Preemies account for anywhere between a third to half of all cerebral palsy diagnoses. Premature infants are born with less developed brains, making them more vulnerable to damage that can cause cerebral palsy.
Thanks to advances in healthcare that allow for early identification and intervention, symptoms of cerebral palsy can be minimized to optimize a child’s quality of life.
This article will go over what to expect if your preemie has cerebral palsy and how to effectively manage it.
Is Premature Birth Preventable?
For a birth to be considered premature, the baby must be born before 37 weeks. In the US, about 1 in every 10 infants is born prematurely.
Many factors can cause premature birth including:
- High blood pressure
- Genetic influence
- Carrying multiple babies
- Mother’s age
- Pre-existing health problems
Mothers of preemies often blame themselves for premature birth but many times, the cause cannot be determined. Sometimes, it just happens.
Instead of feeling guilty, focus on staying positive and educate yourself on how to best care for your baby.
7 Signs of Cerebral Palsy in Preemies
Generally, the earlier a child is born, the higher the risk of developmental complications like cerebral palsy.
About 10% of preemies born before 28 weeks have cerebral palsy.
Therefore, it’s essential to keep an eye out for early signs of cerebral palsy. The sooner you identify complications and seek management for them, the less impact they’ll have on your child’s quality of life.
Signs of cerebral palsy in preemies include:
1. Developmental Delays
Typically, developmental delays are the first detectable sign of cerebral palsy in children.
Cerebral palsy can range from mild to severe. Often, mild cases go unnoticed until children start missing developmental milestones.
Generally, by 6 months, a baby can roll in both directions. By 9 months, they likely are able to sit without support. Around12 months old, children can stand, and by 15 months, they should be able to walk on their own.
Remember to adjust your preemie’s age! For example, if your baby is 12 months old and was born 8 weeks early, their adjusted age would be 10 months.
Not all babies develop at the same pace. Sometimes, infants will be delayed in one area of development, but may be on target or even ahead in other areas. However, if you notice your child missing any developmental milestones, be sure to ask their pediatrician about it.
2. Abnormal Walking Patterns
Cerebral palsy can affect various areas of the body. The most common type of cerebral palsy is spastic diplegia, where only the legs have motor impairments.
As a result, preemies with spastic diplegia usually have completely typical upper body functions. Motor impairments may only become apparent once the child starts walking.
Walking patterns characteristic of cerebral palsy include:
It’s important to seek physical therapy and correct these walking patterns early before poor habits form to relieve excess pressure on the joints that can disrupt growth or cause pain.
Fatigue is an extremely common outcome of both premature birth and cerebral palsy.
Because of their motor impairments, individuals with cerebral palsy have to use more energy to move and tire out much quicker.
As a result, your preemie may require more time to perform everyday activities like feeding and getting dressed.
4. Lack of Interaction with their Surroundings
While it might appear like your child is disinterested in exploring their surroundings, they usually aren’t.
Rather, their motor impairments make it difficult for them to move around, which discourages them from interacting with their environment.
Bringing toys closer to the child and encouraging them to try to explore as much as possible can help them to engage more with their surroundings.
5. Favoring One Side of the Body
Spastic hemiplegia is a type of cerebral palsy that only affects one side of the body.
While we all have a dominant side, children with spastic hemiplegia may develop a habit of using only one side and avoid engaging the other at all.
For example, your child might tend to lean in a certain direction, drag a leg behind when walking or crawling, or clench their affected hand.
Management for hemiplegia is essential to develop bilateral coordination.
6. Floppy or Stiff Muscles When Held
Depending on the location of brain damage, preemies may experience extremely high or low muscle tone.
When held, children with low muscle tone will feel floppy and might droop their heads.
Those with high muscle tone will feel stiff and resist movement, which can make it difficult to place them in a car seat or highchair.
7. Poor Feeding
If cerebral palsy affects the oral motor muscles, children may struggle to chew and swallow their food.
As a result, many children with cerebral palsy have feeding difficulties, which puts them at risk for malnutrition and dehydration.
Preemies are born smaller than infants born at term. They usually catch up in size around 2-3 years, but only with proper nutrition.
If you notice that your infant is not eating very much, speak to your child’s pediatrician right away to ensure they are getting the nutrients they need to continue to grow and develop.
Now that you understand what symptoms to look out for in young children, let’s go over CP management.
Managing Cerebral Palsy in Preemies
One of the best practices for managing cerebral palsy in preemies is to get regular checkups to make sure your child is developing at a healthy rate.
Physicians often hesitate to diagnose mild cerebral palsy in infanthood because motor impairments identified before the age of 1 often resolve on their own.
However, parents shouldn’t passively wait until symptoms improve or worsen. Even if your infant doesn’t have cerebral palsy, early management for motor problems can significantly improve mobility.
Management for cerebral palsy typically consists of:
- Physical therapy (to stretch and strengthen tight muscles and improve range of motion)
- Occupational therapy (to learn how to use adaptive tools and perform everyday activities)
- Speech therapy (for feeding or communication difficulties)
- Proper nutrition (to promote normal growth and musculoskeletal health)
- Orthotics (to support proper musculoskeletal alignment)
- Medications (to temporarily relieve high muscle tone)
Early management is proactive and helps address symptoms before they turn into habits.
Additionally, children’s brains have more plasticity than adult brains, which makes it easier for them to adapt and replace abnormal movement patterns. The younger the child is, the easier it is for their brains to learn and adapt.
Understanding Cerebral Palsy in Preemies: Key Points
Children born prematurely have an increased risk of cerebral palsy.
Therefore, parents need to be aware of what symptoms to look out for and seek management as early as possible.
Hopefully, this article helped you better understand cerebral palsy in preemies and the importance of early management. Good luck!
Featured images: ©iStock.com/monkeybusinessimages/jarenwicklund/boitano/Antonio_Diaz