The 3 Stages Of Severity In Babies With HIE

Hypoxic-ischemic encephalopathy (HIE), also called perinatal asphyxia, describes when a lack of blood flow starves the brain of oxygen, which can result in a brain injury. These types of birth injuries can occur during pregnancy, childbirth, or shortly after birth, and they can range from very mild and temporary to severe or even deadly, depending on how long the baby is deprived of oxygen.

Breaking Down The Three Stages Of HIE Severity

Let’s break down the technical medical terms found in hypoxic-ischemic encephalopathy:

  • Hypoxic: This describes when the body or part of the body is not getting enough oxygen.
  • Ischemic: This describes when the body is not getting enough circulation or blood flow (blood flow supplies oxygen).
  • Encephalopathy: This is damage or disease to the brain.

When the brain does not get oxygen or enough oxygen, there can be lasting damage, depending on how long it was starved of oxygen. The severity of HIE can be broken into three stages.

Stage 1 (Mild HIE)

This includes behavioral issues, which might be hard to differentiate from normal issues, such as poor sleep and feeding, as well as irritability and crying. These cases typically resolve in 24 hours.

Stage 2 (Moderately Severe HIE)

In these cases, the baby is lethargic (i.e., tired and sluggish), with significant muscle limpness and poor reflexes, including little or no grasping and sucking reflexes. There may be periods of apnea (brief pauses in breathing). If there are seizures, they occur within the first 24 hours. These cases can have a full recovery within a couple of weeks.

Stage 3 (Severe HIE)

The symptoms are far more severe, including:

  • Delayed seizures (24-48 hours after onset)
  • Stupor or coma
  • Irregular breathing
  • Muscle weakness
  • Absence of neonatal reflexes (e.g., sucking, swallowing, grasping)
  • Unusual eye motion or dilation
  • Problems with heart rate and blood pressure

The prognosis for Stage 3 HIE can be increased deterioration, injury, and even death.

The health issues will vary depending on the child and the severity of the HIE. There can be a total recovery, while others might have a permanent disability, such as developmental delay, cerebral palsy, epilepsy, or cognitive impairment.

Treatment For HIE

The primary treatment for babies in any stage of hypoxic-ischemic encephalopathy is therapeutic hypothermia, a brain cooling therapy. Studies show that reducing the brain’s temperature can reduce the amount of damage from oxygen deprivation. In addition, the drop in temperature effectively slows down the processes that cause brain damage.

Therapeutic hypothermia involves placing the baby on a cooling pad for 72 hours and closely monitoring them for heart rate, temperature, blood pressure, breathing patterns, brain activity, discomfort, and more. Diagnostic tests, such as a blood test, are also run during the cooling period. After three days, doctors gradually rewarm the baby over a 12-hour period.

Additional Support Therapies Provided

While performing the cooling procedure, doctors might provide other therapies to support the baby’s health, such as:

  • Heart support and treatment to regulate blood pressure
  • Treatments to sustain kidney and liver function
  • A breathing tube if the baby cannot breathe on their own
  • Seizure medications

Long-Term Effects Of HIE On Children

Monitoring your child’s development after an HIE diagnosis is essential during the first two years of life. Depending on the severity of the HIE, your child may have long-lasting health, cognitive, behavior, or mobility problems.

Some children who suffer from HIE develop cerebral palsy. Your healthcare professional will evaluate your baby’s developmental progress between the ages of 18 and 24 months in these areas.

Motor Skills

Brain injuries often affect the ability to move various body parts with control and precision in infants and adults. They may have problems with gross motor skills that involve using larger muscles and body parts (e.g., kicking a ball) or fine motor skills involving the movement of smaller muscle groups, like pointing a finger.

Sensory Function And Processing

HIE brain damage could impair your baby’s sense of sight, taste, touch, hearing, or smell. Thus, your physician will closely monitor your baby’s ability to use the senses and process information learned through them.


HIE may also affect your baby’s ability to communicate. Therefore, a doctor will monitor the child’s ability to understand language and speak.

Cognitive Development

Your physician will also track your baby’s ability to think, learn, and reason over time to assess any existing gaps.

Our Attorneys Can Help If Medical Negligence Caused Your Child’s HIE

No matter when HIE occurs, the truth is it is often the direct result of a medical provider’s negligence. If you believe a medical error led to your child’s HIE, a birth injury lawyer at our firm could help you determine whether you have a viable case for compensation and recover the money you need to care for your child adequately. In addition, our attorneys will investigate the cause of your child’s HIE and search for evidence of negligence.

We set ourselves apart from other law firms in Maryland by offering:

  • A particular focus on nursing home negligence and medical malpractice cases, including birth injury.
  • More than 137 years of combined experience as appellate and trial lawyers
  • 24/7 availability to offer free case reviews

Let Brown & Barron Stand Up For Your Child And Family

If your child was the victim of HIE, contact Brown & Barron today to schedule a free consultation. Our HIE lawyers in Baltimore are proud to be able to stand up for injured infants who have suffered due to someone else’s mistakes. It is our goal to secure for you the compensation that can help your child and your family move forward with the best possible future, as well as a deserved sense of justice and closure.

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