§ GUIDE · NEWBORN BRAIN INJURY

The first hours matter,
and so do the minutes.

Not every birth injury happens during delivery. Some of the largest claims arise from the days after birth, when a newborn's blood sugar or feeding is not monitored properly. Others turn on a delay of minutes in the delivery room. These judgments show both.

MGS settlement

£9.3M + PPO

Delay in CNZ

6.5 minutes

Judgments here

Claim until child turns

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§ AFTER THE BIRTH

Low blood sugar in a newborn can cause permanent damage.

Babies at risk, including those with low birth weight, need their blood sugar monitored and their feeding managed carefully in the first hours and days. If hypoglycaemia goes unrecognised and untreated, it can cause permanent brain injury.

MGS v University Hospitals Bristol and Weston NHS Foundation Trust [2023] EWHC 1547 (KB) concerned a low-birth-weight baby born in October 2009 who was not fed adequately overnight and whose blood sugar was not checked early enough. The resulting brain injury caused learning difficulties, behavioural problems and uncontrolled epilepsy. The trust admitted liability in 2018 and the court approved a settlement of a £9.3 million gross lump sum plus periodical payments starting at £190,000 a year and rising to £238,000. Because the trust accepted the claimant's Part 36 offer late, it also owed additional interest.

§ DURING LABOUR

Monitoring the baby's heartbeat, and acting on what it shows.

Continuous monitoring (CTG)

In CCC v Sheffield Teaching Hospitals [2023] EWHC 1770 (KB) a pathological CTG trace went unread for 50 minutes before an emergency caesarean. The child was born with severe quadriplegic cerebral palsy, and the trust admitted liability in 2019.

Intermittent listening

In a low-risk labour the baby's heartbeat may be listened to at intervals rather than continuously. In Astley v Lancashire Teaching Hospitals [2023] EWHC 1921 (KB) the midwife failed to detect a fetal bradycardia through proper intermittent auscultation, and the baby was born severely asphyxiated with the cord around the neck three times. Breach and causation were both proved.

§ MINUTES DECIDE CASES

A delay of six and a half minutes was enough.

CNZ v Royal Bath Hospitals NHS Foundation Trust [2023] EWHC 19 (KB) concerned the birth of a second twin in 1996. The mother asked for a caesarean during labour and was refused. Ritchie J found the trust negligent in delaying the birth by six and a half minutes, and held that without that delay the claimant would have avoided all brain injury. She recovers her damages in full, to be assessed.

The case makes two points. Very short delays can be both negligent and causative in acute oxygen deprivation. And a mother's reasonable request for a caesarean during labour should be properly considered and explained rather than simply refused.

§ SETTLEMENTS AND STRUCTURE

Lump sum now, care funded for life.

Where a newborn brain injury claim succeeds, the settlement is usually a lump sum plus periodical payments for care. AXA v Airedale NHS Foundation Trust [2024] EWHC 2499 (KB), a bradycardia during induced labour causing dystonic cerebral palsy, was approved at a £5,750,000 lump sum plus stepped periodical payments of £147,500, £305,000 and £350,000 a year, with a total capitalised value of £16,707,835.

Because the injured person is a child or lacks capacity, a judge must approve the deal. Those hearings are public, which is why cases like these are visible at all.

§ THE JUDGMENTS BEHIND THIS GUIDE

Four judgments from the first hours of life.

Two approved settlements and two liability judgments, covering blood sugar monitoring, CTG interpretation, intermittent listening and a six-minute delay.

Settlement approved£9.3M

MGS v University Hospitals Bristol and Weston NHS Foundation Trust

[2023] EWHC 1547 (KB)·2023·Settlement approved by the court

A low-birth-weight baby was not fed adequately overnight and his blood sugar was not checked early enough, causing hypoglycaemic brain damage; the Trust admitted liability in 2018. The court approved a £9.3m lump sum plus periodical payments and held the Trust also owed interest for accepting the offer late.

Negligence in the first days of a newborn's life, not just during labour, can produce some of the largest clinical negligence awards. If a defendant accepts a Part 36 offer late, interest for the delay can be claimed on top.

Claimant succeeded

Jayden Astley (a minor, by his father and litigation friend Craig Astley) v Lancashire Teaching Hospitals NHS Foundation Trust

[2023] EWHC 1921 (KB)·2023·Liability decided at trial

The baby was born severely asphyxiated at Royal Preston Hospital after the midwife failed to detect a fetal bradycardia through proper intermittent listening to the heartbeat. Martin Spencer J found breach of duty and causation proved, so the child will recover damages to be assessed later.

