Types of birth injuries

Erb’s palsy and other brachial plexus injuries affect the nerves that control the muscle function of the hands, arms, and shoulders.

These injuries often happen due to shoulder dystocia, which is when the baby’s head delivers, but the shoulders are stuck in the birth canal.

Common symptoms of brachial plexus injuries and Erb’s palsy include:

• Lack of muscle control in the elbow, wrist, or hand
• Less sensation in the affected limb(s)
• Paralysis or weakness of the affected limb(s)

Brain damage or brain trauma is often the result of intracranial hemorrhage (bleeding around or in the brain), oxygen deprivation, blood clots, and other complications.

Symptoms of brain injury include:

• Abnormal vital signs, including low blood pressure and low oxygen levels
• Decreased or lack of standard newborn reflexes
• Difficulty swallowing or eating
• Lacerations on the baby’s scalp
• Muscle tremors
• Seizures

Cerebral palsy (CP) is a group of neurological disorders typically caused by brain damage. The condition affects muscle control and tone and can lead to problems with movement, posture, and balance.

The five main types of cerebral palsy are spastic, ataxic, athetoid (dyskinetic), hypotonic, and mixed type.

While symptoms of CP can vary by type, they often include:

• Delayed speech or growth development
• Impaired fine motor skills, such as picking up objects
• Neurological complications, such as abnormal eye movements
• Spasticity or prolonged muscle tightness

Forceps delivery complications may happen when medical providers apply too much force onto a baby’s head when using forceps to assist with delivery.

Injury from forceps delivery include:

• Intracranial hemorrhage, a severe condition where bleeding occurs inside the skull
• Nerve damage causing temporary facial nerve palsy (drooping or weakness) that heals within a few weeks
• Severe brain injury leading to long-term neurological complications or developmental delays
• Skull fractures that heal on their own and don’t cause long-term damage
• Surface wounds to the face or head that heal in a few days

Hydrocephalus is a neurological disorder caused by a buildup of cerebrospinal fluid in the cavities within the brain. This extra fluid puts pressure on the brain by causing its cavities to widen.

Symptoms of hydrocephalus in infants include:

• Eyes that are fixed downward
• Head size that is larger than average
• Problems feeding or sucking
• Seizures
• Sleepiness
• Vomiting

Hypoxic-ischemic encephalopathy (HIE) is one of the more severe types of brain injuries. HIE happens when a baby’s brain doesn’t get enough oxygen or blood for a period of time during labor or delivery.

It can be the result of newborn infections, heart disease, lung malformations, severe fetal anemia (low amount of blood cells that carry oxygen to the body), placental issues, and other problems.

Symptoms of HIE depend on the extent and severity but may include:

• Abnormal seizures or movements
• Kidney, lung, heart, blood, and liver dysfunction
• No reaction to sounds or sights
• Weak cry

Infant meningitis is an inflammation of the membranes that cover the spinal cord and brain (meninges). It is caused by viruses and bacteria, and infants are more susceptible to this if they have had brain surgery or a skull fracture. Vaccinations in the mother can help prevent infant meningitis.

Signs and symptoms of infant meningitis include:

• Drowsiness and lack of energy
• Fever
• Headache
• Irritability
• Poor appetite
• Stiff neck

Newborn kernicterus, also known as bilirubin encephalopathy, results from high levels of bilirubin (yellow pigment from red blood cell breakdown). It can cause brain damage, hearing loss, cerebral palsy, and cognitive problems.

Kernicterus often results from untreated jaundice, which causes a yellow tone in the skin, mucous membranes of the mouth, and the white part of the eyes.

Symptoms of newborn kernicterus include:

• Decreased or absent reflexes
• Fever
• Floppy muscle tone
• Irritability with a high-pitched cry
• Lack of energy
• Vomiting

Meconium is a baby's first stool or feces. If a newborn passes meconium before they are born, they can breathe in a mix of amniotic fluid and meconium into the lungs around delivery time. This can cause meconium aspiration syndrome (MAS) to occur. MAS can lead to long-term harm and even death.

