Toledo Birth Injury Signs and Symptoms

When a baby is born, parents are focused on one thing: a healthy delivery. Most of the time, that’s exactly what happens. But in some cases, complications during labor and delivery—or mismanagement by medical providers—can result in a birth injury that affects a child’s brain, nerves, muscles, or other organs.

One of the most difficult aspects of birth injuries is that the signs aren’t always obvious right away. Some injuries are visible at birth, while others only become apparent weeks, months, or even years later as a child misses developmental milestones. Knowing what to look for can make an enormous difference, both in getting your child the care they need and in understanding whether a medical error may have played a role.

At Nurenberg, Paris, Heller & McCarthy, we represent families whose children have suffered birth injuries caused by negligence during pregnancy, labor, or delivery. If something felt wrong about your child’s birth, or if your child has been diagnosed with a condition you believe may have been preventable, we encourage you to contact us for a free consultation.

What Is a Birth Injury?

A birth injury refers to physical harm that occurs to a newborn during the birthing process. Birth injuries are distinct from birth defects, which develop before labor begins.

Common causes include oxygen deprivation during labor, improper use of delivery instruments such as forceps or vacuum extractors, excessive force applied to the baby’s head or neck, prolonged or difficult labor, and failure by medical providers to recognize and respond to signs of fetal distress.

Significant birth injuries occur at an average rate of 6 to 8 injuries per 1,000 live births—and nearly half are potentially avoidable through anticipating and treating risk factors.

Warning Signs of a Birth Injury in Newborns

Some birth injuries are apparent immediately after delivery. Medical staff assess a newborn’s health using the Apgar score, which evaluates heart rate, breathing, muscle tone, reflexes, and skin color at one and five minutes after birth. A persistently low Apgar score (below 7) can be one of the earliest indicators of a birth injury.

Other immediate warning signs that may indicate a birth injury include:

Difficulty breathing or the need for respiratory support shortly after birth
Limpness, floppiness, or abnormally low muscle tone
Unusual stiffness or rigidity
Seizures or tremors
Bluish, gray, or pale skin coloring
Abnormal or high-pitched crying
Difficulty feeding, sucking, or swallowing
Swelling, bruising, or visible deformities on the head or face
A sunken or indented area on the skull, which may indicate a depressed skull fracture
Unresponsiveness or reduced alertness

It’s important to note that not all of these signs confirm a birth injury on their own. However, any of these symptoms, especially after a difficult delivery, calls for prompt evaluation by a medical professional.

Types of Birth Injuries and Their Signs

Hypoxic-Ischemic Encephalopathy (HIE)

HIE is a type of brain damage caused by oxygen and blood flow deprivation to a baby’s brain before, during, or shortly after birth. Besides the brain, HIE can also affect the heart, lungs, kidneys, and liver.

Signs of HIE in newborns may include:

Seizures
Difficulty breathing
Floppiness or lack of muscle tone
Reduced level of consciousness or not reacting to sights and sounds
Excessive drowsiness
Poor feeding

If HIE is suspected, time is critical—Nationwide Children’s Hospital notes that therapeutic hypothermia treatment must be initiated within the first six hours after birth to be effective.

Intracranial Hemorrhage

Bleeding inside or around the brain can occur as a result of birth trauma, particularly following deliveries involving forceps or vacuum extraction. Newborns with a significant intracranial hemorrhage may present with apnea (pauses in breathing), seizures, an enlarging head, hypotonia or floppiness, a poor Moro reflex, or extensive retinal hemorrhages.

Brachial Plexus Injuries (Erb’s Palsy)

The brachial plexus is the network of nerves that controls movement in the shoulder, arm, and hand. According to Stanford Medicine Children’s Health, brachial plexus injury is most common when there is difficulty delivering the baby’s shoulder—a condition called shoulder dystocia—and causes the baby to lose the ability to flex and rotate the arm. Signs include:

A limp or immobile arm
The arm held stiffly rotated toward the body
Absence of normal reflexes in the affected arm
Weakness or paralysis on one side of the body

Facial Nerve Injuries

During labor or birth, pressure on a baby’s face may injure the facial nerve. This can result in facial paralysis, typically visible when the baby cries, as one side of the face may not move normally.

Bone Fractures

The clavicle is the most frequently fractured bone during birth, though arm, leg, and skull fractures are also common. Loss of movement in a limb is an early sign of fracture, as well as swelling and pain in the affected area.

Cephalohematoma

A cephalohematoma is an area of bleeding under the scalp, appearing as a raised lump on the baby’s head. Most cephalohematomas are harmless, taking two weeks to three months to disappear completely. In some cases, large cephalohematomas can lead to anemia, infections, and jaundice.

Caput Succedaneum

Caput succedaneum refers to the swelling of the baby’s scalp, due to pressure during passage through the birth canal or from vacuum extraction. The swelling usually goes away in a few days without problems.

Developmental Signs That May Emerge Later

Some birth injuries don’t become fully apparent until a child begins missing developmental milestones. Parents are often the first to notice that something seems off.

If your child is not meeting expected milestones, speak with your pediatrician promptly.

Cerebral Palsy

Cerebral palsy (CP) is a neurological condition caused by damage to the developing brain that affects movement, muscle tone, and posture. According to the CDC, it is the most common motor disability in childhood.

Early signs of cerebral palsy include developmental delays—the child being slow to reach milestones such as rolling over, sitting, crawling, and walking—and abnormal muscle tone, where body parts appear either floppy (hypotonia) or too stiff (spasticity).

Other developmental warning signs of CP include:

Using one side of the body significantly more than the other when reaching, crawling, or moving (hemiplegia)
Legs that become stiff and cross when the child is picked up
Head that lags when lifted from a lying position
Difficulty with feeding, sucking, or swallowing
Seizures
Muscle spasms (dystonia)
Problems with vision or hearing

General Developmental Delays

Even without a formal CP diagnosis, developmental delays can be a sign of an underlying birth injury. The American Academy of Pediatrics (AAP) recommends developmental screenings at 9 months, 18 months, and 30 months, with additional evaluations any time a concern arises. Talk to your child’s doctor if you notice:

Failure to hold their head up by 3–4 months
Not sitting independently by 9 months
Not crawling by 12 months
Not walking by 18 months
Significant speech delays
Persistent difficulty with fine motor tasks like grasping objects

When Birth Injury Signs May Indicate Medical Negligence

Not every birth injury is the result of negligence—some complications are unavoidable. However, many birth injuries occur because warning signs were missed, standard protocols were not followed, or medical providers made errors in judgment. Medical negligence may be a factor when:

Fetal distress signals, such as abnormal heart rate patterns, went unrecognized or unaddressed
A necessary cesarean section was delayed
Improper use of forceps or vacuum extractors caused trauma
Maternal infections such as chorioamnionitis were not diagnosed or treated in a timely manner
Oxygen deprivation went unaddressed in the critical window after birth

If your child was diagnosed with cerebral palsy, HIE, Erb’s palsy, or another condition following a difficult birth, and you believe medical errors contributed, you may have legal options.

Support for Your Family

Families dealing with a child’s birth injury face enormous challenges—emotionally, medically, and financially. The costs of long-term care, therapy, and support can be overwhelming, and parents deserve answers about what happened and who is responsible.

The attorneys at Nurenberg, Paris, Heller & McCarthy have extensive experience representing families in complex birth injury cases. We work with medical experts to investigate what went wrong, identify negligence, and fight for the compensation your family needs to secure your child’s future.