Claims for brain injury to newborn babies

If your newborn baby needed specialist care in a neonatal intensive care unit (NICU) for birth or newborn complications and has cerebral palsy or neurodevelopmental disability after mistakes in their medical care, they may have suffered a neonatal brain injury.

As parents, you trust your midwives, doctors and neonatal clinicians to provide your newborn baby with the care that they need during their most vulnerable time after birth. Delays or mistakes in the midwifery, medical or nursing care of a newborn baby can lead to serious complications including brain injury and lifelong disability from conditions, such as infection, jaundice and kernicterus, hypoglycaemia, VKDB (vitamin K deficiency bleeding) and hypoxic ischaemic encephalopathy (HIE). Neonatal (newborn) brain injuries are devastating and parents are often left feeling overwhelmed and confused as they come to terms with their baby’s injury and what that means for their child and their family’s future.

On this page you will find answers to some of the most common questions that families have about neonatal brain injury: what it means, how it happens and when you should seek help.

Our neonatal brain injury solicitors have helped countless families of babies who suffered brain injury after birth to understand how their injury occurred and to claim the compensation and support that they need for their child. We can help you answer these questions with advice from trusted, independent medical experts, and secure the compensation and practical support that your child deserves. If you would like to find out more about your newborn baby’s brain injury, and what that means for your baby and family, or if you have been contacted by MNSI or NHS Resolution, contact us to talk, free and confidentially, to one of our experienced neonatal brain injury claims solicitors.  

Can medical negligence cause brain injury in a newborn baby?

A newborn baby must be treated with specialist care if they are unwell or were born prematurely, with low birthweight or following a complicated labour.  Depending on their needs for monitoring, treatment and respiratory (breathing) support, the newborn baby (or neonate) will receive specialist neonatal care in a neonatal unit (NNU) (sometimes known as a special care baby unit or SCBU), or a neonatal intensive care unit (NICU). Their care may be provided by neonatologists, paediatricians, anaesthetists, midwives and nurses.  Babies who are healthy at birth will also occasionally need care from hospital midwives and doctors, as well as from their GP and emergency services.

In the first few weeks after birth, babies are vulnerable to brain injury from conditions caused by their body’s inability to regulate their blood sugar and bilirubin, or produce vitamin K or antibodies to fight off infection. They may also need specialist care for birth injury, such as resuscitation and cooling after HIE. They rely on their neonatal care clinicians to prevent, monitor, recognise and treat signs of potentially harmful conditions. Mistakes or delays in any of these types of neonatal care can lead to brain injury from life-threatening conditions such as hypoglycaemia, kernicterus, VKDB or meningitis, or worsen an existing brain injury causing increased disability.

Medical negligence claims for neonatal brain injury usually involve neonatal intensive care and monitoring failures, and delays in diagnosis and treatment of potentially serious neonatal conditions.

What are the most common neonatal brain injury claims?

There are many ways in which negligent neonatal care or a negligent medical response to signs of illness, such as jaundice, hypoglycaemia or infection, can injure a newborn baby’s brain, but certain neonatal conditions and their treatments feature more commonly in neonatal brain injury claims.

Newborn babies are highly vulnerable to severe complications, including brain injury, from untreated infection or from metabolic emergencies caused by poor monitoring and treatment of their blood sugar and bilirubin levels. Failure to administer vitamin K increases their risk of severe bleeding, including into their brain. Delays and mistakes in resuscitation, oxygenation and ventilation can cause brain injury to premature babies or those suffering from respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS) or extend an HIE-birth-injured baby’s episode of oxygen-deprivation. Delays and errors in therapeutic cooling after hypoxic birth injury can lead to a significant increase in their lifelong disability.  

Resuscitation and ventilation after birth asphyxia

When a baby has breathing difficulties or acidosis from hypoxia (oxygen deprivation) at birth, specialist neonatal nurses or doctors (neonatologists or paediatricians) must be present at the birth to clear the baby’s airway and provide immediate resuscitation. Depending on the baby’s condition, they may need ongoing help with breathing to maintain safe oxygen saturation levels. This may include ventilation with specialist monitoring and support in the neonatal intensive care unit (NICU).

Failure to resuscitate or monitor and maintain adequate oxygen levels in a newborn baby can cause or extend an existing hypoxic injury to their brain or cause brain injury from respiratory or cardiac arrest. 

Medical negligence claims for neonatal brain injury caused by inadequate resuscitation and ventilation often involve delayed or inadequate resuscitation, incorrect technique or problems with equipment, monitoring failures as well as poor staff teamwork and communication.

Read more about hypoxic brain injury claims.

Hypocarbia from over-ventilation

Ventilation involves using a ventilator machine to push air into the baby’s lungs, at a set rate and volume, to control or assist with the baby’s breathing. Over-ventilation can cause hypocarbia, a dangerous condition in which the baby’s  carbon dioxide levels become dangerously low, reducing the blood flow to their brain and causing severe injury, including cardiac arrest, brain haemorrhage, and brain injury disability, such as cerebral palsy. 

