Erb’s palsy is a type of birth injury that affects the nerves in a baby’s shoulder and arm, often caused by trauma during delivery. It can lead to weakness, limited motion, or unusual positioning of the arm, but the severity varies from child to child. Early detection is key to improving quality of life through physical therapy or other interventions.
If you suspect your child has Erb’s palsy and want to learn about your legal options, contact a lawyer who has extensive experience representing families in birth injury claims.
Understanding the signs, symptoms, and diagnostic process can help you advocate for your child’s health and ensure they get the care they need.
What is Erb’s Palsy?
Erb’s palsy occurs when the brachial plexus, a network of nerves that controls the shoulder, arm, and hand, is stretched or injured during birth. This type of injury is most commonly linked to shoulder dystocia, which is when the baby’s shoulders get stuck during delivery. It can also be caused by the use of forceps or vacuum-assisted tools.
The severity of Erb’s palsy can range from mild weakness that resolves on its own, to more significant nerve damage that requires therapy or surgery. While some babies recover fully, others may continue to have weakness or limited movement.
How Doctors Diagnose Erb’s Palsy
Diagnosing Erb’s palsy usually begins shortly after birth, often when a pediatrician notices abnormal arm positioning or reduced movement. The process may involve several steps:
- Physical Examination: Doctors will observe the baby’s arm posture and movement. They’ll check muscle tone, reflexes, and the baby’s ability to move the arm compared to the unaffected side.
- Range of Motion Tests: Gentle stretching and movement assessments help evaluate which muscles and nerves may be affected.
- Imaging Tests: In some cases, X-rays or an MRI may be ordered to rule out fractures or assess the extent of nerve injury.
- Electromyography (EMG) or Nerve Conduction Studies: If recovery is slow or the injury is severe, tests that measure nerve function may be performed to determine the degree of damage and guide treatment.
Signs and Symptoms to Watch For in Babies
Parents are often the first to notice signs of Erb’s palsy. Early observation can help ensure prompt evaluation and treatment. Common signs include:
Weakness in the Arm
One of the first clues parents may notice is that one of the baby’s arms doesn’t move as freely as the other. The affected arm might appear limp or “floppy” and may stay close to the baby’s body instead of moving naturally.
When the baby startles, stretches, or reaches, you may see little to no movement on that side. This weakness happens because the nerves that control the shoulder and upper arm muscles are injured, reducing strength and control.
Limited Range of Motion
Babies with Erb’s palsy often have difficulty lifting their arm above shoulder level or bending it at the elbow. You might notice that your baby struggles to raise the arm to the mouth, or that the arm doesn’t rotate outward like the other one.
This limited range of motion can make everyday activities, like reaching, feeding, or grasping toys, more challenging as the baby grows. Gentle range-of-motion exercises may be recommended to prevent stiffness while awaiting medical guidance.
Abnormal Grip or Hand Position
Even though Erb’s palsy primarily affects the upper arm and shoulder, it can sometimes influence how the baby holds their hand. The fingers may stay curled tightly or the wrist may twist inward, creating a noticeable “waiter’s tip” posture (where the arm hangs by the side, the wrist flexes, and the palm faces backward).
This occurs when certain muscles are weak or paralyzed, causing others to overcompensate and pull the hand into an awkward position.
Lack of Reflexes
Reflexes help doctors and parents gauge a baby’s nerve and muscle function. In babies with Erb’s palsy, reflexes like the Moro reflex (the startle reflex, where both arms extend outward when the baby is startled) may be weaker or absent on the affected side.
The grasp reflex, which is how tightly a baby holds your finger, may still be present if the lower nerves are intact, which can help doctors pinpoint which part of the brachial plexus is injured.
When to Contact a Pediatrician or Specialist
If your baby shows signs of Erb’s palsy, it’s important to seek evaluation promptly. You should contact your pediatrician if:
- Weakness or abnormal arm movement persists beyond the first few weeks.
- There is no noticeable improvement despite physical therapy or home exercises.
- You want a referral to a pediatric neurologist or orthopedic specialist for further evaluation.
Early diagnosis and intervention can make a significant difference in recovery and long-term function.
Treatment and Outlook
Treatment depends on the severity of the injury. One common approach is physical therapy, where a doctor will use stretching and movement exercises to improve strength and flexibility. In severe cases, surgery may be needed to repair nerves and improve function.
Many babies recover partial or full use of their affected arm with early and consistent care.
Moving Forward
Recognizing the signs of Erb’s palsy and seeking treatment as soon as possible can greatly impact your child’s recovery. If you have concerns about your baby’s development, reach out to a pediatrician or specialist as soon as possible.
Families can also explore additional guidance on caring for a child with special needs to ensure their child gets the support they need.
For families navigating birth injuries, understanding your legal options can also be important. A lawyer who handles birth injury cases can help you learn about your rights and available support.