10 Must-Know Early Signs Of Infant Cerebral Palsy

One of the main signs of infant cerebral palsy (CP) is when brain damage occurs during pregnancy or shortly after. But how do know for sure?

When a baby is welcomed into this world it can be an uncertain time, especially for those who have experienced a challenging high-risk pregnancy or delivery.

This was my situation…a high-risk pregnancy followed by the early birth of our twin girls (who were born 3 months premature). I’ll share my experience on how our sweet Lua was diagnosed with CP. More importantly, a very important tip with the diagnosis of cerebral palsy.

With that said, let’s explore everything you need to know:

• What is cerebral palsy?
• How does it happen in infants?
• What early signs do you need to look for?
• And MORE…

This original post is featured in my other blog, Intensive Therapy for Kids.

How Cerebral Palsy May Occur in Infants

Even though there is always a chance that something may go wrong during the birth process, most babies are delivered with few or no physical injuries.

On average, 29 out of every 1,000 babies in the United States suffer some kind of birth trauma (1). Most commonly, infant brain damage (also known as acquired brain injuries or ABI) happens either by trauma to the baby’s brain or lack of oxygen flow to the brain near the time of birth.

Acquired brain injuries may also happen in several other ways:

During Pregnancy.

Random fetal movements may occur increasing the risk of the umbilical cord being wrapped around a baby’s neck cutting off or limiting oxygen flow to the brain.

Premature Birth.

Having an early birth may put a baby at risk for developing brain bleeds or in severe cases, fluid on the brain.

This was the case for our little miracle Lua. She suffered a pulmonary hemorrhage within 48 hours after I gave birth via emergency c-section. Her brain bleed was diagnosed as a Grade 4 (the most severe) on the right side and a Grade 3 on the left.

Grade 4 brain bleeds, also called intraparenchymal hemorrhage, are when blood clots form and block the flow of cerebrospinal fluid. When this happens, it leads to increased fluid in the brain (known as hydrocephalus) (2). Lua started to develop hydrocephalus after her brain bleed. Because of this, she had surgery to put in a temporary shunt about 6 weeks after birth to drain the fluid from her brain.

Delivery.

During delivery, the poor use of instruments used or improper handling of a newborn by the medical staff may cause brain damage to an infant.

Nonetheless, at any age, the acquired brain injury may lead to a mild to severe disability that is temporary or permanent.

What is Cerebral Palsy?

As mentioned, if brain damage takes place before or right after birth, an infant may develop a motor disability called Cerebral Palsy (CP). That is what Cerebral Palsy is, brain damage, that affects a child’s motor functions such as sitting, crawling, rolling, walking, etc.

CP is one of the most common motor disabilities in children.

It is a neurological (brain) disorder that causes the loss of normal motor functions or motor delays.

Having CP is a lifelong condition that affects the communication between the brain and muscles which causes abnormal movements and weakness.

For instance, CP can hinder a child’s ability to move in a coordinated way when walking, talking, and eating.

The good news is the condition does not worsen but may drastically improve through various forms of pediatric therapies, surgery, or other non-invasive interventions like brain stimulation or botulinum toxin-A injections.

It’s important to keep in mind each child develops at their own pace.  Not all signs are visible at birth and may become more noticeable as your child grows and develops.

With that said, let’s dive into the meat and potatoes of this post…the most common concerns that pop up IF we think our child has CP…how can you tell if your baby has cerebral palsy?

10 Must-Know Early Signs Of Infant Cerebral Palsy

You may notice certain developmental milestones are not being met. This is often one of the first signs that lead to a diagnosis.

Here are ten early signs of infant cerebral palsy to look for. Keep in mind, the developmental milestones mentioned below are based on the average age a babe is expected to do the motor skill.

1. Can not hold up their head.

Unable to hold up their head while being picked up, lying down on their back, or stomach.

Around 2 to 4 months old, babies lift their heads unsupported.

2. Unable to roll over.

Unable to roll over independently front to back.

Around 4 to 6 months old, babies roll over unassisted from belly to back and back to belly.

3. Hand control issues.

Has difficulty with hand control such as bringing the hands together or to the mouth (3). You may also notice a baby reach out with one hand while the other hand remains in a closed fist.

Around 4 months old, babies clasp their hands together or bring their hands up to their mouths.

4. Feel floppy, heavy, or limp.

When held, they feel ‘floppy, heavy, or limp’ due to poor muscle tone in the limbs like the arms and legs.

5. Tense legs.

When held, the legs become tense or cross-like scissors. The leg movements may look or feel stiff or rigid.

