What Is Hypoxic Ischemic Encephalopathy & How Does it Affect Children?

When a child experiences complications at birth, the outcome can leave lasting effects on their health and quality of life. One of the most serious conditions is hypoxic ischemic encephalopathy (HIE), which is a type of brain injury that can be caused by oxygen deprivation. For many families, understanding what causes hypoxic ischemic encephalopathy in newborns and how it impacts a child’s development is the first step in getting answers and finding support.

In this blog, we’ll explain what HIE is, its common causes, the short- and long-term effects it can have on children, and what families can do if medical negligence may have played a role.

What Is Hypoxic Ischemic Encephalopathy (HIE)?

Hypoxic ischemic encephalopathy in a newborn is a serious birth injury that includes brain injuries caused by reduced or halted oxygen or blood flow to the brain before, during, or soon after birth.

Oxygen is vital for brain development, so even a short period of deprivation can cause permanent brain damage. The severity of HIE ranges from mild to severe, with some children having no long-term consequences and others facing severe disabilities or death. The severity of the brain injury depends on:

• How long the brain lacks oxygen or blood flow
• How much of the brain is affected
• The ability of the child’s brain to repair itself

According to the National Institute of Neurological Disorders and Stroke, in addition to brain injuries, a decrease in blood flow or oxygen can affect the heart, lungs, kidneys, or liver. During or after the brain injury, the affected infant may experience:

• Low heart rate
• Breathing problems
• Excessive acid in bodily fluids (acidosis)
• Seizures or unusual movements
• Stained meconium (newborn’s first stool)
• Low muscle tone
• Blue or very pale skin
• Low reflexes

Diagnoses of perinatal encephalopathy, perinatal asphyxia, neonatal encephalopathy, or birth asphyxia are a result of hypoxic ischemic encephalopathy.

What Causes Hypoxic Ischemic Encephalopathy in Newborns?

There are many potential causes of HIE, including complications during pregnancy and delivery. Some of the most common medical causes include:

• Umbilical cord complications such as cord prolapse, cord around the neck (nuchal cord), or compression
• Uterine rupture or placental abruption, which cuts off the baby’s oxygen supply
• Prolonged labor or delayed C-section, increasing the risk of fetal distress
• Maternal health issues like low blood pressure (hypotension) or infection
• Improper monitoring of fetal distress, leading to missed warning signs

While some cases of HIE are unavoidable, others result from preventable medical errors. For example, failing to perform a timely C-section or ignoring signs of oxygen deprivation may be considered medical negligence.

How HIE Affects a Child’s Brain & Development

The effects of hypoxic ischemic encephalopathy can vary depending on the duration of brain oxygen deprivation, the specific areas of the brain affected, and the promptness of treatment initiation. In many cases, hypoxic ischemic encephalopathy impacts motor control, cognition, memory, and communication.

Some early warning signs of HIE include:

• Low Apgar scores after birth
• Abnormal cord blood gases
• Seizures in the neonatal period
• Need for NICU admission

The prognosis for hypoxic ischemic encephalopathy depends on the extent of brain damage and how the medical team treats the baby after injury. According to the HIE Help Center:

• Infants with mild hypoxic ischemic encephalopathy have a generally positive outlook, surviving without developing serious or lasting effects.
• Those with moderate HIE have a chance of developing minor neurological conditions (10%-20%), or more serious complications (30%-50%).
• Infants with severe HIE have a 25%-50% mortality rate, most often occurring within the first few days after birth. Babies that do survive are at high risk (roughly 80%) of developing serious complications.

Cognitive & Learning Challenges

Children with HIE may experience cognitive impairment leading to learning disabilities or intellectual delays, often requiring additional academic support. These cognitive challenges may be present with or without a physical disability. A child who has been diagnosed with hypoxic ischemic encephalopathy may struggle with:

• Attention and concentration
• Short- and long-term memory
• Reasoning and problem-solving

Physical & Motor Delays

HIE can affect motor control, leading to:

• Delayed milestones such as rolling over, crawling, or walking
• Fine motor skill difficulties, such as handwriting or self-feeding
• Increased risk of cerebral palsy, affecting roughly 30 percent of children diagnosed with moderate-severe HIE

Language & Communication Barriers

Many children with HIE experience:

• Delayed speech development
• Difficulty understanding or expressing language

These barriers will necessitate the use of speech therapy or alternative communication tools throughout the child’s life.

Risk of Seizures & Neurological Disorders

Seizures are a common symptom of HIE, especially in the neonatal stage. Some children may develop epilepsy (around 16% of those with moderate-severe HIE), requiring ongoing seizure management and medication. These conditions can significantly affect daily life for both the child and their family.

Long-Term Outlook for a Child with HIE

The long-term prognosis depends on the severity of the brain injury and how quickly treatment, like therapeutic hypothermia, was initiated. Some children show significant improvement with therapies, while others require lifelong care.

Common interventions include:

• Physical therapy to strengthen motor function
• Occupational therapy to build daily living skills
• Speech therapy for language and communication
• Special education services for academic support
• Assistive devices and adaptive technology for mobility and independence

For parents, the long-term outlook often includes financial and emotional challenges. Raising a child with HIE can mean ongoing medical costs, specialized care, and educational support, all of which add up over time.

Can Hypoxic Ischemic Encephalopathy Be Prevented?

Not all cases of HIE can be prevented. Unfortunately, many instances of HIE are linked to avoidable medical errors, including:

• Failing to monitor fetal distress during labor
• Delaying a medically necessary C-section
• Ignoring the warning signs of placental or cord issues

If you suspect medical negligence may have contributed to your child’s condition, reviewing medical records with a birth injury lawyer can help determine your legal options.

FAQs: Hypoxic Ischemic Encephalopathy in Children

What is the life expectancy of children diagnosed with hypoxic ischemic encephalopathy?

Life expectancy depends on the severity of HIE. Mild cases may have little impact on lifespan, while severe cases can shorten life expectancy due to complications.

How long can HIE be diagnosed after birth?

Hypoxic ischemic encephalopathy is usually identified within the first days of life, but some symptoms, like developmental delays, may not appear until months or years later.

Can a child recover from HIE?

Recovery depends on the extent of the injury. Some children improve significantly with early intervention, while others may face lifelong challenges requiring ongoing care.

Get Legal Support for HIE Birth Injuries

Learning your child has hypoxic ischemic encephalopathy is overwhelming. You may feel uncertain about what caused the injury and how you will manage the financial burden of lifelong care.

If you believe medical negligence may have contributed to your child’s condition, the attorneys at Simon Law are here to help. As trusted birth injury lawyers serving St. Louis, Missouri, and Illinois, we fight for families to secure the compensation they need for medical expenses, therapies, and future care.

Contact Simon Law today to schedule a free consultation with one of our experienced birth injury attorneys.