ChildRC: Birth Injury Resource Center

What Causes Erb’s Palsy?

Erb’s palsy, also known as brachial plexus injury, is the result of a stretch or tear to the network of nerves that supply the child’s shoulder and arm.  This type of injury can occur during childbirth, when the baby’s shoulder becomes stuck behind the mother’s pubic bone, and the appropriate delivery techniques are not used to deliver the baby.  There are some factors that can be present that may increase the risk of inappropriate delivery techniques and a resulting Brachial Plexus injury:

• High birth weight
• Breech birth (baby is delivered buttocks first rather than head first)
• Obese or diabetic mothers (which may increase the chance of a high birth weight baby)
• Prolonged labor
• Use of force such as vacuum extraction or forceps to pull the baby from the birth canal

Traumas

There are four types of Brachial Plexus injuries:

1. Neurapraxia, the most common type, occurs when the nerve has been damaged, but not torn

2. Rupture occurs when the nerve is torn, but not separated from the spine

3. Avulsion, the most severe type, occurs when the nerve is torn from the spine

4. Neuroma occurs when scar tissue grows around the injury, and places pressure on the injured nerve, thereby interfering with the nerve's ability to send signals to the muscles

It is very important that you understand that a birth injury caused during delivery in many cases could have been the result of Medical negligence, and therefore could have been prevented.  It would be virtually impossible for a parent, on their own, to determine if medical negligence caused their child's Erb’s Palsy.

Start the process of getting your birth injury legal questions answered.

Learn more about identifying the symptoms of an Erb’s palsy injury.

Symptoms of a Erb’s Palsy Injury

Erb’s palsy symptoms can be seen as early as in the delivery room or in the nursery. Unlike cerebral palsy, which can effect a child’s entire body, symptoms of Erb’s palsy only occur in the shoulder, arms and hands. Erb’s palsy symptoms include:

• Lack of movement in the arm or hand
• Missing Moro reflex, which causes an infant to react when startled by a sudden, loud noise by stretching out the arms and flexing the legs
• Inability to maintain the arm in a normal position (flexed at the elbow and held against the body)
• A limp arm
• The affected arm may flop when the infant is rolled from side to side
• Lack of spontaneous movement in the arm or hand
• Decreased grip on the affected side

Learn more about the causes of Erb’s palsy and how it differs from cerebral palsy.

What is a birth injury?

A birth injury, also referred to as birth trauma, is any type of injury sustained by an infant as a result of the childbirth process. It is estimated that as many as seven babies out of 1,000 in the United States suffer harm during labor and delivery. Birth injuries can take on many forms and vary in severity. In some cases, unfortunately, birth injuries are caused by negligence on the part of a professional medical provider.

Although there are numerous types of birth injuries, some of the more common occurrences include:

• Bruising, lacerations, or forceps marks
• Brain damage
• Internal bleeding
• Severe swelling of the scalp
• Breakage of small blood vessels in the eyes
• Facial paralysis
• Fractures
• Shoulder dystocia injuries
• Erb’s palsy (also called brachial plexus palsy)
• Cerebral palsy

What is the difference between a birth defect and a birth injury?

A birth defect is present at the time of birth, caused by factors such as a genetic condition or toxic exposure inside the womb. In contrast, a birth injury generally results from complications arising from the childbirth process itself.

Find out more about the causes of birth injuries.

Erb’s palsy, sometimes referred to as brachial plexus palsy, is a type of injury in which a network of nerves in the neck and upper chest (known as the brachial plexus) is injured. The brachial plexus is the network of nerves that supply feeling and control to the child's shoulder and arm. The injury results in a loss of movement and feeling in the arm, hand and fingers. This type of injury can occur during childbirth, if the baby's shoulder becomes stuck behind the mother's pubic bone, and the appropriate delivery techniques are not used to deliver the baby. Although an Erb’s palsy injury can occur at any time, most cases of Erb’s palsy are the result of injuries that happen during the birthing process.

One to two of every 1,000 babies are afflicted by Erb’s palsy. The prognosis for these babies depends largely on the type of injury sustained.  In time, and with proper treatment and therapy, most infants who suffer an Erb’s palsy injury will recover full use of their affected arms.

