"Preterm birth" baby, or "preemie" describes an infant born prior to 37 weeks of gestation, which occurs in approximately 12 percent of all live births in the U.S. An infant born too early is at risk for cerebral palsy, which is a non-progressive injury to the brain that can lead to lifelong difficulties in walking, talking and carrying out other daily activities. Early detection is a key to improved outcomes later in the child's life.
Increased Muscle Tone
A typically developing infant exhibits flexibility and can easily move his joints through a large range of motion. An infant with cerebral palsy may have tightness in his muscles, which gets even tighter with faster movement. You will see a child with cerebral palsy having difficulty bending his legs or arms, scissoring or crossing his arms or legs, and keeping one or both hands in a fist position past the age of six months.
Abnormal Primitive Reflexes
According to an article by Susan Smith and colleagues in a 1982 issue of "Physical Therapy Journal," all children with cerebral palsy retain one or more reflexes that they should grow out of after infancy. Testing reflexes remains a standard diagnostic tool. These include startling at loud noises past the age of three or four months, strong grasping of the hands past five to six months and at the feet past nine to 12 months, and straightening of the arm when the head is turned to the same side, which is abnormal past six to nine months.
Abnormal Deep Tendon Reflexes
In a routine well-baby checkup your physician will check your baby's deep tendon reflexes. She will tap the elbow, wrist, knee and ankle with a reflex hammer. In a healthy infant, the baby's body part will move as an automatic response to the tapping. A too-brisk, or hyperactive, response may signal a neurological problem such as cerebral palsy.
Delayed Milestones
Because an injury to the brain causes cerebral palsy, it makes normal movements difficult. Premature infants often take longer to reach developmental milestones, but severe delay is cause for concern. If an infant has reached seven or eight months and does not roll over, 10 to 11 months old and does not crawl using all four limbs, or 18 months and does not walk, cerebral palsy is one possible cause.
Miscellaneous Signs
Cerebral palsy presents differently depending upon the severity of brain injury. A more severe injury is likely to affect more parts of the body. Taken alone, difficulties with hearing, tracking objects or people visually, feeding, drooling, excessive irritability and speech delays may not lead to a diagnosis of cerebral palsy. However, if the baby also exhibits abnormal motor reflexes and developmental delays, she may receive a diagnosis of cerebral palsy.
References
- March of Dimes: Preterm Labor
- "Physical Therapy for Children"; Suzann Campell; 2000
- "Handbook of Physical Therapy, 2nd edition"; Toby Long and Kathy Toscano; 2002
- "PT Journal"; Selected Primitive Reflexes in Children with CP; Susan Smith; Aug. 1982
