Causes of Infant Brain Injuries

When a baby suffers a brain injury, parents face both immediate medical concerns and long-term questions about development, care, and prognosis. Understanding what causes these injuries can help families make sense of their child’s diagnosis, advocate for appropriate treatment, and access the right support services. This page explains the most common causes of infant brain injuries, who is at risk, and what families should know about prevention and care.

Brain injuries in infants are not rare. They happen for many reasons, from complications during labor and delivery to accidents at home or infections that develop in the first weeks of life. While some injuries are unavoidable, others occur due to preventable medical errors or lapses in care. Knowing the difference matters, both for your child’s treatment and for understanding what happened.

What Is Infant Brain Injury?

Infant brain injury refers to damage to a baby’s brain tissue that occurs before, during, or shortly after birth. These injuries can be caused by physical trauma, lack of oxygen, infection, metabolic problems, or other medical events. The damage may be mild and temporary, or it may lead to long-term challenges such as cerebral palsy, developmental delays, epilepsy, or cognitive impairments.

Brain injuries in infants are especially serious because the brain is still rapidly developing. Even though young brains have the remarkable ability to adapt and heal, severe or prolonged injury during this critical period can have lasting effects on movement, learning, behavior, and overall development.

Medical professionals classify infant brain injuries based on their cause and timing. Some happen in the womb due to maternal illness or placental problems. Others occur during labor and delivery when oxygen supply is interrupted. Still others happen in the days, weeks, or months after birth due to accidents, infections, or abuse.

Traumatic Brain Injury in Infants

Traumatic brain injury, or TBI, refers to physical damage to the brain caused by an external force. This can include blunt impact, violent shaking, or penetrating injury. TBI in infants is classified as mild, moderate, or severe depending on the extent of damage and symptoms.

Infants are particularly vulnerable to traumatic brain injury. Their heads are proportionally large and heavy compared to their bodies, their neck muscles are weak, and their brain tissue is less developed and more fragile than in older children or adults. This means that forces that might cause minor injury in an older child can result in serious brain damage in a baby.

Common Causes of Traumatic Brain Injury

The leading causes of traumatic brain injury in infants include:

• Falls, which are the most common cause. Babies fall from changing tables, beds, couches, or caregivers’ arms. Even a short fall can cause injury, especially if the baby lands on a hard surface or strikes furniture on the way down.
• Motor vehicle crashes, whether the baby is properly restrained or not. High-speed collisions generate significant force, and an infant’s developing brain is easily injured even in crashes that adults walk away from.
• Abusive head trauma, also called shaken baby syndrome. This occurs when someone violently shakes or strikes an infant, causing the brain to move back and forth inside the skull.
• Birth trauma from instrumental deliveries. The use of forceps or vacuum extractors during difficult deliveries can sometimes result in skull fractures, intracranial bleeding, or direct brain injury.
• Sports injuries, though these are much rarer in infants and toddlers than in older children.

Nationally, pediatric traumatic brain injury accounts for more than 500,000 emergency department visits and 60,000 hospitalizations each year in the United States. About 3,000 children die annually from head trauma. Infants under 12 months old represent a significant portion of the most severe cases.

Hypoxic-Ischemic Brain Injury

Hypoxic-ischemic encephalopathy, or HIE, is the most common type of non-traumatic brain injury in newborns. It happens when the baby’s brain does not receive enough oxygen or blood flow around the time of birth. The resulting damage can range from mild and temporary to severe and permanent.

When oxygen supply to the brain is interrupted or reduced, brain cells begin to die within minutes. The longer the oxygen deprivation lasts, the more extensive the damage. Even after oxygen is restored, secondary injury can occur over the following hours and days as inflammation, swelling, and metabolic changes continue to harm brain tissue.

Causes of Oxygen Deprivation

HIE most often results from complications during labor and delivery, including:

• Birth asphyxia, when something blocks or reduces oxygen delivery to the baby during the birth process
• Placental abruption, where the placenta separates from the uterine wall before delivery, cutting off the baby’s oxygen supply
• Uterine rupture, a rare but catastrophic event where the uterus tears during labor
• Umbilical cord problems such as prolapse (cord slipping into the birth canal ahead of the baby), compression, or tight nuchal cord (cord wrapped around the baby’s neck)
• Prolonged or obstructed labor that places extended stress on the baby
• Severe blood loss in the fetus or newborn

Hypoxic-ischemic injury can lead to serious, lifelong conditions including cerebral palsy, intellectual disability, seizure disorders, and developmental delays. Early recognition and treatment with therapeutic hypothermia (cooling therapy) can reduce the severity of brain damage in some cases, but this intervention must begin within six hours of birth to be effective.

