Four out of every thousand babies born in the U.S. suffers brain damage.
Traditionally, there was nothing doctors could do to prevent the lifetime of disabilities that could follow. But now, they're using a simple blanket to save brains and change lives.
The Acevedos have a hard time imagining life without their baby's smile. But it almost happened.
Nine months pregnant, Kalipay's placenta ruptured. Doctors rushed her into an emergency C-section. By then, baby Siana had been deprived of oxygen for 13 minutes.
"As I'm waiting, I notice they bring the priest out to talk to me, and I know something is wrong," says Miguel Acevedo, Siana's father.
Doctors at the University of Florida told the family they were going to use a blanket to save Siana's brain.
"We feel this therapy offers hope for the hopeless," says Dr. Michael Weiss, neonatologist at the University of Florida.
Instead of keeping the baby warm, the blanket cools her from about 98 to 91 degrees. Cold water circulates through the blanket, triggering a kind of protective hypothermia that prevents brain damage.
"It decreases the amount of cerebral edema, or swelling, around the brain," says Dr. Weiss.
In an 18-month study, the cooling blanket reduced the death rate, risk of seizures and cerebral palsy, and improved mental scores, motor skills and vision.
Babies must be cooled within six hours of birth -- for a total of 72 hours.
"I really thought it was going to be some high-end, high-tech procedure," says Kalipay Acevedo, Siana's mother. "It amazes me that something like that could save or help you know a little baby's life."
A year and a half later, the little girl who wasn't expected to make it surpasses every milestone.
"She's so responsive. She smiles with everyone," says Miguel.
Their small sweetheart, proving to be the strongest member of the family.
This treatment can help any baby deprived of oxygen at birth, including those who have umbilical cords wrapped around their necks.
Right now, the blanket is only used at academic medical centers. Dr. Weiss wants to create a network to implement the treatment nationwide.
TOPIC: BLANKET SAVES BABIES' BRAINS
BACKGROUND: Babies can be deprived of oxygen at birth due to a variety of complications. "There could be a problem with the placenta where the placenta separates prematurely, causing these babies to have a lack of oxygen and glucose in-utero, which starts a cascade, which can produce brain injury. They can also have problems with the umbilical cord wrapping around the neck, and they can have problems with the umbilical cord coming out before the baby's actually born," Michael Weiss, M.D., of the University of Florida in Gainesville, told Ivanhoe. That lack of oxygen can lead to brain damage, blindness and a variety of developmental problems. Until now, there was no treatment designed specifically to save babies' brains.
THE BIG CHILL: Babies who have sustained moderate brain damage due to lack of oxygen or low blood supply are now eligible for a technique known as brain cooling. Babies who are less than six hours old and were born after at least 36 weeks of gestation may be helped by a cooling blanket. It's a simple blanket that has tubes of cold water flowing through it. Over a period of 72 hours, it lowers the baby's body temperature to about 33.5 degrees Celsius or 91 degrees Fahrenheit. The body's systems slow, reducing energy requirements and reducing swelling in the brain, potentially preventing further brain damage.
"Before the cooling blanket, we really didn't have any therapies that were brain-specific, so before, we would just provide supportive care for these babies. By cooling the babies, it actually decreases the amount of brain injury these babies have," Dr. Weiss told Ivanhoe. Studies have shown that the cooling blanket technique can reduce the disability and death rates in babies born with brain damage. It can also improve functional outcomes and motor skills and lower the risks of cerebral palsy and blindness.
"What it does is it decreases the amount of cerebral edema, or swelling, around the brain. It can also decrease cell death and decrease the release of excitatory factors, which can cause brain injury. It also decreases the inflammation that's typically seen after brain injury," said Dr. Weiss. "One of the biggest things that I think we offer the parents in this case is hope because a lot of these babies we don't see the initial benefits of the treatment. It's really as they progress, and we look for them meeting their developmental milestones," said Dr. Weiss.
Dr. Weiss says the therapy is only available at major medical centers. He is trying to get a state-wide therapy protocol up and running in Florida. He hopes this will become a nationwide program in the future.
FOR MORE INFORMATION, PLEASE CONTACT:
Michael D. Weiss, M.D.
University of Florida