LIFTING: Special attention for safety is needed as you lift your baby. Lift your child with one hand under the buttocks, the second hand behind the head and upper back. Avoid placing your hands around the baby’s chest lifting with upward pressure through the arm pit. Pre-position the baby’s limp arm on the chest before lifting the baby. Avoid having the arm dangle.

DRESSING: Dressing your baby’s arm can be made simple and safe by following these suggestions: Select front-opening clothing whenever possible. Loose pull over clothing will be easier to put on than tight tops. Dress the affected arm first while you can glide the sleeve freely over the arm. Start with the affected arm at the baby’s side. Slide the sleeve up the arm then put the shirt around the back. Lastly, put the other arm into its sleeve. Undress the affected arm last when the sleeve is free to slide off the arm.

Follow your doctor’s advice about positioning your baby’s arm. Some physicians might recommend pinning the sleeve on the affected side to the chest, for a very short time following the birth, so that the arm does not dangle and cause undo discomfort. Once the first transitionary week (or two) has passed, a variety of positions is recommended rather than keeping the arm in the same spot all the time.

POSITIONING: Your baby needs to be held or placed in the same variety of positions as any baby. Laying in different positions will not cause further injury to the nerves, muscles or joints. For sleeping/tummy play, position the arm in front of the chest when laying on the injured side. Bend the elbow bringing the hand close to the baby’s mouth. Check for pink skin color on the back of the hand after 45 seconds. If it is pale or bluish move the baby to a new position on the back or uninjured side.

EXERCISES: A therapist, pediatrician or a nurse may have shown you exercises for your baby’s arm. These exercises are called Range of Motion (ROM)*. ROM’s are done to keep the joints flexible even if your baby can not move the joint. Avoid bringing the upper arm close to the ear and pushing downward toward the chest. The underarm may become over stretched or the shoulder joint out of natural alignment.Move the joint slowly and gently, not forcefully. The baby may fuss. Stop the exercise if excessive crying begins. Restart once the baby has calmed. Position your hands with one joint in between them. Move one joint at a time.

*Passive range of motion exercises can be obtained from Home Program Instruction Sheets for Infants and Young Children Therapy Skill Builders, Tucson, AZ 85733 Telephone, (520) 323-7500.

Terry Higbee OTR/L, has been a pediatric OT specialist for 22 years. She is a Certified Infant Massage Instructor and is certified reliable in Neonatal Individualized Developmental Care and Assessment Program. She is currently affiliated with the Desert Samaritan Medical Center in Mesa, Arizona