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What parents should know about Erb’s palsy

Many expectant mothers experience some level of anxiety over the labor and delivery process. However, because their doctors specialize in identifying potential problems and lowering the risk, most mothers and their babies will come through the birthing process with little or no long-term physical issues. The American Academy of Orthopaedic Surgeons notes doctors often may be able to identify and prevent the risks that cause an infant to suffer Erb’s palsy.

Palsy simply means weakness, and in this case, the weakness comes from nerve damage near the baby’s neck. The bundle of nerves there is the brachial plexus, which gives the body the ability to move and feel the shoulder, arm, hand and fingers. Consequently, when those nerves sustain injury, an infant may not be able to move or feel those parts of the body.

There are different levels of injury that affect whether the infant will recover quickly, require treatment or intervention, or suffer from a life-long injury:

  • Neurapraxia: When the nerve stretches but doesn’t tear, it generally heals without treatment in about three months.
  • Neuroma: When the nerve fibers sustain damage that leads to scar tissue, that tissue can create pressure on the nerve that prevents total recovery.
  • Rupture: A doctor may be able to repair nerves that rupture completely by grafting donor nerves, but a torn nerve cannot heal on its own.
  • Avulsion: Nerves torn from the spinal cord suffer permanent damage. A nerve graft may provide a limited amount of function.

As babies move through the birth canal, one to two out of 1,000 will have the brachial plexus nerves stretched or torn. It is particularly likely if the baby is large, the mother’s pelvis is small, the baby is breech or labor goes on for too long. It is also common when complications arise and the doctor must use force to move the baby through the birth canal.

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