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Warning-sign checks

Brachial plexus injury in newborns: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Seek emergency care if the baby has trouble breathing, turns blue or gray, is very difficult to wake, or develops another sign of serious illness.

    And for anyone, someone who:

    • is bleeding heavily and it will not stop with firm pressure
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact the baby’s clinician promptly if:

    • Arm movement decreases after it had been improving
    • The arm becomes swollen, unusually painful, pale, cool, or discolored
    • A joint becomes difficult to move
    • The baby develops a new eyelid droop or unequal pupils
    • Home exercises appear to cause pain
    • Feeding, growth, or developmental progress becomes a concern

    Breathing difficulty can have many causes and should not wait for a routine appointment.

  3. 3

    Does any of this apply?

    Book an appointment

    Follow-up should begin soon after the injury is recognized.

    The clinician will track active movement, joint flexibility, sensation, reflexes, and growth of the arm.

    Families may be asked to continue a home exercise program between therapy visits.

    Routine appointments are important even when movement is improving.

    Recovery may be uneven, and shoulder tightness can develop while nerves and muscles are changing.

    The care team may adjust exercises, arrange imaging, or refer the baby for a surgical opinion when needed.

The article also says

Keep a record of appointments, exercises, and changes in movement.

Short videos may help the specialty team compare the baby’s arm function over time.

Ask the clinician how to position, carry, dress, and play with the baby safely.

Every sign above is quoted from the sofidex article on Brachial plexus injury in newborns. If you are not sure, err upward — it is always reasonable to be checked.