Skip to main content

Contact us to arrange your
FREE initial consultation

Email us Call me back

HIE brain injuries caused by lack of oxygen to the baby’s brain around the time of birth are the most common cause of claims from negligent maternity and neonatal care. These injuries are devastating, often causing the child a lifetime of physical and/or intellectual disability and leaving them forever dependent on others for all their daily needs.  

HIE – what parents of brain injured babies should know 

Most of the parents who come to us after their child’s birth injury know little about HIE but are beginning to realise that mistakes or problems at birth may have injured their child’s brain. They may have been contacted by the hospital trust where their baby was born or invited to meet with representatives from NHS Resolution, HSIB or MNSI. This is because all stillbirths, neonatal (newborn) deaths or brain injuries to babies from HIE must be reported by the NHS trust which provided the maternity care for further investigation.

The annual numbers of HIE birth injuries in England were highlighted as a cause for concern by the Royal College of Obstetricians and Gynaecologists’ (RCOG) Each Baby Counts programme, which tried to reduce harm by helping the NHS learn from mistakes in maternity care. The government and the NHS’s defence organisation, NHS Resolution, are trying hard to cut the cost of compensation which is paid out to the hundreds of children who suffer severe HIE brain injuries from negligent maternity care each year. This has led to parents being interviewed and data gathered from them by HSIB and NHS Resolution, which could form evidence in a future claim, without them being advised to seek independent legal advice. ‘Early intervention’ was supposed to lead to earlier financial help for the injured babies’ families, but the published figures suggest that interim payments made to families (who have not sought advice from their own solicitors) have been rare.  

At Boyes Turner, we understand the impact that HIE birth injuries have on the child and their family, now and into the future. Our cerebral palsy specialists have helped countless families affected by HIE birth injuries to claim their child’s entitlement to compensation to help pay for care, adapted accommodation, therapies, specialist aids and equipment, special education and lifelong needs. We remain committed to securing practical and financial help for severely injured children and their families after devastating injuries have been caused by negligent maternity care.

If you have been contacted by the NHS trust where your baby was born, HSIB, MNSI or NHS Resolution following the birth of your baby, you should contact us here for free, independent, specialist legal advice straight away. If negligent care during pregnancy, labour, delivery or immediately after birth have caused your child to suffer an HIE brain injury, your child may be entitled to an immediate interim payment and substantial compensation.

If your child is entitled to compensation and you decide to make a claim, we can offer a range of funding options, including Legal Aid and no-win-no-fee, depending on what’s best for the child. 

Previous Cases

£21 million settlement ( £6.59m plus lifelong, annual payments of £250,000pa) for a teenager whose hypoxic brain injury and cerebral palsy was caused by negligent maternity care at the time of his birth.  After forcing an admission of liability from the defendant hospital, we secured an interim payment of £250,000 to meet our client’s needs whilst the claim was ongoing.

Liability settlement in an ongoing claim for a boy who suffered an HIE brain injury from lack of oxygen immediately before and immediately after his birth. The injury left him with dyskinetic cerebral palsy, cerebral visual impairment, epilepsy and learning disability. A period of cooling probably significantly reduced the extent of his neurological damage. The 90% liability settlement was obtained despite apparently normal midwife records of the unborn baby’s heart rate during labour and the defendant hospital’s denial of liability.

£19 million settlement (£3.9m lump sum plus lifelong payments of up to £158,500pa) for a girl who suffered an HIE brain injury and dyskinetic cerebral palsy as a result of negligent delays in her delivery. We secured an admission of liability, an apology and an interim payment of £200,000 to meet our client’s immediate needs whilst the claim was ongoing.

Multi-million dollar settlement in an international claim for a child who suffered an HIE brain injury as a result of oxygen deprivation during delays in his delivery at a London hospital. Our client’s compensation reflects the costs of meeting his additional needs from his disability in his current country of residence. 

£5million plus lifelong payments of up to £232,750pa plus guaranteed full funding of a Treloar’s SEN placement for a boy who suffered traumatic and HIE brain injuries from an attempted forceps delivery which delayed his birth. We secured an early admission of liability and judgment against the defendant and interim payments totalling £900,000 to meet our client’s immediate needs arising from his cerebral palsy and severe disability whilst the case was ongoing.

What is HIE?

