What Are the Signs of Brain Damage in a Baby?

Every expectant parent hopes for a healthy, normal baby. Most pregnant moms do everything they can to ensure their baby’s well-being. This could include watching what they eat, exercising, getting prenatal care, and finding a reputable doctor and facility to handle the birth. But despite the best efforts of parents and health care practitioners, some infants end up with brain damage.

The term brain injury covers a wide range of injuries with various causes, ranging from a mild concussion from a bump on the head to severe traumatic or acquired brain injuries that result in permanent disabilities or even death.

Infants and young children typically can’t describe their symptoms to their parents or a doctor, so it’s up to parents, caregivers, pediatricians, and other health care practitioners to recognize the signs of brain damage and provide appropriate treatment.

In this article, we’ll cover some of the causes and signs of brain damage in infants and young children and point you to some resources that may help you in caring for a brain-damaged child.

Causes of Brain Damage in Infants

The most common causes of brain damage in infants and young children vary depending on when the damage occurs—during pregnancy, during labor and delivery, or after birth, in early childhood.

Causes of Brain Damage During Pregnancy

One type of brain damage in babies is congenital brain defects. Congenital means “present from birth.” Congenital abnormalities in the brain develop while a baby is in the womb, and the baby is born with brain damage. Examples of congenital brain defects include:

• Spina bifida occurs when the neural tube (a structure in a fetus that develops into the brain and spine) doesn’t close all the way.
• Hydrocephaly occurs when there are problems with the circulation of cerebrospinal fluid (CSF). This fluid acts as a kind of shock absorber for the brain and spine. In hydrocephaly, CSF builds up in the brain, causing pressure that can result in brain damage if left untreated.
• Microcephaly is when the head and brain are smaller than usual. It can be caused by genetic factors but has been linked to infection with the Zika virus during pregnancy.
• Megalencephaly is when the brain is much larger than usual. It is usually caused by genetic factors.
• Encephalocele is when a portion of the brain protrudes from the skull, usually at the back of the head.

Researchers have found that many congenital birth defects have genetic causes. However, they also recognize that other factors play a role. In most cases, they don’t fully understand all the biological mechanisms contributing to these defects. Risk factors include:

• A family history of congenital brain defects
• A lack of dietary folic acid
• Smoking while pregnant
• Alcohol or drug abuse
• Exposure to toxic chemicals or radiation
• Infection with some viruses during pregnancy
• Uncontrolled diabetes
• Exposure to some prescription drugs (taken by the mother)
• Issues with the umbilical cord that interrupt a baby’s supply of oxygen and nutrients

In most cases, congenital brain defects occur as a result of genetic or developmental processes as a baby grows in the womb. Pregnant women can take steps to minimize risk factors for these defects, but they usually can’t be avoided. In rare instances, a congenital brain defect may result from medical malpractice—for example, if a doctor prescribes an expectant mother a medication that can harm a fetus.

Causes of Brain Damage During Delivery

It’s important to differentiate between congenital abnormalities (or birth defects) and birth injuries:

• Birth defects develop in the womb.
• Birth injuries occur during the labor and delivery process.

 A baby can sustain brain damage as a result of a birth injury. Common causes of brain injuries at birth include:

• Umbilical cord defects: The umbilical cord is a baby’s source of oxygen and nutrients while in the womb. If the umbilical cord is ruptured or compressed at birth, the resulting lack of oxygen can cause brain damage.
• Hypoxic ischemic encephalopathy (HIE): This is a broad term for brain damage from any type of interruption to a baby’s supply of oxygen during delivery. HIE is a common cause of cerebral palsy.
• Assisted vaginal delivery: In about 3% of vaginal deliveries, the doctor uses forceps or a vacuum device to help move the baby through the birth canal. Misuse of these mechanical devices can sometimes cause birth injuries.
• Birth canal problems: For various reasons, a baby sometimes has trouble passing through the birth canal. When an infant’s head is in the birth canal, uterine contractions put pressure on the head. Physicians must closely monitor a baby’s progress through the birth canal to avoid infant brain injuries.

Birth injuries can cause infant brain damage; they can also affect other parts of the body. The WKW blog provides more information on other common birth injuries. Some birth injuries are unavoidable, but others are due to the negligence of health care practitioners.  Examples of how a doctor’s negligence might lead to a birth injury that results in infant brain damage include:

• Misuse of forceps or vacuum devices in delivering a baby
• Failure to investigate the source of vaginal bleeding
• Failure to properly monitor fetal heartbeat
• Waiting too long to order a cesarean section (c-section)

Causes of Brain Damage in Early Childhood

In early childhood, brain damage usually results from a traumatic brain injury (TBI). Common causes of TBIs include:

• Car accidents
• Falling
• Child abuse, including shaken baby syndrome

You can read more about common causes of brain injuries in children on the WKW blog.

Recognizing Signs of Brain Damage

It’s helpful for parents to learn how to spot potential signs of brain damage, because babies and young children are typically unable to tell an adult about any symptoms they’re experiencing.