Infections That Cause Brain Injury

Infections are another important cause of infant brain injury. Babies can develop infections before birth (from the mother), during delivery (from exposure to bacteria or viruses in the birth canal), or in the weeks and months after birth.

The developing brain is particularly susceptible to infection-related damage. When bacteria, viruses, or other pathogens invade the brain or the membranes surrounding it, inflammation and swelling can injure delicate brain tissue. Even after the infection is treated, some babies are left with permanent neurological damage.

Common Infectious Causes

Brain injuries in infants can result from several types of infections:

• Meningitis, an infection of the membranes covering the brain and spinal cord. Both bacterial and viral meningitis can cause brain injury, though bacterial meningitis tends to be more severe.
• Encephalitis, which is direct infection and inflammation of brain tissue itself.
• Intrauterine infections passed from mother to baby before birth, including cytomegalovirus (CMV), rubella, toxoplasmosis, and chorioamnionitis (infection of the amniotic fluid and membranes).
• Sepsis, a life-threatening systemic infection that can lead to shock, reduced blood flow to the brain, and secondary brain injury.

Premature babies, infants with low birth weight, and babies born after prolonged rupture of membranes face higher risk for infections that can damage the brain. Quick diagnosis and aggressive treatment with antibiotics or antiviral medications can make a significant difference in outcomes, but some infections cause damage before they are recognized or despite appropriate treatment.

Abusive Head Trauma

Abusive head trauma, or AHT, is one of the most devastating causes of infant brain injury. Also known as shaken baby syndrome, AHT occurs when someone violently shakes or strikes a baby, causing severe brain damage. It is the leading cause of traumatic death in infants under one year old.

When an infant is shaken, the brain moves rapidly back and forth inside the skull. This can tear blood vessels, causing bleeding between the brain and skull (subdural hematomas), damage brain tissue directly, and cause bleeding in the retinas of the eyes. The resulting injuries are often catastrophic.

Understanding the Risk

Abusive head trauma typically occurs in moments of frustration, often related to inconsolable crying. The peak age for AHT is around two months, when infant crying tends to be most frequent and intense. Risk factors include:

• Young parental age
• High levels of stress in the household
• Lack of social support or isolation
• Low socioeconomic status
• Prior history of child abuse or domestic violence
• Lack of knowledge about infant development and normal crying patterns

The mortality rate for infants with abusive head trauma is approximately 11 percent. Among survivors, the rate of severe lifelong disability is extremely high. Many children who survive AHT face cerebral palsy, intellectual disability, blindness, seizures, and other profound impairments.

Prevention depends on educating caregivers about the dangers of shaking, teaching safe ways to cope with crying, and identifying families who need additional support. Health care providers, social workers, and community programs all play a role in protecting vulnerable infants.

Other Causes of Infant Brain Injury

Beyond trauma, oxygen deprivation, infection, and abuse, several other factors can cause brain injury in infants.

Metabolic disorders, including inborn errors of metabolism, can damage the brain if not diagnosed and treated quickly. These genetic conditions affect how the body processes nutrients and can lead to toxic buildup of substances that harm brain cells.

Severe jaundice in newborns can cause a condition called kernicterus, where high levels of bilirubin damage parts of the brain. This is largely preventable with proper monitoring and treatment of newborn jaundice, but it still occurs when warning signs are missed.

Vascular events such as stroke, brain hemorrhage, or aneurysm rupture can happen even in babies. Premature infants are especially vulnerable to bleeding in the brain due to fragile blood vessels. Full-term infants can suffer strokes due to blood clots, infection, heart defects, or other medical conditions.

Congenital malformations affecting the brain or blood vessels, such as arteriovenous malformations or hydrocephalus, can lead to brain injury either directly or through complications that arise after birth.

Risk Factors for Infant Brain Injury

While any baby can suffer a brain injury, certain factors increase the likelihood. Understanding these risk factors can help identify infants who need closer monitoring and earlier intervention.

