Is lifting arm to mouth while sitting up a good sign?

[Trent's mom]

O'kay I need some input!! Trent is 13 weeks old with ROBP. At our 6 week eval he had complete finger and wrist movement but the rest of his arm was completely limp. Our neurologist said it didn't look good, by 6 weeks we should see some progress if there was to be a non-surgical recovery. Over the past 7 weeks he seems to make progress everyday. He started on his back being able to get his arm on his belly, then his hand to his mouth, then his arm stretched over his head. Then movement started while sitting up, arm on his lap, then bent up to his chest. Tonight while I was feeing him rice cereal (he has acid reflux so we started spoon feeding him once a day at 3 months) in his bouncy seat he used his right arm several times to interfear with the feeing process and his hand reached his mouth each time. In you all's experinces is this a good sign? Could he be healing on his own? I know every case is different but do you all who have been through this have far more experience, do you think that this is positive? Or am I just getting my hope up? Please be honest. We do go to our neourologist in a week and Nath in 2 weeks, but I am jumping out of my skin waiting for answers and thoughts. Thanks!!
Anita

[Mandie]

awesome!!! way to go little man!

That is wonderful, congrats!

[tcon]

YES!!!! that is a great sign. I believe they base decisions about primary surgery on whether or not they are able to get hand to mouth against gravity (sitting up)! So that is great news!! congrats.

[katep]

I am pretty sure all the doctors Joshua saw would have said no primary for your child. Joshua just barely got his hand to his mouth at 4.5 months and everyone universally ruled out primary for him because of that.

Kate

[admin]

Yes, this is a HUGE sign of recovery! Congrats!!

Did you know that some doctors years ago, and some today, will do a "cookie test?"
If the baby can get his/her cookie (that is in his/her injured hand) up to their mouth while sitting up then NO nerve surgery is needed. Today, we have many different things to look at and different tests, but my doctor told us about this one and we were very happy when Ella passed the test! Of course, some may say that such a simple test cannot prove that nerve surgery is not in the future of the child, but it is a great help to figure things out.

~Krista~

[TNT1999]

Hello, Anita. Yes, this is a very good sign! Congratulations! It certainly is an indication that he might not need nerve surgery. However, and I don't want to be the downer here, please don't just take these replies and get your hopes built up too much. You see, while hand to mouth is a very good indicator, I do know that some babies are just very clever in compensating and could be doing it without biceps (there's another muscle, the brachioradialis (sp?) which can appear as biceps function too). Either way, the fact that he can do that movement already is great. I'm only saying this b/c if I was a new Mom post here and reading the other replies (which I'm not saying are not great replies b/c they are), I think I would really be getting my hopes up and counting on no surgery. That's all. Another thing to consider is that while Trent might not need nerve surgery -- which is wonderful news if he doesn't -- it doesn't mean that there won't be other surgery recommended. I know that sometimes Dr. Nath "skips" nerve surgery in less severe cases, but might recommend "secondary" surgery at a younger age. Of course, even if surgery is recommended, your family will ultimately have to decide if it's the way you want to go or if you want to hold it off longer. Sooo, what I would say at this point is that it sounds like Trent is doing great and very well might not need nerve surgery, but I wouldn't rule it out. In the meantime, just celebrate his success today!! I hope you understand and that people don't condemn me for posting this.

BTW, just thought I'd mention something else. You mentioned that he's ROBP. While it's too soon to tell, it would be more likely that he will be right-handed, simply based on the odds. I discussed this w/Dr. Nath once -- the recovery for a dominant side injury -- and he agreed with my theory that if the dominant side is the injured side then it's more likely that there will be a better recovery b/c the brain will keep telling the child to use the arm even though it's injured. In our daughter's case, she has a LOBPI, and functions very well with her right hand. So, it's likely that the right hand would've been her dominant side even w/o the BPI. It was a struggle for us to get her to use her left arm at all b/c her brain wasn't telling her to use it. Does that make sense to you? Another thing that's "on your side" is that he has complete finger and wrist movement. I've also always felt like there's more "incentive" for the baby to move their arm if their hand can actually do something once it gets there. If the baby / child has no hand function, then what's the use of them moving their arm, if you know what I mean. Anyway, just thought I'd end this on a positive note that you likely have a couple things working in your favor. Okay, I've babbled long enough here.

Congratulations!!

~Tina, bpmom@comcast.net, Mom to Nicole, 6 y.o. w/LBPI & Joshua, 1 y.o. c-section

[BIGJAVSMOM]

Congrats on hand to mouth. I sat and waited for this for 3 months. Of course it never happened,it was pretty much impossible. But I am happy for you and you're baby.
I like the cookie test idea. Buy lots of cookies!!!

Sincerely, Marlyn

[dmom]

Anita,

That is so great that your baby is making good progress!

I have to say that Tina made a lot of the same points I would have made. My son Danny could do all of the same movements you say your son can do at the same age. It seems like he is healing. Danny got out of primary nerve surgery because he could get that hand up to his mouth, like Trent. He had neuromas on the nerves, not avulsions.

HOWEVER, he never did get external rotation (out to side) and the arm over the head as he was sitting up (see, they cheat -- they get the arm over the head while lying down, but that's just gravity!). Those are two key movements to look for as you're evaluating your baby: external rotation and arm over the head.

Danny ended up needing the mod quad (muscle-tendon transfer) with Dr. Nath at 10 months because his internal rotation was so strong. How is Trent's internal rotation? And can he do those other movements?

At any rate, Dr. Nath is awesome and will be able to tell you exactly what's going on and what Trent needs. You're doing all the right things - and I hope and pray Trent just keeps gaining more and more movement!

Keep us posted!
Janet

[Trent's mom]

Thank you all soo- much for your insight and comments. Every bit helps. We know that this is not the end for Trent, but every small step is an accomplishment compared to where he was 13 weeks ago in the hospital. We just hope everyday brings another small movement. We tried the cookie, no luck. At 3 months old it is a bit hard to have him hold the cookie in his good hand much less his bad hand, but we will keep trying b/c it is a wonderful idea that we would have never thought of. We’ll keep you posted. We are looking forward to seeing Dr. Nath on the 27th for his opinion of our little guy.

[admin]

Just to make sure you understand. External rotation and getting the arm up over the head is addressed by having secondary surgery. Many children who have a BP injury are likely to have a secondary surgery if full or almost full recovery doesn't happen in the first few months. My post was strictly speaking of nerve surgery as I stated in that post. I just thought I would post again so you are not confused. I believe that the posters who are saying that it is a great sign and no surgery are only speaking of nerve surgery. It is MUCH too early to predict whether or not your child will need secondary surgery. Hand to mouth is awesome. No matter how it gets there, that is really great news at this point and any specialist would agree with that. Some children have nothing at all at this point. Later on (in a couple of months) when the baby is a little older you can talk to your specialist about compensation and such so you can make a more finalized decision if the injury doesn't seem to be severe. For now, love what you see...it is true that at least some recovery is taking place. Congrats, again.
PS some info regarding my daughter...
She was able to get hand to mouth sitting up at about 4 1/2 months old. She just started to bend her arm at 3 months old. We waited patiently b/c we saw signs of recovery along the way. She did not need nerve surgery, but at 2 years and 4 months old she had secondary surgery to address shoulder issues as well as external rotation, getting arm over head, etc. She can do all of that and is doing very well today b/c of the surgery.
~Krista~