Signs of Acute Brain Injury

If your infant or young child experiences a head trauma, seek immediate medical attention if you see any of the following signs of acute TBI:

• Loss of consciousness or excessive sleepiness
• Unusual crying or irritability
• Altered eating habits
• Seizures
• Vomiting
• Clear fluid (spinal fluid) coming out of the nose or ears
• Unequally sized pupils
• Trouble walking (in children that have already learned how to walk)

These symptoms could indicate more serious ongoing problems in the brain—problems that, if left untreated, could result in further brain damage or death. Hence, prompt treatment is critically important.

The National Institute of Neurological Disorders and Stroke (NINDS) provides a detailed list of signs of acute brain injury.

Signs of Brain Damage in Infancy and Childhood

Congenital brain defects like spina bifida, hydrocephaly, microcephaly, and megalencephaly can sometimes be diagnosed while a baby is still in the womb with ultrasound, amniocentesis, or other tests. These conditions may or may not be evident at birth. If they are not diagnosed at birth, they may become apparent as a child grows. For example:

• A bulge in the soft spot on top of an infant’s head could be a sign of hydrocephaly.
• An abnormally small head may be a sign of microcephaly.
• An abnormally large head or distorted facial features can indicate megalencephaly.

Whatever the source of brain damage in an infant—whether they were born with brain damage or received a brain injury in the birth process—the damage can go undetected for weeks, months, or even years.

According to the Brain Injury Association of America, “While the symptoms of a brain injury in children are similar to the symptoms experienced by adults, the functional impact can be very different. Children are not little adults. . . . When an adult is injured, these deficits can become apparent in the months following the injury. For a child, it may be years before the deficits from the injury become apparent.”

As a child grows, there may be more signs of brain damage that took place in the womb or at birth. These signs can be grouped into three main categories:

1. Physical, including spasms; seizures; stiff muscles; lack of motor skills; problems with speech, vision, hearing, or eating; and physical developmental delays
2. Cognitive, including difficulty processing information; an inability to pay attention or concentrate; poor short-term memory; or trouble with communicating, reading, and writing
3. Emotional or behavioral, including selfishness, moodiness, anxiety, or a lack of self-control

Physical Developmental Delays

As we’ve seen, it can be harder to identify signs of brain damage in infants and young children than in adults. Let’s compare an adult and an infant with a TBI:

• We may notice that the adult’s speech is affected. But the child hasn’t learned to speak yet, so their lack of speech doesn’t give any indication of a TBI.
• We may notice that the adult has difficulty walking. But the child hasn’t learned to walk yet, once again leaving us without any indication of their TBI.

Consequently, developmental delays may provide early signs of brain damage in newborns and infants. Pediatricians have identified when babies should reach developmental milestones like smiling, rolling over, sitting up, crawling, and walking.

One possible indicator of brain damage is when a baby doesn’t reach important developmental milestones within the typical time frame for most children. The American Academy of Pediatrics created a website to help parents “learn more about physical developmental delays” in children under five years old. Parents should discuss developmental issues with their pediatrician to determine whether further investigation is warranted.

If brain damage is suspected, doctors often use computed tomography (CT) or magnetic resonance imaging (MRI) scans to help with diagnosis.

Can a Baby Recover From Brain Damage?

Suppose a newborn or young child suffers a traumatic brain injury. They will most likely require treatment in two phases—an acute phase and a long-term phase.

In the acute phase of treatment, the goal is to stabilize the infant or young child and prevent any additional (or secondary) brain damage. Acute treatment might include:

• Surgery to stop bleeding in the brain or remove a cerebral hematoma (a pool of blood in the brain)
• Surgery to relieve intracranial pressure (pressure caused by swelling in the brain)
• Measures to control a child’s blood pressure and make sure their brain receives enough oxygen
• Life support measures (e.g., a ventilator) to support a child who’s in a coma

After a brain-injured child is stabilized, the long-term work of helping them recover begins. In general, brain cells do not regenerate once damaged or destroyed. 

However, the brain is neuroplastic. According to the American College of Rehabilitation Medicine, “neuroplasticity is the brain’s ability to change and adapt as a result of interacting with the environment. These adaptations can take place both on a structural and functional level. Rather than being ‘hard-wired,’ the brain can actually create new neural networks to take over the functions that were managed by [a] damaged area.”

Long-term therapies and rehab aim to help brain-damaged patients develop new pathways in their brains that circumvent the damaged parts and allow them to regain lost abilities.

Because brain damage ranges in severity and in the affected bodily functions, it is almost impossible to predict the extent of an individual’s recovery accurately.

Experienced Birth Injury Attorneys

A brain-damaged child may require years or even a lifetime of various forms of therapy. They may also need assistance with routine daily activities and/or devices like orthotics, wheelchairs, and scooters to help them get around. These requirements can be a heavy burden on the child’s parents or caregivers.

If your child sustained brain damage as a result of a doctor’s substandard care, you may be able to receive compensation for medical costs and pain and suffering through a medical malpractice claim. It’s advisable to discuss your case with a birth injury attorney.

The Indianapolis birth injury lawyers at Wilson Kehoe Winingham can help you cope with the financial pressure of caring for a brain-injured child by pursuing a medical malpractice lawsuit. 

Contact us today for a free, no-obligation consultation.

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