Diagnosis and Treatment
How Do Doctors Diagnose HIE?
HIE is diagnosed through the help of imaging testing. When doctors suspect HIE, they will order tests such as MRIs and other types of neuroimaging. Specific tests such as diffusion weighted imaging and MR spectroscopy can help doctors arrive at the diagnosis. Some of these tests must be performed within a certain amount of time following the child’s birth to be effective.
When diagnosing hypoxic ischemic encephalopathy, it is important for doctors to watch for certain things in the child to get to the correct differential diagnosis. For example, if the child had meconium stained fluid, was blue in color at delivery, had to be rushed to the NICU, and suffered seizures, HIE should be a possible diagnosis to be ruled out.
What Types Of Treatment Are Available For HIE?
Because many of the children who suffer from hypoxic ischemic encephalopathy go on to develop a subsequent cerebral palsy diagnosis, much of the treatment stems around occupational therapies to help the child. For many children who have suffered from HIE, the lack of blood and oxygen causes permanent injury to the brain. These types of injuries cannot be reversed. With that said, below is a new treatment method which is now being used with more and more babies who have signs of HIE.
How Do Parents Know If Their Baby Is Suffering From HIE?
Parents can sometimes be made aware that their baby is suffering from HIE because of certain things that may unfold during labor and delivery. Even though a lot is usually going on during the labor and delivery of a child, sometimes when parents remember back things which may not have been noticed during delivery, are now clear to the memory. In the context of HIE, parents may notice the following:
Recently, a new treatment developed for babies who are battling hypoxic ischemic encephalopathy. This treatment is called Hypothermia Cooling, or brain cooling. The treatment looks to cool the baby’s body temperature to between 33.5 and 34.5 degrees Celsius. The treatment must be done within six hours of birth and must be done continuous for seventy-two hours. The goal is to lower the baby’s metabolic rate, thus helping injured cells and decreasing the severity of the injury.
Medical professionals will wrap your baby in a cooling blanket and allow the baby to rest. Close attention will be given to your baby to make sure that vital signs are within range and that your baby is as comfortable as possible. Below are other treatments which may be administered during the cooling process if other organs in the body have been also injured:
Treatments to support the kidneys and liver if they have been injured
Treatments to support the heart and maintain a safe blood pressure
Treatments for seizure activity if the baby is suffering from seizures
Breathing treatment (mechanical breathing tube) if the baby is having breathing and oxygen related issues
Doctors must be alert for the possibility of hypoxic ischemic encephalopathy in newborns who demonstrate certain findings. Delay in diagnosing HIE, or not following the proper procedures for brain cooling, can lead to the baby losing out on important treatment.
Occupational therapy can be used to help with HIE. Occupational therapy can be used to assist with physical, sensory, cognitive, and motor skills. An occupational therapist can help in some of the following areas:
Fine motor skills
Learning basic developmental tasks (getting dressed, brushing teeth, etc.….)
Work with hand eye coordination
Help with sensory and focus issues
Gauge and evaluate the need for specialized equipment (wheelchairs, braces, walkers, etc.….)
Physical therapy can be used to help with HIE because in many cases, a baby might have mobility problems. Parents who have a child diagnosed with HIE, and a subsequent cerebral palsy diagnosis may especially need physical therapy.
Physical therapists can work, using a variety of treatment options, to help build strength and improve movement. Some of the therapies can help with the following:
Balance and working on coordination
Developing skills to help with crawling and walking
Using heat and cold to stimulate circulation
Flexibility exercises to help increase range of motion
Hippotherapy is a type of physical, occupational, and speech therapy that can be used by children who not only have an HIE diagnosis, but also a CP diagnosis. It works by allowing a therapist to use the movements of a horse to help with motor and sensory input. The movement of the horse is key to the treatment, as there is no focus on learning to “ride” the horse.
Aqua, or water therapy can help with treatment for children who have been diagnosed with HIE and CP. Using an aqua therapist, the water can help children with physical function. Water allows for buoyancy and this can help the patient move more effectively. Some types of aqua therapy are as follows:
Walking in water
Exercises based on movement in the water
Like with any therapy, aqua therapy should be done with the aid of a trained professional.
Why We Care
The HIE Resource Place is a website owned and operated by Boston Law Group, LLC. We are birth trauma legal professionals who help families gain an understanding into the world of HIE. This website is a continuation of our mission (more than 200k views on our YouTube educational video channel) to provide families with an avenue to learn more about their baby’s HIE condition from a medical legal standpoint.
It has been our experience that for many families, when a baby is diagnosed with HIE, there are many questions. From how did the HIE diagnosis occur, to what do we do now, families can experience fear and isolation due to “not knowing what’s next.”
Please use this website to expand your understanding of HIE from a medical legal standpoint and do not hesitate to contact us regarding your questions. If you are wondering, you only pay our legal fees if we win for you and your family. We can be reached for a free discussion and talk about your baby’s story at 1-833-4HIEHELP or 1-833-444-3435.