Client stories – Jamie’s story
Jamie suffered hypoxia and HIE due to delay responding to drops in his heart rate. We investigated for him and got an early admission from
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Last updated: July 2026 to improve accuracy and add additional resources.
For many families, a diagnosis of cerebral palsy does not arrive from the moment of birth. Instead it comes gradually, as their child misses early developmental milestones such as sitting, crawling, and walking. In some cases, the underlying cause is hypoxic-ischemic encephalopathy (HIE); a brain injury sustained when the supply of oxygen is interrupted around the time of birth.
Appreciating the relationship between HIE and cerebral palsy is often the first step towards understanding whether negligent care played a part in the outcome. If it did, establishing your options for the future becomes hugely important.
For a full explanation of the condition, and what a diagnosis means for many children, see our dedicated guide: Understanding Hypoxic Ischaemic Encephalopathy (HIE): A Guide for Parents.
What is the Link Between HIE and Cerebral Palsy?
Cerebral palsy is an umbrella term for a group of lifelong conditions that affect movement, muscle tone, and coordination, and is caused by injury to the developing brain. HIE is one of the most significant causes of cerebral palsy in children born at or near term.
The relationship between the two is very close; when a baby’s brain is deprived of oxygen, the injury that results can affect the areas responsible for movement and motor control. The extent and location of that injury will determine whether cerebral palsy develops, and if so, its type and severity.
The main types of cerebral palsy associated with HIE are:
- Spastic Cerebral Palsy: The most common form, characterised by stiff or tight muscles and a reduced range of movement. Spastic quadriplegia, affecting all four limbs, is most commonly associated with severe HIE and significant injury to the brain’s white matter.
- Dyskinetic Cerebral Palsy: Characterised by involuntary, uncontrolled movements. This type is mainly associated with injury to the basal ganglia and thalamus, the areas of the brain most vulnerable to the specific pattern of injury seen in acute cases of hypoxia at birth.
- Mixed Cerebral Palsy: Where features of more than one type are present, reflecting injury across multiple areas of the brain.
It’s important to understand that not every baby who experiences HIE will develop cerebral palsy. The outcomes will be determined by the severity of the HIE, the timing and extent of the oxygen deprivation, and the speed and effectiveness of treatment received in the neonatal period.
For more detail on how HIE severity is graded, and what each grading means, read our guide: HIE Grades and Stages: Understanding Your Baby’s Diagnosis.
HIE, Cerebral Palsy, and Premature Babies
Much of the focus around HIE and cerebral palsy centres on babies born at term. However, premature babies also face a distinct and, in some ways, heightened risk. Because the premature brain is more vulnerable to an oxygen-deprivation injury, both the resulting pattern of injury and the type of cerebral palsy may differ from those seen in term babies.
In premature infants, injury to the periventricular white matter is particularly common, often resulting in a condition called periventricular leukomalacia (PVL). PVL is strongly associated with spastic cerebral palsy affecting the legs.
The symptoms of cerebral palsy in premature babies may be subtle at first. It can take months or even years to become apparent, as the signs only truly emerge as a growing child develops motor skills. For more on PVL specifically, see our guide: What is PVL? Causes, Symptoms and Support Explained.
Signs of cerebral palsy in premature babies to look out for include:
- Poor head control beyond the expected age.
- Difficulty feeding.
- Asymmetrical movement or use of limbs.
- Muscle stiffness or floppiness.
- Delayed sitting, crawling, or walking.
- Persistent use solely of one hand before the age of 18 months.
The Long-term Effects of Cerebral Palsy Following HIE
The long-term effects of cerebral palsy depend largely on the type and severity of the condition. For children whose cerebral palsy is associated with HIE, additional complications are common, reflecting the broader impact of the original brain injury.
These can include:
- Epilepsy or seizures.
- Learning difficulties and cognitive impairment.
- Speech and language delays.
- Hearing and visual impairments.
- Emotional and behavioural difficulties.
- Respiratory or orthopaedic conditions.
Some children will require lifelong care and support; but, with the right combination of therapies and educational support, others will be able to become much more independent. Early intervention can make a huge difference to the outcome. Children who receive early and intensive physiotherapy, occupational therapy, speech and language therapy, and educational support consistently achieve better outcomes than those who do not.
Securing the resources to fund that support, and sustaining it throughout a child’s development, is one of the most valuable things a compensation claim can achieve for a family.
For more on the long-term effects of oxygen deprivation at birth, see our blog: The Causes, Signs and Long-Term Effects of Oxygen Deprivation at Birth.
