Brain bleeds in preemies

Bleeding in the brain, known as intraventricular hemorrhage (IVH), occurs in some premature babies. A baby born before about 32 weeks of pregnancy is at highest risk. The bleeds usually occur in the first 3 days of life and generally are diagnosed with an ultrasound. Fortunately, a preemie’s brain, which is still developing, has great stamina. Most brain bleeds are mild and resolve themselves with no or few lasting problems.

Generally speaking, the younger, smaller and sicker a baby is at birth, the more likely he is to have an IVH. A baby whose birth weight is less than 1,000 grams has roughly a 35% chance of having an IVH (20% of having a serious one), while a baby born between 1,000 and 1,500 grams has only about a 7% chance of a serious IVH. After 30 weeks of gestation, the risk of developing a serious IVH drops to less than 1%.

Intraventricular hemorrhages are given a grade (1 to 4) according to their location and size, and the right and left sides of the brain are graded separately. Grades 1 and 2 are mild, generally resolve themselves and have no long-term problems associated with them.

More severe, serious bleeds (grades 3 and 4) can affect, though not always, the substance of the brain or cause the fluid-filled structures (ventricles) in the brain to expand rapidly. These severe bleeds can cause increased pressure on the brain that can lead to brain damage bringing about complications such as cerebral palsy and learning and behavioral problems. When fluid persists in the ventricles, neurosurgeons may need to insert a tube (shunt) into the brain to drain the fluid and reduce the risk of brain damage.

The long-term outcome for a premature baby who suffers an IVH depends on many variables: the grade of the bleed, the degree of injury caused by lack of blood and oxygen flowing to the brain around the time of the bleed, mechanical interventions required to help the baby (such as the use of a ventilator), and any complications the baby has (such as infection or hydrocephalus). Head ultrasounds and MRIs will be used to closely monitor changes over several weeks. Test results will help doctors predict what parents may see once their baby comes home.

It’s essential to note that no two babies are alike and each baby has his own path to walk. What’s important is that the parents of each baby provide a nurturing and stimulating environment in the early years to help him develop to his full potential.

Learn more about brain bleeds in premature babies, including what to expect when you leave the hospital, and where to go for support.

If you had a baby with a brain bleed, please feel free to share a little of your story with us.

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210 Responses to “Brain bleeds in preemies”

  1. Jenn Says:

    My daugther was born 24 weeks at 620 grams. She’s on her 2nd week now and foUnd our that she has grade 2 bleeding in her brain and got serious brain infection. This morning she have seizures and doctors are constantly monitoring her. Her level of infection shoot up from 7 to 100+. I really don’t know what to do but just to keep praying and trust all the Doctors advise. Praying she’ll get better.

  2. Sheena Says:

    Jenn,

    A baby in the NICU is rough! Very, very rough! Being on the other side of it though, I can tell you what may seem grim today can actually have the best outcome. You will learn just how strong you can be in there. You’ll also learn the incredible strength that teeny tiny baby has! My son was born at 32 weeks, weighing 1503 grams. If you read above he should not have had a bleed. On day 7 of our 45 day NICU experience we learned he had a grade 3 bleed on both sides of his brain. Day 8 we learned he may have bacterial meningitis. Day 9 was 12 hours to place a PICC line, and day 10 was possible seizures. That was hell on earth! Today he is a beautiful, healthy 3 year old that is developing perfectly. Back then I struggled so much to just trust he would be OK. If you get to that place just know its very possible. Keep praying (I will too), keep trusting the doctors, but ask all the questions you need to understand, and just know that she can push through. Take care of yourself along the way! I know all you are concerned with is her well being, but make sure you are sleeping and eating too! If she is stable its OK to go home to rest (I really struggled with that). You should be able to call and check on her anytime. I ended up with PTSD after we got home. Who would have thought! Its that rough of an experience. Just breath and take it one day at a time. The NICU is 1 step forward and 2 steps back! Lots of prayers for baby girl’s recovery!

  3. Devoira Davis Says:

    Our preschooler(former 30weeker) had a grade 1 IVH that we weren’t even told about until the day of discharge and so we thought nothing of it. Fast forward to now she is really struggling with things like tracing her name, wiping, answering questions(she can do simple questions like what’s your favorite color), holding a utensil. Her gate is still off and she is struggling so bad in pre-K. I feel horrible for her cause she cries a lot and states she is trying but can’t do it. Is there anyone who can help point me in the right direction to getting help? I was told by five she’d be out of the woods with a lot of this stuff but she just isn’t and I want to help her as much as I can. No one really knows the extent that prematurity reaches and maybe other preemies have done just fine, but ours is struggling and we truly believe it’s because of this bleeding that occurred.

  4. Sara Says:

    Hi Devoira. If you have concerns about your daughter’s development, make sure you talk to her health care provider. News Moms Need also has a series of posts on delays and disabilities. You can see the table of contents here: http://newsmomsneed.marchofdimes.org/?p=17219. Hopefully you can find some helpful information.

