What you need to know about HIE, before HIE Awareness Day

This Sunday, 4 April, is HIE Awareness Day and we are proud to have supported the charity Peeps HIE in their event for HIE Awareness Day with a donation to their Pledge for Peeps initiative.

Peeps HIE’s Pledge for Peeps campaign asks people over the month of April to set their own challenge to raise money and awareness for the charity. This could be a sponsored walk, a wheelchair push, a themed online meeting, or even just a ‘wear it yellow’ day. If you want to get involved you can register your interest on their website here.

Peeps HIE do some fantastic work with children who have been affected by HIE, and having worked with many families living with complications of the condition, we know how important this work is. So, if you can, please join us in supporting the charity with a Pledge for Peeps!

So, what is HIE?

HIE stands for hypoxic-ischaemic encephalopathy and describes an injury to the brain that has occurred because of a lack of oxygen. HIE often occurs at birth.

How does HIE happen?

There are many reasons why blood flow and/or oxygen may be restricted either before or during a baby’s birth.

Causes include:

• placental abruption (where the placenta supplying necessary nutrients and oxygen to the baby comes away from the wall of the womb)
• issues with the umbilical cord, such as compression, prolapse, wrapping or knots
• intrauterine growth restriction
• a baby becoming trapped through impacted fetal head or shoulder dystocia
• delays to delivery

Can HIE be treated or even avoided?

Avoiding HIE usually comes down to effective monitoring of the baby during pregnancy and labour.

Monitoring of the baby in labour involves listening carefully to the fetal heart. Obstetricians and midwives will study the heart rate carefully to ensure it is within the normal range. They will also listen out for drops in heart rate because these may indicate that the supply of oxygen to the baby’s brain is running low.

In many of the scenarios that can cause HIE, prompt recognition of what is happening and swift action to deliver the baby is required.

Taking issues with the umbilical cord as an example: The umbilical cord transfers essential oxygen and nutrients from mother to baby. During delivery, the cord may descend before or alongside the baby and become compressed and the supply of oxygen to the baby reduced.

Cord prolapse needs to be recognised quickly and the midwives will take steps to alleviate pressure from the cord. The baby will be delivered (usually be caesarean section) as quickly as possible and commonly within 15 minutes.

We detail many of the causes and ways to mitigate infant brain damage in our guide to the causes here.

Happily, due to the skill and training of our amazing NHS, even when potential causes of HIE arise, they are identified and the necessary action is taken and HIE is avoided. But just like the charity Peeps, we know this is not always the case, and are therefore proud to contribute to the work they do in supporting families across the UK affected by HIE.