Before and During Birth

• Prematurity and low birth weight increase vulnerability to bleeding in the brain, infection, and oxygen deprivation
• Complicated labor and delivery, including prolonged labor, fetal distress, or difficult deliveries requiring instrumentation
• Large fetal size or breech presentation, which can make delivery more traumatic
• Maternal health conditions such as preeclampsia, diabetes, or blood clotting disorders
• Maternal infections that can be passed to the baby
• Substance use during pregnancy, including alcohol, tobacco, or drugs
• Lack of prenatal care, which can mean that risk factors and complications go unrecognized

After Birth

• Prematurity-related complications including respiratory problems, infection, and unstable blood pressure
• Household risk factors for injury or abuse, including lack of safe sleep practices, unsafe environments, or high-stress family situations
• Delayed recognition of medical problems, such as undiagnosed infection or untreated seizures

Statistics and Long-Term Outcomes

Traumatic brain injury, birth asphyxia, and abusive head trauma represent the leading causes of brain injury and death among infants in the United States. The consequences reach far beyond immediate medical care.

Research shows that approximately 10 to 15 percent of infants with severe brain injury from any cause may die. Among survivors, many face long-term challenges. These can include:

• Cerebral palsy and other movement disorders
• Developmental delays in reaching milestones
• Intellectual disability
• Epilepsy and seizure disorders
• Vision or hearing impairment
• Behavioral and emotional difficulties
• Learning disabilities that become apparent as the child grows

The severity and type of disability depend on which parts of the brain were injured, how extensive the damage was, and how quickly treatment began. Early intervention services, including physical therapy, occupational therapy, speech therapy, and specialized educational support, can help children reach their full potential despite these challenges.

Major medical centers, including those in New York City such as Mount Sinai, are actively involved in research aimed at improving diagnosis, treatment, and rehabilitation for infants with brain injuries. Advances in imaging, therapeutic hypothermia, and early intervention continue to improve outcomes for affected children.

Prevention and Family Support

Many infant brain injuries are preventable. Public health efforts and medical practice improvements focus on reducing the most common causes.

Prevention Strategies

Key prevention approaches include:

• Universal prenatal care to identify and manage maternal health conditions and pregnancy complications
• Continuous fetal monitoring during labor to detect signs of distress early
• Prompt recognition and response when complications arise during delivery
• Safe sleep education to reduce fall risk and ensure babies sleep in safe environments
• Home safety guidance including proper use of changing tables, baby gates, and car seats
• Education about normal infant crying and safe strategies for coping with frustration
• Screening and support for families at risk of child abuse or neglect
• Infection prevention including maternal vaccination, proper hygiene, and early treatment of newborn infections
• Careful management of newborn jaundice to prevent kernicterus

Support for Affected Families

When an infant does suffer a brain injury, comprehensive support makes a significant difference. Hospitals provide coordinated care that may include:

• Neurocritical care and specialized neonatal intensive care
• Advanced imaging and monitoring
• Treatment interventions such as therapeutic hypothermia for HIE
• Neurosurgical procedures when needed
• Rehabilitation services starting in the hospital
• Social work support to help families navigate medical decisions and access resources
• Connections to early intervention programs

After discharge, families benefit from ongoing coordination among medical specialists, therapists, educators, and community support services. Many families also find connection and information through support groups and organizations focused on specific conditions such as cerebral palsy or HIE.

At NYBirthInjury.com, we provide trusted information to help families understand birth injuries and connect with qualified medical and support resources. Whether you are trying to understand a recent diagnosis, seeking information about treatment options, or looking for support services in New York or elsewhere, we aim to offer clear, compassionate guidance during a difficult time.

Moving Forward

Learning that your baby has suffered a brain injury is devastating. The medical terminology can be overwhelming, and the uncertainty about the future is frightening. But information is a tool that helps you advocate for your child and make the best decisions for their care.

Understanding the cause of your child’s injury provides important context. It can guide treatment decisions, help predict possible complications, and inform long-term planning. It can also help you determine whether the injury was preventable and whether medical care met accepted standards.

Every infant’s situation is unique. Some babies recover fully or nearly so. Others face significant lifelong challenges. What remains constant is that early intervention, appropriate medical care, and family support all improve outcomes. Your child deserves the best chance possible, and you deserve accurate information, compassionate support, and access to the resources that can help your family move forward.