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Early warning signs of brachial plexus palsy in newborns & How to act

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Early warning signs of brachial plexus palsy in newborns & How to act

Brachial Plexus Palsy (BPP) also known as obstetric brachial plexus palsy is a condition that occurs when the network of nerves controlling movement and sensation in the shoulder, arm, and hand is injured. This condition is particularly common in newborns and is often caused by complications during childbirth. Early identification and timely intervention can significantly improve outcomes. 

This blog will help parents and caregivers understand the early warning signs of brachial plexus palsy in newborns and guide them on what steps to take if they suspect their child may be affected.

  1. Weakness in one arm.
  2. Lack of reflexes in the arm.
  3. Abnormal positioning of the arm.
  4. Loss of sensation.
  5. Swelling or Bruising around the shoulder or neck.
  6. Delayed milestones.

What is brachial plexus palsy?

The brachial plexus is a network of nerves that runs from the spinal cord through the neck and into the arm. These nerves control the movement and sensation in the shoulder, arm, and hand. Brachial plexus palsy occurs when these nerves are stretched, compressed, or torn, often during difficult deliveries.

The main following reasons are:

  • Shoulder dystocia (when the baby’s shoulder gets stuck behind the mother’s pelvic bone during delivery).
  • Excessive pulling or pressure on the baby’s head or shoulders during birth.
  • Breech delivery (feet-first birth).
  • Use of tools like forceps or vacuum extractors during delivery.
  • Larger-than-average baby size or prolonged labor.

Early warning signs of brachial plexus palsy in newborns

Detecting brachial plexus palsy early is crucial for starting appropriate treatment. Here are the most common signs to watch for:

1. Weakness in one arm

  • The baby may show less movement in one arm compared to the other.
  • Difficulty lifting or moving the affected arm, even during reflexive movements.

2. Lack of reflexes in the arm

  • The Moro reflex (startle reflex) may be absent or weaker on the affected side.
  • Reduced or no response when the palm of the hand is touched.

3. Abnormal positioning of the arm

  • The affected arm may hang limply by the baby’s side.
  • The forearm might be rotated inward, a condition often called “waiter’s tip” posture, where the hand faces backward.

4. Loss of sensation

  • The baby may not react to touch, pinching, or other stimuli on the affected arm.
  • Crying or discomfort may not occur even if the arm is moved or touched.

5. Swelling or Bruising around the shoulder or neck

  • Visible signs of trauma may indicate nerve damage. Bruising may occur due to pressure during delivery.

6. Delayed milestones

  • As the baby grows, they may struggle to reach age-appropriate milestones involving arm and hand movements, such as grasping objects, rolling over, or crawling.

What to do if you suspect brachial plexus palsy?

If you notice any of the above signs in your newborn, it’s essential to act promptly. Here’s what you should do:

1. Consult a pediatrician immediately

  • Schedule an appointment with your child’s pediatrician to discuss your observations.
  • The doctor will conduct a physical examination and may refer you to a specialist.

2. Get a diagnosis

  • The doctor may recommend imaging tests like X-rays, ultrasounds, or MRIs to assess the extent of the nerve damage.
  • A specialist in pediatric neurology or orthopedics may also be involved in the diagnosis.

3. Start treatment early

Early treatment is crucial to maximize the chances of recovery. Treatment options include:

  • Physical therapy: Gentle, guided exercises can improve the baby’s mobility and prevent stiffness in the affected arm. These exercises focus on gradually increasing the range of motion and ensuring the muscles develop properly despite the nerve injury.

  • Occupational therapy: Occupational therapy emphasizes improving the baby’s ability to perform everyday tasks using the affected arm. Therapists work on strengthening the arm, improving hand-eye coordination, and teaching parents exercises they can perform at home to aid recovery.

  • Surgical intervention: In severe cases where nerve damage does not heal on its own, surgery may be required. Procedures may involve nerve grafting, nerve transfer, or other specialized techniques to repair the damaged brachial plexus. Performing surgery early, ideally within the first few months of life, can significantly enhance the baby’s chances of regaining full function.

4. Follow through with rehabilitation

  • Consistent follow-ups with your healthcare provider and adherence to therapy plans are crucial.
  • Parents may also learn specific exercises to help their child at home.

Conclusion

Recognizing the early warning signs of brachial plexus palsy in newborns is critical for timely intervention. If you notice your baby showing weakness in one arm, abnormal positioning, or delayed milestones, consult a healthcare professional immediately. At Krisha Hand Hospital, we are committed to providing world-class care for newborns with brachial plexus palsy. Early diagnosis and treatment can make a significant difference in your child’s recovery and quality of life.

If you have concerns about your child’s arm movements or need expert advice, don’t hesitate to contact us. Schedule a consultation today and take the first step toward your child’s healthy future.

FAQs

Early intervention is key. Treatment, including physical therapy, should ideally begin within the first few weeks after birth to improve outcomes.

Parents play a crucial role by ensuring their child attends therapy sessions, performing prescribed exercises at home, and providing emotional support during the recovery process.

In some cases, brachial plexus palsy may be preventable by carefully managing labor and delivery, especially in high-risk situations. Prenatal care and planning for potential complications can reduce risks.

Progress can often be seen in small improvements in movement and strength over time. Regular follow-ups with your doctor or therapist will help track your baby’s recovery.

The condition is often caused by physical trauma during childbirth, including shoulder dystocia, breech delivery, or excessive force during delivery. It can also result from the improper use of delivery tools like forceps.

Many babies with brachial plexus palsy recover fully, especially with early intervention. However, the extent of recovery depends on the severity of the injury and the effectiveness of the treatment.

Signs of improvement include increased movement in the affected arm, stronger grip strength, and better response to stimuli. These changes may occur gradually over weeks or months.

Typically, the condition only affects the nerves in the shoulder, arm, and hand. However, severe injuries can sometimes lead to compensatory movements or strain in other body parts as the baby grows.

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