Wendy asks a number of questions about a baby just diagnosed with CP.
If it were my baby I would want to know what implications the diagnosis has
for immediate basic care, especially feeding.
CP is a lot of different things, and the cause is in most cases not known.
It is defined as a neuromuscular dysfunction of central origin, that is,
having its origin in the brain, and not the peripheral nerves or muscles.
There are many forms.  Some people have minor involvement of a limb, others
have all limbs involved as well as muscles involved in speech and eating.
Some forms become apparent only after developmental milestones are not
reached.
If the baby has facial involvement, breastfeeding will be different from if
the CP only affects the legs, for example.  The facility who diagnosed the
baby should have a multiprofessional team to work with the family in sorting
out the details of everyday living (referring to the best of all possible
worlds now!).  In any case, the baby will benefit even more than other
babies from getting mother's milk, as it gives the central nervous system
the optimal building blocks for development, and if baby is able to
breastfeed, this is good physical training as well.  It also gives mother a
better chance to really fall in love with the baby and deal with her own
likely sadness at learning there is something wrong.  It could be a
wonderful way for them to heal together.  They will surely need
knowledgeable support.

To my knowledge CP does not cause hypoglycemia.  Whether prolonged
hypoglycemia of such severity as to cause seizures, could cause CP, is
something I don't know.  My hunch is that the seizures or the irritability
observed in the baby initially, were actually expressions of the
neuromuscular problem, and if the baby was feeding poorly so blood sugar
simultaneously was low, the cause could have been misdiagnosed.  Low blood
sugar is much more common than CP, after all.

Wendy asks about whether they should contact a lawyer.  There is a long
statute of limitations for bringing lawsuits after injury in health care
settings, and I doubt whether conversations with a lawyer at this point
would meet the immediate needs of this family.  My bias would be to let them
settle in with baby, concentrate on the task at hand, and not get
sidetracked into a possibly fruitless pursuit of someone to blame.  The
current educated opinion (backed up by excellent epidemiologic research) is
that about 90% of cases of CP have nothing to do with birth.  Much more of
it may be heredity than we have realized.  The reality of the baby's
condition will not be changed by talking to a lawyer now.  There is time for
that later, if it seems appropriate.  They may, however, want to secure
copies of all the medical records at this point, for later use.

That baby's birth weight is not considered pathologically high where I live,
nor in many parts of Europe.  It would not lead to any investigation of the
mother's metabolic status, unless the baby seems to have typical stigmata
for babies of diabetic mothers.

Good luck, Wendy.
Rachel Myr
midwife, IBCLC
Norway

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