Symptoms of meconium aspiration syndrome include:

• Bluish skin color
• Breathing problems
• Dark streaks or other signs of meconium in the amniotic fluid
• Limp muscle tone

Newborn cephalohematoma or skull bleeding is when blood collects between a newborn’s skull or scalp. It happens when pressure is put on an infant’s head, breaking blood vessels in the scalp.

Complications and symptoms of cephalohematoma may include:

• Anemia (low red blood cell count)
• Calcifications (hardened bone deposits) around the cephalohematoma mass
• Infections
• Reddened blood-filled bulge on the back of the skull, usually more on one side
• Skull fractures

Periventricular leukomalacia (PVL) is a neurological condition mainly affecting infants, especially those born prematurely.

PVL involves damage to the brain's white matter, the area near the brain’s ventricles (cavities). This happens when there's inadequate blood flow or oxygen to the brain tissue. PVL is considered one of the more serious birth injury types when it results in significant brain damage.

Symptoms of PVL vary but may include:

• Coordination challenges
• Developmental delays
• Muscle stiffness
• Problems with motor skills

In some cases, PVL can lead to more serious types of birth injuries like cerebral palsy.

Shoulder dystocia occurs when one or both of an infant’s shoulders or arms get stuck during vaginal birth after the head is delivered.

It can result in physical injuries, such as a broken clavicle (collarbone) or oxygen deprivation. When shoulder dystocia occurs, it cuts off the infant’s oxygen supply. It is a life-threatening emergency for the infant. It is also one of the more common causes of Erb’s palsy.

Shoulder dystocia is more likely to occur in the following situations:

• Baby is positioned incorrectly for birth, such as in the breech position (feet or buttocks first)
• Birth weight exceeds 8 pounds and 13 ounces (fetal macrosomia)
• Limited pelvic space due to the birthing position
• Mother's pelvic opening is smaller than the baby's size

Newborn spinal cord injuries are rare but serious conditions that can occur during childbirth. These types of birth injuries can result from excessive pulling or twisting, especially in difficult deliveries.

The consequences can range from mild, temporary issues to more severe, long-term disabilities. Early detection and treatment of these birth injury types are crucial for the best outcomes.

Signs and symptoms of spinal cord injuries include:

• Breathing difficulties if the injury is high in the spinal cord
• Muscle stiffness or spastic movements
• Noticeable pain or discomfort when moving the baby's spine or limbs
• Poor feeding due to weakness or coordination problems
• Weakness or paralysis in arms or legs

Stillbirth or intrauterine fetal demise (IUFD) is when a baby dies in the womb at or after the 20th week of pregnancy.

IUFD can be caused by genetic disease, infection, pregnancy complications, problems with the umbilical cord or placenta, and other issues.

The following risk factors can affect the likelihood of experiencing a stillbirth:

• Previous pregnancy complications: Those who have had a stillbirth before are at an increased risk of experiencing another.
• Stress: Significant stressors, like relationship or financial troubles, may elevate the risk of stillbirth.
• Substance use: Using alcohol, smoking, or recreational drugs can increase the chance of stillbirth.
• Type of pregnancy: Pregnancies involving multiples (twins or triplets, for example) carry a higher risk of stillbirth.

Vacuum extraction complications happen when delivery teams fail to use extractors properly during vaginal delivery.

Complications from vacuum extractors include:

• Cephalohematomas
• Facial nerve injuries and palsies
• Retinal (eye) hemorrhage
• Scalp lacerations

In addition to the more common types of birth injuries already mentioned, there are several other forms of birth trauma that can affect delicate newborns.

These other birth injury types may occur during childbirth:

• Caput succedaneum: Fluid buildup or swelling on the scalp
• Cervical dystonia: Contraction of neck muscles causing involuntary turning of the head
• C-section injuries: Harm caused during cesarean deliveries
• Facial paralysis: Loss of facial muscle movement
• Hematoma: Blood accumulation in a tissue
• Infant torticollis: Twisted neck
• Intraventricular hemorrhage: Blood accumulation in the brain
• Klumpke’s palsy: Nerve damage that affects the muscles of the arm
• Subconjunctival hemorrhage: Blood accumulation in the eye