A broken collarbone during birth can be frightening news for any parent. You’ve just welcomed your baby into the world, and now you’re learning about a fracture. It’s natural to feel worried, overwhelmed, or unsure about what this means for your child’s health and future.

This page explains what neonatal clavicle fractures are, why they happen, and what families can expect during recovery. While any injury to a newborn is concerning, the reality is that clavicle fractures are the most common bone injury during delivery and nearly all heal completely with simple care. Understanding the facts can help you feel more confident as you care for your baby and make informed decisions about follow-up care.

NYBirthInjury.com provides trusted medical information to help families understand birth injuries, treatment options, and available support throughout New York and beyond.

What Is A Clavicle Fracture In A Newborn?

A neonatal clavicle fracture is a break in the collarbone that occurs during the birth process. The clavicle, the bone that runs from the breastbone to the shoulder, is the most frequently fractured bone in newborns. Most of these fractures are greenstick fractures, which means the bone bends and cracks but doesn’t break all the way through, similar to how a green twig breaks. The fracture typically occurs in the middle section of the bone.

Many clavicle fractures aren’t immediately obvious in the delivery room. Doctors and nurses may not detect the injury until they perform follow-up examinations over the first few days of life. Sometimes parents first notice something is wrong when they see that their baby moves one arm less than the other, cries when being lifted, or develops a small bump over the collarbone as healing begins.

How Common Are Clavicle Fractures During Birth?

Clavicle fractures occur in approximately 2 to 7 out of every 1,000 live births, making them by far the most common bone injury in newborns. One large medical center reported finding 92 clavicle fractures among more than 21,000 births, an incidence of about 4.3 per 1,000 deliveries.

Recent studies show that the rate of these fractures has decreased as obstetric practices have evolved. One population-based study found that clavicle fracture rates dropped from about 17.6 per 1,000 vaginal births to 6.2 per 1,000 as doctors became better at managing difficult deliveries and identifying high-risk situations. Despite improvements in care, certain risk factors continue to make these injuries more likely.

What Causes A Clavicle To Break During Delivery?

Clavicle fractures happen when the baby’s shoulder experiences pressure and pulling forces while passing through the birth canal. During delivery, the shoulders must navigate through the pelvis after the head is born. When the shoulders are difficult to deliver, the collarbone can be compressed or subjected to traction forces that cause it to break.

The injury typically occurs during what doctors call shoulder dystocia, a complication where the baby’s shoulder becomes stuck behind the mother’s pubic bone after the head has already been delivered. When this happens, the medical team must act quickly to free the shoulder, and the urgency and maneuvers required can sometimes result in a clavicle fracture.

Which Babies Are At Higher Risk For Clavicle Fractures?

Several factors increase the likelihood that a baby will experience a clavicle fracture during birth:

Higher birth weight, particularly babies weighing 4,000 grams (about 8 pounds, 13 ounces) or more
Male sex, as boys tend to have slightly larger shoulders relative to head size
Prolonged labor, especially a lengthy second stage when the mother is actively pushing
Shoulder dystocia, when the shoulder becomes stuck during delivery
Operative vaginal delivery using vacuum extractors or forceps
Maternal diabetes, both gestational diabetes and pre-existing diabetes, which can lead to larger babies
Advanced gestational age, when babies are born past their due date

Recent research has identified additional risk factors that may be preventable in some cases. These include labor induction under certain conditions, maternal smoking during pregnancy, vitamin D deficiency, and signs of fetal distress during labor. However, birth weight remains the strongest predictor of clavicle fracture risk.

Can Clavicle Fractures Occur With Other Birth Injuries?

Clavicle fractures often occur alongside other birth complications, particularly brachial plexus injuries. The brachial plexus is a network of nerves that runs from the spinal cord through the neck and shoulder area, controlling movement and sensation in the arm and hand. Because these nerves lie very close to the clavicle, they can be stretched or compressed during the same difficult delivery that causes the collarbone to break.

Large studies of shoulder dystocia cases have found that having a clavicle fracture doesn’t significantly change the risk of nerve injury compared to shoulder dystocia without a fracture. This suggests that the fracture is more of a marker indicating a difficult delivery rather than a cause of additional complications or a protective factor.