6. Feeding issues.

You may notice things like:

• Difficulty closing their lips
• Chewing with an open mouth
• Poor tongue control or tongue thrusts
• Exaggerated bite reflex

Cerebral Palsy in newborns commonly shows signs of swallowing problems (also known as Dysphagia) or feeding difficulties.

7. Muscle spasms or tremors.

Due to tight and stiff muscles, you may see movements that are uncontrolled, spasms, or jerky movements. You may also notice tremors such as shaky hands.

8. Sitting issues.

Unable to sit up without assistance.

Around 9 months old, babies sit up independently.

9. Standing issues.

Unable to stand up, rock back and forth, or bounce on their legs.

Around 9 months old, babies stand up independently, bounce, or rock back and forth.

10. Walking issues.

Unable to walk without assistance or support.

Around 1 year to 18 months, babies walk unassisted.

Again, keep in mind each child develops at their own pace.  Not all signs are visible at birth and may become more noticeable as your child grows and develops.

When Can a Child be Tested for Cerebral Palsy?

The great news, children can be tested early on to see if they show signs of having a developmental disability in a couple of ways:

General Movements Assessment

Between birth and up to 3 months of age, a General Movements Assessment is done. This is an inexpensive medical test that is non-invasive. The purpose of the assessment is to show if the child has neurological issues which could lead to Cerebral Palsy.

A therapist, doctor, or medical personnel will complete the movement assessment by lying the child on their back while they are awake and videotaping for three to five minutes.

The medical individual is trained to score the video based on the child’s movements.

Early Development Appointment

For our Lua, she went to an early development appointment to meet with a physical therapist (PT) for her motor skills assessment. She was 3 months old “corrected”. During this appointment, no videotaping was done.

During the session, the PT noticed she had stiffness in both her legs and left arm. This was expected because her Grade 4 brain bleed happened on the right side of her brain. We were told this could impact the left side of her body and that cerebral palsy was a strong possibility.

The PT had a Neurologist come in to assess Lua further. During that assessment with Neuro is when Lua became diagnosed with CP. Now, this didn’t happen right away, I asked one question which led to the diagnosis. Let me explain how this happened next.

When Is Cerebral Palsy Diagnosed?

Cerebral Palsy is a complex disability due to the wide range of cases ranging from severe to mild. Because of this, diagnosis is a tricky process early on.

Doctors who commonly diagnose a child with cerebral palsy depend on the symptoms present:

• On average, most children with cerebral palsy are diagnosed within the first 18 months to 2 years of age because over time, symptoms become more apparent.
• During extreme cases, CP may be diagnosed in as little as a few months after birth. This is what happened to Lua because of her severe brain bleed.
• In mild cases, a child may not become diagnosed until their brain is fully developed at three to five years of age.

To summarize, diagnosis can take place anywhere from a few months after birth up until five years of age. This is one of the most discouraging parts early on for parents because if a child shows signs and symptoms of cerebral palsy, a diagnosis may take time. 

But let me share this important tip about my daughter’s experience…

I’ve been working in the cerebral palsy field since 2017. The children we help through our foundation are normally diagnosed around 18 months, sometimes sooner AND sometimes later. My nephew, Lenny, was diagnosed at 18 months with cerebral palsy.

The earlier a child is diagnosed with CP the better because early intervention may help a child thrive, like intensive therapy.

Tackling therapy right away can actually rewire a child’s brain to improve motor functions through neuroplasticity.

Neuroplasticity is the brain’s ability to adapt and change. It’s when the nervous system changes its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections after injuries, such as a stroke or traumatic brain injury (TBI) (4).

That’s why neuroplasticity is so important because it can help babies with cerebral palsy improve motor functions that are affected by damage to the brain. The brain is extremely adaptive and thanks to neuroplasticity, improvements are possible at any age.

To learn more about the benefits of intensive therapies, click here.

When the time came for Lua’s diagnosis, the Neuro started talking about the stiffness in her legs and left arm.

Cerebral Palsy was not mentioned right away but I knew this was an early sign of it. So I asked the Neuro, “Will a CP diagnosis happen when she’s 18 months old?”. From my experience, most doctors diagnose babies around this time just like my nephew Lenny.

Because I asked this one question, it opened the conversation about a cerebral palsy diagnosis. That day Lua was diagnosed with it. The diagnosis went into her chart which allowed her to qualify for more therapy immediately. Had Lua not been diagnosed until 18 months, we would have lost over a whole year of qualified therapies like occupational, physical, feeding, and vision.

As you can see, the opportunity to diagnose a child earlier the better!

Our experience does not constitute medical advice but is for informational purposes only. Always seek professional medical advice if you have any questions or concerns.

If You’re Concerned…

If you believe your infant is not meeting developmental milestones as we just mentioned, it’s best to follow up with your pediatrician or nurse to share your concerns.

