What causes stroke in babies?

Although it’s very rare, babies can have a stroke in the womb or just after birth. It’s not always possible to find out what caused a baby’s stroke. It can even happen to babies who are otherwise healthy and born after a normal pregnancy and delivery.

Some parents tell us they worry about a baby’s stroke being their fault. But you are not to blame for the rare complications that can cause a stroke. 

This video explains why this is not the case. 

 

Strokes in babies can be due to conditions like a blood clot developing in the placenta and travelling to the child’s brain. A blood clotting disorder in the mother or baby can also raise the risk of a stroke.

If you’re not sure what led to your child’s stroke, speak to a member of your child’s medical team. Ask them to explain what happened and give you reassurance. 

It’s possible that some babies and children can be at a higher risk due to heart problems, infection in the mother or baby, and blood clotting disorders. However, more research needs to be done to find out why strokes happen in babies and what can be done to prevent them.

Terms used for stroke in babies

  • Perinatal stroke: stroke in a baby from week 20 of pregnancy until 28 days after birth. 
  • Prenatal stroke: stroke in an unborn baby.
  • Neonatal stroke: stroke in a newborn baby, from birth up to 28 days.
  • Childhood stroke: a stroke in babies and children from 29 days to 18 years.

Diagnosing and treating a stroke

It’s not always possible to identify stroke before birth or in newborns. It’s sometimes only recognised later in life, when problems arise with a child’s motor development or learning.

They may have difficulties with movement on one side, known as hemiplegia, which might only emerge when they begin grasping, crawling and walking.

Signs of stroke in a newborn baby

  • Seizures

Seizures are a common sign of stroke in newborns. A baby can have abnormal movements, and they might be extra sleepy and more drowsy than normal.

  • Other signs of stroke
Babies can have sleep apnoea, where they stop breathing for short periods during sleep. They might also have feeding problems.

Diagnosing stroke in a newborn baby

If a baby shows signs of a stroke they should have a brain scan. This could be magnetic resonance imaging (MRI) or computed tomography (CT). The scan may confirm a stroke and find out if it’s due to a clot or a bleed.

After a stroke, a baby might be treated in a neonatal intensive care or special care baby unit. They will have specialist care, including any treatment they need for the stroke. They will be monitored closely for signs of another stroke, and signs of too much pressure inside the skull.

Your baby will be assessed to find out if they have any health problems. For example, they may be screened for blood clotting disorders and heart problems.

Impact of stroke on babies

Some of the effects of stroke and brain injury may only emerge over time. For example, children may take longer learning to walk. They might be more likely to have seizures or epilepsy, and they may have learning difficulties or communication delay. Some children may have vision problems.

The early years are a crucial time for brain development, when a child develops language, motor skills and other abilities. They can benefit from early physiotherapy and occupational therapy to support them as they grow. Your baby should have follow-up with a multidisciplinary team in an outpatient setting, at school and home. The length of treatment will be different for everyone, and happen at different times throughout childhood.

Brain development continues throughout childhood and into young adulthood. So some of the consequences of early stroke may affect children and teenagers, and their need for support can also change over time.

The focus is on identifying the child’s needs as they develop. The aim is to ensure they have the support and treatment they need to make progress in their development and learning.

Hemiplegia

Stroke often leads to a weakness on one side of the body. This is called “hemiplegia”, or unilateral cerebral palsy. It is important to remember that almost all children who had a perinatal stroke will be able to walk.

Fatigue

Fatigue and tiredness can have an impact, even when a stroke has happened some years before. In small children this may show itself as behavioural difficulties or frustration. Fatigue may not only come from being physically active, but also being in a noisy and busy environment, and responding to the social demands of school or nursery. Fatigue can happen to any child after a stroke, even if they don’t have a physical disability.

Support needs in childcare and education

When a child who had a stroke as a baby joins an education setting such as a nursery or Reception and Year 1 at school, this might be the first time their support needs are assessed and identified.  

Some children might take longer to gain new skills after having a stroke as a baby. For example, they may need more support with dressing and changing themselves, using the toilet independently, holding a pen, concentrating in a classroom environment, listening and retaining information.

Even if your child has some early intervention or support as a baby to allow them to function well at home, new support needs may emerge in the school environment. To find out more about how children are supported in education after a stroke, read our free online resource, supporting children after a stroke.

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