Newborns’ Brachial Plexus Injury: Parent Guide

Just picture this – you’re over the moon, greeting your new little one, but then you see their arm just hanging there. This could be a sign of a nerve injury that’s messing with the movement of their shoulder, arm, and hand. It’s something that can happen during birth, especially with bigger babies or tough deliveries. Even though it’s not that common (happens in 1-3 out of 1,000 births), remember, if you’re dealing with this, you’re not alone. Don’t hesitate to reach out to your doc for advice and ways to help your kiddo grow strong and healthy.

There are four main types of injuries in newborns:

Type of InjuryDescription
NeuropraxiaMildest form; temporary conduction block due to myelin sheath damage
AxonotmesisMore severe; nerve fibers disrupted but myelin sheath intact
NeurotmesisMost severe; complete nerve disruption requiring regeneration
Erb’s Palsy (C5-C6)Upper plexus injury; affects shoulder and elbow flexion
Klumpke’s Palsy (C8-T1)Lower plexus injury; affects wrist and hand function
Total Plexus Palsy (C5-T1)All nerves affected; complete paralysis of the arm

Neurapraxia is the most common type of nerve injury where the nerves get stretched but not torn. The silver lining is, most kiddos dealing with this bounce back completely in just a few weeks or months.

On the flip side, Neurotmesis is a more serious type of nerve injury that involves the nerves getting torn. Recovery from this might be partial or, in some unfortunate cases, might not happen at all.

Ramping it up, Avulsion is the most severe type of nerve injury where the nerves get ripped right off the spinal cord. Sadly, these injuries are usually permanent.

Then there’s Klumpke’s Palsy, a nerve injury that affects the lower nerves and is often seen with breech deliveries. Babies dealing with Klumpke’s Palsy might show weakness or even paralysis in the hand and forearm.

Type of InjuryPrognosis
NeuropraxiaMost recover fully within 3 months
AxonotmesisOften recovers within months, but may not be complete
NeurotmesisRecovery possible, but often requires surgery and extensive therapy
Erb’s Palsy (C5-C6)Good prognosis, often recovers within 6 months
Klumpke’s Palsy (C8-T1)More challenging prognosis, may require long-term therapy
Total Plexus Palsy (C5-T1)Variable prognosis, depends on severity and treatment

The main reasons behind nerve injuries in newborns usually come from too much tugging or yanking on the neck during birth. This situation often happens when the baby is a bit on the chunky side, the mom has a narrow pelvis, or if the delivery takes a long time or gets rough.

Additional potential causes:

Shoulder dystocia: 

This here’s what happens when the little one’s shoulder gets wedged behind the momma’s pelvic bone during birth.

Forceps Delivery: Now and again, forceps are brought into play to lend a hand with the birth. But if they ain’t used proper, they can do some harm to the baby’s nerves.

Vacuum Extraction: This here’s another method used to assist with delivery. But if the vacuum cup ain’t positioned right on the baby’s noggin, it can do a number on the baby’s nerves.

If your baby winds up with NBPP, remember, you ain’t on your own in this. There’s a heap of help out there for you and your baby. Your doc can connect you with experts who can help your baby get better and reach their full potential.

In the interim, there are several proactive measures you can take to aid your baby dealing with NBPP:

  • Nurture patience and heap on the love; healing for most NBPP young’uns is a slow and steady journey.
  • School yourself on the right ways to position ’em to fend off stiffness and contractures in the affected arm.
  • Get involved in gentle exercises with your baby, keeping your sights on preserving range of motion and building up strength.
  • Encourage interaction by chit-chatting with and involving your baby, specifically using their affected arm to boost overall growth and coordination.
  • Link up with other folks dealing with the same hurdles by joining a support group dedicated to NBPP.

Always remember, your little one’s got grit and toughness. With your steady love and backing, they got the chops to flourish, even with NBPP.

Brachial Plexus Injury in Newborns
Brachial plexus injury in newborns is a damage to the nerves that control the movement and sensation in the shoulder, arm, forearm, and hand

When a baby gets hurt, you might spot the signs right after birth or see ’em come up slowly. How bad these signs are and which nerves got hit play a part in how things pan out.

Look out for these common signs:

  • Weakness or paralysis in the affected arm or hand
  • Less movement or feeling in the impacted arm or hand
  • The affected arm or hand taking on an odd position
  • Trouble moving the fingers or thumb
  • No Moro reflex on the side of the injury (the Moro reflex is when the baby spreads and then brings back its arms)

Docs usually spot this injury in a newborn by giving ’em a good once-over and checking out the baby’s medical past. Sometimes, they might also call for tests like X-rays, ultrasounds, or MRIs to make sure of the diagnosis.

