Erb’s palsy happens when a baby’s neck is stretched during labor and delivery. This can cause damage to the upper nerves of the neck and shoulder. The nerve damage can then cause certain muscles in the baby’s arm to be weak. Over time, the baby can recover movement. Feeling in the arm can also be recovered. In some cases, long-lasting damage can occur.
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Erb’s palsy is usually caused by: Long, difficult deliveryDelivery of a large babyShoulder dystociaBreech delivery
Factors that increase your chance of delivering a baby with Erb’s palsy include: History of delivering larger babiesHistory of prolonged laborGestational diabetes
Tell your doctor if you have any of these risk factors.
Often, Erb’s palsy is discovered after birth due to the typical signs and symptoms, such as: Inability of your baby to move an arm or shoulderArm is bent inward toward the bodyWeak or absent reflexes in the armLoss of feeling in the arm
The doctor may ask about your baby's symptoms and medical history. A physical exam will be done. Other tests may include:
Your baby may need images taken of bodily structures. This can be done with:
Your baby may need to have muscle and nerve activity recorded. This can be done with:
Nerve conduction study
Talk with the doctor about the best treatment plan, which may include: Physical therapy—This can help keep your baby’s joints and muscles flexible and strong. You will take an active role in moving your baby’s shoulder, arm, and hand. Massage may also be an option.Surgery—This may be recommended in cases where there is no improvement.
When your child is older, other treatments may be recommended, such as: Muscle and tendon transfer surgery to improve functionJoint fusion surgery
To help reduce your baby’s chance of Erb’s Palsy, take the following steps: Have regular prenatal care visits.Tell your doctor if you have had previous difficult deliveries.Follow your doctor's instructions if you are diagnosed with gestational diabetes.
Brachial plexopathy. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated December 19, 2012. Accessed March 13, 2013.
Erb’s palsy. Patient UK website. Available at:
http://www.patient.co.uk/showdoc/40001379. Updated January 22, 2010. Accessed March 13, 2013.
Erb's palsy (brachial plexus birth injury). American Academy of Orthopedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=a00077. Updated December 2010. Accessed March 13, 2013.
Last reviewed March 2014 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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