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When a baby is born too quickly, or the baby is too big for the mother’s birth canal, the baby’s head can get delivered, but the shoulders and chest get stuck. This is a potentially deadly situation for the child, since the umbilical cord is pinched during this time as well. Due to the risks to the baby, the doctor or nurse delivering the baby will do what is needed to make the delivery happen while avoiding pulling on the head or neck (which could cause permanent nerve damage to an arm).
Sometimes this means the collarbone becomes broken. The humerus (upper arm bone) can also become broken. This can be a scary thing to learn about your newborn child, but it is a better outcome for the situation. A neonatal humerus fracture will most likely heal and will become just fine on their own
Your baby will react to a humerus fracture by not moving the affected arm at all. Moving the arm increases the pain, so this is a logical response. As caregivers, you and your nurses will find a way to keep the arm from moving too much. Usually this means leaving it inside the onesie, or using a long-sleeve onesie and pinning the sleeve to the opposite shoulder. A stretchy netting (often used for burn patient dressings) can be used over the chest to help hold the arm.
Splinting or casting is not recommended for newborn humerus fracture. Unfortunately, your baby cannot tell you he or she is in pain, and a splint or cast could easily become too tight or slip out of place causing permanent scarring or damage to the nerves. This makes these devices too risky for a newborn. Surgery is not recommended, because the healing process without surgery occurs so quickly and reliably that surgery is not needed.
In a newborn, the bone does not need to be lined up much at all to achieve perfect healing. The bone can be angulated 45 degrees and the body will straighten it out on its own. It is a natural process.
After about 10 days to 2 weeks, there is early bone healing (called callus) that gently holds the bone ends in place. About this time, the infant is less bothered when the arm is disturbed. He or she may start moving the hand and wrist at this time.
At about 4 to 5 weeks, the healing callus is visible on X-ray, and you can really feel the huge bump of bone in your baby’s arm. Do not worry. It is not a tumor and it will go away. This is very strong bone. At this point, the bone is completely healed. However, the body is not done with it yet. Over the next few weeks to months, the bone will become more and more narrow so that about 3 to 4 months after birth, the bone is normal in appearance and function.
In the end, the bone is normal. It is not more likely to break again, and will not be too long or too short. It will not be crooked. It will function normally throughout your baby’s life.