HIE (each letter is pronounced separately as H.I.E) is a shortened form of the medical term hypoxic ischaemic encephalopathy. Hypoxia means lack of oxygen. Ischaemia means lack of blood supply to an area of the body. Encephalopathy means disease or damage which affects the brain. Hypoxic ischaemic encephalopathy (or HIE) describes brain damage which is caused by lack of oxygen in the blood supply to the brain.

Newborn babies who are diagnosed with HIE have suffered an injury to their brain from a disruption to their blood oxygen supply during pregnancy, labour and delivery or immediately after birth. Other medical terms are sometimes used to describe brain injuries at birth from lack of oxygen.  These include asphyxia or anoxia (which means without oxygen).

HIE is not the only type of birth injury that leads to cerebral palsy and neurodevelopmental injury, but where it occurs, it often arises from mistakes in maternity and neonatal care.

Read more

How do I know if my baby has HIE?

HIE is a serious condition with long-term consequences for the child. There are different grades of HIE which indicate the severity of the injury to the brain.

Newborn babies who are suffering from HIE may show any of the following signs and symptoms in the first few days of life:

•            low APGAR scores;

•            blue or pale skin colour;

•            low heart rate;

•            breathing (respiration) difficulties or grunting;

•            fits (convulsions or seizures);

•            problems with feeding;

•            hypotonia (floppiness, reduced muscle tone);

•            organ failure;

•            abnormal response to light;

•            abnormal level of consciousness.


Babies who have HIE often need help with breathing and may need resuscitation and ventilation immediately after birth. They need specialist neonatal care and may be transferred to the neonatal unit (SCBU, NNU or NICU).  If the baby has moderate or severe HIE, they will usually be treated with therapeutic hypothermia, also known as ‘controlled cooling’ or simply ‘cooling’.

In addition to recognising these potential signs that a baby has suffered HIE, the following tests are often used to provide a formal diagnosis.

  • Umbilical cord blood gas tests

The umbilical cord blood test that is carried out immediately after the baby’s birth provides information about whether the baby was deprived of oxygen (hypoxia) during labour and delivery. As soon as the baby is born the midwives test samples of blood which they take from the blood vessels in the umbilical cord.

The umbilical cord has one vein and two arteries. The vein takes food and oxygen from the mother (via the placenta) to the baby. The two arteries take the waste (including carbon dioxide, lactic acid) from the baby back to the placenta/mother. When a baby has been starved of oxygen in labour, the blood sample from the umbilical artery contains an abnormally high level of acid.

  • APGAR scores

APGAR scores are another commonly used way of checking the condition of a newborn baby. The acronym ‘APGAR’ comes from the five things that are checked and scored when carrying out the test. The midwives rate the baby’s appearance, pulse, grimace, activity and respiration, at one minute, five minutes and ten minutes of age. Each sign is given a score between zero and two. The combined total score (out of ten) at each point in time that the test is taken gives a general impression of the newborn baby’s health. The APGAR score is less reliable than the umbilical cord blood test because it depends on the midwife’s observation of the baby. However, if a baby has low APGAR scores at five and ten minutes of life, this may indicate that they have HIE.

  • MRI brain scan

Where there is concern that a baby has suffered an injury to their brain, an MRI scan can identify which areas of the brain have been damaged. MRI brain scans are used to diagnose other conditions affecting the brain as well as HIE. The cause of the injury and its timing and severity can often be identified by the pattern of injury on the MRI scan of the baby’s brain.

Read more

What is cooling?

When a baby has moderate or severe hypoxic ischaemic encephalopathy or HIE from oxygen deprivation but is expected to survive  they must be treated with therapeutic hypothermia, more commonly known as ‘cooling’. This treatment has been found to slow down the rate of damage that is caused to the brain from the hypoxia (lack of oxygen). If correctly administered, controlled cooling can significantly reduce the injured baby’s permanent physical disability.

Therapeutic cooling must be carried out in specialist neonatal units in accordance with strict safety guidelines. Babies who need cooling should start their treatment as soon as possible, usually within six hours after birth. Cooling treatment normally continues for around three days.

During cooling, the temperature of the baby’s brain is lowered from normal body temperature of 37°C to between 33°C and 35°C. This is done by placing the baby on a cool fluid-filled mattress or by cooling their head with a special cap. The baby’s condition must be carefully monitored before, during and after controlled cooling takes place. This may include blood tests (blood gas and glucose levels), checking for infections, checking for seizures or fits with EEG monitoring, sedating the baby, and providing respiratory and cardiovascular support. The baby’s body temperature is monitored by a rectal thermometer. At the end of the cooling period, the baby’s temperature is gradually brought back up to normal temperature. This is known as rewarming.

