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What Causes Weakness In Both Arms In A 3 Month Old?

Posted on Mon, 5 Oct 2015

Question: My baby boy is 3 months old. He was a straight forward vaginal delivery at 40 weeks and was a big baby at almost 9 lbs. He is alert, holding his head, communicative, smiley, batting for toys and also is now reaching and grasping toys around him and bringing them to his mouth. However his arms are concerning me when he is held in an upright position he seems to hold them very straight down by his sides almost like the upright position is restricting his shoulder movement. As already described he has no movement issue in a lying position. He is now a very big chubby baby and has long arms. I am worried as anything that I look up regarding arm movement brings up cerebral paulsey which is terrifying me. Please advise.

Answered by Dr. Pradeep Kumar Jain (3 hours later)

Brief Answer:
Chances of cerebral palsy are remote

Detailed Answer:
Hello

Thanks for asking on this platform

I can understand your concern.I have gone through the details.
Cerebral palsy is a neurological disorder and it can be dtected early by neurological and general clinical examination.
Cerebral palsy can present in various forma like weakness of both lower limbs(spastic diplegia),weakness of all the four limbs(Quadruplegia),weakness of one side of both limbs(hemiplegia) or in the form of abnormal movements(Athetoid cerebral palsy).
As you have mentioned there is abnormality in upper limbs that too only in upright position only.
I would like to know if there is any tightness in upper limb while passive or active movement..
Isolated involvement of both upper limbs in cerebral palsy is very very rare.
The early marker of cerebral palsy are-
1)Persistent crying(Not in your case)
2)Clenched fists
3)Increased tightness in lower limb,while upper limbs and neck remain loose
3)Slow head growth(Not in your case)
4)Purposeless movement of limbs
5)No interaction with mother or absence of smile

I did not find most of these features in your case.
You may have only subjective finding.So I request you get him evaluated by a pediatrician to find out any abnormality if it is there and to alleviate your anxiety.
Please let me know if you have any more doubts.
Wishing for your baby's good health.
Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Pradeep Kumar Jain (1 hour later)

Thank you for your response. He is a placid happy baby, fists not clenched, no tightness of lower limbs and can bare his weight on both legs, normal head growth, great interaction with me. While I say that his arms are straight in an upright position, when sitting on my knee he will still reach out for toys that are held in front of him, it's really just when lifted up under the arms Almost like his shoulders are a bit weak or fighting gravity. I hope it's just something muscular that physical therapy will sort out.

Answered by Dr. Pradeep Kumar Jain (15 minutes later)

Brief Answer:
He is still achieving his milestones

Detailed Answer:
Thanks for follow up

I completely understand your concern.But age of 3 month is too early to comment any muscular weakness as he is still in the process of development.
I don't think that even physical therapy is needed.
The way you have explained, his motor and social development is up to the mark.
As part of motor development baby gradually develops coordination of various movements and at around 5-6 months of age he will be able to lift his arm at or above the shoulder level and will do roll over from prone(when lying down abdomen touching the surface)to supine(When back touches the surface)and then supine to prone position.

So I wont get overly worried and would like to closely observe for developmental milestones.

All the beat and take care.
Warm regards

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Above answer was peer-reviewed by : Dr. Yogesh D