Erb's Palsy

This leaflet is not meant to replace the information discussed between you and your paediatrician or physiotherapist, but can act as a starting point for such a discussion or as a useful reminder of the key points.

What is Erb’s Palsy?

Erb’s Palsy is a problem that causes your baby to have difficulty moving their arm. This is because of an injury to the nerve supply along their arm.

Erb’s Palsy can also be known as:

• Shoulder Dystocia; or

• Obstetric Brachial Plexus Injury

How does it happen?

This injury happens during birth, as your baby journey’s through the birth canal. The nerve along their arm becomes stretched.

How long will it take to recover?

This is difficult to predict, but approximately 85 out of every 100 babies (85%) have a full recovery. Mild cases recover within one to eight weeks.

How can Erb’s Palsy be treated?

Erb’s Palsy is an injury, so to begin with it needs rest to recover rather than treatment. This means keeping your baby’s arm supported and moving their shoulder as little as possible.

Here are some ways in which you can help your baby’s recovery

• Positioning

  When your baby is being picked up or carried, give their arm support with your arm or body so that the weight of their arm does not drag on their shoulder. This can feel awkward to begin with but gets easier with practise. You can also support your baby’s arm close to their body with a toy when they are lying in their cot.

• Dressing

  Dressing is awkward at the best of times and not often appreciated by your baby, and this is something that can be made more stressful if your baby has Erb’s Palsy. When dressing, put your baby’s affected arm through the sleeve first. This leaves their non-affected arm to do the twisting and turning. When undressing take their non-affected arm out first. Their affected arm will then easily slip out without any twisting.

• Washing

  Support your baby’s arm when washing them, as you do when carrying and picking them up (see Positioning above). You will have to move your baby’s arm to be able to clean under it, but try to move it as little as possible for the first 48 hours. Your paediatric physiotherapist can show you how to do this, if you are concerned.

• Sensory stimulation

  Because your baby is unable to move their own arm, they are unable to feel other textures and parts of their body as they do naturally with their other arm. So it is important that you gently stroke and massage their arm. Do not forget to open their hand fully and massage their palm and fingers (they get a lot of sensory information from their hands).You can also safely bend their elbow to help them touch their face, mouth (they like to suck their fists), and their other hand.

Physiotherapy after five days

After five days the nerve has been rested enough to allow very gentle exercises to begin. You should be referred to the physiotherapist by your paediatrician.

The aims of these exercises will be:

• To prevent your baby’s muscles from becoming short.

• To prevent your baby’s joints becoming stiff.

• To give your baby the feeling of normal movement, so that when their recovery begins they will not have forgotten how to use their arm (remember those kicks and punches in the womb).

• To continue to stimulate the feeling in your baby’s arm.

Are there any support groups?

Yes there are. Ask your physiotherapist to give you the contact address of the local or national support group when your baby is assessed.

Further information

If you have any further questions or concerns, please contact the Paediatric Orthopaedic Team.

• Paediatric Orthopaedic Team
  Telephone: 01227 783065
  Email