What Does the HIE/Cerebral Palsy Link Mean for a Negligence Claim?
If your child has been diagnosed with cerebral palsy and HIE was identified as the underlying cause, the question of whether negligent care contributed to that outcome deserves to be answered fully.
Firstly, not every case of HIE is the result of negligence. Sometimes oxygen deprivation occurs despite appropriate and timely care. However, in many cases, a detailed review of the medical records reveals failures that could have been prevented.
These often include:
- A CTG trace that was misread or ignored.
- A delay in the decision to deliver.
- A failure to recognise warning signs during labour and delivery.
- Inadequate monitoring during the neonatal period.
Establishing liability in HIE and cerebral palsy claims requires expert evidence from a range of specialists; typically including an obstetrician, midwife, neonatologist, paediatric neurologist, and neuroradiologist.
If we are successful in proving liability in a claim, we can then move on to determining the amount of compensation which should be payable. This step involves obtaining expert evidence from care, accommodation, physiotherapy, and occupational therapy to name a few.
The nature and needs of a child with cerebral palsy directly affects the value of a compensation claim.
Compensation can include lifetime care costs, therapies, specialist equipment, housing adaptations, educational support, and loss of future earnings. For complex cases, these figures can be significant.
You can read about families we have supported in similar situations:
FAQs About HIE and Cerebral Palsy
Q: Does HIE always lead to cerebral palsy? No, the relationship between HIE and cerebral palsy depends on the severity of the HIE, the timing and extent of the oxygen deprivation, and the speed of treatment received. Babies with mild HIE often make a full recovery. However, those with moderate to severe HIE face a higher risk of developing cerebral palsy and associated conditions, although outcomes vary significantly from one child to another.
Q: How is the link between HIE and cerebral palsy established in a legal claim? Expert evidence from an obstetrician, midwife, neonatology, paediatric neurologist and neuroradiologist is usually needed to help to prove the claim and show whether any failings in care during the pregnancy, labour or delivery caused the child’s injury.
Q: When do the signs of cerebral palsy become apparent after HIE? In some children, signs are apparent shortly after birth or in the first few months of life. In others, particularly those with milder injuries or premature babies, the signs might only emerge as motor development falls behind expected milestones. A diagnosis of cerebral palsy may not be made until a child is one to two years old, or sometimes even later. This is why developmental monitoring in the years following an HIE diagnosis is so important.
Q: Is there a time limit for making a claim? For claims brought on behalf of a child, the three-year limitation period does not begin until their 18th birthday, so a claim can be brought any time before they turn 21. (Limitation Act 1980, s.28) Acting earlier is strongly advisable, as not only is evidence better preserved but an interim payment, which can fund early therapies and care, can only be secured once proceedings are underway.
Q: What if we were never told our child’s cerebral palsy was linked to HIE? This is not uncommon. Families are not always given a clear explanation of the chain of events that led to their child’s diagnosis. If your child has cerebral palsy and there were concerns about their condition at birth — including a low Apgar score, the need for resuscitation, seizures, or admission to a neonatal unit — it is worth seeking a specialist legal opinion, even if no one has explicitly used the term HIE.
Could Negligent Care Have Contributed to Your Child's HIE or Cerebral Palsy?
If your child has been diagnosed with cerebral palsy following HIE, and you have concerns about the care received during pregnancy, labour, delivery, or the neonatal period, CL Medilaw’s specialist birth injury team is here to help.
Support for Families
A diagnosis of HIE and cerebral palsy can feel overwhelming, and no family should have to navigate it alone. Several organisations provide specialist information, practical help, and peer support:
- Peeps HIE: A UK charity dedicated to supporting families affected by HIE.
- Bliss: The special care baby charity, supporting families of premature and sick babies. CL Medilaw sits on the Bliss legal panel, reflecting our commitment to the families they support.
- Scope: The leading UK charity for people with cerebral palsy.
We have supported many families in similar situations, securing the compensation they need to access the care, therapies, and opportunities their children deserve. Our solicitors hold accreditations from the Law Society, APIL, AvMA, Headway, and the Brain Injury Group, and we sit on the legal panels of Peeps HIE and Bliss.
If you would like a free, no-obligation confidential case review, contact our team today.
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Kay
Kay is a Partner in the CL Medilaw team.
Kay is an expert in claims involving injuries incurred at birth, including those resulting in cerebral palsy. Kay acts for clients with long term disabilities including brain injuries, spinal injuries, amputations and injuries arising from a failure to diagnose or properly treat meningitis. She also acts for families whose loved ones have died while under the care of a medical professional.
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