United Brachial Plexus Network, Inc.

Hi there, I am new to this message board and just had a couple of brief questions. Thought this looks like the place to ask them!

My wife gave birth to our son one week ago today (born March 7th). Zach was born with shoulder dystocia in the left shoulder. When he was first born, his left arm and hand did not appear to move at all. Within a few hours, he was able to move some of the fingers on the left hand, but that was about all.

The doctor and nurses told me it was shoulder dystocia, something I had never heard of before, but have learned a lot about since. I went home and used the internet to learn lots of things--that is what I feel is best about the internet--puts a lot of power in the hands of regular folk...

Anyway, it looks like Zach has this Brachial Plexus injury (or Erb's Palsy) in the left arm. During the past week, he has made some improvements. It seems he has almost complete control of the left hand now. He can move the fingers and hand freely. But, the rest of the arm still just kind of hangs there. Zach is able to move the lower arm at times--and just yesterday--we noticed him flexing some muscles in the upper arm for the first time.

We are taking Zach in next week and our pediatrician says we will see how the arm is doing then. She claims a lot of these types of injuries do get better over time, but Zach would probably need physical therapy and maybe some surgery.

When I lift Zach's arms, I can feel quite a difference between the two. The right one is normal and has tension to it. The left one just feels limp and seems to have almost no tension to it. My question is if any of you have had (or know of) similar situations and what his odds are for recovery. I keep hearing this general "most infants recover" stat, but I never get a hard figure on how many actually DO completely recover. From what I've seen, it seems you should give it three months time or so to see what your child's situation really is. I am almost positive Zach will at least need some therapy because I can just tell his arm will not be functioning normally in one weeks time.

I know many of you have a worse situation than what we are going through and I am saddened by some of the stories I have read. I've also read what seems to be a general consensus that this sort of injury should never happen. Do you feel this is so? Zach weighed in at 11 pounds 2 ounces at birth, but his ultrasound showed him to be just over 9 pounds and we were taking him ten days early just to be safe (so we thought). I witnessed the birth and yes, it was a long labor, but when Zach was actually being pushed out and delivered by my wife--that part all went relatively quickly and I didn't notice anything unusual. I mean, the whole process of pushing and actual delivering couldn't have been more than ten minutes and I didn't notice any abnormal amounts of pushing or pulling. Of course, a baby this size doesn't come out the easiest and I expected it not to be a piece of cake and my wife informs me that it certainly WAS NOT a piece of cake on her end!!!

Anyway, I wish you all the best of luck and thanks for taking the time to listen to my ramblings and answering my questions.

-----------Derek

Hi! Welcome to the boards. Sorry to hear about your situation but here is where you'll learn alot. Sounds like he's already getting some recovery and most likely has a upper brachial plexus injury. It's pretty much wait and see till the end of the first 3 months. In the mean time you should be doing range of motion excercises taught to you by a therapist. Francine has a great website with alot of info. www.injurednewborn.com
Hope this helps a little. I know what you're going through, you are not alone! By the way I'm sure that an 11 pound baby was no easy push. LOL LeeAnne Browning

Hello Derek and welcome.

First, congratulations on your precious new son! I hope your wife is recuperating quickly and little Zach is allowing both of you to get some rest.

I am so very sorry that you have to reach out to our community of parents, but I'm so glad that you (as I) have this place to come with questions and concerns.

Zach's progress thus far does sound encouraging and you are to be commended for taking such an active role in his treatment so quickly. I wish we had hard and fast statistics for you as far as spontaneous recovery, but the range I've heard varies from 85% - 99%. Just in my own experience, I tend to lean toward the lower percentage.

When visiting with your pediatrician next week, ask for a referral for therapy. Hopefully, you will have access to someone with BPI experience. At this point, your mainly looking at passive range of motion exercises for the entire limb--every joint. We did 10 reps with every diaper change when our Natalie was a baby.

The next step I would recommend would be to get in touch with a brachial plexus specialist--preferably a multi-disciplined group. There are many many families on this board who use the team at Texas Children's Hospital in Houston, but there are other reputable specialists throughout the country. Let us know where you are and I'm sure some names will come up.

In the meantime, enjoy that baby! It's so easy to get overwhelmed with the emotion and information of brachial plexus injuries so be careful not to OD on the negative. Take care of yourself and your wife and just soak in all the sweetness of your new addition. Again, congratulations and welcome!

Stacy

Welcome to the board and congratulations on your new baby boy! Boys are such a blessing. You are fortunate to have a diagnosis so early and have started doing research. Although most babies who suffer a brachial plexus birth injury do recover spontaneously, parents still need to be aware of the timeline involved so they monitor the injury and get medical advice from a brachial plexus specialist. Caution is advised for those parents whose child does have a spontaneous recovery. Sometimes, unfortunately, it appears the child is all better but, as the child ages, deficits might be apparent. That is why therapeutic intervention is recommended from an early age.

I suggest you visit http://www.injurednewborn.com for further information and links. You might also locate a support group nearby and talk to parents about the specialists they have used locally.

If you're near Ohio, we are having a picnic June 1st and a brachial plexus team from Texas Children's Hospital will be there to evaluate children, free of charge. Visit: http://members.aol.com/kritz74433 for information about the Ohio picnic and Ohio links.

