What is a brachial plexus birth injury?
A brachial plexus birth injury occurs when the nerves controlling movement and sensation in a baby’s shoulder, arm, and hand are damaged during childbirth. One of the most common types of this injury is Erb’s palsy.
A brachial plexus injury at birth typically happens during long or difficult deliveries, especially if the baby is large and in a breech (feet- or buttocks-first) position.
In these situations, the brachial plexus nerves can be stretched, compressed, or even torn, resulting in weakness or paralysis in the affected arm.
The severity of these injuries can differ, and families may be able to take legal action if medical negligence is to blame.
In one case, our trusted legal partner secured over $2 million for a North Carolina family whose child suffered a brachial plexus birth injury.
Cerebral Palsy Guide works with an extensive network of experienced birth injury lawyers who can help families in all 50 states. As of 2026, they’ve recovered over $1 billion for preventable harm, including brachial plexus injuries.
If you suspect your child’s brachial plexus birth palsy could have been avoided, see if a top birth injury attorney can help your family pursue the money you deserve. Get a free case review right now.
Signs of a brachial plexus injury in newborns
Brachial plexus injury symptoms can vary depending on the type and extent of nerve damage.
- Arm held in a fixed position (often straight, turned inward — “waiter’s tip”)
- Lack of startle response (Moro reflex) on the affected side
- Limp or hanging arm
- Little or no movement in one arm
- Weak grip in the affected hand
These symptoms may be noticeable immediately after birth or develop soon after delivery. Many newborns with a brachial plexus birth injury don’t experience pain. However, severe nerve damage may require further medical evaluation and care.
If your child is showing brachial plexus injury at birth symptoms, you probably have questions.
Cerebral Palsy Guide has experienced labor and delivery nurses on staff who may be able to help. Connect with a registered nurse — there’s no cost or obligation.
What causes brachial plexus injuries during childbirth?
One of the most common causes of brachial plexus injury at birth occurs when a baby’s neck is pulled or stretched too forcefully during delivery. This movement can overstretch or tear the brachial plexus, which starts in the neck and extends through the shoulder, arm, and hand.
Medical negligence, such as improper handling of a difficult delivery, can contribute to these birth injuries.
- Apply excessive force on the baby’s shoulders during a head-first delivery
- Mismanage shoulder dystocia (baby’s shoulders get stuck after the head delivers)
- Pull the head and neck to one side as the shoulders pass through the birth canal
- Put pressure on the baby’s raised arms during a breech delivery
- Use tools like forceps or vacuum extractors improperly
When these nerves are damaged, they may not transmit signals properly, leading to weakness, loss of sensation, and even paralysis in the affected arm.
In severe cases, the nerves may be completely torn from the spinal cord, resulting in more severe complications.
“If the condition could have been prevented with proper care, and the medical professionals deviated from that standard of care, that’s considered medical negligence.”
— Ricky LeBlanc, birth injury attorney at Sokolove Law
Risk factors for brachial plexus injury in newborn babies
Certain conditions related to the mother and baby make it more likely that neonatal brachial plexus palsy will occur. These risk factors increase the likelihood of injury and may include delivering a large baby or maternal diabetes.
“One of the things we see with brachial plexus injuries is that we have moms who are diabetic and have large babies.”
— Andi Lowe, DNP, MSN, on-staff labor & delivery nurse
Doctors and other health care providers should evaluate risk factors and take proactive steps to protect both mother and child. Failure to properly manage the risk of a brachial plexus birth injury can be considered medical negligence.
If your child’s injury was preventable, a birth injury lawyer may be able to help your family pursue compensation to support your child’s medical care and long-term needs.
See if you can connect with a top brachial plexus injury lawyer near you — get a free case review right now.
Types of brachial plexus birth injuries
Brachial plexus birth injuries can vary based on how much the nerves are damaged. Neurapraxia, the mildest form, happens when the nerve is stretched but not torn, and most babies recover on their own.
More serious injuries involve a torn nerve. A rupture means a torn nerve is still attached to the spine. A neuroma forms when the nerve heals with scar tissue. The most severe injury, avulsion, happens when the nerve is pulled from the spinal cord.
Learn about the main types of brachial plexus birth injuries below.
Erb’s palsy
Erb’s palsy occurs when the upper part of the network of nerves is injured. This type of brachial plexus birth injury often results in weakness or paralysis in the shoulder and bicep muscles.
Common symptoms include a limp arm, a weak grip, and difficulty moving the shoulder. Treatment for Erb’s palsy involves physical therapy to prevent stiffness and maintain muscle function, starting as early as three weeks after birth.
Total plexus involvement
This is a more severe injury that affects the entire network of nerves in the shoulder, arm, and hand.
