Newborns’ Brachial Plexus Injury: Parent Guide
There are four main types of injuries in newborns:
| Type of Injury | Description |
| Neuropraxia | Mildest form; temporary conduction block due to myelin sheath damage |
| Axonotmesis | More severe; nerve fibers disrupted but myelin sheath intact |
| Neurotmesis | Most 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 issue where the nerves get stretched but not torn. The good news is, most kiddos dealing with this bounce back completely in just a few weeks or months.
On the flip side, Neurotmesis is more serious, involving torn nerves. Recovery might be partial or, in some unfortunate cases, might not happen at all.
Taking it a step further, Avulsion is the most severe, with the nerves being completely ripped from the spinal cord. Sadly, this is usually permanent.
Then there’s Klumpke’s Palsy, which affects the lower nerves and is often seen with breech deliveries. Babies facing this might show weakness or even paralysis in the hand and forearm.
| Type of Injury | Prognosis |
| Neuropraxia | Most recover fully within 3 months |
| Axonotmesis | Often recovers within months, but may not be complete |
| Neurotmesis | Recovery 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 |
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:
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 catch this in a newborn by giving ’em a good once-over and checking out the little one’s medical history. Sometimes, they might also call for tests like X-rays, ultrasounds, or MRIs to be sure.
| Symptom | Description |
| Weakness or paralysis in the arm or hand | This 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 extremity | This can range from mild tingling to complete numbness, depending on the nerves affected. |
| Abnormal arm position | The 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 side | The 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 side | The 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. |
| Challenge | Description |
| Upper Limb Weakness | Difficulty using the affected arm and hand due to muscle weakness. |
| Pain and Spasticity | Chronic pain and muscle stiffness in the affected arm and hand. |
| Sensory Loss | Reduced or absent sensation in the affected arm and hand. |
| Joint Deformities | Contractures or dislocations of the joints in the affected arm and hand. |
| Psychological Impact | The emotional ups and downs and social hurdles that come with living with a nerve injury in the arm. |
| Treatment | Advantages |
| 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 does the future hold for babies in this situation? It really depends on how severe the damage is and which specific nerves are affected. While most little ones tend to recover well, some may experience lasting weakness or even paralysis in the affected arm or hand.
Monetary Support and Insurance Help
Dealing with the challenges of raising a child with this condition takes a lot of thought and care. No matter how tough things get, it’s important to remember that they deserve all the love and support you can give. Here are some expert tips for parents in this situation:
Hang in there—healing from this type of nerve damage takes time. Stay positive, and don’t get discouraged if progress isn’t immediate.
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: Take advantage of every resource available for parents facing this challenge. Talk to your doctor about finding support groups or online communities where you can connect with 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.
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