    If you have additional questions, you can always email us at AskUs@marchofdimes.org.

  5. Jen Says:

    Devoira, I just came on to find out about brain bleeds in premature babies. I just took my 7yr old daughter (she is a 28weeker) to a developmental neurologist today bc she is struggling in school. We delayed starting her in K bc we felt she needed an extra year and her teachers agreed. So she is 7.5yrs in 1st grade and is one of the lowest academically in her grade. She is on an iep and gets lots of help but still struggles especially in reading. The doctor brought up her grade 1 brain bleed and ordered an mri for her. I don’t know what to think about it all.

  6. Jessica Says:

    My daughter was born at 29 weeks she had a grade 3 & 4 bleed… I was told all the worst things that could happen, she would have cerebral palsy, that she would need a permanent shunt. Well she is 18 Months now and we just got cleared by her neurosurgeon, she does NOT need a permanent shunt. && the only issue she has is extra tone on her left side. Which causes her left hand and foot to be tense. Something she will learn how to relax. She did have a temp shunt put in at a week old to drain that fluid off her brain and I can not stress how thankful I am for that. If we wouldn’t have don’t the temp shunt I def think she would have had more issues. Yes these preemie babies are fragile but they are resilient. They can heal themselves. Prayers for all of your babies!!

  7. Cyndy Says:

    If anyone could reach out to me, to offer some encouragement. My daughter was born at 34 weeks, with a grade 3 IVH on the left side of her brain. She has subtle cerebral palsey on the right side of her body but it does affect her, she is right now 17 months and is in the early stages of beginning to walk. Neurologist has also ordered speech therapy on top already getting physical and occupational therapy. I would just like to more or less how someone else has “weathered” these challenges it’s just hard when not any body that I know has ever been in my shoes, not too many ppl to talk to. Thanks in advance.

  8. Cait Says:

    Hello everyone. I’d love to share some encouragement for you all. My name is Caitlin and I am a NICU Graduate. I was born 31 years ago at Albany Medical Center and was born at 26 weeks. I weighed 2lbs 2oz and only given 10% chance of survival. At the time I had a 3 degree brain bleed on my left side and was told on the 5th day that I was not going to make it through the night. My parents had a priest come in and baptize me, expecting to come the next morning and I would have passed. Miraculously I was still there, fighting. Fast forward to several other issues, and leaving the hospital 3 months later at a hefty 4 lbs. The only ‘disorder’ I have is a slight learning disability. I have a Masters in Library and Information Science and was able to carry my own 2 children to 38 weeks with no problems. I hope that despite the roller coaster of emotion you all are going through to be a light of hope to you all. You have little fighters and prayers to everyone! If you have any concern/questions please email me 🙂 <3

  9. Leah Says:

    My son was born at 30 weeks he had high blood pressure high heart rate suspected scepticaemia and was in intensive care for 1 month before moving back and forth between hd and int for another month. he suffered a grade 3/4 bilateral bleed on day three. He had numerous bradycardias and 3 blood transfusions he had seizures and I can tell you. I felt like my life wasn’t worth living because I was so helpless for our baby. I cried every minute of every day I was ill, I couldn’t eat sleep and actually found myself walking out of the hospital not even knowing how I got there. We stayed by his side day and night. He was untibated then Cpap the intubated, he was in billy Rubin lights he was tube fed for what seemed an eternity and even ended up back on oxygen in special care. A junior dr said at one point that if our baby was to make he would be dead behind the eyes!! So there is little wonder why we or I was like I was.

    Our gorgeous little boy is now two. He is amazing. He has Physio OT speech therapy. Although he isn’t walking but he is really trying and I spend my days walking him around everywhere he is cheeky he has a gorgeous personality he isn’t talking but I did a sign course and he’s already picked up ten signs. He is making lots of sounds though so I’m optimistic about that happening. He has just been given a little splint to help balance him. All I can say is, yes it’s the most upsetting thing in the world, yes it’s not what we wanted for our babies, no I definitely cannot accepted it but I will definitely make sure my baby explores the world however he chooses and if need to be there with him then I will be. You might not think this now but you will get stronger. I am an extremely emotional person and I think a lot but I am actually stronger to deal with this now and he’s amazing. He took four steps on his own last week. It’s not as bad as your mind makes it because our babies have their own uniqueness and if you know in your heart that they’re happy and you see them smile then we have to do the same. There is hope. Not knowing is bad and we’re still going through that but I honestly believe that our little preemies who have had a bleed just need lots of time love and support. We can absolutely do this!!! X x x

  10. Priya Says:

    Hi,
    My daughter was born 24 weeker at 1 lbs 10oz and had low grade IVH. We came out of NICU after 4 months. It was a roller coaster but she was great through it. She has done good otherwise except for speech delay. She is not talking yet although cognitively pretty advanced. Has anyone experienced this? Could this be related to the brain bleed. She is 2.5 years now.

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