A tough delivery can leave lasting effects on a baby’s shoulder and arm.

Many cases resolve with time and therapy, but some need early, focused care.

The sooner you notice signs, the faster your team can step in. This guide flags common clues in the first weeks.

One arm that stays still or hangs low

Compare both arms when the baby startles, stretches, or cries. In infants with Erb’s palsy, one arm can hang by the side with the elbow straight and the palm facing back. Movement may be limited at the shoulder. The baby may also have trouble bending the elbow.

Keep the arm supported during diaper changes, and don’t force range of motion. Note the time stamps when you see the posture, and be sure to share clips with your pediatrician. Ask for a brachial plexus exam during the first week.

Weak shoulder rotation during routine care

Check the shoulder during dressing, bathing, and burping. If lifting the arm causes a visible shrug or the shoulder seems stuck, flag it. Limited rotation can hint at nerve stretch or muscle imbalance.

Be sure to ask your clinician how to position the arm for sleep and feeding. Read trusted online resources on care and costs. You can also pursue an Erb’s palsy settlement to plan for therapy and equipment needs.

Elbow flexion that seems late to appear

After a few weeks, most babies show a natural bend at the elbow. If the elbow stays straight or bends only with shoulder hiking, take note. See if the biceps reflex fires on the affected side. Track milestones with simple notes, dates, and short videos. Bring your log to hospital visits. Make sure to ask whether a therapy referral, imaging, or nerve study is appropriate. Early physical therapy and gentle home exercises can help protect motion.

Wrist or hand differences that persist

Look for a wrist that curls inward or fingers that seem tight. Compare grip strength during bottle holds or while resting on your chest. Check for skin changes from positions that the baby favors.

In addition, keep the hand warm and supported during naps. Ask for a therapist to teach safe stretches and splint basics. Small, frequent sessions work best.

Pain, swelling, or shoulder popping with routine handling

Watch for discomfort during routine care. If crying spikes in certain positions, or you hear or feel a pop at the shoulder while dressing, stop, and reposition the baby. Note what you were doing and the time.

Swelling, warmth, or tenderness needs a prompt exam. Your clinician may order imaging to check for fractures or joint problems. Do not force range of motion. Be sure to also keep the shoulder in a neutral position and wait for guidance from your care team.

Endnote

Many families face the same questions after a difficult birth. Keep simple records, including dates, short videos, and a running list of concerns. Ask for a coordinated plan that includes physical therapy, occupational therapy, and regular specialist check-ins. Be sure to also build small home routines that support progress.