The brachial plexus is a network of nerves that enables the spinal cord to transmit signals to the neck, shoulders, arms, and hands. When a newborn’s nerves are overstretched or torn during vaginal childbirth, the injuries may be temporary (the majority of cases) or permanent. Temporary dysfunction might still require surgery and/ or physical therapy to correct. Permanent dysfunction manifests as numbness, weakness, functional impairment, persistent pain, or localized paralysis.
How can Brachial Plexus Injuries Happen?
Brachial plexus injuries (BPIs) during vaginal childbirth are frequently due to medical malpractice. A baby’s head or shoulder may get stuck at the top of the birth canal. The OB-GYN or certified nurse midwife pulls too hard on the baby’s delicate head or uses excessive lateral traction (pulling sideways), which overstretches or tears brachial plexus nerves. Improper use of forceps or a vacuum extractor during delivery may be involved as well.
In addition to excessive force and misuse of tools, other medical errors associated with BPIs include:
- Failure to recognize or respond to distress.
- A delayed decision on switching to a C-section.
- Unnecessary pressure placed on a baby’s arms during a breech delivery.
- Medication errors during delivery.
- Improper follow-up.
An avulsion is the most serious type of BPI. Nerves are pulled clean off the spinal cord — a clear indication that excessive force was applied and a possible clue that the doctor panicked.
Symptoms of Brachial Plexus Injuries
In some cases, a baby will leave the hospital with an undiagnosed BPI. Although babies can’t communicate and some symptoms don’t cause obvious distress, one abnormality parents can be on the lookout for is an arm that does not move and is “floppy.” Other symptoms to look for with Brachial Plexus injuries:
- Lack of movement: If the baby is not moving their arm or hand, or if the movements are limited or weak, it could be a sign of brachial plexus injury.
- Arm held against the body: If the baby is holding their arm tightly against their body and seems reluctant to move it, it could be a sign of injury.
- Weak grip: If the baby is not able to grip objects firmly with their hand, or if they have a weaker grip on one side compared to the other, it could be a sign of injury.
- Asymmetrical Moro reflex: The Moro reflex, also known as the startle reflex, is a reflex that causes the baby to extend their arms and legs in response to a sudden noise or movement. If the baby's arms do not extend equally, or if one arm does not extend at all, it could be a sign of injury.
- Abnormal muscle tone: If the baby has reduced muscle tone, or if the muscles in one arm or hand are visibly smaller than the other side, it could be a sign of injury.
- Numbness or tingling: If the baby seems to be experiencing numbness or tingling in their arm or hand, it could be a sign of injury.
- Lack of sensation: If the baby does not seem to be able to feel touch or other sensations in their arm or hand, it could be a sign of injury.
- Pain: If the baby is experiencing pain in their arm or hand, or if they cry when the affected limb is touched or moved, it could be a sign of injury.
If your baby suffers a brachial plexus injury, it might be due to medical malpractice. Promptly schedule a free consultation at our office.