Types of Erb’s Palsy Injuries

Neurapraxia injuries (in which when the nerve has been damaged but not torn) typically heal within three months of birth without assistance. In more serious cases of Erb’s palsy, weakness and loss of feeling may persist. Physical therapy may be an option. If no significant improvement in arm strength is seen within three to six months of age, corrective surgery may be required.

In the case of nerve ruptures and avulsions -- the most serious types of nerve injury seen with Erb’s palsy -- it may be possible to repair a rupture by grafting a nerve from another nerve in the child's body. Although it is not possible to repair a tear from the spinal cord, nerve grafts may help to restore some function in the arm.

Learn more about the symptoms of Erb’s palsy.

Learn more about what causes Erb’s palsy.

Start the process of getting your birth injury legal questions answered and advocating for your child.

What Causes Cerebral Palsy? 

Cerebral palsy (CP) is a group of chronic conditions affecting body movement and muscle coordination.  CP is caused by an injury to the brain before, during, or shortly after birth; or during infancy.  In some cases, the cause of the brain injury is unknown. However in many instances cerebral palsy is a result of inappropriate delivery methods or medical mistakes. 

Infants born prematurely tend to be at higher risk of experiencing key symptoms that cause cerebral palsy.  Because the brain and other organs have not fully matured, complications such as severe bleeding or respiratory distress from underdeveloped lungs deprive the brain of oxygen and could cause cerebral palsy.  

During labor and delivery, unusual prolonged delays resulting in lack of oxygen to the brain or severe physical trauma to the mother or child may cause injury.  Medical professionals are trained to recognize signs that a fetus is in distress, and should know which measures are necessary when faced with such complications. 

There are many factors that can injure the developing brain and may produce cerebral palsy. A risk factor is not a cause; it is a variable that may increase the chance of cerebral palsy occurring.  Even though a risk factor is present, it does not mean cerebral palsy will occur; likewise, the absence of a risk factor does not mean that cerebral palsy will not occur. If a risk factor is present, parents and physicians should be even more observant to the infant's development. The following risk factors may increase a newborn's risk of developing cerebral palsy:

• Premature birth
• Breech birth (baby is delivered buttocks first rather than head first)
• Low birth weight
• Difficult labor and delivery
• Infection or virus of the mother during pregnancy
• RH or A-B-O blood type incompatibility between mother and infant
• Fetal growth or development issues

It is very important that you understand that a birth injury caused during delivery in many cases could have been the result of Medical negligence, and therefore could have been prevented.  It would be virtually impossible for a parent, on their own, to determine if medical negligence caused their child's cerebral palsy or brain damage.

Start the process of getting your birth injury legal questions surrounding your child’s birth answered.

Learn how to identify the symptoms of cerebral palsy.

Cerebral palsy may be mild or severe, depending on the part of the brain and the size of the area affected, as well as the parts of the body controlled by that area of the brain. The physical signs of cerebral palsy are often evident to parents and health care providers early on in a child's life. However, occasionally symptoms will not manifest themselves until later in a child’s development.

Signs that you may observe in the delivery room, or shortly after birth, that may suggest possible cerebral palsy include:

• Hypotonic; infant has a floppy appearance, indicating lack of muscle tone
• Torticollis; infant has poor control of head position
• The infant is dusky, or blue in color
• The infant fails to breathe immediately following delivery
• The infant requires some type of resuscitation at delivery
• Seizures that develop shortly after delivery

Signs of Cerebral Palsy that may appear over time include:

• Not reaching developmental milestones on time (sitting up, crawling, walking, talking, etc.)  
• Inability or difficulty walking
• Hypertonic, or "tight" muscles in arms and/or legs
• Hypotonic, or "floppy" muscles
• Dystonia, chorea, or tremors
• Lack of coordination
• Dysarthria or other difficulties with speech
• Difficulty swallowing or feeding

Cerebral palsy can also cause some children to have severe cognitive impairment, while others who have the disorder have little or no cognitive impairment.

Learn about the causes of cerebral palsy.

Start the process of getting your birth injury legal questions answered.

Cerebral palsy is a group of chronic conditions that affect body movement, muscle condition, learning and thinking due to problems with brain development. The term cerebral refers to the brain, while palsy is a paralysis or lack of control with one's body. Cerebral palsy is not a disease. Rather, it is the name given to a group of disorders that affect one's ability to move and to maintain balance and posture.

