Hypoxic Ischemic Encephalopathy (HIE) is the clinical state that results from a lack of oxygen and blood in the brain immediately before or during birth. Depending on the intensity of this deficiency, it can also cause damage to other internal organs such as the heart, kidneys, liver and intestines.

HIE is manifested by a number of observable alterations in the newborn, such as: reduced ability to wake up and stay awake, alteration of muscle tone and posture, low level of response to stimuli and often the onset of convulsions. Based on these signs it is graduated as mild, moderate or severe. Biel had seizures at birth and in the following hours, so his HIE was classified as severe.

The causes of an HIE are all situations that cause the interruption of blood and oxygen to the fetus. This can occur due to a variety of causes: an abnormal blood flow between the mother and fetus, a placental detachment, a major compression of the umbilical cord, or even a rupture of the uterus. But often, the cause of this deficit is not known for certain. The incidence of EHI is around 6 for each 1000 full-term newborns. Asphixia is the 5th leading cause of neonatal mortality.

When brain damage is severe, the baby may develop movement, communication and learning disorders, eating difficulties or epilepsy during childhood. Problems with movement and posture are often called cerebral palsy. This word indicates motor disorder, that can be very mild or affect the person´s movement abilities.