Questions?About Infant Hypoxic-Ischemic Encephalopathy
Neonatal hypoxic-ischemic encephalopathy is a type of birth asphyxia that happens when a baby’s brain doesn’t get enough blood (ischemia) or oxygen (hypoxia). This birth injury is also known as hypoxic ischemic encephalopathy or HIE.
HIE begins when blood flow to the brain is restricted, reducing the supply of oxygen and glucose to the brain. This can trigger a harmful rise in calcium inside brain cells, which may lead to cell death.
If enough brain cells are damaged, a child may face lifelong neurological impairment, like cerebral palsy (CP). Oxygen deprivation can also affect other organs, including the kidneys, liver, and heart. The longer the brain is deprived of oxygen, the greater the risk of lasting injury.
Watch our short video to learn more about HIE.
Learn about hypoxic-ischemic encephalopathy (HIE), a serious condition affecting newborns during childbirth, and what to do if your baby was harmed. View Transcript.
Duration: 1 min 03 sec
Infant hypoxic-ischemic encephalopathy, or HIE, is a life-threatening condition that can affect unborn children and newborn babies.
It occurs when a baby doesn’t receive enough oxygen or blood flow during the birthing process causing brain cells to die.
Without immediate treatment, severe HIE can result in permanent disabilities like cerebral palsy, brain damage — and even death.
According to the American Medical Association, HIE is estimated to cause more than 1 million deaths each year across the world.
The important thing to know is that some cases of HIE are preventable, which means they could have been caused by a doctor or health care professional’s medical mistakes.
You may have legal options if your baby’s HIE was caused by medical malpractice. Connect with the team at the Birth Injury Justice Center today to learn more. Our trained labor and delivery nurses are standing by to talk with you.
When HIE could have been prevented, families may be able to take legal action. An HIE lawyer can help determine what went wrong during delivery and whether medical negligence played a role.
Taking legal action won’t change the diagnosis, but it may provide financial support for long-term care and hold negligent health care providers accountable.
The Birth Injury Justice Center has partnered with lawyers who can help families in all 50 states. Our legal partners have secured over $1 billion for families affected by birth injuries.
Find out if we can help your family — get a free case review now.
Signs of HIE in Newborn Babies
Some newborns show symptoms of hypoxic-ischemic encephalopathy right after birth, while others may not show signs until after a few hours of life or even days later.
Early signs of HIE often require emergency treatment and should never be ignored. If you suspect something is wrong, seek medical attention immediately.
- Abnormal movement or difficulty controlling limbs
- Blue or pale skin tone
- Decreased or absent breathing at birth
- Difficulty feeding
- Floppy or stiff muscle tone with poor reflexes
- Meconium (first feces) in the amniotic fluid, which may signal fetal distress
- Seizures, especially within the first 24 hours
- Unusual response to sights or sounds
- Vital organ problems, such as heart, lung, or kidney issues
- Weak cry
- White matter brain lesions, visible on imaging scans
Infants with mild HIE may not have seizures, while babies with moderate HIE often have seizures that start in the first few hours and fade within a day. In more severe cases, seizures may be delayed and last longer.
Developmental delays or missed milestones may become apparent as a child grows.
Causes of Hypoxic Ischemic Encephalopathy
Hypoxic-ischemic brain injury is often caused by complications that occur before, during, or shortly after birth. When a baby is deprived of oxygen for too long, even briefly, the result can be a serious brain injury with lifelong effects.
Many cases of HIE occur in otherwise healthy full-term infants, which makes proper monitoring during delivery critical.
- Extended labor or delivery complications
- Impaired lung function at or after birth
- Medical malpractice, such as failing to respond to signs of fetal distress
- Placental abruption, when the placenta detaches from the uterus too early
- Prolonged umbilical cord compression or a true knot that blocks oxygen flow
- Uterine rupture, a rare but severe delivery emergency
If you’re not sure what caused your baby’s condition, our experienced labor and delivery nurses are here to help. They can talk with you about what happened and whether medical negligence may have played a role in your child’s HIE.
Connect with one of our registered nurses right now.
Beth has more than 18 years of specialized experience in labor and delivery. She’s available to hear your story and help you figure out the cause of your child’s injury — and what you can do next.
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Risk Factors of Infant HIE
Certain conditions during pregnancy or delivery may increase the risk of hypoxia-ischemia and lead to long-term complications.
Research suggests that babies born prematurely face a higher risk of hypoxic encephalopathy and may experience more severe outcomes. Because the preterm brain is especially fragile, any oxygen-related injury is more likely to result in lasting effects.
- Drug or alcohol use during pregnancy
- Maternal infections, such as pelvic inflammatory disease
- Pre-eclampsia, or dangerously high blood pressure
- Very low maternal blood pressure (hypotension) during pregnancy or labor
Many of these risks can be managed with attentive prenatal care. When health care providers fail to monitor or address known risk factors, it may be considered medical negligence.
