Facial palsy is a condition characterised by weakness in the facial muscles, causing part of the face to droop or become paralysed. This is usually due to damage to the facial nerve, also known as the seventh cranial nerve, which is responsible for controlling the contraction of muscles connected to the eyebrows, eyelids and cheek muscles.

Bell's palsy is the most common form of facial palsy and accounts for 80% of all cases. It results in partial or complete paralysis of one half of the face, which in turn leads to severe and often lifelong symptoms, such as:

• An inability to close one eye
• Difficulty eating and involuntary salivation
• Problems with speech
• Impaired sense of taste

There are different degrees of facial paralysis, depending on the extent of the nerve damage. Sometimes only the lower half of the face is affected, whereas in other cases it will affect one side of the face, or the entire face.

When facial palsy results from birth trauma, it can present in the following ways:

• The baby’s mouth does not pull down on both sides when crying, a condition known as asymmetric crying faces
• The area below the eyes appears uneven when crying
• One of the child’s eyelids may not close fully or blink normally
• There is little or no movement on one side of the face

There are a number of causes of facial palsy, including viral infections, bacterial causes, genetic syndromes and stroke. However, it can also be the result of birth trauma, which most often occurs when deliveries that require the use of forceps are not carried out correctly.

The pressure of the forceps blade on the baby’s head can cause damage to the facial nerve, causing some degree of facial palsy. In many cases these injuries are not severe, meaning the symptoms will resolve after a few months. However, in other instances, the effects are long-lasting and debilitating.

Medical professionals and midwives are trained in the use of forceps, but if fast action needs to be taken - for instance, if a baby experiences distress during birth and needs to be delivered quickly - then mistakes can easily be made.

Treatment for facial palsy and Bell’s palsy depends on the nature and severity of the symptoms. Examples include:

• A course of steroid-based medicine
• Eyedrops and ointments to stop the affected eye drying out
• Surgical tape to keep the eye closed at bedtime

Other treatments and therapies include a form of physical therapy, known as ‘facial retraining’, and surgery to relieve pressure on the facial nerve, although surgery is rarely recommended. Generally speaking, the affected child will need to be monitored by medical professionals for an extended period of time to determine how best to treat them.