Cerebral palsy results from injuries or abnormalities in the brain. Cerebral palsy can also result from brain damage sustained by an infant during childbirth due to trauma or low oxygen levels. The early signs of cerebral palsy appear in the first years of a child's life, typically prior to age 3. In more than 80 percent of cases, cerebral palsy develops within the first month of life.

In the United States, approximately 8,000 infants and 1,200 to 1,500 preschool-age children are diagnosed with cerebral palsy each year.

Some people with cerebral palsy require little or no assistance. Others with proper therapy and assistive devices-such as crutches, braces, walkers, and wheelchairs-can learn to be mobile and independent. Those with severe cerebral palsy may require special medical, educational, and social services. 

In addition to its physical effects, cerebral palsy can put tremendous financial stress on the family of a child with the disorder. In 2003, the average lifetime cost of cerebral palsy-related expenses for one person was estimated at $921,000. This figure represents both direct and indirect costs, such as medical expenses, accessibility modifications to homes and cars, special education, and lost wages.

Learn about the symptoms of Cerebral Palsy.

Find out about the causes of Cerebral Palsy.

Get your questions answered and advocate for your child, click here.

Dangerous Chemical Pregnant Women Should Avoid 

Everyday in workplaces across the country, American workers are exposed to thousands of chemicals. Fortunately, these substances usually pose no threat when used under controlled circumstances.

Some chemicals, however, are so toxic that even strict adherence to safety protocols can't provide complete protection. In other cases, disregard for safety rules or improper handling of toxic chemicals place workers at risk for serious work-related illnesses and injuries. Among the most tragic results of workplace exposure to dangerous chemicals are birth injuries suffered by a developing fetus in a mother's womb.

Silent Victims

One out of every 33 babies in the U.S. is born with some type of birth defect. While the cause of injury is unknown in most cases, studies have linked some serious birth injuries to workplace exposure to certain chemicals.

According to one study published in the Journal of the American Medical Association, women who are exposed to organic solvents at work are 13 times more likely than unexposed mothers to have a baby born with major defects.

Workplace Chemicals and Associated Risks

Fumes from noxious chemicals in an expectant mother's workplace can travel through the placenta to affect the unborn fetus, especially in the first trimester of pregnancy. The following graph lists a few of the more widely recognized toxic workplace chemicals, their potential effects on developing fetuses, and some of the occupations associated with their use.

Often times women can be exposed to these chemicals and not even know it. Start the process of getting your birth injury legal questions answered.

Other Prescription Medications That Can Cause Birth Injuries 

In addition to anti-depressant medications (SSRIs), there are several other medications that have been linked to serious birth injuries when used during pregnancy. Below is a list of some non-SSRIs that fit that description. For some women, the benefits of taking certain drugs during pregnancy may outweigh their risks. Only a licensed medical provider can make this determination.

• Accutane (Isotretinoin) - Isotretinoin is a prescription drug used to treat severe cases of acne. When taken by a woman during pregnancy, this medication has been found to cause serious birth defects affecting the baby's skull, heart, brain and eyes.

• ACE Inhibitors - including benazepril (brand name: Lotensin), captopril (brand name: Capoten) and others. ACE (Angiotensin Converting Enzyme) inhibitors describe a class of drugs that help to lower blood pressure. Use of these medications during the first trimester of pregnancy has been linked with malformations of the fetal heart and central nervous system.

• Diethylstilbestrol (DES) - Diethylstilbestrol, a synthetic hormone, was given to millions of pregnant women in the U.S. between 1938 and 1971. While the drug was originally thought to prevent miscarriage and premature birth, it is today associated with numerous health problems for both mother and child. Up to one-third of daughters born to women who took DES have an increased risk of infertility, miscarriage or premature birth. Sons of women who used DES also have a greater risk of problems relating to their reproductive tract.

• Tegison (Etretinate) - Used to treat serious psoriasis, etretinate has been linked to birth defects in infants of mothers who use it during pregnancy. The drug has since been taken off the market in the United States.