Medical Negligence and Infant Hypoxic-Ischemic Encephalopathy
Although hypoxic-ischemic encephalopathy can occur unexpectedly, some cases are caused by medical negligence during labor or delivery.
- Delaying a cesarean (C-section) delivery after signs of fetal distress
- Failing to monitor or treat a maternal infection
- Ignoring changes in the baby’s heart rate during labor
- Mismanaging complications with the umbilical cord or placenta
- Misusing forceps or vacuum extractors
- Missing early warning signs like a low Apgar score
- Neglecting to begin resuscitation quickly after birth
- Overlooking signs of oxygen deprivation during or after delivery
In many cases, health care providers do not test umbilical cord blood for signs of acidosis, which can indicate severe oxygen deprivation.
If a baby is diagnosed with HIE after receiving poor medical care, families may have legal options. Compensation from an HIE lawsuit may help cover the cost of lifelong medical care and more.
Most parents are never told that HIE could be tied to a preventable medical mistake. If something felt wrong during labor — or if your baby went to the NICU or needed oxygen right after birth — medical negligence may have occurred.
Get a free case review now to find out if we can connect you with a top HIE infant attorney near you.
Complications of HIE in Babies
Infant hypoxic-ischemic encephalopathy can result in a number of secondary diagnoses, ranging from mild to severe.
- Cerebral palsy
- Epilepsy or other seizure disorders
- Hearing or vision loss
- Learning disabilities or developmental delays
These diagnoses may be apparent at birth. But in many cases, they won’t emerge until the child is older and starts missing certain brain development milestones.
For example, some behavioral challenges may not occur until age 10, when the frontal lobe begins to develop. It can take years to determine how a child will be affected by HIE.
Hypoxic Ischemic Encephalopathy Compensation
If your child has been harmed by this life-threatening condition, you may be able to file an HIE claim for compensation.
A settlement can provide financial relief and help ensure your child gets the care they need now and in the future.
- Assistive equipment and home modifications, like wheelchairs, braces, and ramps
- Medical treatments, including surgery, medications, and specialist visits
- Therapy services, such as physical, occupational, and speech therapy
Some HIE settlements help cover access to treatment options that aren’t always covered by insurance, such as alternative therapies or private care.
Families only have a limited time to take legal action. Call us at (800) 914-1562 right now or Click to Live Chat to see if we can help you file your HIE claim.
How Is HIE Diagnosed in Babies?
Getting a definitive HIE diagnosis in a newborn involves a combination of clinical exams, imaging studies, and laboratory tests. Doctors look for signs of oxygen deprivation and assess the extent of any brain injury.
- Electrocardiography (ECG or EKG) to evaluate heart function
- Electroencephalogram (EEG) to monitor electrical activity in the brain and detect seizures, sometimes with CP
- Magnetic resonance imaging (MRI) to identify brain swelling, white matter injury, or areas affected by a lack of oxygen
- Ultrasound (cranial ultrasonography) to examine the brain structure and detect bleeding or hemorrhage (loss of blood from a damaged blood vessel)
Because HIE can affect multiple body systems, doctors may order additional tests or evaluations.
Blood tests can check for metabolic imbalances and organ dysfunction, including problems with the baby’s liver, kidneys, or heart.
Hearing tests are often used to detect sensorineural hearing loss, which may result from brain injury. Ophthalmic exams can also assess vision problems linked to HIE.
Together, these tests help determine the severity of the injury and guide the baby’s treatment plan.
Hypoxic-Ischemic Encephalopathy Stages and Levels
Infant hypoxic-ischemic encephalopathy involves two stages of brain injury. HIE stages reflect how the brain responds to oxygen deprivation and the body’s attempt to recover.
- Stage 1: Primary energy failure happens when the brain is first deprived of oxygen and blood flow during or shortly after birth. Cells begin to shut down rapidly.
- Stage 2: Reperfusion injury occurs when blood and oxygen return to the brain. This can cause damaged cells to release toxins, leading to further injury in the hours or days that follow.
Early diagnosis and proper classification of HIE can help families get the right care, therapies, and support as soon as possible.
Severity Levels of HIE
Doctors also classify HIE based on its severity, using a system called the Sarnat Grading Scale, also known as Sarnat staging.
This scale helps determine the type of care a baby may need and their potential long-term outlook.
- Alertness or level of consciousness
- Autonomic function, such as breathing and heart rate
- Gastrointestinal function and feeding ability
- Muscle tone and reflexes
- Secretions from the lungs or mouth
- Seizure activity
HIE severity is typically described as mild, moderate, or severe. This classification helps guide treatment and gives families a better sense of what to expect.
Hypoxic Ischemic Encephalopathy Life Expectancy and Prognosis
Globally, hypoxic-ischemic encephalopathy is one of the leading causes of newborn death. Estimates suggest that HIE contributes to hundreds of thousands of infant deaths each year, particularly in areas with limited access to emergency obstetric and neonatal care.
