Definition

Erb palsy is loss of motion and weakness in the arm of a newborn.

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Causes

Erb palsy happens when a baby's neck is stretched during labor and delivery. This can result in damage to the upper nerves of the neck and shoulder. The nerve damage causes muscles in the baby’s arm to be weak.

Stretching may be caused by:

• A long, difficult delivery
• Delivery of a large baby
• Shoulder dystocia —when the baby's shoulder gets caught above the mother's pubic bone during delivery
• Breech delivery—a baby that is born bottom first instead of head first

Risk Factors

Things that may raise the risk of delivering a baby with Erb palsy are:

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

Symptoms

A baby may have:

• Problems moving an arm or shoulder
• An arm that is bent in toward the body
• Poor reflexes in the arm

Diagnosis

Symptoms are often noticed after a baby is born. In others, the doctor may ask about the baby's symptoms and health history. A physical exam will be done.

Images may need to be taken. This can be done with:

• X-ray
• MRI scan

Muscle and nerve activity may need to be tested. This can be done with:

• Electromyography (EMG)
• Nerve conduction study

Treatment

Most babies get better with time, though some weakness may remain. Physical therapy can help improve strength, flexibility, and range of motion.

Older children who are not helped by other methods may need surgery to improve function. Choices are:

• Nerve graft or transfer
• Releasing thickened tissue around the joints
• Tendon transfer

Prevention

There are no known guidelines to prevent this health problem.