What kinds of brain injuries can a baby have? What can parents and caregivers do to reduce the chances of their baby experiences brain injury?
Babies are at risk of brain damages, as they brain is still immature and thus more fragile. Premature babies develop more often damages to the white matter, i.e., the connections of the nervous cells within the brain. Term babies develop more often to the peripheral and deep grey matter, i.e., the nervous cells. Unfortunately, most of the time, there is not much that parents can do to prevent to reduce the chances of their baby to have brain injury. Once admitted to the neonatal intensive car unit, caregivers have to keep the baby the most stable as possible to try avoid further brain damages, but unfortunately there is not much else that they can do for now to influence the initial brain damages.
Dr Pia, you specialize in asphyxia, will you share what birth asphyxia is ? What are the potential causes of birth asphyxia and is there any way parents can prevent it while pregnant?
Birth asphyxia is when a baby may have lacked oxygen and/or blood flow around the time of birth. His/her brain is at risk of damage, and thus he/she is at risk for future developmental problems. Unfortunately, again, most of the time, there is not much that parents can do to prevent to reduce the chances of their baby to have brain injury. Moms feel often very guilty, as they keep asking themselves what they could have done differently. But they should know that they did not do anything wrong, and that this was mostly bad luck that this happens around time of birth.
Can you explain to parents why baby may be treated with hypothermia? What is the benefits of it? Are there are side effects that parents should be aware of?
Decreasing body temperature shortly after birth may slow down brain activity, help with brain recovery, and thereby reduce the chances of further damage occurring. Treatment with hypothermia has been proven in several scientific studies to reduce the risk of death and long-term developmental problems in babies who have suffered from birth asphyxia. Hypothermia is now the standard treatment for term and near-term babies (≥ 36 weeks of gestational age and ≥ 1800 grams at birth) who may have lacked of oxygen and/or blood flow around the time of birth (referred as birth asphyxia), and who demonstrated signs that their brain had suffered (referred as neonatal encephalopathy). Visit also www.neobrainparents.org for more information.
For babies who do not have brain damage, what is life like for them after this medical process?
For babies who do have brain damage, life will be most probably similar as the one of a normal baby, even if parents may remain traumatized by this initial event and may remain worried while their child grows older. These babies still need to be followed up through, as some rare babies without evident brain damages may still develop some developmental problems. Sometimes the imaging performed in the neonatal period did not see all the brain damages, or sometimes the child would have develop these developmental problems anyways.
For babies who have brain damage, what is life like for the families after this medical process?
After discussing with many parents going through this situation, I believe that life will be forever changed for these families, whatever the outcome is for their little one. This first experience in the NICU is quite traumatizing, since this was not at all what parents were expecting on the day their baby was born. Families need to rebuild themselves, learn to be a family, find their respective roles, while still taking care of each other.
Any encouraging words that you would like to share with parents who have experienced babies have experienced asphyxia and they are thriving?
Parents who have experienced babies who have experienced asphyxia and are thriving should recognize their chance, and enjoy their little one every day. They should let him/her grow and develop while trying not to overprotect him/her too much.
Any encouraging words that you would like to share with parents who have experienced babies have experienced asphyxia and they are not thriving?
Parents who have experienced babies who have experienced asphyxia and are not thriving should know that they are not alone, that there are resources out there to help them and support them along the way, whatever may be their need: health care providers, social worker, psychologists, group of parents. So they should not hesitate to reach out and to ask for help. Groups of parents that went through similar situations such as HopeforHIE and Parents2Parents constitute amazing resources, and the possibility now to reach them via social media offer unique opportunities to connect. Hope, strength and courage should remain in every parenting situation.
Any encouraging words that you would like to share with parents who have experienced babies have experienced asphyxia and they are experienced child loss?
I believe that this is probably the most difficult event that you can experience in a lifetime, and that no word can really soften the feelings you may have in your heart. One set of parents of such child, which whom I stay in contact, told me that they think their little one had become an angel, and that the little girl was still looking at them from above, sending them strength to continue to live, and sometimes sending them little signs when a day was particularly hard. And I believe that there is something true to this, if it does not seem very scientific, so watch for these little signs and keep the courage and strength.
You are a pediatrician and neonatologist, what inspired you to work with nicu babies? What do you want people to know about your work and the families that you have invested your research, and your passion into?
When I was a medical student rotating in the neonatal intensive care unit (NICU), I took care of a little premature babygirl. She was really sick, but she fought a lot and she survived. However, her brain had suffered and she had severe brain injury. When I was a pediatric resident, I continued to follow her, as she was still hospitalized due to her condition. And now, even after all those years since she was born, I see her continue to grow and smile through life, as her mom is fortunately still sharing pictures of her with me.
Through this story, and many other that I have witnessed over the years, I continue to find that frustrating and unfair that it is possible to help all the other body organs of a baby to recover when he/she is sick, except the brain. Once brain damages are there, only supportive treatments are available. The idea behind the NeoBrainLab would be to change that, and that, one day, these babies with brain damages may have a better outcome. We have recently launched the first study to try and repair brain damages in sick babies, we are looking for more funding to expand it, and we hope to be able to provide a new solution in a few years for future parents going through these event.