Cerebral palsy (CP) can indeed be missed at birth, and this is a recognized challenge in neonatal and pediatric medicine. CP is a group of permanent movement disorders caused by damage to the developing brain, often occurring before, during, or shortly after birth. However, the signs of CP are not always immediately apparent in newborns, making early diagnosis difficult.
At birth, infants with cerebral palsy may not show obvious symptoms. The brain injury that causes CP might not manifest as clear motor impairments right away. Instead, symptoms often develop gradually over the first months or even years of life. For example, delays in reaching motor milestones such as rolling over, sitting, crawling, or walking are common early indicators but may not be evident immediately after birth[1]. Muscle tone abnormalities—either unusually floppy (hypotonia) or stiff (hypertonia)—and asymmetrical use of limbs may also be subtle or absent initially[1].
Medical professionals rely on developmental assessments over time to detect CP. According to research, multimodal developmental assessments in high-risk infants are crucial because some children diagnosed with CP are only identified after months or years of follow-up[5]. This means that even with careful monitoring, some cases are not diagnosed until the child fails to meet expected developmental milestones.
Several factors contribute to CP being missed at birth:
– **Subtle or delayed symptoms:** Newborns may appear normal initially, with symptoms like abnormal posture or muscle tone becoming more obvious only as the child grows[1].
– **Lack of immediate neurological signs:** Brain injuries causing CP may not produce acute symptoms detectable by routine newborn exams.
– **Prematurity and low birth weight:** These increase CP risk but also complicate early diagnosis because premature infants often have other health issues that mask or mimic CP symptoms[1].
– **Medical oversight or negligence:** Failure to identify risk factors such as maternal infections, preeclampsia, or fetal distress can delay diagnosis and intervention[4]. Improper use of delivery tools like forceps or vacuum extractors can cause brain trauma leading to CP, but if not recognized, the injury may be missed at birth[4].
– **Limited early screening tools:** While neuroimaging (MRI) and neurological exams can help, they are not always definitive immediately after birth. Some brain injuries evolve or become more apparent over time.
The consequences of missing CP at birth are significant because early intervention is critical. Therapies started in infancy can improve motor function, speech, and overall quality of life[3]. Delayed diagnosis means lost opportunities for early treatment, which can affect long-term outcomes.
Medical negligence can play a role in missed or delayed CP diagnosis. For example, failure to monitor fetal distress, inadequate prenatal care, or ignoring signs of maternal complications can contribute to brain injury and missed diagnosis[1][4]. Families affected by such negligence may seek legal recourse to obtain compensation for medical care and support[3][4].
Statistics show that CP affects about 2.3 to 3.6 per 1,000 live births in the U.S., and it is often linked to factors like premature birth, low birth weight, and multiple births[1][6]. Despite advances in neonatal care, some cases remain undetected at birth due to the reasons outlined above.
In summary, cerebral palsy can be missed at birth because its signs often develop gradually, newborn neurological exams may not reveal subtle brain injuries, and medical factors including negligenc