Claims for neonatal brain injury caused by over-ventilation often involve monitoring and treatment errors, as well as technical training and equipment failings.

Our recent hypocarbia cases include a £13 million compensation settlement for a premature twin who was left with spastic diplegic cerebral palsy after negligent neonatal care, including over-ventilation, caused an injury to his brain. 

Meconium aspiration

Meconium is the thick, dark green, sticky, tar-like first faeces (poo) that a newborn baby passes after birth.  During labour and birth, significant meconium in the amniotic fluid (waters) is a sign that the unborn baby is not getting enough oxygen and is suffering from fetal distress. If a baby has aspirated (inhaled or breathed in) meconium during labour or delivery, it must be cleared from their airway immediately to allow them to breathe.

Failure to clear meconium from the baby’s airway can lead to respiratory distress and increase the baby’s risk of neonatal bacterial infection.  Delays in clearing an asphyxiated (oxygen-starved) baby’s airway of meconium and providing resuscitation immediately after birth prolongs their hypoxia, causing or increasing the severity of their HIE brain injury, and neurodevelopmental disability, such as cerebral palsy.

Medical negligence claims involving meconium often involve delays in delivering or resuscitating, or clearing meconium from the airway of a distressed (hypoxic) baby.

Read more about meconium in birth injury and cerebral palsy claims.  

Unsupervised skin-to-skin contact

Skin-to-skin contact involves placing a newborn baby on their mother’s chest immediately after birth. The mother may be left to hold and feed her baby whilst she is exhausted, affected by sedation, in pain, or on gas and air whilst undergoing perineal suturing. She may not be able to see her baby clearly and be unaware that the baby is poorly positioned and struggling to breathe or has changes in their colour or tone. 

Safe skin-to-skin contact requires careful supervision by the midwife at a time when they are usually busy with postnatal tasks. Unsupervised skin-to-skin contact can cause sudden unexpected postnatal collapse (SUPC), the cardiorespiratory collapse of an otherwise healthy baby soon after birth. SUPC can cause hypoxic brain injury and long-term disability.  Babies with SUPC need resuscitation, ventilation and specialist neonatal intensive care. Babies with moderate or severe HIE should also be treated with cooling. 

Medical negligence claims for neonatal brain injury caused by cardiorespiratory collapse after skin-to-skin contact may involve midwives’ negligent observation, supervision and positioning of the baby, or leaving a sedated mother to hold and feed her newborn baby, as well as delays and errors  in resuscitating or cooling the injured baby.

Cooling

Cooling is a treatment for newborn babies with moderate or severe HIE which can prevent or reduce long-term physical disability.  Cooling (also known as therapeutic hypothermia) lowers the baby’s temperature to a level which reduces swelling and pressure within the brain, slows brain cell metabolism and slows the rate of damage to the baby’s brain.

Cooling treatment must follow a strict safety protocol. It must be carried out in a specialist neonatal intensive care unit (NICU) by clinicians who are trained and experienced in using cooling to treat severely ill newborn babies. Cooling must start no later than six hours after the baby’s birth or episode of hypoxia. The baby’s temperature must be lowered safely and kept between 33C° and 35°C for 72 hours.  Alongside cooling, the baby must receive neonatal intensive care, including regular blood tests, monitoring of their temperature, blood pressure, heart rate and brain activity, and checking for signs of infection. They should receive sedation and pain relief and respiratory and cardiovascular support if needed. At the end of the treatment, they must be gradually rewarmed to normal temperature (37°C), taking care to avoid reperfusion injury.

Neonatal brain injury claims from cooling errors usually involve breaches of the safety protocol, delays in starting cooling treatment, NICU and monitoring errors, and mistakes in controlling the temperature, resulting in over-cooling or rapid rewarming.

We recently secured a judgment for a child whose HIE birth injury and disability was worsened by a lengthy period of negligent cooling at a dangerously low temperature during transfer to a more specialised NICU.  

Read more about cooling after HIE birth injury.

Kernicterus from untreated jaundice

Kernicterus is a rare type of brain injury which can occur when persistent neonatal jaundice is untreated. Jaundice and kernicterus are caused by excessive levels of a natural chemical called bilirubin in the newborn baby’s blood. Jaundice is a common condition in newborn babies, best known for the yellow discolouration it causes to (particularly White) babies’ skin and the whites of a jaundiced baby’s eyes.

Most newborn babies’ jaundice quickly resolves without the need for treatment but neonatal jaundice should always be diagnosed and carefully monitored. If the jaundice does not resolve, the baby will need to be treated with  phototherapy or an exchange transfusion to prevent the bilirubin in the baby’s blood from building up to a dangerously high level (hyperbilirubinaemia). Untreated hyperbilirubinaemia causes kernicterus brain injury and severe lifelong disability. 