Even in a low-risk labour monitored by intermittent auscultation, midwives must listen at the right times and act on a slow heartbeat. Winning on liability is only the first stage; the value of the claim is then assessed separately.

Claimant succeeded

CNZ (suing by her father and litigation friend MNZ) v Royal Bath Hospitals NHS Foundation Trust & Secretary of State for Health and Social Care

[2023] EWHC 19 (KB)·2023·Liability decided at trial

The mother of twins asked for a caesarean during labour and was refused; the second twin was delivered 6.5 minutes later than she should have been and suffered damaging oxygen deprivation. Ritchie J found the Trust negligent for the delay and held that without it the whole of her brain injury would have been avoided.

A delay of only a few minutes in delivery can be negligent and can be enough to cause the entire injury. A mother's reasonable request for a caesarean during labour should be properly considered and explained, not simply refused.

Settlement approved£5.75M

AXA (a child, by her father and litigation friend MXA) v Airedale NHS Foundation Trust

[2024] EWHC 2499 (KB)·2024·Settlement approved by the court

A child born in April 2019 after an induced labour suffered fetal bradycardia and a brain injury; the Trust admitted the clinical failures by letter in April 2021. The court approved a settlement of a £5.75m lump sum plus lifelong index-linked periodical payments, worth about £16.7m in total.

Serious cerebral palsy claims are usually settled as a lump sum plus annual periodical payments for care, so the headline total depends on how long the child lives. Before approving a deal for a child the judge checks it sits within the range a court would have awarded.

Browse the whole case library →

Contains information licensed under the Open Justice - Licence v2.0. Judgments from Find Case Law, The National Archives. Summaries are ours; amounts only where printed in the judgment.

§ QUESTIONS

Common questions

Can negligence after the birth cause brain injury?

Yes. MGS v University Hospitals Bristol and Weston concerned a newborn whose feeding and blood sugar were not managed properly overnight, causing permanent brain injury. The settlement approved was £9.3 million plus payments for life.

What is a CTG and why does it matter?

Cardiotocography continuously records the baby's heartbeat and the mother's contractions during labour. A pathological trace calls for action. In CCC v Sheffield a pathological trace went unread for 50 minutes.

Can a delay of a few minutes really be negligent?

Yes, in acute oxygen deprivation. In CNZ v Royal Bath Hospitals a delay of six and a half minutes was found negligent, and the judge held that without it the child would have avoided all brain injury.

I asked for a caesarean and was refused. Does that matter?

It can. In CNZ the mother's request was refused and the delay that followed was found negligent. A reasonable request should be properly considered and explained, and since Montgomery patients must be told about material risks and reasonable alternatives.

How long do we have to bring a claim for our child?

The three years do not start until the child turns 18, so a claim can usually be brought until their 21st birthday. If the child will never have capacity to manage their own affairs, no time limit runs.

Will we have to go to court?

Most claims settle, but where the injured person is a child or lacks capacity a judge must approve the settlement at a short hearing. See our guide to court approval.

§ MORE GUIDES

Plain answers to the other questions people ask.

How big awards are built →

How a multi-million medical negligence award is assembled: general damages, care, accommodation, prosthetics, lost earnings and lost years. Real judgments.

Periodical payments →

How periodical payment orders work: a lump sum plus index-linked yearly payments for life, stepped payments, and why headline totals differ. Real settlements.

Settlement approval →

Why a settlement for a child or protected party must be approved by a judge, what the judge checks, and what public approval judgments reveal about real sums.

Payout examples →

UK medical negligence payout examples by claim type, typical compensation ranges, and what decides the amount. Then check your own claim free.

Fatal negligence payouts →

What compensation after a death caused by medical negligence can include: the bereavement award, dependency, funeral costs and the estate's claim.

NHS payout data →

Official NHS Resolution figures, band by band, for 2024/25.

This guide is general information about the law in England and Wales, not legal advice about your case. ClaimGavel is run by Costart Projects Ltd on behalf of Tomlin & Partners, a specialist medical negligence firm regulated by the SRA. The free assessment on this page is an AI overview to show you roughly where you stand; a solicitor confirms the position in a free, no-obligation conversation.

The first hours matter,and so do the minutes.