Neonatal hypoglycaemia brain injury claims

Hypoglycaemia means low blood sugar. Newborn babies may develop neonatal hypoglycaemia if they can’t maintain healthy blood sugar levels from feeding in the first few days of life. If neonatal hypoglycaemia is not recognised and treated, it can cause permanent brain injury and disability.

Midwives and hospital neonatal care teams are responsible for ensuring that a newborn baby is properly fed, so that their blood sugar does not drop below a safe level. If a baby suffers neurological disability as a result of delayed or incorrect treatment of hypoglycaemia, they may be entitled to claim compensation.

All babies are at risk of hypoglycaemia immediately after their birth until they have settled into a healthy feeding pattern. The risks are higher for babies:

• whose birthweight is below 2.5kg;
• whose mothers have diabetes;
• who have intra-uterine growth restriction (IUGR) and are small for their gestational age (small for dates).

Newborn babies who have none of the risk factors listed above may still be at risk of hypoglycaemia if there are concerns about their feeding. Signs of poor feeding may include:

• the baby doesn’t wake up for feeds;
• the baby doesn’t suck properly during feeding;
• the baby demands feeding frequently, because they are not receiving enough milk at each feed.

Neonatal hypoglycaemia is a medical emergency but serious injury is preventable with timely, correct midwifery and neonatal care.

Midwives must look out for neonatal hypoglycaemia and take steps to prevent it. They do this by taking heel-prick blood tests to check the blood sugar of babies, particularly those who are at increased risk, and by making sure that a newborn baby is feeding properly and is getting enough milk.

If a baby’s blood sugar (or glucose) is low, swift action is needed to bring their blood sugar up to a safe level. In most cases, feeding the baby quickly may restore their blood glucose. If they can feed effectively, their blood sugar may be raised by breastfeeding, expressed breastmilk or by formula milk. In some cases, a baby may need to be given glucose by intravenous infusion (IV drip).

Neonatal hypoglycaemia is a medical emergency requiring fast action to restore and maintain healthy blood sugar levels. Any delays in treatment of a baby with neonatal hypoglycaemia can cause permanent brain injury and severe neurological disability.

Babies with hypoglycaemia may show signs of illness, including:

• sweating.
• feeding difficulties;
• tremors;
• irritability;
• a high-pitched or weak cry;
• hypothermia (low body temperature);
• fits or seizures or being jittery;
• floppiness (hypotonia);
• lethargy or altered level of consciousness;
• infection;
• respiratory (breathing) difficulties.

Hypoglycaemia may also occur with other serious conditions.

Claims for brain injury and disability caused by hypoglycaemia usually arise from negligent failure or delay in identifying and treating babies with hypoglycaemia.

Common mistakes in the care of babies with hypoglycaemia include:

• failing to monitor the blood glucose of a baby at increased risk of hypoglycaemia owing to:
  • low birthweight, particularly when the baby is born weighing less than 2.5kg;
  • maternal diabetes;
  • IUGR or being small for gestational age;
  • poor feeding, or where the mother expresses concerns about the baby’s feeding;
• delay or failure to obtain or act on blood glucose test results;
• failing to have a baby with hypoglycaemia reviewed by a paediatrician (doctor);
• failing to admit a baby with significant hypoglycaemia to the neonatal unit (NNU);
• delayed or insufficient administration of intravenous (IV) glucose to a baby on the NNU;
• failing to provide safety-netting advice to mothers on preventing hypoglycaemia and seeking help when the baby is discharged from hospital.

Disability from neonatal hypoglycaemia may not be obvious, even to the child’s parents, in the child’s early years. Unlike cerebral palsy birth injury, disability from hypoglycaemia may only become apparent in later years, when the child or teenager struggles to keep up at school. Without a clear diagnosis, these children may be misunderstood, as their disabilities are often complex or partially hidden. In our experience, children and teenagers who have suffered brain injury from hypoglycaemia often need extensive support.

Neonatal hypoglycaemia brain injury disability affects children in varying but complex ways. Our clients with severe brain injury from hypoglycaemia often have one or more of the following disabilities:

• physical disability, such as cerebral palsy;
• epilepsy;
• learning disability;
• behavioural problems;
• extensive care/support needs owing to their independent mobility but lack of awareness;
• problems with social interaction;
• visual impairment.

In each case, we work with our client’s family, our trusted experts and our SEN specialists to ensure that the child’s injury, disability and lifelong needs are properly assessed, and that they are fully compensated so that their lifelong needs are met.

As with all medical negligence claims, the amount of compensation that can be claimed depends on the severity of the injury and the way it affects the individual’s life. In our experience, children who suffer brain injuries caused by neonatal hypoglycaemia often need extensive support throughout their lives, even when their mobility and physical independence are less severely impaired. Depending on the injury, disability, and the client’s individual circumstances, neonatal hypoglycaemia brain injury compensation may include sums for:

• pain, suffering, and disability;
• case management;
• the costs of extensive care and support;
• therapies and rehabilitation, including:
  • behavioural management programmes;
  • psychological support;
  • physiotherapy;
  • occupational therapy (OT);
  • speech and language therapy;
• increased costs of accommodation or home adaptations;
• SEN – special educational needs;
• specialist equipment and aids;
• adapted vehicles and increased transport costs;
• medical and surgical treatment costs;
• loss of earnings and pension;
• Court of Protection and deputyship costs.