Brachial Plexus Injury in Babies



baby in hand

A traumatic birth can cause brachial plexus injury in babies and subsequent neck pain and mobility problems.

Brachial plexus injury may occur through trauma or accidents in adulthood but is also a possibility during the birth of your baby. The brachial plexus is a complex of nerves between the neck and shoulder with spinal nerves exiting and dividing, then rejoining and combining throughout the region. The complicated arrangement of the nerves C5, C6, C7, C8, and T1 and their myriad branches make injury to the area likely to produce a number of different symptoms. Four major types of nerve injury can occur, neurapraxia, neuroma, rupture, and avulsion, with the likelihood of permanent damage increasing in line with the severity of the injury.

Brachial Plexus Injury Statistics

Estimates of brachial plexus injury occurring at birth range from around 0.03% to 0.2% with the risks higher if labour was difficult and the baby was delivered forcibly after their shoulders became stuck. Delivery trauma accounts for the majority of cases of brachial plexus palsy discovered following the birth of a baby. Larger babies are at a higher risk of this occurring, which is worrying considering that babies with higher birth-weight are becoming more common.

Erbs Palsy

Injury to the brachial plexus nerves during birth causes Erb's Palsy

Erb’s Palsy and Neck Injury in Children

Erb’s Palsy (brachial plexus injury in babies) may also be a result of abnormal growth through restricted limbs during gestation, trauma prior to, or during delivery, amniotic bands, or congenital chicken pox.

Symptoms of Erb’s Palsy

If an injury occurred prior to the birth then fibrillations are usually detectable within the first week after delivery. In some cases there may be a visible disparity between one shoulder/arm and the other to indicate a developmental abnormality. Paediatricians will usually notice the problem at a routine check-up and conduct a physical examination prior to deciding if further tests are necessary. Parents should watch out for signs in their baby such as an inability to raise their arm, turn their wrist, or squeeze with their hand.

The injury to the nerves in the area may be overcome using physical therapy and occupational therapy where it occurs in adults, but children may require neck surgery to correct the problem and continue to have difficulties with their brachial plexus. Getting a prompt diagnosis and commencing treatment quickly will offer the best chance for a full recovery from brachial plexus palsy in your child.

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