby’s need a little help to deliver. It’s quite common for midwives and practitioners to step in with forceps or a ventouse suction cup. Deliveries like these are common and most are successful with only minor complications such as light bruising and cuts.

Forceps work by holding the baby’s head to help it through the birth canal. Before using forceps, a doctor needs to ensure that the baby is engaged in the correct position in the pelvis and that the mother is fully dilated, or serious complications can arise. A ventouse suction cup uses suction to extract the baby from the womb. It is placed on the baby’s head. It is widely considered to be safer than using forceps, although severe and even fatal injuries have occurred as a result of the use of a ventouse suction cup.

What are the risks?

Brain bleeds are the most dangerous complications.

• Cephalohematoma: An injury that can occur when using forceps; it is bleeding under the skin between the baby’s skull and periosteum (vascular connective tissue) due to the pressure placed on the skull during the birth. Although not common, there may also be an underlying skull fracture.
• Subgaleal haematoma: A bleed on the brain. It can be caused in the same way as cephalohematoma following pressure applied by the forceps. In extremely rare cases subgaleal haemorrhage can be fatal. The symptoms of subgaleal haemorrhage can take several days to appear.

 What are the symptoms?

• Cephalohematoma: An unnatural bulge on the baby’s head.
• Subgaleal haematoma: Extensive blood loss and a slow increase of the circumference of the baby’s head. Bruising around the eyes, ears and scalp.

Horner’s syndrome

What is it?

Horner’s syndrome is a very rare condition occurring in approximately 1 in every 100,000 babies. Horner’s syndrome affects the nerves that lead from the brain to the eye, usually just on one side of the face. Horner’s syndrome can be caused by the incorrect use of forceps, pulling too hard on the baby during the delivery or the incorrect procedures being used in a breached birth, although this is rare.

What are the symptoms?

• Pupils may seem to be different sizes and the one in the affected eye might appear constricted.
• The pupil takes time to dilate.
• The affected eyelid may appear to droop, and the eye appear sunken.

Epidural birth injuries

In some deliveries, the mother can elect to have an epidural to lessen the pain of childbirth. If the mother is having a caesarean section, then she will also have an epidural injection. Epidural anaesthesia is the injection of an anaesthetic into the epidural space of the spinal cord. It works by numbing the pain nerves in the spinal cord to reduce the feelings in the chest and lower body, the pain levels are determined by the amount of anaesthetic given.

An epidural is a frequently used procedure and is successful in most cases. However, issues can arise including nerve damage which can be temporary or permanent. In rare cases (around 1 in 100) the dura, which is the outer layer of the spinal cord, is punctured.

What are the complications?

Other more common issues arise when the mother doesn’t give consent for the procedure, the anaesthetic is not correctly monitored or the wrong type of anaesthetic is used by the medical team which can cause a sudden drop in blood pressure, seizures, fever, severe changes in the baby’s heart rhythm, and respiratory issues for the baby. There is also an increased risk of vacuum extraction or forceps being used in the delivery which can lead to further problems.

Recognised post-birth injuries

The birth of your baby should be a joyous occasion, sadly many families are left picking up the pieces of a mismanaged birth, in some cases, for years to come. Whether your baby is in immediate danger after being delivered, or complications don’t manifest until hours or even days afterwards, if you believe you or your baby have experienced a mishandled birth, you should speak to us as soon as possible.

Some of the most common post-birth injuries, include:

Meconium aspiration syndrome

What is it?

Meconium is the dark green or black-like substance that will form your baby’s first bowel movement. However, when this substance fills the baby’s lungs and amniotic fluid instead before or during delivery, it can lead to a life-threatening situation. As the baby’s airways become blocked, medical staff must act quickly and treat the baby before complications occur. Babies who have had this substance successfully cleared should be monitored for at least 24 hours. In some cases, the baby may need a ventilator and will be monitored every 2 hours.

What are the symptoms?

• The amniotic fluid may be dark green.
• Staining of the baby’s skin at birth.
• The baby may appear limp.
• Laboured, rapid or abnormal breathing.

Retained placenta

What is it?

A retained placenta is where the placenta or part of the placenta remains in your womb for over an hour after the birth of your baby.

