Brachial Plexus Injuries in Newborns

birth injuryThe first recorded instance of a brachial plexus injury (also referred to as neonatal brachial plexus palsy or BPP) happened back in 1779. A child was born who experienced weakness in one of their arms for several days before it simply disappeared. Since that time, medical professional have learned a lot more about the brachial plexus and the various dangers that threaten it. Nonetheless, brachial plexus injuries remain one of the most common affecting newborns.

What Are Brachial Plexus Injuries?

Beginning at the spine and running through the neck and arms is a cluster of nerve fibers called the brachial plexus. If any harm comes to this system, it is called a brachial plexus injury. Depending on where it happens and what happened, though, the symptoms can be quite different.

This type of injury is so common in newborns because difficult labors often make it impossible for a baby to come out of the birth canal normally. A physician may need to use force to pull the baby through or rely on tools like forceps or even vacuum extractors. As a result, this area of nerves can be impacted in a way that results in this type of injury.

Specific causes may also include:

  • Infants who are large in weight or size
  • Maternal diabetes
  • A breech delivery
  • An infant getting their shoulders lodged in their mother’s pelvic region
  • Underdeveloped neck muscles in the infant
  • Obesity in the mother

It should be noted that the risk of brachial plexus injuries may sometimes be seen as the lesser of two evils. If a doctor is worried that the baby is stuck and may begin suffering from asphyxia or some other dangerous complication, using a significant amount of pressure on the child may be deemed necessary to save them from something far worse.

Sometimes, all it takes is contractions for a baby to suffer from brachial plexus injuries. If the labor goes on for too long and the child becomes lodged in the birth canal, contractions can actually put undue pressure on the infant’s head, shoulder, and upper arms. The result might be bruising, tearing or even fractures to the brachial plexus.

Types of Brachial Plexus Injuries and Diagnosis

There are four main types of brachial plexus injuries:

  • Neuropraxia: Fortunately, while neuropraxia is the most common of brachial plexus injuries, it is also the least severe. Its symptoms usually entail very minor tears or strains to these nerves. Usually, it goes away after a few months because the actual nerve is left unharmed; only it’s covering and lining are affected.
  • Erb’s Palsy: This type of brachial plexus injury occurs when the nerves of the upper arm are harmed during birth. Depending on how it happened, the infant might experience full of partial paralysis of the arm. They could lose sensory or motor function in that area too, including the inability to make a fist or properly grip.
  • Klumpke’s Palsy: This version affects the lower portion of the arm. The affected arm may end in a hand that makes a “claw” shape. This palsy happens when the baby gets stuck in the pelvic region and excessive pulling causes shoulder dystocia.
  • Neuroma: After an injury to the brachial plexus, scar tissue may develop that causes excessive pressure on the nerve. This pressure makes it hard for the nerve to communicate with muscles in the arm.

The good news is that most instances of these injuries can be treated and the infant can make a full recovery. Physicians will generally use a number of tests to confirm whether or not a baby has it.

However, if you notice that one of your child’s arms does not seem to be operating properly and the birth was difficult, it is a good idea to seek medical attention immediately.

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