Other injuries that can occur in the same context include fractures of the upper arm bone (humerus), cephalohematoma (a collection of blood under the scalp), and facial nerve injuries, particularly when forceps or vacuum assistance is used.

Medical guidelines emphasize that any infant delivered after shoulder dystocia should be carefully examined for clavicle fractures, arm fractures, and signs of nerve injury as part of standard post-delivery care.

What Are The Signs That A Baby Has A Broken Clavicle?

The symptoms of a newborn clavicle fracture can range from subtle to more obvious. Common signs include:

Decreased arm movement on the affected side, sometimes called pseudoparalysis because it can look like the arm is paralyzed even though the nerves are working
Asymmetric Moro reflex, a startle response where the baby extends both arms suddenly but one arm doesn’t move normally
Crying or discomfort when the baby is moved, dressed, or lifted under the arms
Localized swelling or tenderness over the collarbone area
A firm lump that appears over the fracture site after several days as the bone begins to heal

Many newborns show minimal symptoms in the first hours after birth. Pediatric experts note that most clavicle fractures are only discovered during repeat physical examinations or when parents notice reduced arm movement or feel the healing callus (the bony bump that forms as the fracture heals) a week or two after going home.

How Do Doctors Diagnose A Clavicle Fracture?

Diagnosis is primarily based on physical examination. An experienced pediatrician or neonatologist will gently feel along the collarbone, check how the baby moves each arm, and look for signs of tenderness or swelling. In many cases, especially when the clinical findings are clear and there are no complications, X-rays are not routinely necessary.

When imaging is used, X-rays can confirm the exact location of the fracture and help rule out other injuries. Some fractures are so subtle that they only become visible on X-rays after a healing callus has formed, which typically happens within the first 7 to 10 days. Studies of healing patterns show a predictable timeline of bone repair and remodeling that continues over the first few weeks to months.

How Are Clavicle Fractures Treated In Newborns?

The standard treatment for uncomplicated clavicle fractures in newborns is conservative management, which means allowing the bone to heal naturally without surgery or complex interventions. The approach focuses on comfort and protection:

Gentle handling is essential. Parents and caregivers learn to support the baby’s head and body together when picking them up, avoiding lifting under the arms on the affected side.

Temporary immobilization helps reduce movement and pain. This is usually accomplished by pinning the sleeve on the affected side to the baby’s clothing or using a soft wrap or sling for a few days. The goal is to limit motion without causing additional discomfort.

Pain management typically involves acetaminophen (given as recommended by the pediatrician) and comfort measures like swaddling and gentle positioning. Most babies show significant improvement within 7 to 10 days as the initial pain subsides and healing progresses.

Surgery is not indicated for routine birth-related clavicle fractures. Even when the bone fragments are displaced (separated), infant bones have remarkable healing and remodeling capacity. Pediatric orthopedic specialists emphasize that these fractures heal with nonoperative care, and the bone will reshape itself over time.

What Is The Expected Recovery Timeline?

Neonatal clavicle fractures heal relatively quickly. Most babies experience noticeable pain relief within the first week to 10 days. The bone begins forming a callus almost immediately, which is why parents often notice a firm bump over the fracture site by the end of the first or second week.

Full bony healing, as seen on X-rays, typically occurs within a few weeks. The visible and palpable callus will gradually remodel and become less prominent over several months, though some babies may have a small bump that remains visible for a longer period or even permanently. This residual thickening is purely cosmetic and doesn’t affect function or cause pain.

Activity restrictions are minimal and short-term. As pain decreases, babies naturally begin moving the affected arm more. By the time families attend follow-up appointments, most infants are using both arms normally.

Will There Be Any Long-Term Problems?

Multiple studies following babies with birth-related clavicle fractures have found overwhelmingly positive outcomes. Almost all children recover completely with no long-term functional problems, no limitations in arm or shoulder movement, and no neurologic complications from the fracture itself.

When a brachial plexus injury occurs alongside the fracture, the nerve injury is the primary concern for long-term function. Fortunately, many brachial plexus palsies also resolve spontaneously within the first few months of life. Babies who continue to show weakness or limited movement should be referred to specialized brachial plexus programs for ongoing assessment, physical therapy, and possible intervention.