Once you’ve given birth, your placenta should also pass through the birth canal and be delivered within 30-60 minutes of giving birth. However, if the placenta doesn’t pass and it’s left untreated, a retained placenta can cause postpartum haemorrhage, a life-threatening condition and the third leading cause of maternal mortality in the UK. A retained placenta can cause excessive blood loss which is dangerous if left undiagnosed and untreated.

A poor, mishandled birth can often mean this crucial stage of labour is overlooked. There are three different types of retained placenta.

1. Placenta adherens: The most common type of retained placenta, occurs when the placenta remains attached to the uterine wall rather than being expelled as afterbirth.
2. Trapped placenta: A placenta which detaches from the uterine wall but is not expelled is known as a trapped placenta. This tends to happen if the cervix starts to close before the placenta can be expelled.
3. Placenta accreta: Placenta accreta occurs when the placenta attaches to the muscular layer of the uterine wall rather than the lining. Delivery is much more difficult and excessive bleeding can occur, which may necessitate a blood transfusion or, in the worse cases, a hysterectomy.

What are the symptoms?

• Severe blood loss.
• Stomach cramps.
• Foul smelling vaginal discharge.
• Fever.
• Absence of breastmilk.

Subconjunctival haemorrhage

When labour is long and difficult, the baby is under more pressure and stress for a longer period. This means that your baby is more susceptible to a subconjunctival haemorrhage, a condition where the blood vessels in the whites of the eyes burst. Leaving their eyes bloodshot.

Although not life threatening or limiting, your baby should always be checked over carefully, to ensure no other signs of trauma have developed. This condition will usually correct itself within a few weeks.

What are the symptoms?

• Severely bloodshot eyes.
• Pinkness of the white of the eyes.

Caput succedaneum

What is it?

“A diffuse swelling of the scalp in a newborn, usually caused by the trauma of the scalp pushing through a narrowed cervix during birth. The swelling may extend across the midline of the scalp and may exhibit discoloration or bruising”

(source: Family Practice Notebook)

Long, difficult labours are not unheard of, especially if it’s your first baby, making this one of the more common birth complications, still it can be alarming for a new parent. This condition is usually harmless. It is where the scalp of the baby swells and a bump or lump can appear on the baby’s head shortly after being delivered. It is not present in all births and more common after the membranes have broken because the amniotic sac is no longer there to support and cushion the baby’s head. It commonly occurs in deliveries that are difficult or long.

Treatment is not usually needed for the condition as it resolves itself in a matter of days. A doctor or midwife may perform an initial examination to check for jaundice which can be associated with Caput succedaneum. If quickly and correctly treated jaundice poses no harm to your baby but can lead to serious complications if left untreated.

What are the symptoms?

• The baby’s head may appear swollen, soft and puffy and may appear bruised or discoloured.
• The section of the head presented first is usually most affected.

Jaundice

What is it?

Jaundice is quite common in new-born babies and it is recognised by the yellowing of the skin caused by the baby producing too much bilirubin. It is easily spotted by the medical team and can be quickly and simply treated using phototherapy. In more stubborn cases a blood transfusion may be necessary although this is rare.

Kernicterus is an incredibly rare form of damage to the brain which is caused by excessively high levels of bilirubin. If jaundice is not recognised or treated appropriately and in a timely manner, then it can lead to cerebral palsy and hearing loss.

What are the symptoms?

The symptoms of jaundice are usually the colouring of the baby’s skin and whites of the baby’s eye which will appear yellowish.

For the kernicterus, the symptoms can be more difficult to identify but may include:

• A high degree of jaundice.
• The startle reflex is missing.
• The baby suckles poorly.
• The baby seems overly sleepy and has low muscle tone.

Necrotising enterocolitis (NEC)

What is it?

Necrotising enterocolitis (NEC) is an inflammation of the bowel. This can be a serious illness. It only tends to affect babies between a few days and a few weeks old. The inflammation of the bowel can cause intolerance to milk. In its severe form, the illness causes the bowel tissue to die and creates a hole in the bowel where the contents of the intestines leak into the abdomen which can cause a dangerous infection.   

Necrotising enterocolitis is rare, affecting approximately 1 in every 10,000 births. In most cases the condition is treated by resting the bowel, feeding intravenously and giving antibiotics if there is a high risk of infection. In the most extreme cases surgery may be needed to repair the hole in the tissue.  

What are the symptoms?

