Definition

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.

Causes

Erb’s palsy is usually caused by:

• Long, difficult delivery
• Delivery of a large baby
• Shoulder dystocia
• Breech delivery

Risk Factors

Factors that increase your chance of delivering a baby with Erb’s palsy include:

• History of delivering larger babies
• History of prolonged labor
• Gestational diabetes

Symptoms

Often, Erb’s palsy is discovered after birth due to the typical signs and symptoms, such as:

Diagnosis

You may be asked 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:

• X-ray
• MRI scan

Your baby may need to have muscle and nerve activity recorded. This can be done with:

• Electromyography (EMG)
• Nerve conduction study

Treatment

Over time, the baby can recover movement. Feeling in the arm can also be recovered. In some cases, long-lasting damage can occur.

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 function
• Joint fusion surgery

Prevention

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.

Family Doctor—American Academy of Family Physicians http://familydoctor.org

Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

Erb’s palsy. Patient UK website. Available at:
http://www.patient.co.uk/showdoc/40001379
Accessed January 12, 2014. Updated December 1, 2014.

Erb’s palsy (brachial plexus birth injury). American Academy of Orthopedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=a00077
Updated October 2014. Accessed December 1, 2014.