Parents are often understandably distressed when they first learn their newborn has a broken bone or when they feel the healing callus. It’s important to know that the thickened area where the bone is healing will continue to remodel and smooth out over time. Permanent deformity is extremely rare, and functional limitations are not expected.

Can Clavicle Fractures Be Prevented?

At an individual level, clavicle fractures during birth are difficult to predict or prevent completely. However, at a population level, research has identified several obstetric practices that can reduce overall risk.

Preventing extreme fetal macrosomia (very large babies) through good prenatal care and diabetes management is one important strategy. When diabetes is well-controlled during pregnancy, babies are less likely to grow excessively large, reducing the risk of shoulder dystocia and associated injuries.

Careful decision-making about mode of delivery matters, particularly for suspected large infants or babies of mothers with diabetes. When a baby is expected to be very large or other risk factors are present, discussing the possibility of cesarean delivery may be appropriate in some situations.

Skilled management of shoulder dystocia when it does occur is critical. Professional medical societies provide detailed guidelines on the stepwise maneuvers that should be used when a shoulder becomes stuck. These techniques, such as the McRoberts maneuver (flexing the mother’s thighs toward her abdomen) and suprapubic pressure (pressing just above the pubic bone), aim to free the shoulder while minimizing traction and avoiding excessive force. Proper technique reduces but doesn’t eliminate the risk of clavicle fractures and other birth trauma.

In very rare, life-threatening cases of severe shoulder dystocia when other maneuvers have failed, some obstetric literature describes intentional fracture of the clavicle as a last-resort technique to deliver the baby and prevent brain damage from lack of oxygen. This extreme measure highlights the difficult decisions providers sometimes face when balancing different types of harm.

What Kind Of Medical Follow-Up Is Needed?

Most newborns with uncomplicated clavicle fractures are managed by the hospital’s pediatric or neonatology team before discharge, with follow-up by the baby’s regular pediatrician. Orthopedic consultation is reserved for unusual cases, such as when there are additional fractures, concerns about how the bone is healing, or associated injuries that need specialized care.

Major medical centers and children’s hospitals in New York and throughout the country provide written guidance and educational materials for parents on home care, including how to dress the baby, safe positioning for sleep and feeding, and what to expect during healing. These resources help families feel confident managing their baby’s care at home.

Routine follow-up visits allow the pediatrician to check that the baby is moving the affected arm normally, that the callus is forming as expected, and that no complications have developed. For the vast majority of babies, these visits confirm that healing is progressing well and no additional intervention is needed.

When Should Parents Seek Additional Help?

While most clavicle fractures heal without problems, certain situations warrant prompt attention. Contact your pediatrician if:

Your baby seems to be in significant pain that isn’t improving after the first week
The affected arm remains motionless or very weak after two to three weeks
You notice new swelling, redness, or warmth over the fracture site
Your baby develops a fever
You have any concerns about how your baby is feeding or breathing

Persistent weakness or limited arm movement may indicate an associated brachial plexus injury that requires evaluation by specialists. Early referral to a brachial plexus program ensures that babies who need physical therapy or other interventions receive them at the optimal time.

Finding Support And Information

Learning that your newborn has any kind of injury can be emotionally difficult. Parents may experience guilt, anger, confusion about what happened, or worry about their child’s future. These feelings are completely normal and valid.

Understanding the medical facts about clavicle fractures can provide reassurance. While these injuries signal that delivery was stressful or difficult, they are also among the most predictably benign birth injuries, with healing that is typically complete and uncomplicated. Most babies with clavicle fractures go on to develop normally and have full use of their arms and shoulders.

If you have questions about your baby’s injury, treatment plan, or recovery, your pediatrician and the hospital staff who cared for your baby after delivery are important resources. They can explain what happened, what to expect, and when follow-up is recommended.

For families who want to better understand birth injuries, medical care options, and support resources available in New York, NYBirthInjury.com provides comprehensive, medically accurate information to help you navigate these situations with confidence and clarity.

Clavicle Fracture