Broken Collarbone (Clavicle Fracture) at Birth
The short answer
A broken clavicle (collarbone) is one of the most common birth injuries, occurring during difficult deliveries, especially in large babies or when shoulder dystocia occurs. While concerning to parents, clavicle fractures in newborns heal very quickly (usually within 2-3 weeks) without any specific treatment. The prognosis is excellent.
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By Age
What to expect by age
A clavicle fracture may be detected at birth or in the first few days when parents or doctors notice the baby is not moving one arm as much, seems uncomfortable during dressing or handling of one side, or has an asymmetric Moro reflex. You may feel a bump or hear crepitus (a crackling sensation) over the collarbone. Sometimes a fracture is found incidentally on a chest X-ray. Treatment is conservative: gentle handling, avoiding pulling on the affected arm, and positioning the baby comfortably. The fracture heals rapidly in newborns, typically within 2-3 weeks. You may notice a bump (callus) forming at the fracture site, which is a sign of normal healing.
By this time, the fracture should be healed. The callus bump is a normal part of healing and gradually remodels over months. Your baby should be moving the affected arm normally. If arm movement has not returned to normal, there may be an associated brachial plexus injury that needs further evaluation.
The fracture is fully healed. The callus bump gradually becomes less noticeable over time as the bone remodels. Both arms should move equally and normally. No long-term complications are expected from a newborn clavicle fracture.
The clavicle has fully remodeled and there should be no evidence of the previous fracture other than perhaps a slight bony prominence that will continue to smooth out. Full function is expected.
What Should You Do?
When to take action
- Baby has decreased movement of one arm with tenderness over the collarbone area
- A healing bump (callus) forms over the fracture site within 1-2 weeks
- Baby returns to full arm movement within 2-3 weeks
- The bump gradually remodels and disappears over months
- You notice your baby is not moving one arm as much as the other
- You feel a bump on the collarbone that wasn't previously noted
- Your baby cries when you move their arm to one side during dressing
- Your baby is not moving one arm at all or the entire arm appears limp, which could indicate a more serious injury involving the nerves (brachial plexus)
- Signs of infection at any site of injury: increasing redness, warmth, or swelling with fever
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Medical Concerns
Erb's Palsy (Brachial Plexus Birth Injury)
A brachial plexus injury (Erb's palsy) occurs when the nerves controlling the arm are stretched during delivery, most often during shoulder dystocia. The affected arm may appear limp or have limited movement. The good news is that 80-90% of cases resolve within the first 3-6 months with conservative management and physical therapy.
Uneven Startle Reflex in Newborns (Asymmetric Moro)
An asymmetric Moro reflex, where one arm responds differently than the other during startle, is an important finding that should be evaluated by your pediatrician. It may indicate a birth injury such as a broken clavicle (collarbone) or brachial plexus injury (Erb's palsy). Early evaluation and treatment lead to the best outcomes.
Bruising After Difficult Delivery
Bruising from delivery is common, especially after difficult or prolonged labors, vacuum-assisted deliveries, or forceps deliveries. The bruising typically appears on the face, scalp, or body and resolves on its own within 1-2 weeks. Birth-related bruising can contribute to newborn jaundice as the blood breaks down, so your baby's bilirubin levels may be monitored.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
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Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.