Starved of oxygen at birth - is this a factor do you think?

[tanfastic]

As is evident from some of my posts recently we are having terrible problems with my son with behaviour/social anxiety and his stammering. We've only recently asked for help from the HV - he's 4.3 and starts school in September. She has said that his behaviour is severe and has referred us to some parenting team (for parenting classes I assume, she mentioned Triple P course). She also said we could probably benefit from help from CAHMS but said they may not take him on due to his young age (she was waiting for a phone call back but we've not heard from her since). We also have an assessment with SALT on Thursday.

Every day with him since he was born really has been a real struggle. We've often thought it was due to the way he was born. I got diagnosed when I went into labour with severe pre-eclampsia and had a C section under a GA to get the baby out. He was born not breathing and fitting and had to be resuscitated. We were told he may have brain damage as a result but the brain scan came back okay. He was under the paed for the first year of his life but then discharged. The paed said he had suffered hypoxic ischemic encephalopathy at birth which is just a fancy name for deprived of oxygen.

We've always thought that his problems that are really starting to be noticeable now he's reached four stem from this but obviously we can't prove it.

Does anybody else have a child with special needs to who had a traumatic birth or was starved of oxygen?

I think many of us consider the birth as one of the potential factors in our children's SN but most of us realise eventually that energy wasted on the past will take away some of the energy needed for the future. Unless you're planning a medical negligence claim, but the money you'd get from that, even if you could PROOVE it would be marginal.

No i'm not planning on claiming anything in respect of medical negligence. I was just interested to see how many of you had birth problems.

Well then yes, I believe the terrible birth experience triggered Ds' autism.

I had a prolonged second stage as DS was so big I couldn't push him out, so had to have an episiotomy and forceps as his heart rate was all over the place, it is possible that he had a lack of oxygen in the birth canal, but whether this is linked to his ASD or not I do not know.

I think it more likely that the fact that DH and FIL are (undiagnosed) on the spectrum is a more likely factor in our case.

Ds1's birth was the only one of my three that was traumatic and he is the only one of my dcs who has ASD. I was in labour for days with him, failed to progress, ended up with drip (syntocin? sorry can't remember the right name), then epidural and he was delivered in a rush by ventouse when his heart rate dropped to 10 and all hell broke loose. They told me at the time that the heart rate drop was just because he had moved lower in the birth canal and they hadn't realised I was fully dilated. I believed them at the time, but have huge doubts about it retrospectively.

I do think his birth is probably a factor, but there is clear genetic history (although undiagnosed) in the family, so I tend to think his birth could have been the trigger, rather than the whole reason he has ASD, iyswim.

As Star said, I tortured myself about it for a while, then realised it's in the past and there's nothing I can do about, whereas I can focus on making sure he has all the support he needs now and in the future, so that's where I expend my energies these days.

my son's paed told us that any neurological damage - even sub-clinical/non-specific/mild (!) - increases the risk of autism & associated conditions. My son had an uncomplicated birth but I believe that one factor in his regression & loss of skills was encephalitis associated with very very severe chicken pox which he had at 21 months.

tanfastic,

With regards to your first paragraph did you approach his future school before they finished for the six weeks holidays?. How are they going to support DS from September onwards?.

Was DS on the special needs register at nursery, was he on anything like Early Years Action Plus?.

HV may not be the best person to seek help or advice from; I would also ask your GP now for a referral to a developmental paediatrician. I do not think you need a parenting course (why are such things always suggested?) so much as proper help instead.

The Michael Palin centre may be worth contacting re your son's severe stammering.

My son's birth was traumatic for both of us but I do not at heart think this was itself the cause of his developmental delays. That all happened post conception and there are many things about genetics that are still not fully understood.

My ds2 needed To be resussitated at birth and has HFA but I think genetics play the main part as dh is very likely aspergers and ds would by aspergers apart from
Speech delay

ds2 needed resussitation at birth but there is also autism in my family. I'm in the same mind as startlight though in that I save my thoughts and energy for the here and now. It is what it is.

Plebas - my dd (7) is awaiting assessment for ASD/aspergers. She suffered a fractured skull at 7 months old (stbxh negligence) and I have often wondered if it's possible that it could have caused the issues she has.

On the birth note, she is my firstborn and the only one of the four I struggled with. The pushing stage went on for a long time and she had decreasing heart rate lasting a good minute or so before picking back up. They were considering sending me to another hospital for a possible c section. When she was born she had what I can only describe as a large blood blister around her scalp, took a week or so to fade caused by how long she was stuck in the birth canal I believe.

I also suspect my brother is aspergers (he suspects it himself).

Attila, No I haven't said anything to his new school. I've spoken to the nursery he attends (since he was 8 months) who say they have no concerns about his behaviour, he is not aggressive at nursery, his social skills are fantastic and there is nothing in him to suggest that he will have any problems in learning at his big school. This has been passed on to the school in his report. They said the only things they notice sometimes is his inability to control his emotions and his stammer is getting worse. They have repeated the same to my HV who seems to have disappeared off the radar since speaking to nursery. She was supposed to be trying to get a referral to CAHMS for me.

He is really aggressive at home which I suppose to some people that might come across as bad parenting but I swear we have a zero tolerance in our house! His dad is a policeman FFS! We are not bad parents, we are decent people who have house rules and try our best where our DS is concerned. It's so hard.

