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 serious; full disconnect that requires the body to rebuild function from scratch. |
| 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 kind of issue where things get stretched but not broken. The good news is, most little ones going through this bounce back fully in just a few weeks or months.
On the flip side, Neurotmesis is a tougher situation—it means something inside got completely torn. Bouncing back might only happen a little, and sadly, in some cases, there’s no real progress at all.
Taking it a step further, avulsion is the most serious kind—where everything gets pulled right out from the spine. Sadly, when that happens, things usually don’t go back to normal.
Then there’s a condition tied to the lower part of that network near the spine, often popping up in breech arrivals. Little ones dealing with it might show signs of weakness or even trouble moving their lower limb on that side.
| 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: Every now and then, these tools are used to help during delivery. But if they’re not handled just right, they might cause trouble with movement or sensation in the little one’s upper limb.
Vacuum Extraction: This method’s sometimes used to help bring the little one into the world. But if that suction cup isn’t placed just right on the head, it can cause some serious trouble with how things move afterward.
If your little one ends up with NBPP, just know—you’re not alone in this. There are plenty of folks and resources out there ready to guide you through. Your doctor can point you toward the right people who’ll help your kid grow strong and thrive.
In the interim, there are several proactive measures you can take to aid your baby dealing with NBPP:
Look out for these common signs:
- Lack of strength or movement in that side or hand.
- Reduced motion or sensation on that side.
- The side that’s not moving right might look a little off or rest in an unusual position.
- Trouble moving the fingers or thumb
- No Moro reflex on one side (this reflex is when your little one stretches their limbs out wide and then pulls them back in).
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 |
| Limited movement or strength on one side. | This can impact how well certain muscles work, depending on how serious things are and where the trouble is. Common signs look like this: |
| * 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 condition: Complete loss of motion and feeling throughout the entire upper limb. | |
| Decreased movement or sensation in the upper extremity | This can range from mild tingling to complete numbness, depending on the nerves affected. |
| Unusual Placement of That Side | The side that’s not moving much might stay in one position—like bent at the elbow and tucked in—or it could just hang loosely. |
| Absent Moro reflex on the affected side | The Moro reflex is a startled reaction where the little one flings their limbs out wide. If this reflex doesn’t show up on one side, it might mean something’s not quite right on that part of the body. |
| 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 feel discomfort in that side or around the shoulder area. |
| Challenge | Description |
| Upper Limb Weakness | Hard time using that side because the muscles aren’t as strong as they should be. |
| Pain and Spasticity | Ongoing soreness and tight muscles in that side can make everyday movement tough. |
| Sensory Loss | Less or no feeling in that side. |
| Joint Deformities | Tightness or joint shifts can happen in that part of the body, making movement harder over time. |
| Psychological Impact | The emotional highs and lows, along with the social challenges, that come with navigating life after something like this can really weigh on a person. |
| Treatment | Advantages |
| Non-operative Management | – Minimally invasive – Gives the body a chance to bounce back naturally on its own – Lower risk of complications |
| Nerve Grafting | – Improves functional outcomes for severe injuries – Can restore sensation and function |
| Neurolysis | – Eases the strain on the compressed area, helping it work better again. – Can help restore movement and sensation more efficiently. |
| Muscle Transfers | – Provides alternative function for paralyzed muscles – Improves quality of life |
After the Operation: Once it’s all done, your little one will need some gentle guidance to get things moving again and build up strength on that side. Getting back to the swing of things might take a few months—or maybe a bit longer. But hang in there. With steady encouragement and plenty of love, most kiddos bounce back and go on to enjoy active, happy lives.
What lies ahead for little ones in this situation? Honestly, it comes down to how much was impacted and exactly where. Many bounce back just fine over time, but for some, there may be lingering struggles with movement or strength on one side.
Monetary Support and Insurance Help
Raising a little one with this kind of challenge takes patience, strength, and a whole lot of heart. Even when the days feel long or uncertain, just remember—they need your steady love more than anything. Here are some down-to-earth tips to help guide you through:
Hang in there—healing from this type of nerve damage takes time. Stay positive, and don’t get discouraged if progress isn’t immediate.
Show Extra Love: Pour on the hugs and reassurance during this important time. Let your little one know you’re right there beside them and believe in their ability to push through whatever comes their way.
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: Just know—you ain’t walking this road solo. Link up with others who’ve been down the same path. With time, kindness, and the right folks by your side, you and your little one can push through and enjoy life to the fullest.
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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