If the neonatal care team recommend therapeutic cooling treatment for a newborn baby, they must first explain the benefits and risks of the treatment to the parents. Once the parents understand what is involved in the treatment, their consent must be obtained before their child’s cooling treatment commences.

In our experience as specialist claims solicitors acting for children with neurological disability, we recognise that cooling helps reduce severe physical disability from HIE, but caution that it does not always provide a total cure. Cooled babies are sometimes left with ongoing subtle, neurological impairments which only become evident when the child struggles to keep up at school. In these cases, the child and young adult may need significant care and support both at school and as they transition into work and independent life.

Where a child or young adult suffers from neurological injury or learning disability which was caused by a hypoxic brain injury (HIE) during birth or as a newborn baby, they may be entitled to substantial compensation.

Read more

What kind of injuries can lead to an HIE brain injury compensation claim?

HIE brain injuries are complex and can lead to a range of neurological impairments and disabilities. Each of our clients’ injuries will have a unique impact on their health, physical and mental capabilities, and their life. In each case we work with a team of experts to ensure that we understand the full extent of our client’s injury and disability. This ensures that we can assess how their condition will develop and secure compensation which meets their additional needs for the rest of their life.

Our clients’ injuries and disabilities often include one or more of the following:

  • cerebral palsy;
  • brain injury;
  • severe neurological disability;
  • impaired mobility;
  • problems with sitting, posture etc;
  • feeding and swallowing difficulties;
  • speech and communication difficulties;
  • blindness or sensory impairment;
  • epilepsy;
  • difficulties with muscle/movement control;
  • learning disability;
  • behavioural problems.
Read more

What compensation can I claim for a child with an HIE brain injury?

Compensation claims for HIE birth injury are among the highest settlements that we achieve for our clients. This is because the compensation reflects not only the injury, but the lifelong cost of meeting the additional needs that arise from our client’s disability. Each client’s compensation is carefully calculated to compensate them for the way their injury will affect their life, in the context of their own personal and family circumstances.

It takes extensive experience of maximum severity birth injury claims and specialist expertise to investigate, understand and assess the financial impact of a birth injury on a baby’s life. Boyes Turner’s nationally acclaimed cerebral palsy and birth injury lawyers have acted for brain-injured babies for over 30 years. We are experts at recovering substantial interim payments and maximum compensation settlements for our clients.

Following HIE birth injury, our clients’ settlements often include compensation for:

  • their pain, suffering and disability;
  • the costs of past, present and future care (professional or provided by family);
  • case management costs;
  • the cost of therapies, such as;
    • physiotherapy;
    • occupational therapy (OT);
    • speech and language therapy;
  • specialist aids and equipment;
  • adapted vehicles, wheelchairs and additional transport costs;
  • increased costs of suitable accommodation or home adaptations;
  • assistive technology;
  • special education (SEN);
  • loss of earnings and pension;
  • private medical treatment;
  • deputyship costs;
  • other expenses arising directly from the child’s disability, such as additional holiday costs.
Read more

What kind of negligence leads to HIE birth injury claims?

HIE birth injury compensation claims are complex. They require careful investigation by specialist solicitors who are skilled in birth injury and brain injury compensation claims. Our experienced birth injury lawyers understand hypoxic ischaemic encephalopathy (HIE) and other causes of brain injury and are skilled at identifying where a child’s injury has been caused by negligent maternity or neonatal care.

Examples of negligent care which can cause HIE and lead to a birth injury compensation claim include:

  • incorrect risk assessment of a pregnant woman;
  • fetal monitoring errors, such as:
    • failing to monitor the fetal heart rate;
    • failing to carry out continuous electronic fetal heart monitoring by CTG or fetal scalp electrode (FSE);
    • poor technique in fetal monitoring by intermittent auscultation (IA);
    • misinterpretation of fetal heart rate on CTG trace;
    • mistaking the mother’s heart rate for the fetal heart rate;
    • failing to recognise a suspicious or pathological CTG trace;
    • failing to act on a suspicious or pathological CTG trace;
  • failing to call a doctor to review the mother following abnormal signs in labour;
  • failing to recognise signs of abruption, uterine rupture, or hyperstimulation in labour;
  • incorrect use of syntocinon/oxytocin in labour;
  • poor delivery technique (shoulder dystocia, impacted fetal head, breech birth, twins) ;
  • failure or delay in carrying out delivery by forceps, ventouse suction or caesarean section;
  • delayed or inadequate resuscitation or ventilation;
  • delayed or incorrect intubation;
  • failing to clear meconium from the baby’s airway;
  • failing to keep the baby’s airway clear during neonatal skin-to-skin contact;
  • cooling errors.
Read more

