Treatment and Therapy for Birth Injuries

Below are a variety of treatments and therapies for birth injuries such as hypoxic-ischemic encephalopathy (HIE) and cerebral palsy (CP). Please note that this list is nowhere near exhaustive, but merely intended to provide a few examples. For advice on which treatments may be best for your child, we recommend that you consult with medical professionals.

On this page, we will discuss treatment and therapy for birth injuries. Some of these treatments must be administered before a birth injury actually occurs (these are preventative measures for high-risk patients), or in the immediate aftermath. Other medical interventions will still improve symptoms if performed later in life. However, it is very important to be aware that in general, the sooner a child receives treatment and therapy for a birth injury, the better their long-term prognosis will be. Of course, the recommended treatments and therapies will differ greatly depending on a child’s diagnosis and unique circumstances. A team of knowledgeable doctors and therapists should be called upon to build a personalized treatment plan.

• Preventing Premature Birth: Premature babies are at a higher risk of birth injuries because of their underdeveloped organs and general fragility. When a mother is at high risk for delivering early, there are certain interventions that can prevent or delay premature birth. These include cervical cerclage, magnesium sulfate (which has multiple purposes; see below), and progesterone therapy.
• Betamethasone: Betamethasone is a type of corticosteroid that is primarily used to speed up lung development in babies who are likely to be born preterm, thereby minimizing the risk of serious respiratory problems and death. It also reduces the risks of intracranial hemorrhages (brain bleeds), a type of intestinal infection called necrotizing enterocolitis, and lifelong disabilities such as cerebral palsy (CP) and seizure disorders.
• Magnesium Sulfate: Magnesium sulfate is an inorganic salt that can be used to suppress early labor and delay premature birth. It can also be given when a baby is likely to be born preterm, in order to provide neuroprotective effects such as increasing cerebral blood flow, decreasing damage from inflammation, and stabilizing membranes. This makes fragile preemies less likely to be injured during the birthing process.

• Therapeutic Hypothermia: Therapeutic hypothermia is a cutting-edge treatment that can be given within six hours of a hypoxic-ischemic brain injury (which occurs when the flow of oxygenated blood to the brain is interrupted). In many cases, this means within six hours of birth. Therapeutic hypothermia can slow down the spread of brain damage that occurs after the initial injury, and prevent or minimize permanent disabilities such as cerebral palsy.

• Botox: Botox (botulinum toxin) can help to reduce muscle tightness in children with mild to moderate spastic cerebral palsy. It can be injected directly into the spastic muscles, and the effects of one injection can last for several months at a time.
• Baclofen: Baclofen is another medication used to treat spastic cerebral palsy. It can be taken as an oral medication, or delivered through an intrathecal pump, which is implanted into the patient’s abdomen and continuously delivers the medicine into the fluid surrounding the spine.

• Selective Dorsal Rhizotomy (SDR): Selective dorsal rhizotomy is a procedure aimed at relieving spasticity in the legs. A surgeon first identifies nerves that lead to spastic muscles, and then carefully cuts abnormal nerve branches.   
• Hip Muscle Release Surgery: Children with cerebral palsy may develop a problem called hip subluxation, in which the hip becomes partially dislocated. To alleviate pain, improve function, and prevent full dislocation, physicians may recommend a procedure in which muscles and tendons in the leg are “released,” or lengthened.

• Physical Therapy: Physical therapy is very important for children with cerebral palsy and other physical issues stemming from birth injuries. It can minimize pain and increase function (strength, range of motion, etc).
• Occupational Therapy: The goal of occupational therapy is to promote a patient’s ability to perform daily activities in a way that will enhance quality of life and increase independent living skills.
• Cognitive Behavioral Therapy (CBT): Cognitive behavioral therapy refers to a group of psychotherapy treatments with scientifically-demonstrated benefits.
• Speech-Language Therapy: Speech-language therapy can be useful to children with speech and language disorders, cognitive communication disorders, social communication disorders, or swallowing issues. Speech-language pathologists can also help nonverbal people learn to use augmentative and alternative communication (AAC) systems.
• Recreational Therapy: Recreational therapy utilizes fun activities in order to improve patients’ health and function.
• Animal-Assisted Therapy: There are a variety of organizations that provide opportunities for children to interact with animals for therapeutic purposes. One well-known example of animal-assisted therapy is hippotherapy (therapeutic horseback riding), which can improve physical function as well as social skills and sensory regulation.
• Complementary and Alternative Therapy: These are types of therapy that are not quite as well established as more ‘traditional’ forms such as physical therapy, occupational therapy, and speech therapy, but may still provide benefit. Recreational therapy and animal-assisted therapy both fall under this umbrella. Other examples include virtual reality gaming, yoga and bodywork, stem cell therapy, and hyperbaric oxygen therapy (HBOT).