Brain bleeds in premature babies

Preterm birth can lead to many different health complications. Brain bleed, also called an intraventricular hemorrhage (IVH), is one type of serious problem that can happen in babies who are born too early, smaller and sicker.  If you or someone you know has a baby with a brain bleed, it can be a very scary and upsetting experience.

Bleeding in the brain is most common in preterm babies who weigh less than 3 pounds, 5 ounces). A baby born before 32 weeks of pregnancy is at the highest risk of developing a brain bleed. This is because the tiny blood vessels in a baby’s brain are very fragile and can be injured easily. The bleeds usually happen in the first few days of life.

How are brain bleeds diagnosed?

In IVH, bleeding occurs near the fluid-filled spaces (ventricles) in the center of the brain. An ultrasound test can show if a baby has a brain bleed and how severe it is. All babies born before 30 weeks should have an ultrasound of the head to screen for IVH, according to The test is typically done between 7 and 14 days of age. Babies born between 30 weeks and 34 weeks also may be screened if they have symptoms of IVH.

Are all brain bleeds the same?

Brain bleeds usually are given a number grade (1 to 4) based on where in the brain it’s happening in and how big the brain bleed is. The right and left sides of the brain are graded separately. Most brain bleeds are mild (grades 1 and 2) and resolve themselves with few lasting problems. More severe bleeds (grades 3 and 4) can cause difficulties for your baby during hospitalization as well as possible problems in the future.

What happens after your baby leaves the hospital?

Every child is unique. How well your baby will do depends on several factors. Many babies with IVH will need to be seen by a pediatric neurologist or another specialist (such as a developmental-behavioral pediatrician) during infancy and early childhood. Some children may have seizures or problems with speech, movement or learning.

If your baby is delayed in meeting their developmental milestones, they may benefit from early intervention services. Early intervention services such as speech, occupational and physical therapy may help your child catch up.

Where can parents find support?

Having a baby with a brain bleed can be overwhelming. The March of Dimes online community, Share Your Story, is where parents can find comfort and support from other parents who have (or had) a baby in the NICU with a brain bleed. Just log on and post a comment, and you will be welcomed.


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    I have a 7 month old who was born at 33weeks. She wasn’t breathing and had to be given CPR. Due to the trauma she suffered a grade IV IVH. She hasn’t really met any milestones, she’s still on a feeding tube, and is on seizure medicine. Anyone have any inspirational stories to lift my spirits?

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    Lynda, I am not yet a mother – I came across this site because close friends of mine gave birth to a premature baby. However, I wanted to let you know that I am praying for you and your sweet daughter. Jesus has created you and her, and I ask that He would encourage your heart and strengthen her body.

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    I was born at 30 weeks and had a grade 4 IVH. I did not meet any milestones, was also on a feeding tube, and had to go through both speech and occupational therapy. My parents were told that I would not be able to see or walk. I am now 20 years old and in college. Medical technology has come along way in the past 20 years so definitely stay positive.

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    Jared, thank you so much for your post. Best of luck to you!

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    Varuna April 8, 2017

    Jared, thank you for sharing your story. I just got the news saying my baby had a grade 4 IVH. I was reading this and suddenly thought of looking through the comments. I’ll definitely share what I will be going through in coming days, I want to share a happy story with all…