• Terbutaline sulfate (brand names: Brethine, Bricanyl or Brethaire) - Terbutaline sulfate is a prescription drug used to treat asthma. Its use during pregnancy has been associated with a higher risk of brain injuries, developmental delays and autism in infants.

• Dilantin (Phenytoin) - Phenytoin is a prescription drug that is used to treat epilepsy. It belongs to a class of medications called anticonvulsants, many of which have been found to be unsafe during pregnancy. If used by the mother during her first trimester of pregnancy, phenytoin can cause birth injuries such as cleft palate, developmental delays, and heart defects. The drug has also been linked with a condition called Fetal Hydantoin Syndrome, which refers to a group of birth defects present in a newborn infant.

• Lithium (brand name: Lithobid) - Lithium is commonly used to treat bipolar disorder and other depressive conditions. Use of this drug during pregnancy, particularly during the first trimester, has been associated with an increased risk of heart abnormalities and goiter, an enlargement of the thyroid gland.

• Antibiotics - Antibiotics are medications used to treat a wide range of bacterial infections. When taken by the mother while pregnant, the antibiotics Tetracycline (brand names: Achromycin, Sumycin) and Doxycycline (brand name: Vibramycin) have been found to have serious effects on fetal bone development.

• Penicillamine (brand names: Cuprimine, Depen) - Penicillamine is an immunosuppressive drug that is used to treat rheumatoid arthritis and scleroderma. Its use during pregnancy has been linked to birth defects.

• Warfarin (brand name: Coumadin) - Warfarin is an oral anticoagulant that is used to treat heart disease. Anticoagulant medications, which slow blood clotting, have been linked with mental retardation, facial deformations and fetal bleeding when taken by the mother during early pregnancy.

Start the process of getting your birth injury legal questions answered.

The Dangers of Anti-Depressant Medications (SSRIs) for Pregnant Women 

Introduced to the nation in 1987, Anti-Depressant Medications, formally known as Selective Serotonin Reuptake Inhibitors (SSRIs) are a newer class of prescription medications designed to relieve depression and anxiety disorders. SSRIs are also used to treat a variety of other psychiatric and physical conditions, including bulimia nervosa, alcoholism, borderline personality disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and obesity. Generally speaking, SSRIs are the antidepressants of choice for many of today's physicians. They are praised as being more effective, safer and better tolerated than older classes of drugs.

Types of Anti-Depressant Medications (SSRIs) 

The first medication in the SSRI category was Fluoxetine, sold under the brand name Prozac. Prozac was approved by the FDA in December 1987. Five more SSRIs followed, including:

• Zoloft (sertraline hydrochloride), manufactured by Pfizer, Inc.
• Paxil (paroxetine hydrochloride), manufactured by GlaxoSmithKline.
• Luvox (fluvoxamine maleate), manufactured by Solvay Pharmaceuticals.
• Celexa (citalopram hydrobromide), manufactured by Forest Pharmaceuticals, Inc.
• Lexapro (escitalopram oxalate), manufactured by Forest Pharmaceuticals, Inc. Lexapro is considered to be an improved version of Celexa.

With the exception of Luvox, all of these Anti-depressant medications are widely prescribed in the U.S. today.

The Problem with Anti-Depressant Medications 

Since every SSRI has its own unique chemical makeup, individual patients may respond differently to a single SSRI. In the same token, each patient may experience varied side effects with different types of SSRIs. For the individual taking the medication, SSRI side effects are rarely severe enough to require a reduction in dosage or discontinuation.

However, when taken by an expectant mother during pregnancy, SSRIs may pose significant health dangers for another, unknowing victim: the unborn fetus. In 2006 the FDA issued an advisory after a breakthrough study regarding SSRIs and pregnancy was published in the New England Journal of Medicine. The study compared mothers who took SSRIs in the second half of pregnancy with mothers who did not take antidepressants at all, or who discontinued their use in the first half of pregnancy. The study found that mothers who were on anti-depressant medication were six times more likely to deliver an infant with Persistent Pulmonary Hypertension of the Newborn (PPHN), a life-threatening condition that affects a baby's ability to breathe after birth. The study also noted less severe complications in another 20 to 30 percent of infants born to mothers who used SSRIs late in pregnancy.

