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Characteristics and causes of Erb's Palsy

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Erb's palsy, also called a brachial plexus injury, is an all too frequent birth injury. Out of 1,000 births, one or two children suffer this injury, which causes loss of motion and feeling in the arm.

Generally, infants with Erb's Palsy experience weakness in their arms due to injuries to the brachial plexus nerves (around the shoulder). Some cases of Erb's Palsy will heal after a few weeks or months of exercise and massage. The more severe injuries will result in long term limited movement of the arm and the most severe cases involve permanent paralysis of the arm.

What causes Erb's Palsy?

Erb's Palsy is almost always preventable. It can be caused by inattention to shoulder dystocia, a birth event that occurs when the baby's shoulder catches on the mother's symphisis pubis or pubic bone. Shoulder dystocia occurs in an estimated one in 200 births, and doctors are supposed to be trained to recognize and quickly respond to it. When a shoulder dystocia is encountered there are a number of maneuvers they can be used to deliver the child without injury, including flexing the mother's legs wide (McRobert's Maneuver), applying pressure just above the mother's pubic bone (Suprapubic Pressure) and rotating the baby' shoulders (Woods Corkscrew Maneuver). However, if the baby's shoulder is lodged against the Mother's pubic bone, the application of pressure behind the rump of the baby (Fundal Pressure) or pulling on the baby's head will not only generally fail to relieve the entrapped shoulder, but can cause an Erb's Palsy injury.

How can you tell that your infant has a brachial plexus injury?

Symptoms of a brachial plexus injury often show soon after the birth. They can include:

  • The infant has an immobile upper or lower arm
  • His or her arm is tight against the body, bent at the elbow
  • The infant can move the arm, but his or her grip is weak on one side

Will your baby recover from Erb's Palsy?

We always hope that a baby will recover and those that do will generally recover within six months of the injury. If, however, your infant has not recovered after six months, he or she may have a permanent injury to the nerves, including what is known as an avulsion of the nerve root. Surgery may help, as well as nerve grafts, but some infants still have permanent, partial or total loss of function that can last for their entire lifetime.

No matter how severe, it is traumatic to see your infant go through an injury, especially a preventable injury like Erb's Palsy.

Learn more about Erb's Palsy by visiting our pages on shoulder dystocia.

Source: PubMed Health, "Brachial plexus injury in newborns," A.D.A.M. Medical Encyclopedia, Nov. 14, 2011

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