November 23, 2006
Strongest Predictor of Cerebral Palsy: Preterm Birth
Strongest Predictor of Cerebral Palsy: Preterm Birth
A baby can develop cerebral palsy for many reasons, there is no one cause. However, the leading cause of cerebral palsy is brain injury from premature birth. Brain injury in premature babies can be caused two ways: from lack oxygen getting into the because a babies lungs are not fully developed or from an infection that causes brain damage. Because lungs do not fully develop until the last stages of pregnancy, babies who are born preterm, even late preterm are at higher risk for developing cerebral palsy. An infection at the time of preterm birth can result in injury to the premature brain white matter; this is known as periventricular leukomalacia (PVL). This damage will also increase likelihood of cerebral palsy. With the risk of brain damage and cerebral palsy being high, special care should be taken to avoid preterm birth, even late preterm birth. Or in case where preterm birth is imminent, steps can be taken to help babies lungs develop before birth. Preventing unnecessary preterm birth or helping unborn babies lungs develop rapidly will reduce chance of a baby having cerebral palsy.
The reason for cerebral palsy is because of damage to the brain or brain injury. The causes of the brain damage are varied and sometimes inconclusive. There are two main causes of brain injury; developmental brain malformation, when the brain does not develop properly or because of neurological damage done to the brain during development, basically a lack of oxygen to the brain.
Because preterm babies are born with less developed lungs they are at higher risk for brain injury from of lack of oxygen. Premature babies are 8 times more likely to develop cerebral palsy then full term babies. A baby is considered premature if born before 37 weeks of gestation. A late preterm birth is between 34 and 36 weeks gestation. This is the time when a baby’s lungs are finishing developing. It is very difficult to determine the exact time a baby is conceived and easy for dates to be off a week or more. If you’re due date determined by your doctor is off by a week or two you may end up with a preterm baby and some of the medical conditions associated with a preterm birth. If your doctor induces labour or recommends a cesarean section and your baby is born at 34-36 weeks the baby may have problems with breathing, feeding, maintaining his body temperature and jaundice. Preterm birth is the number one predictor for a child developing cerebral palsy.
The most common cause of brain injury in a premature baby is an infection or lack of oxygen causing PVL, which is characterized by the softening death of the white matter of the brain. PVL is caused by a lack of oxygen or blood flow to the periventricular area of the brain, which results in the death or loss of brain tissue. This increases the risk of asphyxia and other injury to the brain, which in turn increases the incidence of cerebral palsy. Approximately 60-100% of infants with PVL later develop signs of CP.
When you have a preterm baby your baby is at higher risk for asphyxia and PVL.
If a premature birth is imminent, there are medications you take to help speed up the process of your baby’s lung development. A baby born at full term‘s lungs will naturally produce surfactant, which lubricates the lining of the air sacs within the lungs. This allows the inner surfaces of the air sacs to slide against one another without sticking during breathing. Premature infants whose lungs are producing surfactant have an improved ability to breathe on their own, or with less respiratory treatment, after birth. Corticosteroids are considered standard treatment for women who are 24 to 34 weeks pregnant and may deliver within the next 1 to 7 days. Taking these medications will reduce the risk of brain damage and cerebral palsy.
Avoiding Premature Birth
There are many medical interventions that can help delay or prevent premature birth. Some things your doctor may decide to do if you go into premature labour may include bed rest, medications to stop labour (Magnesium sulfate, terbutaline, brethine), medications to prevent infections and thorough evaluation of your baby’s health.
Another way to avoid a preterm birth is to not have a medically unnecessary induced labour or Cesarean by choice. This is a where a mother opts to have her labour induced for reasons for convenience or sentimentality,
November 21, 2006
Ketogenic Diet and Cerebral Palsy
Seizures are common with children with cerebral palsy, in fact half of children with cerebral palsy are also affected with seizures, brain injuries allow abnormal impulses to occur. If drugs don’t work in treating the seizures, many families turn to alternative treatments such as a ketogenic diet, the most popular diet used to prevent seizures in children.
Known for reducing seizures in children with epilepsy, the ketogenic diet is high in fat and restricted carbohydrates, the diet ketosis: as fat is burned to compensate for reduced glucose (low-carbohydrates), by-products (ketones) build in the blood and inhibit seizures. The diet is more effective in children than adults, particularly when anticonvulsant drug therapy is ineffective.
The diet provides 3-4 grams of fat for every 1 gram of carbohydrate, calling for such foods as high-triglyceride dairy products (such as butter and cream) peanut butter. Carbohydrates, found in breads and starches, are eliminated from the diet, and liquid intake is often restricted as well in order to aid ketone accumulation.
The diet is typically supplemented with calcium, vitamin D, iron, and folic acid.
When the diet works, the response is often rapid and dramatic.
Please consult your doctor before implementing this diet.
More info on Ketogenic Diets:
Epilepsy Action: The Ketogenic Diet
Johns Hopkins : Ketogenic Diet
