Weakness or paralysis of the arm due to birth-related causes is a rare phenomenon in both male and female newborns. The reason for this occurrence is the stretching of the nerve fibers in the neck and shoulder (the nerves in this area are called the brachial plexus).
Illustration of birth-related injury to the brachial plexus
During childbirth, tension can sometimes arise between the shoulder and the newborn's neck, which can cause weakness in the arm. This condition occurs at a similar rate in boys and girls. It is associated with difficult and prolonged childbirth, shoulder dystocia, large babies, and other factors. The condition is diagnosed when the newborn does not move one of their arms regularly. The affected arm appears limp against the chest, and the typical movements of the newborn are either weak or not visible in the affected arm.
It is challenging to accurately assess the extent of nerve damage in the newborn. Sometimes we find only mild weakness, while in other cases, there might be complete paralysis of the arm. In some instances, there may also be a bone fracture, and sometimes the cause of the arm immobility is pain from the fracture, not paralysis.
About 85% of newborns who experience weakness or paralysis of the arm after birth will fully recover without treatment (except for maintaining range of motion). The remaining 15% will require treatment to restore arm function.
We avoid offering treatment in the first 2-3 weeks of the newborn's life. The arm might still be sensitive due to stretching, and the newborn may experience pain if exercises are performed. After that period, a reassessment is carried out. If weakness or paralysis still exists, we recommend starting motion exercises with the parents. The goal is to maintain the range of motion in the shoulder, elbow, and wrist. The assumption is that nerve stretching will improve, and the muscles should be prevented from shortening until recovery occurs. Parents will perform the treatment under the guidance of a physical therapist or occupational therapist specializing in pediatrics.
This explanation does not replace a discussion with the treating medical team and an understanding of the treatment plan. For more detailed articles and to better understand the treatment for infants who have not fully recovered, request more detailed material from the treating physician. An initial explanation will be given by the medical staff at the newborn's discharge or transfer, and follow-up will be within the framework of the hospital's clinics (Pediatric Orthopedic Department, Hand Clinic, and Pediatric Rehabilitation Clinic) or equivalent clinics of the health fund.