Birth Asphyxia

Babies with mild or moderate asphyxia may recover fully. If the cells did not get enough oxygen for a longer time, a baby may have permanent injury. This could affect their brain, heart, lungs, kidneys, bowels or other organs.

Body cooling (therapeutic hypothermia) can improve outcomes for babies born at full term or near term. But babies born 5 or more weeks early cannot have body cooling. In the most severe cases, asphyxia can lead to organ failure and death.

Two stages of injury can happen with birth asphyxia:

• The first stage happens within minutes if blood flow is low and cells do not get enough oxygen.
• The second stage is called “reperfusion injury.” It can last for days or even weeks. This injury happens after the brain starts getting normal levels of blood and oxygen. Toxins released from the damaged cells cause this injury.

Some causes of birth asphyxia include:

• Too little oxygen in the mother’s blood before or during birth
• Problems with the placenta separating from the womb too soon
• Very long or difficult delivery
• Problems with the umbilical cord during delivery
• A serious infection in the mother or baby
• High or low blood pressure in the mother
• Baby’s airway is not formed properly
• Baby’s airway is blocked
• Baby’s blood cells cannot carry enough oxygen (anemia)

Our 32-bed Neonatal Intensive Care Unit (NICU) is the first in the state to be designated level IV. That’s the highest level possible.

We are the only hospital in the Pacific Northwest that provides 24/7 access to all the pediatric medical and surgical specialists your child may need. We stay in close communication with you – and with each other – to plan and provide the best treatment for your child.

We provide the most advanced treatments and services in the region. Some are offered nowhere else in the Northwest. We can monitor and treat babies even when 1 or more body organs have failed.

• Body cooling (hypothermia) to reduce the risk of brain injury in babies with asphyxia.
• Extracorporeal life support (ECLS) that does the work of your baby’s heart or lungs if they are not working well and need time to heal. “Extracorporeal” means outside the body. It is also called ECMO. Our life support team has some of the nation’s best outcomes.
• State-of-the-art breathing support. As needed, we treat your newborn with breathing machines (ventilators) or inhaled nitric oxide (iNO) to open the blood vessels in the lungs.
• Neuro NICU with cutting-edge technology to keep a careful watch on your baby. Near-infrared spectroscopy (NIRS)  measures blood flow in their brain. Video electroencephalography (EEG) helps us monitor brain activity. We use noninvasive MRI (magnetic resonance imaging) to make pictures of your baby’s brain without radiation.
• The largest team of anesthesiologists who specialize in treating only babies and children. Managing your baby’s pain is critical to their healing.
• Continuous dialysis to filter their blood if your baby has kidney failure.
• Mobile life support, including ECLS if needed, to bring babies to Seattle Children’s from anywhere in Washington, Alaska, Montana, Idaho, Hawaii or Oregon. We also can use body cooling during transport.

Our neonatologists are internationally known for their work to protect and heal the brains of babies who did not get enough oxygen at childbirth. We are committed to improving treatments for babies with asphyxia so they have the best possible chance at a healthy life.

Babies in our care can take part in research studies of promising new treatments. These are called clinical trials.

Dr. Sandra “Sunny” Juul co-leads a multicenter national study that uses high doses of the hormone erythropoietin (Epo) combined with body cooling to treat babies with asphyxia. Researchers will test the babies’ thinking and movement at age 2. The goal is to save lives and improve outcomes. The multicenter study is called HEAL (High-dose Erythropoietin for Asphyxia and Encephalopathy). This work builds on earlier research by Dr. Juul and Dr. Dennis Mayock. See Researchers Combine Therapies to Find a Better Way to Treat Brain Injury in Infants.

Our physician-scientists also:

• Study and test innovative mechanical heart devices. Our goal is to develop safer, more effective devices for children with breathing problems or very weak hearts.
• Look for the best ways to reduce stress in the NICU and relieve pain. They also study the long-term effects of stress and pain on the developing brain.

Learn more about Seattle Children’s research to improve newborn care.

• At Seattle Children’s, your family has a full team behind you. We offer a comforting environment for you and your family.
• We work with you to make decisions and treatment plans for your baby. We invite you to share your insights, questions and concerns during daily meetings of your baby’s healthcare team. The meetings are called “rounds.” Consultations are available to help you sort through confusing or difficult medical issues.
• We work with many children and families from around the Northwest and beyond. We can help with financial counseling, housing, transportation, interpreter services and spiritual care. Our goal is to get you and your baby home – or back to a hospital close to home – as soon as possible.