What Are the Causes, Symptoms, and Treatment of Erb’s Palsy?
Discovering your baby has a birth injury can be a debilitating feeling, leaving your family in shock. Many birth injury types are avoidable, caused by an unfortunate occurrence or poor medical handling. Erb’s Palsy, which is also called brachial plexus palsy, is one such adverse condition. This issues stems from physical injury during delivery but is often confused with cerebral palsy due to similar symptoms like paralysis and nerve damage. Understanding how Erb’s palsy happens can help you save your child’s future.
The Causes of Erb’s Palsy
In many cases, Erb’s palsy results from a difficult labor. Your baby’s brachial plexus nerves are affected when the baby passes through your birth canal at an uncompromising angle. At this angle, the baby’s head is turned in one direction while its arm is pulled in another direction.
Erb’s palsy also occurs whenever the baby is being delivered through the birth canal in a breech birth (where the baby is born buttocks or feet first). This position puts undue stress on the brachial plexus nerves. It causes injury once the baby’s arms are pulled back over the head while the delivering doctor pulls the newborn from the birth canal legs-first, violently stretching the baby. With the physician having to apply greater force to deliver the baby, given the fact its head is virtually stuck in the birth canal, it increases injury risk. In conjunction with nerve damage, these awkward turns and forceful pushes can lead to the baby’s shoulders dislocating as well as possible head injuries.
Your baby can be at higher risk of contracting Erb’s palsy if it contracts shoulder dystocia during birth. This condition is caused when the head is delivered, but the shoulders are stuck in the womb. As a result, some babies are born heavier, with the size sometimes going unnoticed or undiagnosed by medical personnel during pregnancy. Delivery in this way can be a traumatic experience for you and your baby, who is denied oxygen due to the dystocia and, in some cases, needs resuscitation. To be fair, an undiagnosed large baby isn’t uncommon given how difficult this can be to determine using ultrasound. However, if there’s evidence to suggest some negligence on the medical staff’s part or that not enough was done to minimize nerve injury risk, you could bring a lawsuit against them. Also, be aware of any assistive birthing tools that are used during delivery such as a vacuum or forceps.
Erb’s Palsy Symptoms
Erb’s palsy symptoms vary depending on how severe paralysis is. If your baby has soreness, weakness, or total paralysis of the arm, these are key signs that your newborn may be suffering from Erb’s palsy. Newborns have little range, mobility, or control to begin with, but they will at least move their arms to show their awareness. If your baby’s arm is weak, numb, or cannot move at all, call a medical specialist right away.
If your child’s arm is bent at the elbow and held against its body, that is also a cause for concern. If the brachial plexus nerves are broken or damaged, the baby’s arm will be positioned abnormally, looking limp and unable to react fast enough.
Other potential symptoms include decreased handgrip strength in the hand of the side affected during delivery, as well as impaired circulatory, nervous, and muscle development. The former is detectable once you place an object into its hands and observe grip strength in each hand. The latter can also be detected through interaction or any noticeable pain the baby exhibits when trying to move around.
There are also several risk factors to take into account which could trigger symptoms of Erb’s palsy. If you’re gaining excessive maternal weight during pregnancy or have gestational diabetes, notify your doctor in advance. Also, if the second stage of labor is prolonged or you have had difficult births in the past, your baby could be at risk. Some complications during pregnancy happen without fault, caused by natural anomalies. Your child’s overall health will also determine the symptoms and to what extent these symptoms will affect them.
Treatment Options for Erb’s Palsy
It is essential to know the various kinds of Erb’s palsy that can be diagnosed before tackling treatment options. One type is neuropraxia, a common nerve injury characterized by nerve stretching. Also known as a ‘burner,’ neuropraxia can be cooled down as it heals within three months with few side effects under normal circumstances. Another type is a neuroma, where nerve fibers are stretched severely. Though it can heal, scar tissue builds up among the nerves causing discomfort and is often difficult to treat. Avulsions, where nerves are torn away from the spinal cord, and ruptures are other serious types of Erb’s palsy.
Many children with Erb’s palsy recover anywhere from three to six months on their own. If after six months, your child’s movement and development are still not optimal, physical therapy is needed. This treatment strengthens the movement and reduces stiffness in your child’s arms and shoulders, with massages and other simple exercise techniques employed to boost mobility. Treatment has to be done on a regular basis, combining the therapist’s techniques with your unconditional love and encouragement, proving very helpful. There’s also occupational therapy, where a therapist will use different moving exercises to improve muscle tone and joint function over time.
For the most severe cases, if there is little to no improvement after three to six months, surgery is recommended. Exploratory surgery can determine how severe the damage is to your child’s brachial plexus and establish a subsequent course of action. A nerve graft is usually performed to try and treat your baby, where a healthy nerve is removed from another area and stitched to the affected nerve. Surgery must be done as soon as possible for healing to progress.
If your child has Erb’s palsy due to medical malpractice, the Safe Birth Project can provide you with the steps needed to proceed with a potential legal case. Contact the Safe Birth Project for more details!