SSRIs are not the only medications known to have caused birth injuries. View descriptions of other dangerous drugs and medications for pregnant women.

Start the process of getting your birth injury legal questions answered.

Medical Negligence or Malpractice during Childbirth 

Sometimes, a birth injury is a result of negligence on the part of the physician and other medical providers who care for a woman during her pregnancy, labor and delivery. Medical negligence, or malpractice, occurs when a doctor, or other health care provider, deviates from accepted standards of practice, and consequently causes harm to a patient.

Birth injuries can be caused by medical negligence in a variety of scenarios, including, but not limited to, the following:

• Failure to accurately interpret fetal ultrasounds or heart rate monitors
• Failure to identify and respond to fetal distress in a timely manner
• Failure to perform a cesarean section (c-section) when warranted
• Failure to expedite delivery of the baby
• Excessive force applied by obstetrical and operative devices such as forceps and vacuum extractions 
• Improper use of Pitocin, a drug which is used to induce or facilitate labor
• Applying excessive force to a baby's neck or shoulders during delivery
• Failure to adequately resuscitate or care for the newborn after delivery

Medical Negligence may also be due to a physician’s improper management of a complicated pregnancy or delivery situation such as:

• Abnormally large babies
• Prematurity; babies born before 37 weeks
• Abnormal maternal bleeding or fetal bleeding
• Compressed or prolapsed umbilical cord
• Prolonged labor
• Abnormally large fetus
• Underweight or premature fetus
• Abnormal birthing presentation, such as breech
• Detached placenta
• Inadequate pelvis size for vaginal delivery
• Maternal infections

Start the process of getting your Birth Injury legal questions answered.

The natural contractions and contortions that come with childbirth can be hard on a small infant, and the potential for a birth injury is always there. Natural birth injury factors such as pelvic irregularities, an abnormally large fetus, or prematurity can increase the chances of trauma during childbirth.

However, in some circumstances, it is revealed that some form of medical negligence, or malpractice, occurred during labor and delivery which may have caused the birth injury. Acts of medical negligence may involve the improper use of delivery aids such as forceps or vacuum extraction.

Other birth injury factors may be exposure to dangerous workplace chemicals or prescription drugs such as SSRI’s , taken by the mother before or during pregnancy.

When a newborn suffers a birth injury in the process of labor and delivery, parents are often left shocked and confused thinking, "What caused this birth injury?"

Factors that May Cause Birth Injuries & Birth Defects 

All too often, birth injuries ranging from simple bruises and fractures to devastating brain damage occurs during . Although delivering the baby by cesarean-section (c-section) may help reduce the risk for certain types of birth injuries, there is no guarantee that the delivery will be completely free of trauma.

The following are just some of the potential causes of birth injury:

• Medical negligence or malpractice: A birth injury can sometimes be caused by carelessness or negligence on the part of the physician and other providers that care for a woman during her pregnancy, labor, and delivery.
• Workplace Chemical Exposure: The exposure to certain dangerous workplace chemicals may cause serious birth defects suffered by a developing fetus in a mother's womb.
• Dangerous Drugs: Birth injuries may sometimes be caused by a particular prescription drug, such as SSRI’s, or other medication taken by the mother before or during pregnancy.
• First delivery (primigravida): A mother's first delivery is generally more prolonged-and therefore more risky-than subsequent deliveries.
• Large fetal head: If the baby's head is too large, it may not be able to pass through the birth canal. This condition can lead to a decreased supply of oxygen and cause a birth injury.
• Small maternal pelvis or pelvic irregularities: The size and shape of the mother's pelvis may not accommodate a vaginal birth.
• Shoulder dystocia: Shoulder dystocia occurs when the baby's head has emerged but the shoulders are stuck behind the mother's pubic bone or the opening to the birth canal and cannot be delivered. It may lead to various types of birth injuries, including Erb's palsy, fractures, or paralysis.
• Abnormal presentation: A breech delivery, in which the baby's legs or bottom emerge first. An abnormal presentation can frequently lead to birth injuries.
• Use of forceps or vacuum extraction to hasten or facilitate vaginal delivery: If these instruments are applied improperly or with too much force, cuts, severe bruising and swelling of the baby's head or face or facial paralysis may result.
• Lack of sufficient oxygen: Some of the most debilitating birth injuries occur when a traumatic birth results in a low supply of oxygen to the baby's brain.
• Prematurity: Babies born before 37 weeks' gestation are more fragile than full-term babies and therefore more vulnerable to birth injuries. Premature babies are among the most likely to suffer hemorrhage in or around the brain.
• Use of monitoring equipment: Sensors attached to an infant's head can cause birth injuries such as scalp trauma and hemorrhaging
• Low birth weight: Like babies born prematurely, low-birth-weight babies may be injured more easily than those of normal weight.
• Excessive birth weight: Babies over 8 pounds, 13 ounces may be too large for a vaginal birth. Attempting vaginal delivery with a baby this size or larger can lead to birth injuries.

