Nursemaid's Elbow (Pulled Elbow) in Baby or Toddler
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published AAP, AAP, NIH guidelines
Last reviewed:
Your baby's physical development is unique, and concerns about nursemaid's elbow (pulled elbow) in baby or toddler, here is what you need to know.
The short answer
Nursemaid's elbow is the most common orthopedic injury in children under 5. It happens when a ligament in the elbow slips out of place, usually after a pulling or swinging motion on the arm. The child suddenly stops using the affected arm, holding it still at their side with the palm turned inward. It is not a dislocation or fracture, and it is easily fixed by a doctor with a quick, gentle maneuver. Recovery is immediate - most children use the arm normally within minutes of reduction.
Key takeaways
- Nursemaid's elbow is the most common orthopedic injury in children under 5. It happens when a ligament in the elbow slips out of place, usually after a pulling or swinging motion on the arm. The child suddenly stops using the affected arm, holding it still at their side with the palm turned inward. It is not a dislocation or fracture, and it is easily fixed by a doctor with a quick, gentle maneuver. Recovery is immediate - most children use the arm normally within minutes of reduction.
- Usually normal when: Your child uses the arm completely normally within 15-30 minutes after medical reduction
- Call your doctor if: Your child is not using one arm after any pulling, swinging, or lifting event
“Supervised tummy time is recommended daily from the time the baby comes home from the hospital to help prevent flat head syndrome and to strengthen neck and shoulder muscles.”
Parents everywhere have the same worry. You are doing the right thing by looking into it.
What Parents Should Know
According to AAP, NIH guidelines, nursemaid's elbow is the most common orthopedic injury in children under 5. It happens when a ligament in the elbow slips out of place, usually after a pulling or swinging motion on the arm. The child suddenly stops using the affected arm, holding it still at their side with the palm turned inward. It is not a dislocation or fracture, and it is easily fixed by a doctor with a quick, gentle maneuver. Recovery is immediate - most children use the arm normally within minutes of reduction. At 0-12 months, nursemaid's elbow is less common in babies under 1 year but can happen when a baby is pulled up by one arm, lifted by the hands, or when an arm gets caught in crib rails or during a roll. The baby will suddenly stop moving the affected arm and may cry briefly then become quiet, holding the arm limply at their side. Seek medical evaluation - the fix is quick and painless. It is generally considered normal when your child uses the arm completely normally within 15-30 minutes after medical reduction. However, you should contact your pediatrician promptly if your child is not using one arm after any pulling, swinging, or lifting event.
Normal vs. Concerning
By Age
What to expect by age
0-12 months
Nursemaid's elbow is less common in babies under 1 year but can happen when a baby is pulled up by one arm, lifted by the hands, or when an arm gets caught in crib rails or during a roll. The baby will suddenly stop moving the affected arm and may cry briefly then become quiet, holding the arm limply at their side. Seek medical evaluation - the fix is quick and painless.
1-4 years
This is the peak age for nursemaid's elbow. Common scenarios include: pulling a toddler by the hand to prevent a fall, swinging a toddler by the arms during play, pulling a toddler's arm through a jacket sleeve, or a toddler catching their arm while rolling or falling. The child will immediately stop using the arm. Do not try to fix it yourself. A medical professional can reduce it in seconds with a specific rotation of the forearm.
What to Tell Your Pediatrician
- Describe when you first noticed nursemaid's elbow (pulled elbow) in baby or toddler and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your child has had nursemaid's elbow and you want to learn how to prevent recurrence.
- Mention if your child has had multiple episodes of nursemaid's elbow.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your child uses the arm completely normally within 15-30 minutes after medical reduction
- Brief crying at the time of injury that settles quickly
- No visible swelling, bruising, or deformity of the arm
- Your child has had nursemaid's elbow and you want to learn how to prevent recurrence
- Your child has had multiple episodes of nursemaid's elbow
- You want to learn the warning signs so you can seek quick treatment
- Your child is not using one arm after any pulling, swinging, or lifting event
- Your child's arm is visibly swollen, deformed, or bruised (may indicate fracture rather than nursemaid's elbow)
- Your child's arm does not return to normal use after medical reduction
- There was no clear pulling mechanism and the child stopped using their arm (other causes need evaluation)
What You Can Do at Home
- Keep track of when you notice nursemaid's elbow (pulled elbow) in baby or toddler — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your child uses the arm completely normally within 15-30 minutes after medical reduction — this is generally within the range of normal.
- At 0-12 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Provide plenty of supervised floor time and tummy time to support your baby's physical development.
- While monitoring at home, seek immediate care if your child is not using one arm after any pulling, swinging, or lifting event.
Related Conditions
Baby Not Using One Arm or Hand
If your baby consistently avoids using one arm or hand, it deserves evaluation. Before 18 months, babies should use both hands roughly equally - strong hand preference before this age can indicate a concern with the less-used side. Possible causes include brachial plexus injury (Erb's palsy) from birth, nursemaid's elbow, fracture, or neurological differences. Early identification leads to better outcomes with therapy.
