Claims for neonatal brain injury from infection

If your baby showed signs of infection soon after their birth and now has neurological disability or cerebral palsy, they may have suffered a neonatal brain injury from infection caused by negligent medical mistakes or delays.

Newborn babies are highly vulnerable to infection before their immune systems have fully developed. Midwives, doctors and neonatal clinicians must recognise and respond quickly to signs of infection in a newborn baby. They must also identify and closely monitor babies who are at increased risk of infection and pregnant mothers for signs of maternal infection. Delays or mistakes in treatment for newborn babies with infection can lead to dangerous complications, such as meningitis, encephalitis or sepsis, and long term neurodevelopmental disability or cerebral palsy from neonatal brain injury.

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

Our neonatal brain injury solicitors have helped countless families of children with neonatal brain injury from infection 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 baby deserves. If you would like to find out more about your baby’s neonatal 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 infection cause brain injury in a newborn baby?

When a newborn baby develops an infection before, during or within 28 days of their birth, this is known as a neonatal infection.

Neonatal infections are caused by one of the following pathogens:

bacteria – such as group B streptococcus (GBS) or staphylococcus aureus (staph);
a virus - such as herpes simplex virus (HSV) or cytomegalovirus (CMV);
fungi - such as Candida albicans (C.albicans);
or parasites.

Early-onset infections occur within 72 hours of birth and are often caused by bacteria passing from the mother to the baby during pregnancy, labour or birth.

Late-onset neonatal infection develops after the first week of life and may come from infected wounds or exposure to pathogens in the external environment, such as from other people in hospital or medical treatment with catheters or IV lines.

Untreated infections can very quickly become dangerous for newborn babies because their immune systems have not fully developed. Any delays or errors in treatment of a newborn baby’s infection can lead to rapid deterioration from life-threatening complications, such as meningitis, encephalitis or sepsis, and cause permanent brain injury, cerebral palsy and other neurodevelopmental disability.

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

What are the most common claims for neonatal brain injury from infection?

There are many ways in which a negligent medical response to signs of infection can injure a newborn baby’s brain but certain types of infections and infective processes feature more commonly in claims arising from negligent maternity and neonatal care.

Maternal infections during pregnancy, such as group B streptococcus (GBS or group B strep), herpes simplex virus (HSV) and inflammation of the membranes surrounding the baby in the womb (chorioamnionitis) are common risk factors for early-onset infection in the newborn baby. Claims often arise where the mother was known to have an infection before delivery, but mistakes were made in treating her infection and in monitoring or treating the newborn baby for signs of infection.

Risk factors such as prolonged or preterm pre-labour rupture of the membranes (PROM or PPROM), premature birth and low birth weight are all known to increase the baby’s vulnerability to infection. Claims for neonatal brain injury from infection commonly involve failure to recognise the baby’s increased risk and to provide them with appropriate monitoring and care.

Where neonatal infection is left untreated, it can rapidly cause severe brain injury and permanent disability from life-threatening complications, such as meningitis, encephalitis and sepsis.

Group B streptococcus (GBS)

Group B streptococcus is a common cause of neonatal infections. You may have heard of it as group B strep or GBS.

If a mother is unaware that she is a carrier of group B streptococcus bacteria, her GBS infection can be passed to her baby during her labour and delivery and cause early-onset neonatal infection. If she has symptoms or signs of infection during pregnancy, (e.g. GBS in her urine tests) she must be told about her GBS condition and offered antibiotics during pregnancy (where needed to treat the maternal infection) and in labour. Her newborn baby must also be carefully monitored for signs of infection. Any signs of group B strep infection in the newborn baby must be diagnosed and treated quickly with antibiotics to avoid life-threatening complications, such as meningitis, encephalitis or sepsis, which can lead to brain injury and neurological disability.

Group B streptococcus is one of the most common types of claims for newborn and child brain injury from infection that we see. We have helped many families secure compensation for their child after negligent maternity and neonatal treatment of their GBS infection caused permanent brain injury disability from cerebral palsy.

Read more about group B streptococcus (GBS) infection medical negligence claims.

