Approach to birth injury (pediatrics) Quiz: Ace Your Exams

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A newborn girl is born at 40.4 weeks gestation via spontaneous vaginal delivery complicated by prolonged labor and vacuum extraction. The pregnancy was complicated by diet-controlled gestational diabetes in the mother. Following delivery, the infant appears vigorous and Apgars are 8 and 9. After spending time with the mother, the newborn is brought to the nursery for evaluation by the pediatrician. Temperature is 36.8°C (98.2°F), pulse is 148/min, respirations are 42/min, and oxygen saturation is 98% on room air. Birth weight is 4400 grams. On physical examination, the infant appears slightly fussy. The anterior fontanelle is open and flat. Cardiopulmonary examination is normal. The upper right arm is adducted and internally rotated and the forearm is extended with the elbow pronated and the wrist flexed. Pulses are 2+ and capillary refill is < 2 seconds. No crepitus is appreciated over the clavicles. Radiographs are obtained, and no obvious deformity is noted. Which of the following is the best next step in management? 

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