Total plexus involvement can lead to little or no movement in the affected arm. Children with this type of injury may need ongoing therapy and, in some cases, surgery to improve function.
Horner’s syndrome
This brachial plexus birth injury is associated with an avulsion injury, when nerve roots are torn from the spinal cord, affecting the sympathetic nerves (which control functions like sweating and pupil size).
Symptoms of Horner’s syndrome include:
- Drooping eyelid (ptosis)
- Reduced sweating on one side of the face (anhidrosis)
- Smaller pupil in one affected eye (miosis)
This condition is linked with severe brachial plexus injury and may require nerve surgery to address the damage.
Klumpke’s palsy
This less common type of brachial plexus birth injury affects the lower nerves of the arm. Klumpke’s palsy can cause weakness or paralysis in the hand and fingers.
Treatment may include physical or occupational therapy, and some children may need surgery depending on the severity.
How are brachial plexus injuries in newborns diagnosed?
When a brachial plexus birth injury is suspected, doctors use a combination of physical exams and imaging tests to confirm the diagnosis.
Diagnosing a brachial plexus birth injury may involve:
- Physical examination: This is the first step and helps detect possible nerve injury through observed symptoms and reflexes.
- X-rays: Doctors often perform X-rays early to check for fractures in the collarbone or shoulder that may contribute to the injury.
- Magnetic resonance imaging (MRI): This provides detailed images of nerves and surrounding tissues and is commonly used if a nerve injury is suspected.
- Computed tomography (CT): A CT scan is used if more detailed imaging is needed, especially when MRI results are inconclusive.
- Electrodiagnostic tests: These include electromyograms (EMG) and nerve conduction studies (NCS) to measure nerve function and determine the severity and injury location.
Early diagnosis is key to starting treatment and supporting your baby’s recovery. Talk with your child’s pediatrician if you suspect a brachial plexus birth injury.
How is a brachial plexus injury during birth treated?
Brachial plexus injury at birth treatment depends on how severe the nerve damage is. In many mild cases, babies improve with non-surgical care.
Gentle massage can help stimulate affected muscles and improve blood flow, while range-of-motion exercises are essential for preventing stiffness and improving muscle flexibility.
Pediatric physical therapists often guide parents in performing these exercises at home, helping babies progress safely during follow-up sessions.
Surgery for brachial plexus birth injury
If a baby does not show enough improvement early on, doctors may recommend surgery to repair the damaged nerves or improve arm function.
- Nerve surgery: This involves either nerve grafts to replace damaged nerves or nerve transfers that redirect nearby healthy nerves to restore function to the affected area.
- Muscle and tendon transfers: Muscles and tendons can be relocated to improve arm movement and control.
- Osteotomy: This involves surgically repositioning bones, like the humerus (upper arm bone), to improve alignment and positioning of the hand and arm.
- Open reduction of the shoulder joint: This procedure stabilizes the shoulder by reducing dislocations and tightening the surrounding tissues.
Early intervention is crucial, and surgery is generally most effective when performed between 4 and 9 months of age.
Don’t wait to find out if you can take legal action and pursue compensation for the best possible brachial plexus injury newborn treatment.
Call us right now at (855) 220-1101 or Click to Live Chat to find out if we can help.
Brachial plexus birth injury complications
Brachial plexus birth injuries can lead to long-term complications, depending on the severity of the nerve damage.
One of the most common issues is contractures, which happen when abnormal muscle contractions with limited mobility cause the muscles to tighten permanently, limiting movement.
Another complication is permanent, partial, or total loss of function in the affected arm. This can lead to complete paralysis of the upper arm or persistent weakness, impacting your child's ability to perform everyday activities.
In more severe cases, these complications can affect shoulder joint development and overall arm growth, and ongoing medical intervention and therapy may be needed.
Treating a newborn brachial plexus injury can be costly, but a birth injury settlement can provide the financial support needed to ensure your child has access to the best possible care.
Legal help for newborn brachial plexus injury
Many families dealing with a brachial plexus birth injury wonder if anything could have been done to prevent the condition.
Some brachial plexus birth injuries are unavoidable. However, there are situations in which medical staff or hospitals may be responsible for causing harm.
If you suspect that medical errors caused your child’s newborn brachial plexus injury, you may have legal options. Pursuing a birth injury lawsuit could help secure financial support to get your child the care they need to recover.
An experienced brachial plexus injury lawyer can help determine whether your child's condition was preventable. Our legal partners have secured over $1 billion for families nationwide impacted by preventable birth injuries.
Call us right now at (855) 220-1101 or get a free case review to find out if we may be able to help your family.
