Clavicle Fracture During Delivery, Neonate

A clavicle fracture is a break in the collarbone. This is a common injury that happens during delivery. It is more common with large and heavy babies and with difficult vaginal births.

CAUSE

A clavicle fracture happens when the shoulders are squeezed during a difficult delivery. This is because the shoulders are the widest part of the baby coming down the birth canal. Clavicle fractures are common in deliveries where the babies shoulders are too big and heavy to fit out of the vagina at the pubic and tail bones shoulder (dystocia). In this case the fracture may be accidental or intentional by the doctor in order to to deliver the baby safely. Sometimes with shoulder dystocia, both clavicles are broken on purpose to deliver the baby quickly and safely. This is a birth complication that often cannot be predicted or avoided.

SYMPTOMS

  • Sometimes the fracture can be seen or felt.

  • The baby holds the arm on the side of the fracture still against the body due to pain.

  • When lifting the baby he/she cries because it causes pain.

DIAGNOSIS

  • Your caregiver may suspect a fracture on examination. An X-ray of your baby's shoulder can confirm the injury.

  • A lump may show up on the fractured part of the clavicle. This may be the only sign that the baby had a fractured clavicle.

TREATMENT

  • Usually no treatment is needed. The fracture will heal in 3 to 10 days on its own.

  • Sometimes the arm may be kept still (immobilized) to the side of the baby's chest to avoid pain.

  • Gently lift the baby so you do not cause your baby pain.

HOME CARE INSTRUCTIONS

  • Only give your child over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • You may pin the baby's sleeve to their shirt to limit movement of the arm.

  • Keep all your follow up appointments for the baby.

SEEK MEDICAL CARE IF:

  • You have questions or concerns about your baby's recovery.

  • If the baby does not move the arm well or at all.

  • The baby continues to have pain upon lifting the baby.