Kernicterus brain injury is avoidable with correct neonatal care. Kernicterus brain injury claims usually involve mistakes and delays in diagnosis, monitoring, referral and treatment of newborn babies with jaundice.

Our experience in kernicterus claims includes a $23 million compensation settlement for a boy who was left with severe cerebral palsy disability from kernicterus after community midwives failed to diagnose, monitor and refer him for treatment of his neonatal jaundice.

Read more about kernicterus brain injury claims.

Neonatal hypoglycaemia

Neonatal hypoglycaemia ( low blood sugar) is a metabolic condition suffered by many newborn babies in the first few days of life. Newborn babies develop hypoglycaemia because they are unable to maintain their own healthy blood sugar levels until a regular pattern of feeding is established.

Neonatal hypoglycaemia is most common in babies with low birthweight (below 2.5kg) and it is standard neonatal practise to monitor the blood sugar levels of any baby born with a birthweight below the 2.5kg threshold. Newborn babies are also at higher risk of hypoglycaemia if they have intrauterine growth restriction (IUGR) or are small for their gestational age, or if they have difficulty feeding or their mother has diabetes.

Neonatal hypoglycaemia is treatable with correct neonatal monitoring, diagnosis and treatment, but can be dangerous if the baby’s blood sugar is allowed to drop below safe levels. Untreated neonatal hypoglycaemia can cause permanent brain injury and lifelong neurodevelopmental disability.

Medical negligence claims for neonatal brain injury caused by hypoglycaemia often involve failure to recognise the baby’s risk of hypoglycaemia and refer their care to a paediatrician or neonatal unit (NNU), and mistakes in monitoring, testing and treatment of the baby to maintain safe blood glucose levels. Claims can also arise from discharging a baby who is at risk of hypoglycaemia from hospital without providing adequate safety-netting advice to their parents.

Our neonatal hypoglycaemia cases include a compensation settlement of over £24 million for a teenager who suffered a brain injury from untreated hypoglycaemia in the first few days of his life.

Read more about neonatal hypoglycaemia claims.

Infection

Neonatal infections can be caused by bacteria, viruses, fungi or parasites. Early-onset infection develops during the first 72 hours of the baby’s life and is often caused by bacteria, such as group B streptococcus (GBS), passing from the mother to the baby in pregnancy or during labour and birth. Late-onset neonatal infection develops later within the first 28 days of life and is more likely to be from pathogens (bacteria, viruses etc) picked up in hospital or the external environment.

Newborn babies do not have the antibodies to fight off infection in the first few weeks of life when their immune systems are still developing. Maternity and neonatal clinicians must identify and closely monitor babies who are at risk of infection and pregnant mothers who could pass on GBS, HSV or other types of infection. It is essential that they recognise and respond quickly to signs of infection in a pregnant mother or her newborn baby, as delays or mistakes in diagnosis or treatment of neonatal infection can lead to life-threatening complications, including  meningitis, encephalitis or sepsis, and cause permanent brain injury and neurodevelopmental disability, such as cerebral palsy. 

Medical negligence claims for neonatal brain injury from infection usually involve delays or mistakes in recognition, diagnosis, monitoring and treatment of neonatal and/or maternal infection.

In a recent neonatal brain injury from infection case, we secured an  £18.4 million settlement   for a child who was left with cerebral palsy after delayed treatment of herpes simplex virus (HSV) infection in the forceps wounds on his scalp.

Read more about neonatal brain injury from infection claims.

Vitamin K deficiency bleeding (VKDB)

Vitamin K deficiency bleeding (VKDB) is a bleeding disorder, caused by a lack of vitamin K. It was previously known as haemorrhagic disease of the newborn or HDN. Vitamin K helps with blood clotting and allows wounds to heal without excessive bleeding.  Vitamin K is a natural substance which our bodies make from bacteria in our intestines or take from our diet. Babies are born without any vitamin K and don’t yet have the intestinal bacteria needed to make it. This means that if they bleed, their blood doesn’t clot, which leaves them vulnerable to brain injury from intracranial bleeding.

Vitamin K deficiency bleeding (VKDB), and the severe brain injury and disability that it causes, is preventable by a standard vitamin K treatment given to newborn babies immediately after their birth. In the rare cases where VKDB occurs, there has usually been a negligent failure by the midwife to give the baby vitamin K after birth, or the baby’s parents have withheld their consent to their baby receiving vitamin K treatment.

Medical negligence claims for neonatal brain injury and disability caused by VKDB usually involve negligent failure to administer vitamin K to a newborn baby after birth, or failure to correctly advise and obtain informed consent from the baby’s parents.

Read more about vitamin K deficiency bleeding claims.