Treatment & What to Expect

Cooling Therapy for HIE

A time-sensitive treatment process for eligible newborns with moderate-to-severe HIE

Cooling therapy is typically available only in a NICU with the right equipment and trained team.

Concern for
HIE at birth

The baby is evaluated at the birthing hospital.

Transfer
if needed

Some babies need transport to a NICU equipped to provide cooling therapy.

Transfer from community hospital to NICU

Start within
6 hours of birth

The treatment window starts at birth, so evaluation and transport are urgent.

Begin as soon as possible — within 6 hours

Cooling for
about 72 hours

The baby’s temperature is carefully lowered and closely monitored in the NICU.

Newborn receiving cooling therapy in NICU

Temperature
Control

Heart
Monitoring

NICU
Care

Gradual
rewarming

After treatment, the baby is slowly rewarmed while care continues.

Ongoing monitoring and supportive care continue.

Therapeutic hypothermia, or cooling therapy, is the standard treatment for eligible newborns with moderate-to-severe HIE. It is typically provided in a specialized NICU with the equipment and trained team needed to safely cool, monitor, and rewarm the baby.

Not every birthing hospital can provide cooling therapy, so babies with suspected HIE may need to be transferred to a NICU that can evaluate and begin treatment. Because cooling is most effective when started within six hours of birth, evaluation and transport are time-sensitive. This window begins at birth, not when the baby arrives at the receiving hospital.

Cooling can help slow ongoing brain injury and reduce the risk of death or long-term complications, but it does not prevent every possible effect of HIE. Babies receiving cooling therapy require continuous monitoring and supportive care throughout treatment. Side effects associated with cooling therapy can include edema (swelling), blood pressure support needs, clotting issues, respirator support needs, and other effects your medical team can watch for and explain. Speak with your healthcare team for more information.

Outcomes & Development

What Can Families Expect?

The effects of HIE vary widely. Outcomes may depend on:

The severity and duration of the injury
Which areas of the brain were affected
How quickly treatment began
The presence of seizures or other complications, including cerebral palsy, the most prevalent outcome for moderate and severe HIE babies
The child’s response to treatment and therapy

Some children develop without major long-term concerns. Others may experience challenges involving movement, learning, communication, feeding, vision, hearing, or seizures. No single test can predict a child’s future with complete certainty.

Although HIE can cause significant injury, the developing brain has a remarkable capacity to adapt. This ability is known as neuroplasticity. For more information on neuroplasticity, please click here

What’s The Difference Between HIE and Cerebral Palsy?

HIE and cerebral palsy are often confused, but they are not the same. HIE is a brain injury at birth, while cerebral palsy is a possible long-term condition that can result from that injury. Understanding this difference helps clarify diagnosis and long-term expectations.