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 the crooked mouth get better?

Zhu Bo, 0~9 year old female. Ask Date: 2020/10/19

Dr. Xie Wanghu reply Pediatrics


Hello, Zhu Bo's mother! 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 old, this is referred to as a patent foramen ovale.
If this defect persists after 6 months of age, it is then classified as an atrial septal defect.
Typically, regular echocardiogram follow-ups are conducted every 3 to 6 months.
If the defect is less than 0.8 cm, monitoring is sufficient, as most cases will close spontaneously.
For larger defects, catheter-based closure may be considered.
Regarding the asymmetry of the lips, where the left side is drooping to the right, this indicates a deficiency in the nerve supply to the orbicularis oris muscle on the left side, which can be improved through rehabilitation therapy.

Reply Date: 2020/10/19

More Info


When it comes to a baby's crooked lower lip, particularly in the context of a newborn, there are several factors to consider. The asymmetry you are observing, especially when your baby cries, can be concerning for parents. However, it is important to understand that there are various potential causes for this condition, and many of them may resolve on their own as the child grows.

One common reason for a crooked lip in infants is related to the development of the facial muscles and structures. In the early stages of life, a baby's muscles, including those around the mouth, are still developing. This can lead to temporary asymmetries that may appear more pronounced during crying or other facial movements. As the baby grows and their muscle control improves, these asymmetries often diminish.

Another possibility is that the position in which the baby was in utero could have influenced the development of their facial features. If the baby was positioned in a way that put pressure on one side of the face, it could lead to temporary asymmetry. This is often referred to as positional plagiocephaly, which can affect the shape of the head and face. As the baby spends more time in different positions and engages in more physical activity, these issues typically resolve.

You mentioned that a medical professional has diagnosed your baby with a diaphragmatic hernia. This condition occurs when there is an abnormal opening in the diaphragm, allowing abdominal contents to move into the chest cavity. While this condition can be serious and may require surgical intervention, it is not directly related to the appearance of a crooked lip. However, it is crucial to monitor your baby's overall health and development, as any associated respiratory or feeding difficulties could impact their growth and well-being.

In terms of treatment or intervention, if the crooked lip is purely a cosmetic concern and there are no underlying health issues affecting your baby's feeding or breathing, it may not require any specific treatment. Regular follow-ups with your pediatrician or a pediatric specialist can help monitor your baby's development and address any concerns you may have.

If the asymmetry persists or worsens, or if you notice other concerning symptoms such as difficulty feeding, unusual crying patterns, or respiratory distress, it is essential to seek further evaluation from a pediatrician or a specialist. They may recommend imaging studies or other assessments to rule out any structural abnormalities or neurological concerns.

In summary, a crooked lower lip in a newborn can be attributed to various factors, including developmental asymmetries, positional influences, or underlying medical conditions. While many cases resolve naturally as the baby grows, it is crucial to maintain open communication with your healthcare provider to ensure your child's health and development are on track. Regular check-ups and monitoring will provide peace of mind and help address any emerging concerns.

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