The brachial plexus is a network of five large nerves that starts at the spinal cord and goes through the neck into the arm. These nerves act like electrical wires that send signals for movement and feeling to the shoulder, elbow, wrist, and hand. When a baby is being born, these nerves can get stretched or torn. This usually happens if the birth is difficult or if the baby’s neck is pulled too hard while the baby’s shoulder is stuck.
Birth injuries to these nerves can range from mild stretching to a complete tear away from the spine. While some infants get better on their own, others face permanent disability. Understanding how these injuries happen is the first step for parents in Atlanta who are looking for answers about their child’s health.
Where Babies Show Symptoms
Where a baby shows signs of a nerve injury depends on which of the five nerves were hurt. Doctors usually put these injuries into three main groups based on what part of the arm is affected.
Erb’s Palsy
Erb’s palsy is the most common type of brachial plexus injury. It happens when the upper nerves in the neck are damaged. This usually affects the shoulder and the elbow. A baby with this condition might keep their arm rotated inward toward their body. This is sometimes called the waiter’s tip position because the hand hangs back like someone looking for a tip. The baby might be able to move their fingers but cannot lift their arm or bend their elbow.
Klumpke’s Palsy
This type of injury affects the lower nerves of the brachial plexus. It impacts the forearm and the hand instead of the shoulder. A child with Klumpke’s palsy often has what doctors call a claw hand where the fingers stay curled up. They may have a very weak grip or no movement in their hand at all, even if they can move their shoulder just fine.
Global Palsy
Global palsy is the most severe version. This occurs when all five nerves in the brachial plexus are damaged. In these cases, the entire arm from the shoulder down to the fingertips is paralyzed. The baby will have no feeling and no movement in that arm.
Identifying Mild Injury Symptoms
A mild injury often happens when the nerves are only stretched rather than torn. This might feel like a shock or a burning sensation for the baby. Since infants cannot talk, parents have to watch for specific behaviors.
A baby with a mild injury might seem to have a “stinger” that lasts for a few days. They might cry when that arm is touched or moved. In most mild cases, the symptoms go away without surgery in about three to six months. Doctors often suggest physical therapy during this time to make sure the muscles stay strong while the nerves heal.
Moderate and Severe Injury Signs
When an injury is more serious, the symptoms are much easier to see. A moderate injury might involve a neuroma, which is scar tissue that grows around the nerve and blocks signals. Severe injuries involve a rupture where the nerve tears or an avulsion where it is pulled completely out of the spinal cord.
Signs of these serious injuries include:
- Total lack of movement in the arm or hand.
- A limp or floppy arm that just hangs by the side.
- No reaction when the arm is pinched or poked.
- Severe pain that makes the baby very fussy or unable to sleep.
One of the best ways to tell if there is a problem is the Moro reflex. This is the natural startle reflex babies have when they feel like they are falling. A healthy baby will throw both arms out equally. If a baby only moves one arm during this reflex, it is a big sign of nerve damage.
Rare Complications Like Horner’s Syndrome
Sometimes a brachial plexus injury affects more than just the arm. Horner’s Syndrome is a rare condition that happens when the nerves going to the face are also hurt. You might notice that the baby has a drooping eyelid on one side or a pupil that looks smaller than the other. Another sign is that one side of the face does not sweat. This tells doctors the nerve damage is deep and located very close to the spine.
Why These Injuries Happen During Labor
Many brachial plexus injuries in Georgia happen because of medical mistakes during a difficult delivery. There are several risk factors that doctors should watch for before birth begins.
Shoulder Dystocia
Shoulder dystocia is an emergency where the baby’s head comes out but the shoulder gets stuck behind the mother’s pubic bone. If a doctor pulls too hard on the head to get the baby out, the nerves in the neck can stretch until they snap. This is often caused by using too much lateral traction or force.
Physical Risk Factors
Certain situations make these injuries more likely:
- Large babies weighing more than average.
- Mothers with gestational diabetes.
- Breech births where the baby comes out feet first.
- Labors that last a very long time.
- Use of tools like vacuums or forceps to pull the baby out.
Statistics and Recovery Outlook
Research shows that brachial plexus injuries happen in about 1 to 3 out of every 1,000 births. While many babies recover, a large number are left with permanent weakness. Mild cases usually heal within 6 months. If a baby does not show improvement by the time they are 3 months old, doctors may start talking about surgery. Surgery might involve nerve grafts to bridge a gap in a torn nerve or nerve transfers to move a working nerve into the place of a broken one.
Understanding Medical Negligence and Claims
If your baby was born with a nerve injury, it might be because the medical team did not follow the standard of care. Doctors and midwives are trained to handle stuck shoulders without using excessive force. When they fail to recognize the signs of a large baby or use dangerous pulling techniques, they may be held responsible.
Going through a legal claim can help your family pay for the physical therapy, surgeries, and specialized care your child will need as they grow. You have to prove that the healthcare provider made a mistake that caused the injury. This usually involves looking at medical records and talking to experts who understand birth complications.
Get Help for Your Child’s Future
If you notice your newborn has a limp arm or a weak grip, you should act quickly to protect their health and your rights. The team at Chance, Forlines, Carter & King, PC understands the pain of seeing your child suffer from a preventable injury. We have decades of experience helping families in Atlanta and throughout Georgia get the support they deserve. You can reach us at 404-760-7400 to talk about what happened during your delivery and find out what your options are.