Chorioamnionitis

Chorioamnionitis is inflammation of the chorion and amnion membranes which surround the baby during pregnancy and labour. Chorioamnionitis often occurs as an inflammatory response to an intrauterine or amniotic fluid infection. This type of infection occurs when bacteria enter the uterus after the membranes which hold the amniotic fluid (liquor or waters) have broken.

Rupture of the membranes (or waters breaking) is a natural process which usually occurs around the start of labour when the pregnancy has reached full term (37 or more weeks). In some cases, rupture of the membranes takes place before labour begins (pre-labour rupture of the membranes or PROM) or before the pregnancy has reached term (pre-term pre-labour rupture of the membranes or PPROM).

From the time that the mother’s waters have broken, the unborn baby is at risk of chorioamnionitis. The infection risk to the baby increases when there is a prolonged time-lapse between rupture of membranes and delivery. In such cases, the pregnant woman should be carefully monitored for signs of infection, such as high temperature or uterine tenderness, and offered antibiotics if necessary. The unborn baby should also be monitored regularly to check on their wellbeing and ensure their safe delivery. They should also be carefully observed after birth and treated urgently if there are any signs of infection.

Failure to diagnose or act on signs of chorioamnionitis and infection could result in permanent brain injury to the child, such as from neonatal sepsis, leading to permanent disability from cerebral palsy.

Meningitis

Meningitis is inflammation of the meninges or protective membranes which cover the brain and spinal cord. Neonatal meningitis is a very serious complication of neonatal infection which can develop rapidly if infection is not quickly and correctly treated. Meningitis occurs when the bacteria which are causing the infection overwhelm the baby’s immune system and spread through the bloodstream to the meninges and into the cerebrospinal fluid. The body’s inflammatory response causes swelling and pressure within the brain which can very quickly cause severe injury to the brain and nerves.

Meningitis can be caused by bacteria, viruses or fungi, but neonatal meningitis is most commonly caused by group B streptococcus (GBS) or E.coli bacterial infection. Early-onset meningitis is usually caused by an infection passing from the mother to the baby during pregnancy or birth. Pregnant women who carry GBS and their newborn babies must be carefully monitored and treated urgently with antibiotics in hospital if they have symptoms or signs of infection. Delays in treatment can result in brain injury and lifelong, severe disability.

Late-onset neonatal meningitis is more likely to be caused by exposure to infection in other ways. Meningitis can also occur in older babies but newborns are particularly vulnerable to lasting injury from infection as their immune systems are not yet developed.

Meningitis in newborn babies and older infants is one of the most common types of claims for brain injury from infection that we see. We have helped countless families secure substantial compensation settlements to provide essential help with care and their severely disabled child’s lifelong needs.

Read more about how we help children with neonatal meningitis.

Encephalitis

Encephalitis is inflammation of the brain. In babies it is most commonly caused by bacterial infections (such as GBS) or a viral infection like herpes simplex virus (HSV).

Neonatal encephalitis can be caused by maternal infection being passed to the baby during pregnancy, birth or breastfeeding, or by contact with infected people or surroundings. Maternal HSV infection can be passed to the baby during childbirth.

If a newborn baby has signs of HSV infection, they must be treated with the correct antiviral medication (such as intravenous or IV acyclovir) to target the underlying viral infection. Antibiotics will not heal a viral infection. Treatment with the correct medication must take place urgently in a hospital specialist neonatal unit to ensure that the baby is properly monitored and treated for any complications.

Delays or failure to recognise, investigate, diagnose and correctly treat signs of HSV infection can result in encephalitis leading to permanent neurological disability, including epilepsy, learning disability and cerebral palsy.

We are experienced in claims involving HSV encephalitis, and recently secured an £18.4 million settlement for a child whose quadriplegic cerebral palsy was caused by delayed treatment of neonatal herpes simplex virus (HSV) infection in the forceps grazes on his scalp.

Sepsis

Neonatal sepsis is a serious condition which occurs when a newborn baby’s undeveloped immune system responds to severe infection by causing inflammation throughout their body. The inflammation interferes with the blood circulation, which causes a severe drop in blood pressure (septic shock) and restricts the oxygen supply to the organs and tissues.

Neonatal sepsis is most commonly caused by bacterial infections, such as GBS. Neonatal sepsis can also be caused by fungi, parasites or viruses, such as herpes simplex virus (HSV). Any baby can develop neonatal sepsis, but premature babies are more vulnerable than babies born at term, because they have not yet developed the antibodies to fight off infection.