Keep us posted with your son's progress!

Hi Derek! Welcome to the boards!

There is a very important page on here you need to read - you will find it on the home page - the button for Information for New Parents. It's a good overview of what you need to know for now. Also there is a whole bunch of more good stuff in http://ubpn.org/awareness - hit the button for birth injury.

Shoulder dystocia is when the shoulder of the baby gets stuck on the mom's pelvic bone...dystocia means difficulty actually....difficulty birthing the shoulder. But the thing that causes the brachial plexus injury is most commonly excessive traction. The nerves inside the baby's neck are stretched - some just are stretched and others may be torn or actually pulled out of the spinal 'socket'.

But you have good news - your baby's hand is moving and that is a really good thing! Time will tell if it's a severe injury or not. The statistics are REALLY high for spontaneous recovery - they say somewhere around 70-90%. At four months of age they are looking for HAND TO MOUTH MOVEMENT WITHOUT THE ASSISTANCE OF GRAVITY. This means that your sweet Zach will be sitting up in a high chair and be able to bring food to his mouth.

Right now you need to get yourself an appointment with a PT and both you and your wife and other family members (if they are interested) get taught how to do Range of Motion exercises - which you will need to do with each diaper change. This is MOST important to keep the joints supple until the nerves grow in and make the muscles move.

Then you should also be researching a brachial plexus specialist. If you tell us where you are, we can tell you if there is a clinic nearby.

How is your wife doing? These births with larger babies are usually pretty traumatic for the mom. Please send her my regards and tell her to come on line and join in. We'll surround her with a lot of suport.

I'm so glad your pediatrician told you the truth. Very often they are saying "it'll get better" and not warning the parents of the possibilities!

Many of us are in a worse situation right now because the majority of people on here are those whose kids are severely injured - we stay here cuz it's a hard road and we need the support from each other. But there are a lot of parents with newborns on here as well because waiting alone is hard too!

We are here for you! Keep on asking a lot of questions and we will do our best. We each have such different experiences (and yet the same experiences) - it's like a melting pot and that is good!

Kissies to sweet little Zach! and a big hug to Mommy, too,
francine

http://www.injurednewborn.com

Hi--this is Derek again--just wanted to give everyone here a quick thanks for your replies to my questions! Just posted this last night and there are already four very helpful responses!!!

I've looked at the web pages you suggested and have learned a lot. Yes, our pediatrician looked at Zach the day after he was born and seemed honest that this would need work--physical therapy and possibly surgery if things didn't work out. We're very glad she is honest and caring about this. We're confident she will help lead us in the right direction, as she was already recommending therapy if the arm was not completely recovered by the two week appointment. Plus, she let us know that it was not good and Zach would probably not be recovered by then, so to expect at least therapy. We have no problem with this and are excited to learn how to help our new boy.

By the way, we live in St. Paul, Minnesota. If you have any recommendations for people in this area, we have no problem listening to suggestions from people who are in the know about this.

Hi Derek,

Congratulations on the birth of your son! I'm sure he will bring you great pleasure.

I think there is some really good advice in the replies above. The websites are packed with helpful info. My 3 month old daughter has Erb's Palsy, and I have found the sites to be wonderful resources.

I have a few comments/ideas to add based on the lessons we've learned so far...First off, educate yourself about your son's injury. Learn everything you can so that you can ensure he receives the best care possible. It sounds like you're well on your way in this area.

Also, don't assume that your doctors know everything and are always right. Don't be afraid to question their choices and fight for what you think is necessary and appropriate. Helping your child should be everyone's focus, not worrying about doctors' egos.

Start therapy asap. Why wait for a couple of weeks? It won't hurt your son to have PT/OT and ROM exercises right away, and it is likely to help him.

Take time to enjoy your son and being a dad. I'm sure we can all tell you that it's easy to get wrapped up in the injury, which I think is understandable. Sometimes it's hard to see past the frustration, but remember that you have a beautiful child.

A final thought that sums it all up is that you are your child's voice right now. Do everything that you think is right to fight for him and to help his progress.

I really hope that he continues to regain movement on his own. I'm so glad to hear that he is progressing. I wish him a speedy recovery.

Best wishes to you and your family,
Sarah

How close are you to Minneapolis? (can you tell geography is not my strong point?)

On this current page you will see a post from Missy... click on her post and then click on her name to get her email- she takes her son to a Dr. Drake at Shriner's in Minneapolis and can give you more information about him and how to get into the Shriner's system. From what she has posted, she is very pleased with this doctor.

Keep on asking questions

have a nice weekend,
francine

Hi Derek,

My name is Missy...our family lives in Fargo, ND. We've been taking our son Mitchell (7 yrs old on Monday) to the Shriners Childrens Hospital in St Paul. Mitchell had muscle transfers and pectoral release just before he turned 5 and he's scheduled for a derotational osteotomy in November. His surgeon is Dr. Drake and we have been very happy and impressed with the care he has given to our son.

Since you are right there, you might want to check the Hospital out as an option for you. If you need any direction with getting started with Shriners, let me know. There's an application process to go through...it sounds a bit intimidating, but really isn't! If there are any questions you have, I'll be happy to help.

Congratulations on your little Zach! I'm sure he's a joy! Hope mom is doing well too.

Looking forward to hearing from you,
Missy