• Unstable body temperature.
• Abdominal bloating.
• Feeding problems and vomiting.
• Lack of energy.
• Unstable breathing, heart rate, or blood pressure.
• Diarrhoea and blood in the baby’s stool.

Hirschsprung’s disease

Each year 1 in 5,000 babies are affected by this rare but treatable condition.

What is it?

Hirschsprung's disease is a disorder of the bowel where part of the bowel is permanently compressed causing a blockage. Usually it is the last section of the large bowel which is affected. 

Constipation is the main symptom, ranging from mild to severe, meaning stools move through the intestines more slowly than usual. Some babies and children with Hirschsprung’s disease are not able to pass stools at all and in most cases, this is usually identified very quickly by the medical team and can be corrected with surgery. Babies born with less severe symptoms may have difficulty passing stools and the condition may not be diagnosed until later in their childhood. 

What are the symptoms?

• The first symptom is usually that the baby cannot pass meconium (their first stool).
• Swollen tummy and constipation.
• Vomiting a green fluid (bile).

Group B strep infection (GBS or Group B streptococcus)

What is it?

Group B strep are bacteria found normally in the intestine, vagina, and rectal area in about 25% of all healthy women. Group B strep infections can affect new-born babies.

(source: MedicineNet)

Group B strep is a common bacterium which rarely causes any problems. It is estimated about 1 pregnant woman in 5 in the UK carries GBS in their digestive system or vagina.

During pregnancy, particularly during labour and birth, many babies come into contact with GBS bacteria. The vast majority are not affected, but a small amount become infected. 

Although GBS infection in new-born babies can cause serious complications which can be life threatening, this is not common as most babies are successfully treated. Nonetheless, approximately 1 in 10 babies born with GBS will die, and 1 in 5 babies with GBS infection will survive but be permanently affected.

In extremely rare cases, during pregnancy GBS infection can cause a miscarriage, premature labour, or a stillbirth.

Although routine testing is carried out between 35 and 38 weeks in a number of countries including Australia, Canada, France, Germany and the USA, it is not routine in the UK for two main reasons: first, as testing is typically carried out three to five weeks before the due date, it cannot predict whether or not the woman will still be carrying GBS by the time she goes into labour; and second, the unreliability of the test results would mean many women being given antibiotics unnecessarily, contributing to the current overuse of antibiotics and fears of antibiotic resistance. Campaigners are trying to raise awareness of the condition and are pressing the UK authorities to change their stance on testing.

What are the symptoms?

• The baby may appear limp, unresponsive, and struggles to feed properly.
• The baby seems irritable, grunts and is prone to seizures.
• The baby’s temperature is either too high or too low and their breathing and heart rate are too fast or too slow.

Bells’ palsy

What is it?

Bell’s palsy is a facial nerve palsy named after the doctor who discovered the link between facial paralysis and the seventh cranial nerve. In cases of birth trauma, it is caused when a certain facial nerve (seventh cranial nerve) is put under pressure just before or during delivery, causing the loss of facial movement on the baby’s face. In many instances the cause is unknown but there is evidence that the use of forceps increases the risk of nerve damage. The nerve tends to affect the lower part of the face and mouth and becomes apparent when the baby tries to cry.

The outlook for babies with the condition is good, in most cases the symptoms and facial paralysis disappear of their own accord within a few months of birth. In cases where there is permanent damage and paralysis ongoing therapy may be needed.

What are the symptoms?

• The eyelid on the affected side of the face may not close.
• The lower part of the face may appear uneven or non-symmetrical, particularly when crying.
• The mouth doesn’t move the same way on both sides.
• There may be no movement and complete paralysis on the side of the face affected.

Brachial plexus injury or erb’s palsy

What is it?

The brachial plexus is a series of nerves running from the spine near the neck and shoulders which sends signals to your shoulders, arms, hands and fingers. In simple terms a brachial plexus injury (also known as Erb's Palsy) is an injury to those nerves. Brachial plexus injuries during birth can be caused by many factors including trauma as the baby moves through the birth canal, excessive force on the baby’s shoulders when being delivered or in the instance of a breached birth the arms being under pressure as they are often raised above the baby’s head.

In most cases babies affected by brachial plexus injury will recover in 3 – 6 months. If the damage is more severe and there is no sign of improvement after six months, surgery is an option, although the outlook is variable.

What are the symptoms?

