Baby's Crooked Lower Lip: Causes and Solutions - Pediatrics

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The baby's lower lip is crooked?


Hello, doctor.
My child is not yet one month old, and his lower lip is tilted to the right, which is particularly noticeable when he cries.
We took him for a heart examination, and they mentioned a diaphragmatic hernia.
Will his mouth alignment improve?

Zhu Bo, 0~9 year old female. Ask Date: 2020/10/18

Dr. Xie Wanghu reply Pediatrics


Hello, Mrs.
Zhu! In pediatric cardiology, there is a condition known as the Soft Palate Heart-Facial Syndrome, which predicts congenital heart disease based on facial anomalies.
Your child's echocardiogram currently shows an atrial septal defect.
In infants under 6 months of age, we refer to this as a patent foramen ovale.
If this defect persists after 6 months, it is then classified as an atrial septal defect.
Typically, we conduct regular echocardiographic follow-ups every 3 to 6 months.
If the defect is less than 0.8 cm, monitoring is sufficient, as most will close spontaneously.
For larger defects, catheter-based closure may be considered.
Regarding the asymmetry of the lips, where the lower lip is deviated to the right, this indicates a deficiency in the nerve supply to the left orbicularis oris muscle, which can be improved through rehabilitation therapy.

Reply Date: 2020/10/18

More Info


When it comes to a baby's crooked lower lip, especially in the context of a newborn, there are several factors to consider. The observation that your child's lower lip appears to be crooked, particularly when crying, can be concerning for parents. However, it is essential to understand that there are various potential causes for this condition, and many of them are benign.

One common reason for a crooked lip in infants is the natural asymmetry that can occur in newborns. Babies are still developing, and their facial muscles and structures may not be fully coordinated. This asymmetry can be more pronounced when the baby is crying, as the muscles involved in facial expressions may not function symmetrically. In many cases, this is a temporary condition that improves as the baby grows and their muscles develop.

Another possibility is that the appearance of a crooked lip could be related to the baby's positioning during feeding or sleeping. If a baby consistently favors one side while breastfeeding or bottle-feeding, it may lead to temporary muscle imbalances. Ensuring that the baby is fed from both sides can help promote more symmetrical muscle development.

In your case, you mentioned that a heart examination revealed a diaphragmatic hernia. This condition can indeed affect the baby's overall health and development, but it is not directly linked to the appearance of a crooked lip. However, if the hernia is causing significant respiratory distress or other complications, it could indirectly influence the baby's ability to cry or use their facial muscles effectively.

It is also worth noting that some congenital conditions can lead to facial asymmetry, but these are typically accompanied by other signs and symptoms. If the baby is otherwise healthy, feeding well, and gaining weight appropriately, the crooked lip is likely not a cause for concern.

To address your question about whether the crooked lip will improve, the answer is generally yes. Most infants experience some degree of facial asymmetry that resolves as they grow. However, it is crucial to monitor the situation and consult with your pediatrician or a pediatric specialist if you notice any significant changes or if the asymmetry persists beyond the first few months of life.

In summary, while a crooked lower lip in a newborn can be alarming, it is often a normal part of development. Factors such as natural asymmetry, feeding habits, and muscle coordination play significant roles. If you have concerns about your child's health, especially in light of the diagnosed diaphragmatic hernia, it is essential to maintain open communication with your healthcare provider. They can offer guidance tailored to your child's specific situation and help ensure that any underlying issues are appropriately managed.

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