A brachial plexus injury occurs during birth when the neck is over-distended or one arm is stretched or caught in the birth canal. The injury can result in the tearing of tendons or muscles or even the breakage of bones. In some cases, the injury will heal on its own in about six months. For many children, however, the damage is permanent. The affected arm may be weak or paralyzed, depending on the extent of the damage.
To protect the affected arm from further injury and allow the body to repair some of the damage, swaddle an infant with a brachial plexus injury to keep the arm close to the chest or abdomen. The swaddling should not be so tight as to impair circulation. Do not lay the child down to sleep on the affected arm, as circulation is likely to be impaired in this limb. Passive range of motion exercises can keep the hand and elbow from contracting (drawing up). A physical therapist can treat the child and determine a therapy schedule that best serves the individual needs. These exercises must be done at home every day in order to achieve the maximum benefit. Some cases may require corrective surgery. If the child is left with a weak or paralyzed arm despite treatment, physical and occupational therapy can encourage independence through the performance of daily living activities with the assistance of adaptive equipment. This injury does not affect the intellect or growth of the child.