Find more about the causes of birth injuries.

A B C D E F G H I M N O P R S T V

The following is a list of common terms and phrases used when discussing birth injuries:

If you can’t find a term you’d like us to define or have questions on birth injuries, contact one of our nurses. We’re here to answer your questions. 

Apgar score: A method used to evaluate the physical condition of a newborn immediately after delivery. Apgar scores can range from 0-10 and the “other factor” that is assessed is called grimace. Newborn are given scores at one and five minutes of age and can often be reported as 9/9 (read: 9 and 9) or 0/4 (read: zero and four), etc.  Babies with Apgar scores under 5 at five minutes are scored again at 10 minutes (and so on and so on….. every five minutes until the score is greater than 5).  This information provides the resuscitation team guidance in management of the resuscitation.

Ataxia: Lack of physical coordination and poor depth perception that is often related to a neurological condition, such as cerebral palsy.

Avulsion: The least common and most severe type of Erb’s palsy injury in which the nerve is torn from the spine.

Birth asphyxia: A general term used to describe lack of oxygen to an infant before, during or immediately following childbirth.

Brachial plexus: A network of nerves in the neck that supply feeling and control to the shoulder and arms. This may be stretched or torn during childbirth, resulting in a loss of movement and feeling in the arm, hand and fingers. This condition is called Erb's palsy or brachial plexus palsy.

Breech presentation: Breech presentation is ANY presentation other than head first (vertex) head first – could be a foot, both feet, buttocks, knees, etc. Babies in breech presentation may be more likely to have cerebral palsy.

Cerebral palsy: Cerebral palsy is the outward manifestations of a particular type of birth injury in a child who suffered an interruption in oxygenation to the brain in utero, during delivery, or in the minutes and hours after delivery. It is non-progressive and affects the development of fine and gross motor skills. It also affects cognitive development/learning ability.

Cesarean Section (C-section): An alternate method of childbirth which involves the delivery of a baby through a surgical incision in the mother’s belly and uterus.  A C-section is typically used when problems arise during labor and a vaginal delivery is considered to pose a risk to the mother and infant.

Chorea: Continuous, "jerky" involuntary body movements that are associated with cerebral palsy.

Co-counsel: An attorney who assists with a case and shares the responsibility of providing legal representation to a client.

Cognitive functions: The mental processes involving thought, perception and memory that can be affected by injuries sustained during childbirth.

CT (Computerized Topography) scan: A test that evaluates the brain for abnormalities to determine the origin of cerebral palsy.

Dysarthria: A speech disorder that often affects those with cerebral palsy, characterized by a weakness in the facial muscles that produce speech.

Dystonia: A condition involving abnormal muscle tone that causes involuntary body movements such as twisting, tremors and abnormal posture. Dystonia is frequently present in individuals with cerebral palsy.

Erb's palsy: A condition in which a stretch injury to a network of nerves in the neck, known as the brachial plexus, results in a loss of movement and feeling in the arm, hand and fingers. Most cases of Erb's palsy are the result of birth injuries that happen during labor and delivery.

Fetal distress: Signs appearing during pregnancy, labor or childbirth that indicate the fetus is not well and may have suffered injury. Signs of fetal distress include decreased movement, meconium in the amniotic fluid, and decreased fetal heart rate.

Forceps: Smooth, spoon-like metal instruments that are applied to the sides of a baby’s head to help guide it out of the birth canal during delivery.  Forceps are used to facilitate a vaginal delivery when the baby is not making a steady progression down the birth canal.

