Treatment Options

Not all birth injuries will require surgery. However, in some instances, severe injuries may require surgery in order for the infant to have the best chances of survival. In other instances, surgery can determine if an infant will be able to have full use of any injured limbs.

The most common types of birth injuries that generally require surgery include:

• Severe cases of brachial plexus injuries, when other forms of treatment, such as physical therapy, didn’t work
• Brain hemorrhaging
• A fractured skull

A wide variety of medications are used to treat birth injuries. As with surgery, not all birth injuries require medications. In many cases, however, medication is prescribed for pain, seizures, cognitive disabilities, and more.

The type of medication will depend the type and severity of the birth injury. The most common types of medication include:

• Pain management and anti-inflammatory medications, such as aspirin and corticosteroids
• Anti-spastic medication, such as baclofen, tazidine, and dantrolene
• Seizure medication, such as gabapentin and topiramate
• Anticholinergic medication, including trihexyphenidyl hydrochloride and benzotropinemesylate
• Botox, to weaken injured muscles in an attempt the “catch up” the injured muscles to the other muscles
• Stool softeners

Physical therapy is one of the most common treatment options for children who have brachial plexus injuries, cerebral palsy (CP), shoulder dystocia, and any injury that resulted in weakened muscles, coordination problems, lack of voluntary muscle control, and more.

Physical therapy is a form of treatment that helps people move better, decrease pain, and in some cases, restore physical functions. It has been shown to help children with birth injuries have an easier time with daily tasks and activities, such as walking, getting out of bed, eating, moving around, and playing.

Trained and licensed physical therapists who specialize in working with babies and children will generally work diligently with their patients and their parents to help with:

• Strength and balance
• Coordination
• Flexibility
• Reducing physical limitations
• Increasing fitness, gait, and posture

Physical therapy sessions may include strength training, joint mobilization, specialized exercises, balance ball practice, and more, depending on the child’s condition and individualized plan. Sessions can take place in a doctor’s office, a physical therapy center, hospitals, nursing centers, classrooms, and at home with the trained therapist.

In recent years, studies and research have suggested that hyperbaric oxygen therapy (HBOT) can help reduce the symptoms associated with brain damage in infants who experienced oxygen deprivation during childbirth. When oxygen deprivation occurs, babies are at a heightened risk for brain damage, especially if there is not immediate medical intervention. 

HBOT consists of placing an infant in a hyperbaric chamber that’s filled with 100% pure oxygen. The air pressure is generally raised up to at least three times normal air pressure, allowing the baby to breathe in pure oxygen three times higher than normal.

Although more research is needed to understand how effective HBOT is for infants, there is indication that it may play an important role in treating symptoms associated with CP and autism. However, it’s important to note that the U.S. Department of Health and Human Services states that HBOT has not been clinically proven to treat traumatic brain injuries and health conditions.

Neonatal therapeutic hypothermia is a clinical treatment that reduces an infant’s body temperature in attempt to slow down injuries and diseases. It’s most often used for newborn babies who are at a heightened risk of developing severe brain damage.

Neonatal therapeutic hypothermia works by placing the infant in a cooling blanket. The temperature of the blanket is lowered significantly so that the infant’s entire body temperature is lowered. The therapy usually takes place in a neonatal intensive care unit.

By reducing the baby’s temperature, research suggests that it will help reduce the chances of severe brain injury development.

“We have found that therapeutic hypothermia can reduce the chance of severe brain injury by 25 percent in term-born babies with poor transition or low Apgar scores after birth,” said  Dr. Inder, of the Washington University School of Medicine.

Occupational therapy is a form of treatment that focuses on helping children with cognitive, physical, and sensory disabilities. Occupational therapists who specialize in working with children with disorders and disabilities focus on a variety of treatments, including:

• Developing fine motor skills
• Learning basic skills tasks such as brushing teeth and hair
• Developing positive behavior
• Reducing outbursts and impulsiveness
• Improving focus skills and social skills
• Developing and improving  hand-eye coordination
• Assisting with learning disabilities

Occupational therapy can take place in a myriad of settings, including hospitals, special education classrooms, at-home sessions, rehabilitation facilities, mental health centers, doctor’s offices, outdoor camps, and more.

THINGS A PARENT CAN DO:

Often, the parents of a child that has suffered a birth injury have an idea that something went wrong. Sometimes it’s a nagging feeling and sometimes there are symptoms in the baby that make it impossible to repress any longer. If you suspect that your child has suffered a brain injury, it’s important to speak up to make sure your child gets the care that he or she needs. If you need to know when to speak up regarding your child’s potential birth injury, consider the following steps.

