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Newborn Rib Fractures

Question of the Week

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Updated November 06, 2004

Q. What is the appropriate treatment for rib fractures in a newborn, who is 8 days old? And what is the risk and prognosis? Elsa, Miami, Florida

A. In general, unless there is an underlying lung problem, like a pneumothorax, the treatment for an isolated rib fracture would simply be pain control. And if it is an isolated problem, the prognosis should be good.

The big question though, is how did the baby get a rib fracture.

Unless it was a difficult delivery and a problem was noted when the baby was born, it should raise some suspicion about child abuse. Keep in mind that a study in Pediatrics, Cause and Clinical Characteristics of Rib Fractures in Infants, stated that 'reports of rib fractures in healthy full-term infants attributed to birth injuries are uncommon.' They also found that 'most rib fractures in infants are caused by child abuse.'

In addition to birth trauma and child abuse, a newborn might have a rib fracture if they:

  • have osteogenesis imperfecta, a disorder in which children have fragile bones that are easily broken
  • have rickets, with a deficiency of vitamin D, calcium, or phosphate, causing weak bones
  • have osteopenia of prematurity, which can be found in very low birth weight premature infants
  • were resuscitated and CPR was performed, although this is considered a very rare cause of rib fractures in newborns
  • suffered an unintentional or accidental injury, like a car accident or a fall with a parent

References:

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