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Birth brachial plexus palsy — gentle daily movements for your baby

Shoulder & elbow · Birth brachial plexus palsy (weak arm from birth), for parents

How to use this sheet. Start these movements when we tell you to. Do them with your baby lying relaxed on the back, for example at a nappy change. Move one joint at a time, slowly and gently, only as far as it goes easily, and hold for a moment at the end. Never force, pull or jerk the arm. Do not pull the arm during dressing or lifting. Support the weak arm whenever you pick your baby up, and put it into the sleeve first and take it out last. Do not let anyone massage or pull the arm, a bone-setter included. Keep the skin folds of the armpit, elbow and palm clean and dry. Keep every planned review because early recovery guides treatment.

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Arm up beside the head

Hold the weak arm just above the elbow. Put your other hand on top of the shoulder to keep the shoulder blade gently still against the bed. Slowly lift the arm out to the side and up towards the ear, hold, then bring it back down. Then lift it forwards and up beside the head in the same way.

10 times
3 times a day

Should feel: The arm moving easily, with your baby relaxed Should not feel: Your baby crying with pain — stop and go less far

Turning the arm outwards

Keep the elbow of the weak arm tucked against your baby's side and bent, with the forearm across the tummy. Slowly turn the forearm outwards, away from the tummy, until it points to the side. Hold, then bring it back. This is one of the most important movements on this sheet.

10 times
3 times a day

Should feel: The elbow staying against the side Should not feel: The elbow drifting away from the body

Elbow, wrist and fingers

Hold the weak arm above the elbow. Gently bend the elbow, then straighten it. With the elbow bent, turn the palm up towards your baby's face, then down. Then gently bend the wrist back and open the fingers and thumb.

10 times
3 times a day

Should feel: Free movement of the elbow, wrist and fingers Should not feel: Pushing past the point where it stops easily

Tummy time

While your baby is awake and you are watching, lay your baby on the tummy on a firm surface, with both forearms under the chest so that the weak arm takes some weight. A small rolled towel under the chest helps. Put toys in front and towards the weak side. For sleep, always lay your baby on the back.

Little and often
Every day

Should feel: Your baby lifting the head and leaning on both arms Should not feel: The weak arm trapped under the body

Stop and telephone us if

Your baby does not move the hand or fingers, or moves them less than before
Your baby cries with pain when the arm is moved, or the arm or collarbone looks swollen
The arm is getting stiffer, or it will not turn outwards as far as before

Ready when you are.

Call either clinic during consulting hours, or send a WhatsApp message any time.

Nallasopara West Virar East