1. When you’re trying to determine whether your child is the victim of a birth injury, you need to log as many symptoms as possible. After all, the symptoms are what help you to identify what kind of birth injury your child may have.

2. If your child is an infant or a baby, subtle symptoms may be harder to identify but large symptoms may still be clear, such as high-pitched crying, arched back while crying, writhing movements, evident limb pain or weakness, or seizures. For birth injuries, the most crucial developmental time is from infancy to three years of age. During this time, if you have any doubts about your baby’s development or symptoms, you should consult your doctor immediately. Identifying a problem and not seeking help could make the problem worse.

3. If your child is a toddler or a school-aged child undergoing testing for learning disabilities, you can consider other symptoms. Has your child had any developmental delays or trouble progressing through normal growth stages? Does your child have trouble with gross motor skills, fine motor skills, speech and communication, social skills, or cognitive skills? While a teacher can identify a learning disability within a few months of education, sometimes it could take up to two years for a school-aged child to be diagnosed with a learning disability. The reason for this is because learning disabilities often manifest themselves in different ways, which sometimes makes it harder to identify in individual cases.

Your child may have signs and symptoms of something that could be a developmental problem or a health concern, but this doesn’t automatically mean that he or she has suffered a birth injury. The next phase of identifying a potential birth injury is to recall what happened at the time of birth. Here are few questions to ask yourself:

1. Was there a problem during the pregnancy?

2. Did the mother have any trouble during delivery, such as excessive bleeding, unrelenting pain, or any emergency conditions?

3. Was there any point in the delivery or thereafter that either of the parents sensed the medical staff acted like something wasn’t right?

4. Did either of the parents feel like the medical staff avoided directly answering questions about how things went –particularly complications?

5. What condition was the child when he or she was born? Was there any trouble breathing or discoloration? Were there any lacerations or bulges on the head? Did the child have full mobility?

6. Was the child in the Neonatal Intensive Care Unit (NICU) or require any extra time in the hospital?

7. Did the child have any unusual results in any form of testing? (MRI, ultrasound, or CT-scan, primarily.)

8. Did the child have any seizures within the first few days of life? Has the child has seizures at any period during his or her lifetime?

If your child is exhibiting symptoms of something wrong, it’s important to get your child the care that he or she needs. When you get medical attention, report both the current symptoms and concerns that you recall of your child’s medical history. This may be one point when you speak up about your concerns about your child’s condition being birth injury-related.

If you speak up about concerns related to birth injury, it’s likely that the medical staff or the hospital will send a hospital representative or a legal representative from the doctor’s insurance to speak to you.

Be very careful what you say as these representatives may be eager to cover up the case. You don’t want a fast and easy solution: caring for a child with a birth injury can be very expensive and may last for the child’s lifetime.

Sometimes remembering certain facts aren’t enough. Paperwork can help you remember certain facts, especially if any of the writing on that paperwork is narrative (such as a journal or a diary-like notation). Paperwork is not only helpful to recall your own memory, but it can be used as hard, factual evidence for when you do speak up. Here are a few things that you can use:

1. Your baby’s medical records. The medical records could be one of the most important documents you can use as it should provide the most thorough report.

2. Copies of tests, such as MRI, CT-scans, or ultrasounds.

3. Ask for your pediatrician’s diagnosis in writing. This could be a useful resource to measure up to the medical records and the tests.

4. Correspondence with various parties with regards to the birth injury, particularly with the hospital and the insurance carrier.

5. Bills: This not only accounts for the care your child received, but could predict the kind of care that your child will need in the future.

6. Journal: If you didn’t journal the events as they happened in the hospital, try to write them down as close to the event as possible. Write down names and descriptions of everyone who you had contact with in the hospital, and try to recall conversations as close to your ability as possible. You’re not going to remember everything, but try to remember as many details as you can. This will aid in your testimony.

Once you have accumulated symptoms, recalled what happened of your own testimony with facts and narrative piece of writing, gotten proper care for your child, and organized the appropriate paperwork, you are ready to speak up regarding your child’s birth injury.

When you do speak up, don’t go directly to the hospital as the hospital representatives will work to appease you without looking to the best interest of the child. Instead, work with a birth injury lawyer, someone who will advocate for you and your child, and help get you the best care possible.