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What to Expect If Your Child Has a Brachial Plexus Injury

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Updated September 1, 2019 | Birth Injuries |

What to Expect If Your Child Has a Brachial Plexus Injury

Holding your newborn child in your arms is among the most miraculously happy moments in a parent’s life. All the months of reading, shopping, weird food cravings, and preparing for the baby’s arrival are finally behind you.

For most new parents, the joy is backed by worry—and sometimes fear. Usually such fears are unfounded, but occasionally something goes wrong during the birth, injuring the baby. Sometimes, usually in the case of a prolonged or difficult vaginal birth, a newborn can suffer damage to the brachial plexus nerves—the nerves around the shoulder.

Some insurance plans may not cover physical therapy, which can leave families on the hook for unexpected medical expenses. Coupled with the expenses of birth as well as prenatal and post-partum care, the affected newborn’s additional medical expenses can quickly swallow up a family’s savings.

What Is a Brachial Plexus Injury? What Is Erb’s Palsy?

A brachial plexus injury is one of the most common types of birth injuries, affecting thousands of infants born each year. The brachial plexus is a bundle of nerves that runs through the shoulders to the arm, and injuries occur when damage is done to nerves around the shoulder known as the brachial plexus nerves. This typically happens during delivery when the baby’s shoulder gets stuck and the brachial plexus is stretched.

The term “Erb’s palsy” may also be used, but Erb’s palsy only describes injuries to the shoulder and elbow nerves, while brachial plexus palsy describes injuries to all of the brachial plexus nerves. These injuries are typically tested for with motor evaluations, Moro reflex tests, or a physical examination.

Brachial Plexus Injury Symptoms in Newborns

Because brachial plexus injuries involve nerves around the shoulder, the symptoms mostly concern the infant’s movement. The symptoms, which can vary in severity depending on the extent and cause of your child’s injury, become apparent immediately or shortly after birth and can include:

  • Limited movement of the affected side’s upper or lower arm or hand
  • Decreased or absent grip on the injured side
  • The arm being bent at the elbow and held against the body
  • Alternatively, the arm could hang limp and not have sensory or motor function at all
  • The absence of what’s called a Moro reflex, or a reflex that makes infants respond with fear to feeling like they’re falling
  • Abnormal muscle contractions

What Causes Infant Brachial Plexus Injury?

Risk factors for a newborn brachial plexus injury include:

  • Larger-than-average newborn
  • Smaller-than-average pelvis in the mother
  • Maternal obesity
  • Gestational diabetes
  • Prolonged third-stage labor

While a cesarean birth carries less risk of this type of birth injury, it does not prevent it—and carries its own set of risks for both mother and infant.

These risk factors often result in the following conditions, which can cause injury to the brachial plexus nerves:

  • Pressure on the infant’s shoulders during a head-first delivery
  • Stress on the baby’s raised arms during a breech, or feet-first, delivery
  • Shoulder dystocia (difficulty delivering the shoulder after the baby’s head has already come out

Brachial Plexus Injury Treatments

While every situation is unique, the good news is that the prognosis for brachial plexus injuries is generally good. Most babies fully recover within six months with a prompt diagnosis and treatment. Milder brachial plexus injuries can be remedied with physical therapy and daily massages and exercises to repair the damaged tissues. Proper treatment could make the injury clear up and give your child full use of their damaged arm, hand, or wrist. There are fewer studies done on those who don’t heal within three to six months, and their prognosis is unclear.

In more extreme or severe cases, surgery is also available as a possibility. Nerve grafts or transfers and other procedures could help restore full or partial use of the affected area.

The surgical option is generally considered as an option in severe cases that don’t heal after three months—if an injury doesn’t clear up with physical therapy and massaging alone. There are risks involved with surgery and medication like there would be in any medical procedure, and physical therapy would still be required afterward.

Brachial Plexus Injury and Negligence

Common examples of doctor negligence include:

  • Pulling the baby’s head, arms, or shoulders too roughly
  • Improper use of tools during assisted vaginal delivery (forceps and vacuum extractors)
  • Failure to schedule a C-section when necessary (such as when the baby is too large for vaginal delivery

Contact a Birth Injury Attorney Today

While brachial plexus injuries can be treated, it’s going to be a long and difficult process for everyone. Treatment options can be expensive, especially in cases where surgery is necessary, and insurance might not cover the medical expenses that you could incur.

Unexpected medical costs—on top of all the expenses that come along with proper medical care before, during, and after delivery—can devastate a family.

It’s possible that a doctor’s negligence led to your child’s brachial plexus injury. If you believe that this is what happened to your child, reach out to the Indianapolis Birth Injury Attorneys of Wilson Kehoe Winingham. We can help you and your family move forward and get help after an injury. Call 317.920.6400 or fill out an online contact form for a free, no-obligation case evaluation.

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