Birth Injuries

A clavicle fracture occurs due to forceful pulling of the baby’s arm or shoulder during delivery, whether the head or breech is delivered first.

Symptoms:

• The newborn is unable to move the affected arm.
• Pain when the arm is touched or moved.
• A cracking sound (crepitus) at the fracture site.
• Absence of the Moro reflex on the affected side.
• Formation of a bone callus at the fracture site between days 7-10.

Nurse’s Role:

• Request an X-ray for diagnosis.
• Immobilize and prevent movement of the affected arm and shoulder for 7-10 days.

Brachial Plexus Injury (Erb’s Palsy)

This condition involves paralysis of the upper limb muscles, resulting from a brachial plexus nerve injury during birth. It may also affect the diaphragm, as it shares the same nerve supply from the 5th and 6th cervical vertebrae.

Symptoms:

• The affected newborn is usually large and may have experienced birth asphyxia.
• The affected arm lies limply at the baby’s side and cannot be raised, flexed at the elbow, or rotated outward.
• The arm takes a characteristic posture:
• Shoulder is lowered.
• Arm is rotated inward.
• Elbow is extended.
• Wrist is flexed, with the hand turned inward and backward.
• Breathing difficulties may appear due to diaphragm paralysis.

Nurse’s Role:

• Immobilize the affected arm for one to two weeks, keeping it in a position opposite to the affected posture.
• Call a specialist for physiotherapy sessions after two weeks, continuing for up to three months to maintain muscle and joint flexibility.