It's also called asymmetrical crying facies. If it's isolated (just the 
depressor anguli oris muscle didn't form or is hypoplastic (undergrown), 
it will just affect the lower lip. You can try some supportive 
techniques if this particular baby has difficulty keeping a good grasp 
on the breast, but many have no problem. (see my clinical corner pages 
on my website for some photos).

The big issue is if there are other anomalies, particularly cardiac 
ones. A good exam should rule out any related anomalies.

Let us know how this little one does.

Catherine Watson Genna BS, IBCLC  NYC  www.cwgenna.com

On 3/8/2014 2:47 PM, Duret, Anne wrote:
> Anyone familiar with this facial anomaly?  Looks similar to a torticollis in terms of oral asymmetry but no neck or shoulder involvement.  Left side of mouth appears somewhat paralyzed, especially seen when baby cries.  Digital exam is mostly normal, although baby does have a tendency to bite, and his jaw does have a bit of a tremor similar to tongue tie fatigue, but no tongue tie.  Latch is okay and he is beginning to transfer some colostrum.  Is only 24 hours old at this point so obviously we will continue to monitor.
>
> Did not see this in Supporting Sucking Skills.  Catherine W-G, what say you?  Ever heard of this before?  What should we watch for?  Might he in fact fatigue at breast?
>
> Anne Duret, RN IBCLC
> Eugene, OR
>
>
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