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When a baby does not get enough oxygen and blood flow around the time of birth, doctors may have only a short time to act.
For some babies with moderate-to-severe hypoxic-ischemic encephalopathy (HIE), cooling therapy can lower the risk of death or long-term disability. But this treatment is time-sensitive. It usually needs to start as soon as possible and within 6 hours of birth.
If a hospital misses signs of HIE, delays treatment, or fails to transfer a baby to a hospital that offers cooling therapy, parents may be left wondering whether medical negligence played a role.
What Is HIE?
Hypoxic-ischemic encephalopathy is a type of newborn brain injury. It happens when a baby’s brain does not get enough oxygen and blood flow around the time of birth.
HIE can happen before birth, during labor and delivery, or shortly after birth. Some cases happen even when doctors and nurses provide proper care. Other cases may be linked to medical mistakes, delayed treatment, or missed warning signs.
Neonatal HIE is estimated to occur in about 1.5 out of every 1,000 live births in the United States.
Birth asphyxia and birth trauma are leading causes of newborn death worldwide, according to the World Health Organization.
Moderate or severe HIE can have serious effects. Some babies with HIE may develop cerebral palsy, seizures, or other lifelong disabilities.
Why the First 6 Hours Matter
The first hours after oxygen deprivation are critical because HIE does not always cause all of its damage at once.
When the baby’s brain first loses oxygen and blood flow, brain cells can become injured. But a second phase of injury may happen hours later. During this second phase, inflammation and chemical changes in the brain can cause more brain cells to become damaged or die. This delay creates a short treatment window.
Therapeutic hypothermia, also called cooling therapy or neonatal cooling, is designed to slow this injury process. It lowers the baby’s body temperature in a controlled way to help protect the brain.
For eligible babies with moderate-to-severe HIE, cooling therapy is most effective when it starts as soon as possible and within 6 hours of birth. Treatment is usually continued for 72 hours while the baby is closely monitored.
How Cooling Therapy Helps Newborns With HIE
Cooling therapy is the only proven treatment that can help protect a newborn’s brain after moderate-to-severe HIE.
It can lower the risk of infant death or serious developmental problems in some babies when it starts within 6 hours of birth and continues for 72 hours, according to the American Academy of Pediatrics. It does not prevent every poor outcome, but it may help some babies have a better chance of recovery.
Doctors may look at several factors, including:
- Ability to begin treatment quickly: Cooling therapy usually needs to start within 6 hours of birth.
- Evidence of oxygen deprivation: The baby may have signs of oxygen loss before, during, or shortly after delivery.
- Gestational age: Cooling therapy is generally used for babies born at 36 weeks of gestation or later.
- Signs of moderate-to-severe HIE: Doctors look for symptoms such as poor muscle tone, seizures, abnormal reflexes, or trouble breathing.
- Stability for treatment or transfer: The baby may need to be stable enough for cooling therapy or transfer to a higher-level NICU.
This is why fast recognition is so important. If hospital staff do not identify possible HIE quickly, the baby may miss the short treatment window.
When Delayed HIE Care May Be Medical Negligence
Not every case of HIE is caused by medical negligence. Some babies experience oxygen deprivation even when doctors and nurses follow accepted medical practices.
However, medical negligence may be involved when a hospital fails to meet the standard of care and that failure causes harm.
In HIE cases, baby malpractice may involve:
- Delaying an emergency C-section when fetal monitoring shows signs of distress
- Improperly managing anesthesia during labor or delivery
- Missing signs of HIE after birth
- Misusing forceps or a vacuum extractor during delivery
- Not responding quickly to high-risk pregnancy or delivery complications
- Waiting too long to start cooling therapy or transfer the baby to a hospital that offers it
The key issue is the timeline. Families may need to know when signs of distress first appeared, when the baby was delivered, when HIE symptoms were recognized, whether cooling therapy was started, and whether a transfer should have happened sooner.
Getting Help After a Possible Preventable HIE Injury
HIE can leave families with painful questions. Parents may wonder whether their child’s injury could have been prevented, whether the hospital acted quickly enough, or whether a delay in cooling therapy changed their child’s future.
The 6-hour window is a recognized treatment window for eligible babies with moderate-to-severe HIE. When that window is missed, families deserve to understand why.
Compensation from an HIE lawsuit can help pay for medical care, mobility equipment, and home modifications. It can also help families plan for the care their child may need throughout life.
If your child was diagnosed with HIE or a related birth injury, a no-obligation consultation with our team can help you understand whether medical negligence may have played a role.
Get your free case review now or call us at (800) 914-1562 to learn more.
