Head cooling is a relatively new and effective neonatal brain injury treatment. This technique may reduce infant mortality rates and prevent or reduce the symptoms of a variety of brain conditions, including cerebral palsy.

What Is Head Cooling?

Head cooling is a neonatal treatment introduced in the mid-2000s. It is suitable for newborns deprived of oxygen during birth, showing signs of brain damage or both. Medical professionals place special cooling caps on the heads of newborns at risk. These caps rapidly cool baby’s heads and brains by 35 to 41 degrees. They do a job similar to the cooling blanket NICU staff use for whole-body cooling, but they focus the treatment on the head. Newborns usually wear the cooling cap for a period of 72 hours. Their heads are then gradually warmed up until it returns to a normal temperature.

Since only babies with brain injuries receive head cooling, it is usually done in Level III or Level IV neonatal intensive care units. Some hospitals do not have the technology for head cooling. Babies in need can move to other hospitals, but this process takes valuable time that may impact effectiveness. Researching your intended hospital’s facilities before giving birth can ensure your baby gets the best of care fast.

How Does It Treat Cerebral Palsy?

Head cooling treats a neonatal brain injury, called hypoxic-ischemic encephalopathy (HIE), or suspected brain injuries. Usually, brain damage has different stages:

• The initial brain injury, which kills cells
• Secondary energy failure, several hours after the injury, which creates further damage
• Reperfusion injury, which can occur if blood returns too quickly to the part of the brain deprived of oxygen

With a cooling cap, NICU staff aim to slow down or interrupt the process after the initial brain injury. This may prevent further damage. It may also protect the cells and give them a chance to recover without further injuries.

If a reperfusion injury does occur, head cooling treatment may reduce its severity. Ordinarily, blood rushing back to the head causes an inflammatory response, which can compromise more brain cells. Cooling the brain reduces its inflammatory response. The brain also releases fewer free radicals, which further minimizes damage.

This early treatment option may reduce the disability that results from an early brain injury. Early brain injury can cause several problems including:

• Cerebral palsy
• Developmental delays
• Hearing loss

As many cerebral palsy cases stem from neonatal brain injuries, head cooling may mean the difference between a child experiencing minor or severe CP symptoms.

How Effective Is Head Cooling?

Research shows that head cooling is more effective the sooner treatment begins. Right after birth is preferable, although starting treatment within six hours of birth is standard practice.

Vanderbilt Children’s Hospital evaluated the use of CoolCap caps, one of the most popular devices for head cooling, in 2004. All babies tested were full-term. The babies in the test group received head cooling therapy within five hours of birth. A control group was also observed. Its researchers found the babies in the test group had:

• Roughly 10% reduction in brain damage overall
• Nearly 60% reduction in brain damage among babies diagnosed with moderate brain damage, including cerebral palsy at birth

Further results include:

• The mortality rate for babies with a moderate brain injury reduced from 39% to 25% after head cooling.
• Just 11% of head-cooled babies had cerebral palsy or another severe neuromotor disability, compared to 27.8% of the control group.
• Babies with moderate brain damage at birth showed far fewer signs of cerebral palsy after 18 months.

Note that there was little improvement among babies with severe brain damage, indicating head cooling becomes less effective the more damaged the brain is.

Does Head Cooling Have Any Risks?

Babies don’t typically have any side effects from head cooling. However, there is a small risk of hypothermia if babies are not carefully monitored. Sinus bradycardia, the medical term for a slowed heart rate, may also occur. This condition is not usually life-threatening.

Should the Doctors Tell Me My Baby Is Having Head Cooling?

Medical professionals should inform you of any treatments your baby receives, including head cooling. They should also tell you if your baby has a suspected brain injury. If you are not kept adequately informed about your baby’s progress, you may wonder whether the hospital is covering something up.

If you suspect hospital staff have acted negligently, get legal advice about whether you have a case. The Cerebral Palsy Family Lawyers at Janet, Janet and Suggs have extensive experience seeking settlements for families with loved ones who have cerebral palsy as a result of medical negligence or malpractice

Reviewed by:
Claire Surles, RN
Registered Nurse

Claire comes to JJS after a 10-year career as a labor and delivery nurse. She dedicated her hospital efforts to advocating for families, providing the safest birthing environment possible as Newborn Admission Nurse at UMMC St. Joseph Medical Center in Towson, Maryland. Her passion for helping those who experienced losses at any stage of gestation led to her appointment as Coordinator of the hospital’s ROOTS perinatal loss program. READ FULL BIO

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