Newborn babies who develop early-onset sepsis within the first 72 hours of life have usually been exposed to maternal infection, such as GBS or chorioamnionitis, during pregnancy or birth. Babies with late-onset neonatal sepsis will have acquired their infection after birth from external sources, such as IV tubes and catheters, or during a prolonged stay in the hospital environment.

Sepsis is a medical emergency. If a baby has signs of sepsis from bacterial infection, they must be treated urgently in hospital with intravenous (IV) antibiotics. Their care should take place in a neonatal intensive care unit (NICU) and include careful monitoring and any necessary support (respiratory, blood pressure, anti-viral medication, fluids or transfusions). Delays and mistakes in the diagnosis and treatment of sepsis can be life-threatening or cause permanent injury to the baby’s brain.

Read more about sepsis negligence claims.

What mistakes lead to neonatal brain injury from infection claims?

If your baby’s brain injury was caused by infection as a result of any of the following mistakes in their mother’s or their own maternity and neonatal care, they may be entitled to claim compensation:

failing to recognise and reduce the risks to the baby from maternal infections;
failing to monitor and manage risk factors such as PROM or PPROM;
errors in advising, treating and planning labour for a pregnant mother with GBS;
failing to recommend or administer antibiotics;
failing to monitor and closely observe a baby who is at risk of infection;
misdiagnosis and delays in diagnosis;
failing to carry out appropriate tests and investigations for suspected infection;
medication errors and delays (antibiotics, antivirals etc);
failing to provide specialist neonatal intensive care to a newborn baby with suspected neonatal infection;
incorrectly discharging a newborn baby with signs of infection;
failing to advise parents to seek urgent medical help if signs of infection occur (safety-netting).

Which newborn babies are at risk of neonatal infection?

All newborn babies are more vulnerable to infection whilst their immune systems are still developing. However, your baby may have an increased risk of serious infection if any of the following risk factors affected the pregnancy or their birth:

maternal diabetes;
maternal infection (such as GBS or HSV) or chorioamnionitis;
prolonged or preterm pre-labour rupture of the membranes (PROM or PPROM);
preterm or premature birth;
hypoxia (lack of oxygen) or acidosis;
low birth weight;
skin grazes or wounds from invasive medical equipment (IV lines, catheters, forceps, vacuum extractors);
metabolic, digestive or urinary tract disorders.

Many of the risk factors for neonatal infection can be managed with proper medical care. Negligent failure to recognise, monitor and properly manage a pregnant mother or newborn baby with increased risk of infection can result in severe injury from avoidable infection.

How is infection diagnosed in a newborn baby?

A newborn baby with signs of infection must be treated urgently to avoid the infection spreading or the development of life-threatening complications, such as meningitis or sepsis. Doctors may start treatment with general antibiotics based on their clinical assessment of the baby’s condition, whilst further tests and investigations are carried out to identify the specific pathogens which are causing the infection. This then helps with more targeted treatment.

Common tests and investigations used to diagnose neonatal infections include:

blood tests, which identify which pathogen or bacteria is causing the infection;
C-reactive protein (CRP) tests to measure inflammation;
lumbar puncture (also known as a spinal tap) to test the cerebrospinal fluid (CSF) for meningitis;
X-rays of the chest, to look for chest infection or pneumonia.

What is the treatment for infection in a newborn baby?

The treatment that your baby needs will depend on how unwell they are and the type of infection. Neonatal infection should always be treated urgently to avoid the development of serious complications which could cause permanent, neurological injury. Where a newborn baby has severe infection, they should be treated in a specialist neonatal intensive care unit (NICU) and receive fully supportive monitoring and care.

Depending on their illness, their treatment may include:

intravenous (IV) antibiotics, for bacterial infection;
antiviral medication, for viral infection, such as herpes simplex virus (HSV);
IV fluids;
oxygen therapy and respiratory support, to help with breathing;
supportive neonatal intensive care and monitoring in NICU.

If you think your baby’s brain injury or neurological disability may have been caused by delays or mistakes in their medical treatment, you can find out more about whether your child can claim compensation for their injury by contacting one our solicitors, free and confidentially.