Cooling babies to limit the risk of cerebral palsy

Babies who are starved of oxygen during birth are at a high risk of brain damage and therefore the development of cerebral palsy and all the challenges this will bring them in life.

Previously there was little or nothing that could be offered to babies to stop or limit the damage from occurring, making this type of incident all the more tragic for the child and family involved.

A new treatment

However, a treatment method has emerged in recent years that can bring hope to babies who sadly suffer such a traumatic start to life, giving them the chance to make a complete recovery or greatly reduce the severity of their brain injury.

The ‘cooling’ method is being offered by some UK hospitals and involves wrapping babies who have been starved of oxygen in a blanket filled with fluid that reduces their body temperature from the normal 37C to 33.5C. This is continued for the first few days of their life to induce a mild form of hypothermia to the baby. Doctors do not know why exactly the method works but one theory is that the reduced temperature minimises the number of cells that die from the lack of oxygen.

When a baby’s oxygen supply is cut off, for example due to the blood supply in the cord being cut off, the child can usually withstand it for the first 10 minutes before damage is caused to their brain. However, some medical experts are now of the opinion that the damage is not instantaneous and giving the brain time to recover from the shock with the cooling method is what allows the damage to be limited or even prevented altogether.

Astonishing results

The results the method achieves are astonishing and it has saved lives and prevented major disabilities. It was first trialled in the UK in 2009 when more than 300 babies born full-term who suffered oxygen deprivation at birth received the treatment at 33 hospitals (BBC). The researchers found that the babies were 57 per cent more likely to survive without brain damage after the treatment. The study came after 20 years of research into the method but its findings represented the first conclusive proof that it could be an effective way to help babies who have been starved of oxygen.

Baby Ella: a case study

Since this trial, there have been several moving cases involving babies whose oxygen supply was cut off during their birth yet after receiving the cooling treatment there has been little or no impact on the child. One such example is that of baby Ella who was at significant risk of severe brain damage after her oxygen supply was cut off when he mother’s placenta ruptured during her birth (BBC). When Ella was delivered she did not have a heartbeat but she was resuscitated and put on life support to enable her to breathe. Doctors then started the cooling process and months later Ella was a healthy baby girl with no signs of brain abnormalities, which certainly would not have been expected without the treatment.

Ella’s consultant, Dr Topun Austin, a neonatologist at Addenbrooke’s Hospital in Cambridge where Ella was born, told the BBC that research had shown that brain cells took 24-48 hours to die so there is a window when during which the brain damage can be stopped. He said: “Lack of oxygen is a trigger but it doesn’t happen immediately. The damage can be prevented.”

A major breakthrough in neonatal care

Thankfully in comparison to the large number of babies that are born every day the number who experience oxygen deprivation is relatively few. However, because of the catastrophic impact it can have on whole lives, the provision of this effective treatment marks a major breakthrough in neonatal care.

The specialist solicitors at JMW frequently handle cases involving children who are severely disabled, have profound learning difficulties, behavioural problems and conditions such as epilepsy because their brain was starved of oxygen during birth. Although there are some circumstances where every possible step was taken to deliver the baby safely and the incident could sadly not be avoided there are others where serious mistakes were made that caused the baby’s injury and subsequent cerebral palsy.

More research is needed

The cooling method is a major medical development and one that should be celebrated, but unfortunately it is not successful in every case. Furthermore, because it is a relatively new treatment, we do not have clear evidence of what the long-term effects of cooling might be. Whilst some children may have a good short-term response to cooling, more research is needed to see what future holds for children who have had cooling treatment.

For those children whose brain damage was the result of the negligence of healthcare staff, claiming the compensation they are entitled to is crucial to cover the cost of their specialist care and equipment and to ensure they can cope later in life as they will frequently be unable to live independently.





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