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Cerebral palsy: What parents need to know

There is no cure for cerebral palsy, but thanks to advances in modern medicine, doctors and therapists at Life Healthcare are now able to improve the quality of life for young patients.

Caring for a baby with cerebral palsy (CP) can be challenging, with everyday activities, such as feeding and dressing, causing pain and discomfort.

‘Cerebral palsy is a non-progressive insult (injury) on the motor part of the developing brain,’ explains Dr Amith Keshave, a paediatric neurologist based at Life Entabeni Hospital in Durban. It is the single-largest cause of disability in children worldwide and, according to international statistics, it occurs in about one in every 400 births.

What is CP?

‘[Cerebral palsy] affects motor function in different ways, depending on the severity of the damage and which parts of the body are affected. In a baby with a severe insult to the brain, we can diagnose CP soon after birth,’ says Dr Keshave. He explains that the newborn:

  • Has difficulty feeding
  • Shows excessive irritability
  • Has seizures
  • Lacks spontaneous movement

‘If the insult was mild to moderate, then the symptoms may present later with developmental delays in the form of not attaining key milestones. In the first year of life, these are motor milestones, such as not rolling, or the inability to sit without support,’ explains Dr Keshave.

Other signs of CP include:

  • Stiff muscles
  • Decreased muscle coordination
  • Tremors
  • Difficulty with fine movements, such as picking up small objects

What causes CP?

There is no single cause of CP; it’s the result of a combination of events that occur either before, during or after birth that damage the baby’s developing brain. Some of the risk factors associated with CP include:

  • Premature birth
  • Low birth weight
  • Blood-clotting problems
  • Bacterial infection
  • Prolonged oxygen loss

Dr Keshave says international statistics indicate that in developing countries such as SA, the leading cause for CP is birth asphyxia (lack of oxygen during birth), kernicterus (preventable brain damage due to jaundice) and neonatal infections.

Treating a child with CP may include oral medication, surgery, physical therapy, splints on the upper limbs and braces on the lower limbs.

Caring for a baby with CP

Jade Simmonds, an occupational therapist at the Life Rehabilitation Unit at Life Entabeni Hospital, says, ‘Parents caring for a baby with CP face numerous difficulties, and we draw up a personalised management programme for each child, because no child is the same; they are each unique and come with their own unique potential and limitations.’

The management programme requires a team
‘We work as an interdisciplinary team to provide a holistic treatment for each individual. We involve occupational therapists, physiotherapists, speech therapists, dietitians, psychologists, social workers, doctors, nurses and, importantly, the family. 

‘My focus as an OT is on what we call “activities of daily living”. This includes feeding, grooming, dressing, bathing, toileting and transfers (for example, going from sitting to standing),’ says Jade.

Involve children in everyday activities
‘We also focus on improving upper-limb function or fine motor coordination, and encourage parents and caregivers to involve children with CP in everyday activities, rather than doing everything for the child. So often these tasks are done “to” the child instead of “with” them.

‘For example, instead of feeding the child, put the spoon in their hand and guide their movement. Many parents say that it is quicker for them to feed the child than wait for them to navigate the spoon to their mouth, but encouraging small daily actions like this is beneficial.’

Although CP is incurable, it’s possible for children to become more independent and mobile with the help of a caring team.

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