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Infant Cooling: What It Is and How It's Used

If your infant has been placed into a cooling therapy session, you may have questions about what is happening and why. Here, we have answers and information that can help you learn about what is going on and help you better prepare for the days ahead.

Newborn cooling or cooling therapy is also referred to as:

  • “therapeutic hypothermia”
  • “neonatal hypothermia”
  • head cooling
  • whole body cooling

Often, when a newborn is cooled, it is because of a diagnosis called Hypoxic-Ischemic Encephalopathy, or HIE, is a kind of oxygen deprivation. Cooling therapy is believed to be an effective treatment to minimize damage to the baby’s brain from oxygen deprivation and asphyxia.

Here are answers to the most common questions parents have:

Why is my infant being cooled?

The infant is likely being cooled because the baby suffered from birth asphyxia which called a brain injury called hypoxic-ischemic encephalopatny or HIE.

What is HIE?

HIE stands for Hypoxic-Ischemic Encephalopathy, which means:

  • Hypoxic - Lack of oxygen
  • Ischemic - Decreased blood flow
  • Encephalopathy - Affecting the brain

HIE is also commonly referred to as oxygen deprivation and it can lead to brain damage.

What Causes HIE?

HIE results from asphyxia that can happen at the time of birth – often called birth asphyxia or perinatal asphyxia.

Many things can cause HIE, including:

Problems with the Uterus

  • Uteroplacental Insufficiency
  • Uterine Rupture

Problems with the placenta

  • Placental insufficiency
  • Placental Abruption
  • Placenta Previa
  • Preeclampsia

Problems with the Umbilical Cord

  • Umbilical Cord Prolapse
  • Umbilical Cord Compression
  • Nuchal Cord
  • Umbilical Cord Knot

Delay in Delivery

  • Fetal Distress
  • Failure to monitor and diagnose heart rate abnormalities
  • Delay in Cesarean Section
  • Shoulder dystocia (baby is “stuck” and deprived of oxygen)

Maternal disorders

  • Maternal blood clotting disorders
  • Maternal hemorrhage
  • Maternal hypotension (low blood pressure)

Trauma during delivery

  • Vacuum extractor injuries
  • Forceps injuries
  • Skull fractures
  • Hemorrhage or bleeding in the baby’s brain

For more information on HIE, watch this video where Laura Brown explains the term, or click here to read more.

What is Infant Cooling or Therapeutic Hypothermia?

Infant cooling is a process where medical staff will wrap the baby in a cooling blanket, place the baby on a cooling mattress, or cover the baby’s head with a cooling cap.

This controlled therapy will lower the infant’s brain and body temperature, altering the chemical processes of the brain and reducing the infant’s risk of sustaining permanent brain damage.

When Is Infant Cooling Used?

Infant cooling is typically used within six hours of birth when medical staff believe that the baby suffered from asphyxia and HIE, or oxygen deprivation. The cooling treatment is used because it reduces the risk of brain damage for oxygen-deprived infants.

How Does Infant Cooling Work?

Infant cooling therapy is a process where your infant is cooled and then gradually warmed up again. A specially-made blanket, mattress, or head cap will be used to cool the newborn in a controlled way.

The specific circumstances will determine whether medical staff needs to cool the baby’s entire body or only the baby’s head. Generally, cooling therapy will bring their body temperature to a moderate 92-94 degrees Fahrenheit (32-34 degrees Celsius) for 2 to 3 days.

Cooling the newborn is believed to minimize damage to the baby’s brain by:

  • Reducing energy depletion
  • Reducing the metabolism
  • Decreasing excitatory transmitter action in their brain
  • Reducing ion flux alterations
  • Reducing edema (“swelling”)
  • Reducing vascular permeability
  • Reducing blood-brain barrier disruptions

How Long Does Infant Cooling Last?

The cooling process should always be carefully monitored. The extent and length of cooling therapy that is administered to your infant is in direct correlation to how severe your baby’s injury is thought to be.

A more severe injury will require a longer cooling therapy session. In general, you should expect your infant to be in cooling therapy for 2 to 3 days. Following this time, the infant will be gradually warmed up by a doctor and further assessments will be made of the baby’s condition.

Is Infant Cooling Dangerous?

There are certainly risks involved when medical staff induce hypothermia in an infant. However, research suggests that when the cooling therapy is properly administered, the potential benefits often outweigh the risks.

The most common side effect of cooling therapy is sinus bradycardia, which is a slowed heart rate. This is characterized by a sinus rhythm (heart rate) of 60 beats per minute or fewer.

Sinus bradycardia is not considered life-threatening and--depending on the cause and severity--medical staff will address it appropriately.

What are the benefits of Infant Cooling?

The immediate positive effect of using cooling therapy is that it will slow down the naturally occurring processes happening in the infant's brain. In this situation, that's a good thing because these processes could otherwise lead to permanent brain damage.

Edema, or brain swelling, and brain cell death are the two most common results of HIE. Cooling therapy can help prevent both.

Cooling therapy is still a relatively new treatment. When it comes to the long-term benefits, cooling therapy is believe to minimize injury and improve your child's quality of life for years and years to come.

One study found that more than half of oxygen-deprived babies who were treated with hypothermia (cooling) survive to age 6-7 and had a normal IQ (Intelligence Quotient).

What Conditions Might Affect My Child?

Cooling therapy helps to reduce neurological damage, however, this treatment option cannot always prevent serious medical conditions that are caused by HIE, or oxygen deprivation.

These secondary conditions that the child may suffer from include:

  • Cerebral palsy
  • Developmental delays
  • Blindness
  • Deafness
  • Neuromotor delays

At the end of the cooling therapy, the doctors will assess the child’s condition and talk to the parents about the child’s future treatment options and recovery plan.

What can I do as a parent?

Waiting for your infant to be cooled and monitored can feel as though it’s taking forever but waiting and being patient are the most important things to remember. In the meantime, educating yourself so that you can understand what your infant is going through is a great step. If you have questions, don’t be afraid to ask for help, and take plenty of notes so that you can refer back to what has happened later.

What to Expect After Cooling

The cooling therapy session will last around 2 to 3 days. Following the cooling therapy, the baby will need to be assessed further and continue to be monitored. Monitoring will ensure that the baby is able to eat, digest, and function as a healthy infant.

The medical staff may want to administer multiple tests and monitor various aspects of the baby’s development. They may run MRIs, EEGs, and monitor the baby’s heart rate as standard procedure. This is to ensure that the baby has no abnormal activity in his brain, body, or heart.

The amount of time that the baby will spend in the hospital following his cooling therapy will depend on the overall prognosis and health of the baby. Most babies who begin to feed and digest their food properly and who have regular bowel movements and urinate correctly can be discharged if no other complications are present.

If doctors suspect a secondary condition or complication of some kind, they will communicate that with the parents and they will have the baby kept longer in the NICU to ensure that they are healthy and prepared when the parents take the baby home.

What Should I do if I Believe that Hospital Negligence Caused My Baby’s Injuries?

Although there are different causes for birth injuries, one of the most dangerous and preventable causes is negligent healthcare. When mistakes are made during the labor and delivery process, those mistakes expose the baby to risks like HIE.

If you think your child may have suffered from lack of oxygen, or if your newborn child has been diagnosed with HIE, then your child may be a victim of a birth injury that was preventable. To learn and to best protect your baby, it’s important to act quickly and get help now. Use the live chat button and find out how we can help you.


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