• The baby may have no movement in their arm or hand. No moro-reflex on the side affected.
• The arm may be bent at the elbow and fixed against the body.
• Reduced grip on the affected side.

Cerebral palsy

What is it?

Cerebral palsy is caused when either the part of the brain or nervous system, responsible for muscle control, is damaged. This affects a person’s coordination and movement.

The condition can be caused by either damage to the brain while in utero or an injury caused at birth. The symptoms vary from mild to severe.

There are three types of cerebral palsy:

1. Spastic: In cases of children with spastic cerebral palsy, their muscles are stiff which can cause their movements to look awkward, inflexible, forced and lurching. Spasticity is caused by damage to the motor cortex of the brain which can happen before, during or after birth. Sufferers of spastic cerebral palsy have muscles which are tight, this may worsen over their lifetime. This can make movement painful and awkward.
2. Athetoid: Dyskinetic forms (or athetoid) of cerebral palsy cause involuntary movement which is particularly obvious when the child tries to move. The condition can also affect speech because of the impact on vocal cords. In some cases, eye contact and issues with eating can occur
3. Ataxic: The least common form of the illness and affects around 5% of suffers. In some cases, children may exhibit very few symptoms although, like all forms of cerebral palsy, it affects the movement of limbs and coordination. The main symptoms include trembling and shaking, difficulty with balance, and weaker muscles.

What are the symptoms?

• Stiffness or limpness of the muscles.
• Weakness of the muscles.
• Uncontrolled and random body movements.
• Problems with coordination and balance.

There is currently no cure for cerebral palsy, but treatments are available to improve the quality of life of those affected.

Infant brain damage

There are a number of reasons why damage occurs: a difficult, prolonged labour in which the baby’s head is constricted in the birth canal for too long; a forceps delivery; or, more commonly, oxygen deprivation during labour.

Although symptoms of brain damage can be spotted soon after birth, most tend to be recognised as the baby develops. Missing developmental milestones is one of the more common signs that a baby might have suffered brain damage at birth. The extent of the damage depends on the extent of the trauma experienced: some babies exhibit mild symptoms, others suffer life-changing injuries.

What are the symptoms?

• The forehead may appear abnormally large.
• Facial features may be distorted.
• The head may appear small, this is more evident in younger children.
• Neck stiffness.
• Difficulties in focusing.
• Seizures.
• The spine may appear to have an irregular shape.

Cognitive symptoms

As the child grows the cognitive symptoms are usually identified because they may miss developmental milestones such as:

• Concentrating.
• The processing and recalling of information.
• Processing language.
• Controlling impulses.
• Speech.

In some cases, the damage to the brain isn’t evident until the child is much older and attending school. In these instances, it is usually a learning disability that is highlighted and diagnosed such as attention deficit hyper disorder (ADHD) or attention deficit disorder (ADD).  Asperger’s Syndrome, Autism or other learning difficulties are also indications of possible brain damage.

Physical symptoms

As the child gets older, there may be further symptoms that appear. Some of these symptoms are less obvious, like headaches, other symptoms may be more self-evident.

• Severe tiredness.
• Disruptions in sleep.
• Sensitivity to light.
• Paralysis.
• Tremors.

Dystonia

What is it?

Dystonia is a general term used to describe muscle spasms that are uncontrollable and often painful for the person affected. The condition is a neurological movement disorder where the brain sends incorrect signals to the body resulting in spasms, uncontrollable movements, twisting and abnormal posture. There are nine types of dystonia which affect different parts of the body including the eyes, neck, mouth and voice, arms and hands and the abdomen There is also generalised dystonia which can affect any part of the body.

Dystonia can be caused by a birth trauma, usually because of a prolonged labour or difficulty during the birth resulting in a lack of oxygen to the baby. When dystonia is evident in babies and children it is usually secondary to a primary condition which, in over 80% of cases, is cerebral palsy.

What are the symptoms?

• Involuntary muscle movements.
• Dragging a limb.
• Cramping in the foot.
• Uncontrollable blinking.

Conclusion

What should be the happiest day of your life, shouldn’t be marred by concerns with the care you or your baby received by your healthcare provider.

If you are at all concerned about the care you and your baby were given before, during or after their birth, then please call us to discuss your worries. Our team is here to help and any information given to us is treated with the utmost confidence.