Meet your team

Susan Brown photo

Susan Brown


Julie Marsh headshot

Julie Marsh


Richard Money-Kyrle headshot

Richard Money-Kyrle


Sita Soni headshot

Sita Soni

Senior Associate - solicitor

Vanessa Wand photo

Vanessa Wand

Senior associate - solicitor

Tara Byrne photo

Tara Byrne

Associate - Solicitor

Rachel Makore headshot

Rachel Makore

Associate - solicitor

Alpa Rana headshot

Alpa Rana

Associate - solicitor

Fran Rothwell

Fran Rothwell

Associate solicitor

Ben Ireland headshot

Ben Ireland


Alice Carley headshot

Alice Carley


Audrey Elmore headshot

Audrey Elmore

Medical records coordinator

Nicky Melville headshot

Nicky Melville

Professional support assistant

Susan Brown photo
Julie Marsh headshot
Richard Money-Kyrle headshot
Sita Soni headshot
Vanessa Wand photo
Tara Byrne photo
Rachel Makore headshot
Alpa Rana headshot
Fran Rothwell
Ben Ireland headshot
Alice Carley headshot
Audrey Elmore headshot
Nicky Melville headshot

Related news

Related cases

How much compensation can you get for medical negligence?

How to make a medical negligence claim?

How long do medical negligence claims take?

How to fund a medical negligence claim?

Will I need a medical examination if I make a medical negligence claim for compensation?

Can I make a claim on behalf of a child?

What can medical negligence compensation pay for?

What is HSSIB?

How can you prove medical negligence?

Is there a time limit for claiming medical negligence compensation?

Will I need to go to court to claim medical negligence compensation?

What is causation in medical negligence claims?

Can I claim against the NHS?

Who can make a medical negligence claim?

What is MNSI?

Birth injury cases

View all

Awards & Accreditations

Our teams have been nationally recognised over the past decade for their dedication and commitment to securing maximum compensation for our clients

             Brake | The Road Safety Charity

What our clients say

Our clients constantly recognize us as the most experienced, professional, efficient and supportive

See more

"Julie Marsh is a first rate litigator"

Julie Marsh is a first rate litigator who adds real value to all her cases. I have always been impressed not just by her expertise as a clinical negligence lawyer but by the way she treats every client as an individual and works on their case as if it is the most important thing in the world, which to many clients it really is.

King's Counsel

"You have given fantastic support and guidance"

Boyes Turner have a great asset in Julie Marsh, she has handled my case with such professionalism and has kept me informed at every stage over the 6 years. She has given me guidance, support and that personal touch where I could ring or email at any time and she would always answer and give me answers to any questions I had. Would recommend without hesitation. Thank you

Boyes Turner Client

"I have been impressed"

Tara Byrne kept me well informed at all stages of my claim. I have been impressed with the way my case was handled, and the time scale within which a settlement was reached.”

Boyes Turner Client

"Very Professional "

Boyes Turner helped me through one of the toughest times in my life. They were very professional whilst remaining friendly. At times the process was emotionally tough but they were very patient with me and went through everything with me until I understood it. I cannot recommend them enough. 

Boyes Turner Client

"We cannot thank Susan and her team at Boyes Turner enough"

Words cannot express how grateful we are to Susan and her team for the level of commitment and dedication shown to our family during a time which would be difficult for anyone. Susan demonstrates a calm professional manner which helped us to feel at ease. Her level of knowledge has proven to be the best in the field and we fully recommend her to anyone seeking to investigate birth injury claims. You can be confident that Susan and her team will scrutinise the medical notes thoroughly and will keep you well informed throughout the process. We are very pleased with the outcome of our child’s case and know that her work has resulted in justice being achieved. Our family will now be able to move forward in the knowledge that the finances are securely in place for our child to receive a suitable care package, purchase equipment and receive necessary lifelong therapy. We cannot thank Susan and her team at Boyes Turner enough.

Boyes Turner Client