You can ask your pediatrician for a referral to see a specialist who will be able to perform an in-depth assessment of your child to make a diagnosis.

You may also contact your state’s Public Early Childhood system to request a free evaluation to determine if your child qualifies for intervention services, sometimes referred to as a ‘Child Find’ evaluation (5).  If you do not want to wait on a doctor’s referral or diagnosis, this is a great way to move forward quickly.

How To Set Up A Free Evaluation

You may be wondering, “Who do I call to set up a free evaluation for my child in my state”?

This depends on your child’s age. To move forward in the right direction, the following two centers are great resources to contact:

Early Childhood Technical Assistance Center (ECTA).

The ECTA helps develop early intervention and preschool special education service systems.

It is a national technical assistance center that focuses on building state and local systems to improve outcomes for children with disabilities and their families.

Parent Center.

Call the Parent Center in your state.

Each state has one parent center funded to provide information to parents who have children with developmental disabilities or delays.

Ask your Parent Center about getting connected with an early intervention program near you.

Guided Resources

Cerebral Palsy: A Complete Guide for Caregiving

Are you or someone you know, taking care of a child with Cerebral Palsy? If you answered yes, this is a helpful guide to reference.

The book was established by world-renowned experts and the information is very informative because it walks you through the most current advances in the CP world when it comes to diagnosis, treatment, terminology, and advice on how to care for a child with cerebral palsy.

Treatment of Cerebral Palsy and Motor Delay

If you need a simple resource to provide a thorough overview of cerebral palsy and its treatment, this is a helpful reference to have on hand.

Spastic Diplegia Bilateral Cerebral Palsy

This evidence-based guide is for families who have a child with Spastic Diplegia Cerebral Palsy.

Symptoms of Cerebral Palsy Video

If you need a visual reference the video Symptoms of Cerebral Palsy follows medical professionals who share what to look for and the next steps to take if you feel your child is showing symptoms of CP. Video By: Gillette Children’s Specialty Healthcare

To Wrap It Up

My hope is this post will enlighten other parents who may be concerned about their baby showing early signs of cerebral palsy. For us, this experience of our daughter, Lua’s, diagnosis has made us more knowledgeable. Our ultimate goal is to give Lua the tools she needs to live the best quality of life.

Being aware of the signs makes it possible to take the necessary steps to diagnose cerebral palsy if it does exist. Additionally, early interventions can drastically improve CP altogether. Whatever the case may be, my hat is off to you for learning as much as possible. It’s all about taking targeted action in order to provide the best care for your little one!

We are beyond grateful for our little warrior. Just know, Dave and I are sending you big love and positive energy as you embark on your journey with your sweet pea!

With Gratitude,

Linds

Do you have anything to add or share about infant cerebral palsy? Let me know in the comments below. Your input means a lot and helps other fellow parents who read this post!

References

1. Kimberly Langdon, M.D. Meagan Cline (2021).  Birth Injury Guide: A Comprehensive Resource from Experts Who Care.  Birth Trauma.
2. Certified Health Content Provider. Medline Plus National Library of Medicine. Intraventricular hemorrhage of the newborn.
3. Pierrette Mimi Poinsett, M.D. (2020).  Cerebral Palsy Guidance.  Cerebral Palsy and Developmental Delays.
4. Matt Puderbaugh; Prabhu D. Emmady (2022). National Library of Medicine. Neuroplasticity.
5. Andrew M.I. Lee, JD.  Understood.  What is Child Find?

Thank You

You made my day being here today; thank you!

Was this post helpful? If so, please give it a share (that would make my day EVEN more). 🙂

About The Author

Linds is the proud mom of two little miracles, Mono Mono twin girls, and one AMAZING older brother! She is the founder and content creator of Mono Mono Twins, Intensive Therapy for Kids, and Co-Founder of The LENN Foundation, a 510c3 that helps children with cerebral palsy receive grants for intensive therapies to thrive. ♥

Disclaimer: This post may contain affiliate links for your convenience. I only recommend deals or items I love because you might like them too! With my affiliate relationships, I may earn a small commission at no additional cost to you. Thanks so much for supporting Mono Mono Twins!

The contents of the Mono Mono Twins Site, such as text, graphics, images, and other material contained on the Mono Mono Twins Site (“Content”), are for informational purposes only. The Content is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition.

Disclaimer: This post may contain affiliate links for your convenience. I only recommend deals or items I love because you might like them too! With my affiliate relationships, I may earn a small commission at no additional cost to you. Thanks so much for supporting Mono Mono Twins!

The contents of the Mono Mono Twins Site, such as text, graphics, images, and other material contained on the Mono Mono Twins Site (“Content”), are for informational purposes only. The Content is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition.