Signs of cerebral palsy in a newborn may include abnormal movements and stiff or floppy muscles. Doctors usually diagnose the condition when a child is older.

Symptoms of cerebral palsy can first appear a few months after childbirth, although doctors may not diagnose the condition until an infant is older.

This article looks at the symptoms, risk factors, and diagnosis of cerebral palsy in babies.

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According to the National Institutes of Health (NIH), signs of cerebral palsy can occur in the first few months after childbirth. However, these signs are often subtle.

Signs of cerebral palsy in newborns may include abnormal posture and muscle tone.

An infant may be slow to reach certain milestones, such as rolling over, sitting, crawling, or walking, which typically happen after 4–6 months. A baby may also use one side of their body more than the other when moving, crawling, or reaching for things. Body parts may appear more floppy or stiff than in a typical baby.

Some of these signs may appear in children without cerebral palsy. People will need to talk with a healthcare professional if they notice any symptoms of cerebral palsy in a newborn.

Many children do not receive a diagnosis of cerebral palsy until they are 2 years old or later.

In babies younger than 6 months, symptoms of cerebral palsy may include:

  • being unable to hold their head up if picked up from lying on their back
  • stiff or floppy limbs
  • their legs cross or feel stiff when picked up
  • extending their back and neck away from a person when held, as if pushing away

In babies older than 6 months, symptoms may include:

  • being unable to roll over
  • being unable to bring their hands to their mouth
  • difficulty bringing their hands together
  • reaching out with one hand and keeping the other hand in a fist

In babies older than 10 months, symptoms may include:

  • crawling in a lopsided way, such as using one hand and leg to push while dragging the opposite hand and leg
  • scooting around on their buttocks or hopping on their knees rather than crawling on all fours
  • being unable to stand, even when holding on to something for support

Learn more about cerebral palsy here.

According to the Centers for Disease Control and Prevention (CDC), abnormal development or brain damage before or during birth can cause cerebral palsy. Doctors call this congenital cerebral palsy.

Congenital cerebral palsy accounts for 85–90% of people with cerebral palsy. In many, there is no known specific cause.

Risk factors for congenital cerebral palsy include the following:

  • Low birth weight: There is an association between a birth weight of less than 5.5 pounds (lbs), particularly a birth weight of less than 3 lbs and 5 ounces, and an increased risk of cerebral palsy.
  • Premature birth: Childbirth before week 37 of pregnancy, particularly before week 32 of pregnancy, increases the chance of cerebral palsy.
  • Multiple births: Having twins, triplets, or other multiple births, increases the chance of cerebral palsy, particularly if one baby dies before or shortly after birth. The increased risk may link to preterm delivery or low birth weight.
  • Assisted reproductive technology (ART): ART infertility treatments may increase the chance of cerebral palsy. This may be because ART increases the likelihood of preterm delivery or multiple births.
  • Infections during pregnancy: Infections, such as chickenpox, rubella, and pelvic infections, may increase proteins in the body called cytokines. Cytokines can circulate in the bloodstream and brain of the baby during pregnancy and cause inflammation. This inflammation may cause brain damage in the baby.
  • Jaundice and kernicterus: Many newborns have jaundice, which is a yellowing of the skin and eyes due to a buildup of bilirubin in the blood. Without treatment, severe jaundice may lead to kernicterus, which can lead to cerebral palsy.
  • Maternal conditions: Maternal health conditions, including thyroid problems, an intellectual disability, or seizures, may increase the chance of a child developing cerebral palsy.
  • Birth complications: Problems occurring during birth, including uterine rupture, detachment of the placenta, or umbilical cord problems, may affect the oxygen supply to the baby and increase the chance of cerebral palsy.

The Apgar test measures key signs of vitality in a newborn at 1, 5, and 10 minutes after birth.

The Apgar test provides a score between 0–10 and measures:

  • heart rate
  • respiratory effort
  • skin color
  • muscle tone
  • reflex irritability, which is how a newborn responds to stimulation, such as a gentle pinch

Healthcare professionals consider a score of 7–10 normal, while a lower score can indicate reduced vitality.

Research has found that low Apgar scores link to an increased chance of cerebral palsy, particularly with a low Apgar score at 5 minutes rather than at 1 minute.

A 10-minute Apgar score of 0–3 is a higher risk factor for cerebral palsy than a similar 5-minute score.

Changes in Apgar scores between 1 and 5 minutes are also a risk factor for cerebral palsy. An Apgar score of 0–3 at 1 minute, and a score of 7–10 at 5 minutes, links to a higher risk of cerebral palsy, compared with having a score of 7–10 at 1 and 5 minutes.

A decrease in the Apgar score between 5 and 10 minutes also increases the risk of cerebral palsy.

Learn more about Apgar scores here.

A doctor will perform a developmental screening test if a baby has any risk factors or early signs of cerebral palsy.

Developmental screening tests check for developmental delays. They may involve tests on the child and parental questionnaires or interviews.

Healthcare professionals can usually identify many movement delays in a baby by 9 months, and most of them by 30 months.

If a doctor identifies any issues, they will examine the child further to assess reflexes, muscle tone, and motor skills.

Brain imaging tests can also help diagnose cerebral palsy, such as a CT or MRI scan. Other tests may include:

Early signs of cerebral palsy in an infant include developmental delays, particularly in movements, such as rolling over, sitting, and crawling.

Abnormal development or brain damage before or during birth may cause congenital cerebral palsy. Low birth weight, multiple births, and certain maternal health conditions are also risk factors.

Doctors will assess developmental issues and order imaging scans and other tests to diagnose cerebral palsy.