Gait: A manner of walking which can provide clues to the existence of certain medical conditions, including cerebral palsy.

Hypertonia: Increased muscle tone in a newborn infant, causing it to appear stiff or rigid. Hypertonia is often an early sign of cerebral palsy, a serious birth injury.

Hypotonia: Decreased muscle tone in a newborn, resulting in a "floppy" or relaxed appearance. This is often an early indication of cerebral palsy.

IEP (Individual Education Plan):  A legally binding document that outlines a child’s learning and physical limitations along with steps that must be taken to ensure his success in school. The IEP helps teachers understand a child’s unique learning impairment and needs so they can provide an education that will prepare him for productive and independent living.

Intraventricular hemorrhage (IVH):   A condition that involves excessive bleeding inside or around the spaces in the brain (ventricles) that contain cerebral spinal fluid.  IVH occurs most frequently in premature infants, particularly babies that weigh less than 3.4 pounds.

Malnutrition: A condition in which a person’s intake of nutrients is not enough to support proper functioning in everyday life.  Malnutrition may result from an inadequate intake of calories, the lack of a particular nutrient, or an inability to properly digest or absorb nutrients from food.  Since they often have feeding issues, children with cerebral palsy are especially susceptible to malnutrition and related problems.

Medical malpractice: a negligent act or omission by a professional health care provider which causes injury to a patient.

Moro reflex: A reflex exhibited by a newborn that involves extending its arms when held on its back and tilted backwards so that its legs are above its head. Infants with cerebral palsy or other neurological disorders tend to retain this reflex for a prolonged period of time, beyond 5 months of age. Also known as the "startle reflex".

MRI (Magnetic Resonance Imaging) scan: A special radiology scan that uses magnetism, radio waves and a computer to produce detailed images of internal structures, such as the brain. Used to detect abnormalities in the brain.

Neurapraxia: The most common type of an Erb’s palsy birth injury in which the nerve has been damaged but not torn.

Neuroma: Scar tissue that grows around an Erb’s palsy birth injury, putting pressure on the injured nerve and disrupting its ability to send signals to the muscles.

Orthopedic specialist: A health care provider that specializes in treating disorders involving the bones, muscles, joints, and tendons.

Persistent pulmonary hypertension of the newborn (PPHN): a serious, often fatal condition that affects newborn babies. PPHN limits the amount of blood flowing to an infant's lungs and the amount of oxygen entering the bloodstream. This condition typically involves severe respiratory failure and requires immediate treatment.

Physical therapy: A form of treatment that uses therapeutic exercises and equipment to help individuals regain physical function and skills. Physical therapy may be used to rehabilitate children suffering from cerebral palsy, Erb’s palsy or other birth injuries.

Rupture: A type of Erb’s palsy birth injury that occurs when the nerve is torn but not separated from the spinal column.

SSRI (serotonin reuptake inhibitor):  A class of drugs used to treat depression, anxiety and other mental health disorders.  SSRIs work by blocking receptors in the brain that absorb serotonin, a chemical that is thought to affect mood. Commonly prescribed SSRIs include Zoloft, Prozac and Lexapro.

Seizure: A physical convulsion or combination of several physical symptoms resulting from uncontrolled electrical activity in the brain. Seizures may affect some individuals with cerebral palsy and other types of brain-related birth injuries.

Shoulder dystocia: A condition in which normal vaginal delivery is hindered due to the baby's shoulder being wedged behind the mother's pubic bone. Shoulder dystocia occurs in approximately 0.5 to 1.0 percent of all deliveries, or about 20,000 births each year.  The tactics used to get the infant out of this position can lead to serious birth injuries or even fetal death.

Torticollis: A state of poor muscle tone in the neck muscles that control the head's position, causing the head to turn to one side, forward, or backward. Torticollis may be a result of a birth injury suffered by the infant during delivery.

Tremors: Rhythmic, involuntary muscular contractions affecting various parts of the body, often seen in individuals with cerebral palsy.

Vacuum extraction:  A technique used to assist with the completion of a vaginal delivery.  A plastic cup is placed on the baby’s head and attached to a specialized vacuum. The force of suction on the head combined with the mother’s pushing activity helps the infant to move down the birth canal.