The long-term outcome for babies with HIE often depends on how severe the brain damage is and how quickly treatment begins.
Among those with moderate HIE, up to 50% may experience long-term complications. For severe HIE, as many as 80% of survivors are affected by permanent disabilities.
In most cases, HIE does not directly shorten life expectancy. However, related conditions, like a severe type of cerebral palsy or uncontrolled epilepsy, can increase the risk of secondary complications later in life and may require lifelong medical care.
Infant Hypoxic-Ischemic Encephalopathy Treatment
Babies diagnosed with HIE need urgent, specialized care. The most widely used treatment is therapeutic hypothermia, also known as brain or body cooling.
This process can reduce the risk of long-term brain damage when started within six hours of birth.
During cooling therapy, the baby is placed on a cooling blanket or has their head cooled for about 72 hours. Medications may be used to reduce discomfort and help the baby rest.
Throughout the process, doctors closely monitor brain activity, body temperature, blood sugar, heart rate, and breathing. After cooling, the baby is slowly rewarmed and typically receives nutrition through an IV.
- Cardiac care to support heart function
- Mechanical ventilation for babies who cannot breathe on their own
- Medications to control seizures or prevent them
- Monitoring and support for kidney and liver function
As the baby stabilizes, early intervention becomes essential. Many children with HIE benefit from physical, occupational, and speech therapy to help manage developmental delays and support long-term growth.
Unfortunately, these treatments can be complex and expensive. Compensation from an HIE lawsuit settlement may help families afford top-level medical care, therapy, and equipment, giving their child the best possible chance at recovery and a high quality of life.
Get Legal Help for Infant Hypoxic-Ischemic Encephalopathy
If your child’s HIE could have been prevented, you may be able to take legal action. Poor decisions during labor or delivery can deprive a baby’s brain of oxygen and lead to lifelong complications.
Caring for a child with HIE often involves intensive medical care, seizure management, mobility equipment, therapy, and long-term support. Most families are unprepared for the emotional and financial toll this can take.
When medical negligence is the cause, no family should be left to shoulder these costs alone. Money from a birth injury lawsuit can help cover treatment expenses and hold health care providers accountable for the harm they caused.
We work with experienced birth injury lawyers who can help families in all 50 states.
Our legal partners have secured more than $1 billion for families affected by preventable birth injuries like HIE, and they may be able to help your family, too.
Call us at (800) 914-1562 right now or fill out our case review form to see if we may be able to help you seek the justice and compensation your family deserves.
Infant Hypoxic-Ischemic Encephalopathy FAQs
What is HIE in infants?
Infant hypoxic-ischemic encephalopathy (HIE) is a type of brain injury that occurs when a baby’s brain does not get enough oxygen and blood before, during, or shortly after birth.
This lack of oxygen can cause lasting damage to brain cells and lead to serious complications, including developmental delays, seizures, or cerebral palsy.
Can babies recover from hypoxic ischemic encephalopathy?
Some babies with mild HIE may recover fully, especially with early treatment. Others may experience long-term challenges, depending on the severity of the brain injury.
Therapeutic hypothermia, if started within six hours of birth, can help reduce the risk of permanent damage.
What causes hypoxic ischemic encephalopathy in infants?
HIE is caused by a lack of oxygen and blood flow to the brain. Common causes of HIE include problems during labor and delivery, like umbilical cord or placental issues, or delayed C-section after signs of fetal distress.
What is the life expectancy of a baby with HIE?
Many babies with HIE live well into adulthood, especially if the injury is mild or moderate. In severe cases, life expectancy may be shorter due to complications like uncontrolled seizures, feeding difficulties, or respiratory issues. Each case is unique and depends on the extent of brain injury.
What are the symptoms of a baby with HIE?
Symptoms of HIE in newborns may include weak or absent breathing, pale or bluish skin, and reduced response to sound or touch. Some signs may not appear until days or weeks after birth.
If your child’s HIE was caused by medical negligence, you may be able to file a birth injury lawsuit. This can mean accessing financial compensation to help cover the cost of care and give your child the best possible chance at a healthy future.
Get a free case review right now to find out if our team can help you get started.
Can HIE cause autism?
There is evidence that babies who experience oxygen deprivation at birth, including those with HIE, may have a higher risk of autism spectrum disorder (ASD).
However, not all babies with HIE develop autism, and more research is ongoing to understand the connection.
What is the death rate of severe HIE?
Severe HIE is associated with a high risk of death or serious long-term disability. Studies show that up to 50% of babies with severe HIE may not survive, even with intensive care. Those who survive often face lifelong challenges.
When HIE is caused by medical mistakes, families may have legal options and we may be able to help.
Call us at (800) 914-1562 right now or Click to Live Chat to see if we can connect you with a top HIE attorney near you.