This morning has been awful, he refused to get out of the car after i'd been shopping and so I left him to cool down for a bit but then noticed him trashing the inside of my car so I had to get him out. He then walloped me over the head with a shoe in the porch and broke my hair clip and kicked and punched me. This afternoon he has been an angel (although my mum did come round and give him a bit of a talking to for hurting mummy). He has played with his play doh for an hour whilst I bathed the dog, given me loads of cuddles and apologised a hundred times.

His stammering has only really gotten a lot worse the last couple of weeks so I was hoping it would sort itself out before he started school as it has appeared and disappeared since he was two.

Not sure really where to turn now.

tanfastic

HV may well stay off radar now because they tend to deal with younger children. You need to involve the GP in getting such a referral either to CAMHS or a developmental paediatrician.

As mentioned Michael Palin centre is helpful when it comes to childrens' stammering.

Ds had a difficult ventouse birth where his heart rate kept dropping. He also hardly fed for three days as no one would help me bf and he wouldn't latch on. I think the traumatic birth and lack of nutrition in the first vital few days may have contributed to his aspergers. We do, however, have lots of undiagnosed AS in the family though so who knows?

zzzz - I forgot all about the huge bleed I had during ds's first trimester.

Ds was twice corded and had to be resusitated.

He is the only one of my 4 children who has ASD.

However, like Starlight, I concentrate on what I can do now to help him. For some time, I did torture myself with the what ifs...

No problems with the birth and DS has moderate to severe autism.

What sort of brain scan was it? Was it an MRI?
If you are concerned about birth injuries you can still get legal aid (in the name of the child) to have it investigated for medical negligence - it is much easier to prove a link with some neurological injuries (e.g. CP) than other problems. The link with autism is not really proven. Usually different parts of the brain will show up as affected on MRI e.g. a autistic brain looks very different to a CP brain.

You can get quite large settlements for birth injury for medical negligence actually, but only if its an injury that can be linked to the HIE.

If you are concerned you can get a specialist solicitor to look into it. If they take the case on legal aid it will not cost you anything.

I would not necessarily take the hospitals word for it. I used to do med neg cases and I saw many cases where parents were told children were fine when there were concerns.

But if it is ASD and nothing else then its unlikely you can prove a link, the medical evidence about causes of autism is just not there yet. Children can bring cases until they are 21 though (although it takes about 2 years to gather the evidence and reports so not suggesting you leave it that long).

My dd had HIE and has physical difficulties as a result but fortunately no other complicating factors so far. However, various doctors told me that boys are more likely to sustain injury than girls as a result of oxygen deprivation which may (or may not) lead to behavioural issues. I've always been a bit worried as I know that serotonin levels can be affected by brain injury to some areas of the brain including where my dd sustained her damage. It's a wait and see on that one I guess...

tanfastic,
It might be worth getting an opinion from a legal firm that specialises in clinical negligence. They'd be able to get and scrutinise your medical records to see if there was anything that should have been done to prevent HIE. Being starved of oxygen is almost certainly a factor and it can cause a pattern of problems that wouldn't necessarily be recognised and treated through normal community services.

both of my girls have autism, both pregnancies are pretty bad and placental failures and emerency births for both due to fetal distress. Both were low birth weights and low developers :(

when he was first born we consulted lawyers as our primary concern was cerebral palsy but they basically said that cp takes a while to present itself so wait and see. He doesn't have cp but he def does have behavioural issues. We were told to write a letter of complaint to the hospital straight away and then wait and see.

However we never ended up doing this, I was still recovering from a traumatic birth and pre eclampsia and we just never got round to it

I had a birth de brief last summer (better late than never) but my ds notes were not included only mine. I was pretty shocked by what they told me about me though and how seriously Ill I was.

What strikes me as odd was I was in the maternity assessment unit the day before I went into labour with high bp. I was 9 days overdue at this point. No PE detected though. They did a trace on baby which I remember being told wasn't "text book" and the midwife wanted a consultant to sign me off. Consultant said that he was happy to send me home as I was booked in for an induction in 2 days anyway. That was a big mistake IMO.

The next morning I took myself to hospital (despite being told to take a paracetamol) because I was in so much pain and was diagnosed with severe PE which was 'off the scale'. I was on the verge of fitting and baby in distress.

My ds was only 6 pounds despite being told he would be a big baby and I was told my placenta was completely fucked to
Put it mildly.

I think it would be a minefield to prove negligence, especially without any formal diagnosis of my son tbh.

Not sure what kind of brain scan he had either, Its all a bit of a blur.

CP is far from the only provable consequence. It might be a minefield to prove negligence, but even if there was no negligence, that would possibly be reassuring that the treatment given was adequate at least. Even if there was no negligence, the process of the assessments would provide information that might not otherwise be available. If there was negligence, the financial support that your ds could get throughout his lifetime would be, hopefully, proportionate and helpful.

I agree using legal aid to find out more can be a way of getting answers even if the answer is there was no negligence, or there was negligence but we can't prove a link. At least you would know.
The legal aid would cover getting a report from a indep paediatrician and usually an expert to do / look at MRI scan.
You might even get a diagnosis that way.

ASD runs in our families - DS1 and 2 are the first people with official dx's but there are very obvious traits in both DH and me and our families.

In our case DS1 and 2 were fine births, but DS3 was born not breathing and was touch and go if we could be resucitated. DS3 is my NT child - he did have viral wheeze for a while, but grew out of that last winter.