Traumatic brain injury is the most common cause of death in young children, and the events that cause a skull fracture in an infant can also cause this kind of brain injury. The consequences are potentially serious and it is important to understand infant skull fracture causes so that they can be avoided as much as possible.
There are several ways in which an infant may receive damage to the head to the extent that it fractures, but the leading cause is the use of instruments during delivery. Other possible causes are pressures from inside the womb, more likely if the baby is large or labor is long and difficult, and trauma caused by mishandling or abusing an infant.
The Infant Skull
Babies are born with skulls that are still soft and not yet stitched together completely. This flexibility in the skull allows babies to fit through the birth canal with less risk of damage to the bone, but also allows for growth as a child ages. The infant skull is made up of several plates held together by sutures. The sutures are fibrous and flexible and allow the plates to move and the skull to expand with growth.
Although the skull of an infant helps it come through vaginal delivery with a lower risk of harm and injury, it is still vulnerable. It is more vulnerable to fracture and to resulting damage to the brain than the skull of an older child or an adult. Fractures that do occur and damage the newborn skull are more likely to cause brain damage and other harm.
Fractures to the skull may be one of several types. A linear fracture is a simple split in the bone, but it does not lead to movement between the plates of the skull. A depressed skull fracture occurs when injury causes an indentation in the skull. This can potentially cause serious injury to the brain. A diastatic fracture is a break along a suture, which has the potential to cause injury as a child’s brain grows and the skull and the fracture expand.
Damage from Instruments
The most common cause of infant skull fractures is pressure from instruments used during childbirth. Doctors and others may use forceps or vacuum extractors to aid in the delivery of a baby. Forceps may be used to grip the baby’s head and to pull it from the womb, which when used with too much force may actually crush or break the skull. A vacuum extractor may have the same impact, although it pulls on the baby by suction. Either kind of force, when used excessively can fracture the skull.
Natural Infant Skull Fracture Causes
Use of instruments is overwhelmingly the leading cause of fractures to infant skulls, which typically can be considered negligence or malpractice even if the doctor was trying to help. On the other hand, it is possible for the skull to fracture naturally, whether or not instruments are used.
Delivery and birth are fraught with risks in spite of modern advances in medicine. The physical pressure that an infant is under during labor and delivery can be intense. If the head of the baby is caught on the mother’s pelvis or gets stuck in the birth canal, that natural pressure may cause a skull fracture, although it is not common.
Having a long and complicated labor is a common risk factor for an infant skull fracture, if not a direct cause. If labor is complicated it is more likely that the doctor or other medical practitioner will use instruments. Use of instruments automatically increases the risk that a baby will suffer a fracture.
Even if the doctor is not using instruments, when there are complications, he or she may feel pressured to get the baby delivered as soon as possible. For instance, if the doctor believes the baby is asphyxiating, it needs to be pulled out quickly. This rushed and forced delivery may lead to a skull fracture.
Unusual Presentation and Birth Weight
Specific complications of labor and delivery can also cause a skull fracture or lead to the conditions in which a doctor may use instruments that can cause fractures. For instance, if the baby is breech, with its bottom emerging from the birth canal first, or if the baby is unusually large, labor is more complicated and difficult. Both the breech position and a large head can put more pressure on a baby’s skull and increase the risk of a fracture.
Spontaneous Skull Fractures
Although rare, a skull fracture may occur during what seems to be a normal delivery in which the use of instruments is not required. One case study described a woman who had a normal, uncomplicated delivery. She delivered a baby that after two hours appeared to be listless.
Examination found that the baby had a hematoma, or a pooling of blood in part of the brain caused by a small linear fracture in the skull. The baby died a few days later from complications. The cause of the fracture could not be determined.
Skull Fractures after Delivery
Newborn babies are very delicate and vulnerable to injury. If they are mishandled, or even abused, injuries are likely to result, including skull fractures. A nurse or other hospital worker may accidentally drop a baby, which can cause serious skull damage. Abuse, such as shaking or striking a crying baby, can also cause a skull fracture. These cases are not as common as skull fractures caused by birth complications, but they do happen.
If you have a baby that was born with a skull fracture, or that received a skull fracture in the hospital after birth, you have legal options to seek justice and compensation for your child. Infant skull fracture causes are varied, but too often are caused by inappropriate use of instruments during delivery. If your doctor or other caregiver fractured your infant’s skull in such a way that could have been prevented, you may have a strong case to sue and recover monetary damages.
The consequences for your baby of suffering a skull fracture may range from mild to severe. Your baby may have permanent brain damage and other complications that will affect her for the rest of her life. She will need extra care and treatment and possibly even surgery to correct damage.
Not many families can afford the extensive care needed for a disabled child, but if you can make a case that your caregivers were negligent, you may be able to win enough money to provide the best care. Let an experienced lawyer in medical malpractice and birth injuries help you make a case and fight the hospital that harmed your baby.