SymptomDescription
Weakness or paralysis in the arm or handThis can affect all or specific muscles in the arm, depending on the severity and location of the injury. Common presentations include:
* Erb’s palsy: Arm hangs limp, inability to raise arm above shoulder, weak grip. 
* Klumpke’s palsy: Claw hand, weak wrist and finger flexion. 
* Total brachial plexus palsy: Complete lack of movement and sensation in the entire arm and hand. 
Decreased movement or sensation in the upper extremityThis can range from mild tingling to complete numbness, depending on the nerves affected.
Abnormal arm positionThe affected arm may be held in a fixed position, such as bent at the elbow and close to the body, or it may hang limply.
Absent Moro reflex on the affected sideThe Moro reflex is a startled reaction where the baby flings their arms and legs out wide. If this reflex is missing on one side, it could point to an injury in the arm.
Decreased grip on the affected sideThe baby may have a weak grip or be unable to grasp objects at all.
Pain (less common in newborns)While not as common in newborns, some may experience pain in the affected arm or shoulder.

Long-Term Hurdles for a Kid with Arm Nerve Damage

ChallengeDescription
Upper Limb WeaknessDifficulty using the affected arm and hand due to muscle weakness.
Pain and SpasticityChronic pain and muscle stiffness in the affected arm and hand.
Sensory LossReduced or absent sensation in the affected arm and hand.
Joint DeformitiesContractures or dislocations of the joints in the affected arm and hand.
Psychological ImpactThe emotional ups and downs and social hurdles that come with living with a nerve injury in the arm.
Brachial Plexus

When a newborn’s got an injury, what we do about it really depends on how bad the injury is and which nerves got hit. Most of the time, we’re gonna need to get physical therapy and occupational therapy involved. Physical therapy is all about getting movement back in the arm and hand that got affected. Occupational therapy, on the other hand, is gonna work on making sure the little one can use that limb in their day-to-day life.

For less severe cases, non-surgical approaches take precedence, encompassing:

  1. Physical Therapy: A physical therapist guides parents in gently moving the baby’s affected arm and hand, preventing stiffness and contractures.

  2. Occupational Therapy: Occupational therapists assist in incorporating the affected limb into everyday tasks such as eating and dressing.

  3. Splinting or Casting: The use of splints or casts helps maintain the affected arm in a healing-friendly position.

  4. Medication: Prescription of pain medication to manage any discomfort the baby may experience.

In the tougher cases, we might need to consider surgery, usually done when the kiddo is between 3 and 6 months old. The surgery’s all about fixing any nerves that got hurt or moving muscles from one spot to another. We’re shooting for the best recovery we can get and to make sure that little one is up and running as best as they can.

TreatmentAdvantages
Non-operative Management

– Minimally invasive

– Allows for spontaneous nerve recovery

– Lower risk of complications

Nerve Grafting

– Improves functional outcomes for severe injuries

– Can restore sensation and function

Neurolysis

– Releases pressure on compressed nerves

– Can improve nerve function quickly

Muscle Transfers

– Provides alternative function for paralyzed muscles

– Improves quality of life

After Surgery Care: After the operation, your little one will need some physical therapy to help get the movement and function back in the arm that’s been affected. This rehab process might take a few months or even longer. But don’t worry, with a whole lot of patience and a strong support system, most kids with these kind of nerve injuries can adjust and lead full and active lives.

What’s the future look like for babies with these nerve injuries?: The future for a baby with this kind of injury really depends on how severe the injury is and which specific nerves are involved. While most infants with these injuries tend to bounce back pretty well, there are cases where some may have to deal with lasting weakness or even paralysis in the affected arm or hand.

Monetary Support and Insurance Help

Dealing with the challenges of raising a kid with this kind of nerve injury takes a lot of thought and care. It’s super important to remember that, no matter how tough things get, your child deserves all the love and support you can give. Here are some tips from the pros for parents in this situation:

Hang in There: Healing from this kind of nerve injury takes time. Keep your chin up and don’t get discouraged if you don’t see progress right away.

Demonstrate Affection: Offer heightened love and support to your child during this critical period. Communicate your steadfast presence and belief in their potential to overcome challenges.

Acknowledge Incremental Progress: Celebrate even the smallest advancements. Recognizing these victories can serve as a motivating factor for your child, fostering perseverance.

Reach Out for Help: Make use of all the resources you can find that are designed for parents dealing with this kind of nerve injury. Talk to your doctor about finding support groups or online communities where you can hear from others who’ve been in your shoes.

Find Your Tribe: Remember, you’re not alone on this journey. Connect with folks who are going through the same thing. With a little patience, a lot of compassion, and a strong support network, you and your kiddo can get through this and live a full, happy life.

Team Up with the Docs: Always work closely with your child’s medical team. By working together, you can tackle the challenges head-on and make sure your child is as healthy and happy as possible.

Referral Links

Nemours KidsHealth :

American Academy of Orthopaedic Surgeons (AAOS) : 

Hospital Resources:

Children’s Hospital of Philadelphia : 

Author Bio:

Pamela Harris is a top-notch health writer working with US Health Hub. She’s all about giving parents the lowdown on babies health issues. Pamela’s got a knack for breaking down complicated medical jargon, making sure families can get their hands on the info they need to tackle challenges with their little ones.