Baby Fell Off the Bed or Couch
Falls from beds, couches, and changing tables are one of the most common accidents in infancy. Most falls from furniture height (2-3 feet) do not cause serious injury, but every fall involving the head deserves careful monitoring. If your baby cried immediately after the fall and is now acting normally - alert, feeding, and moving all limbs - serious injury is unlikely. However, certain warning signs require immediate medical evaluation.
Signs of a Broken Bone or Fracture in Baby
Children's bones are more flexible than adults' and often bend or partially break (greenstick fracture) rather than snapping completely. Signs of a possible fracture include: swelling, deformity (the limb looks bent or crooked), inability or refusal to use the limb, severe pain when the area is touched, and a snapping or popping sound at the time of injury. If you suspect a broken bone, immobilize the area (do not try to straighten it), apply ice wrapped in a cloth, and take your child to the emergency room or urgent care for an X-ray.
Related Resources
Frequently asked questions
Is nursemaid's elbow (pulled elbow) in baby or toddler normal?
When should I call the doctor about nursemaid's elbow (pulled elbow) in baby or toddler?
When is nursemaid's elbow (pulled elbow) in baby or toddler normal?
What causes nursemaid's elbow (pulled elbow) in baby or toddler?
What should I mention to my pediatrician about nursemaid's elbow (pulled elbow) in baby or toddler?
Is nursemaid's elbow (pulled elbow) in baby or toddler normal at 0-12 months?
Is nursemaid's elbow (pulled elbow) in baby or toddler normal at 1-4 years?
Should I go to the ER for nursemaid's elbow (pulled elbow) in baby or toddler?
Does nursemaid's elbow (pulled elbow) in baby or toddler go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Nursemaid's Elbow (Pulled Elbow) in Baby or Toddler.
Things to mention
- Describe when you first noticed nursemaid's elbow (pulled elbow) in baby or toddler and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your child has had nursemaid's elbow and you want to learn how to prevent recurrence.
- Mention if your child has had multiple episodes of nursemaid's elbow.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Your child has had nursemaid's elbow and you want to learn how to prevent recurrence
- Your child has had multiple episodes of nursemaid's elbow
- You want to learn the warning signs so you can seek quick treatment
Urgent signs to report immediately
- Your child is not using one arm after any pulling, swinging, or lifting event
- Your child's arm is visibly swollen, deformed, or bruised (may indicate fracture rather than nursemaid's elbow)
- Your child's arm does not return to normal use after medical reduction
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of nursemaid's elbow (pulled elbow) in baby or toddler are normal. Talk to your pediatrician if your child is not using one arm after any pulling, swinging, or lifting event.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Physical Concerns
Baby Not Using One Arm or Hand
If your baby consistently avoids using one arm or hand, it deserves evaluation. Before 18 months, babies should use both hands roughly equally - strong hand preference before this age can indicate a concern with the less-used side. Possible causes include brachial plexus injury (Erb's palsy) from birth, nursemaid's elbow, fracture, or neurological differences. Early identification leads to better outcomes with therapy.
Baby Fell Off the Bed or Couch
Falls from beds, couches, and changing tables are one of the most common accidents in infancy. Most falls from furniture height (2-3 feet) do not cause serious injury, but every fall involving the head deserves careful monitoring. If your baby cried immediately after the fall and is now acting normally - alert, feeding, and moving all limbs - serious injury is unlikely. However, certain warning signs require immediate medical evaluation.
Signs of a Broken Bone or Fracture in Baby
Children's bones are more flexible than adults' and often bend or partially break (greenstick fracture) rather than snapping completely. Signs of a possible fracture include: swelling, deformity (the limb looks bent or crooked), inability or refusal to use the limb, severe pain when the area is touched, and a snapping or popping sound at the time of injury. If you suspect a broken bone, immobilize the area (do not try to straighten it), apply ice wrapped in a cloth, and take your child to the emergency room or urgent care for an X-ray.
Should I Use Adjusted Age for My Preemie's Milestones?
Yes — for premature babies, developmental milestones should be assessed using adjusted (corrected) age, not chronological age, until at least 2 years of age. Adjusted age is calculated by subtracting the number of weeks your baby was born early from their actual age. For example, a 6-month-old born 2 months early would have an adjusted age of 4 months, and should be assessed against 4-month milestones. Most pediatricians use adjusted age for developmental assessment through age 2-3, and for growth charts through age 2.
Baby-Proofing a Small Apartment
Baby-proofing a small apartment is absolutely possible and focuses on the same key safety principles as any home: securing furniture to walls, covering outlets, locking cabinets with hazardous materials, and ensuring safe sleep spaces. Small spaces actually have an advantage - there is less area to monitor. Focus on eliminating the most dangerous hazards first: falls, poisoning, choking, and burns.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.