Neonatal facial nerve palsy arises either from a traumatic birth injury or from hereditary agenesis of the facial nerve nucleus (Moebius syndrome) Traumatic peripheral nerve injury takes place when the facial nerve is compressed as it exits the stylomastoid foramen or branches within the ramus of the mandible Compression of the facial nerve may occur during pregnancy or during delivery and may occur as a result of oblique midforceps application, or pressure on the face by extreme prolonged pressure by the sacrum, other fetal parts or uterine fibroid tumors Peripheral injury is unilateral and may be associated with brachial nerve palsy Traumatic central nerve injury results from destruction of contralateral brain tissue within the posterior fossa or the temporal bone Traumatic central injury is rare and can affect other cranial nerves Neonates with peripheral facial nerve injury will display injury to both the upper and lower face on the ipsilateral side within the first few days Typically the forehead is smooth with inability to close the eye, and there is a smooth nasolabial fold and drooping at the corner of the mouth on the paralyzed ipsilateral side When the baby cries the contralateral corner of the mouth will move Since other cranial nerves are intact the baby will have no trouble feeding Peripheral facial nerve palsy starts to recover within days, with complete resolution within weeks to months Initial supportive care includes corneal protection with petroleum ointment, and eye pad during periods of sleep, or 1% methyl cellulose eye drops every hours Neonates should be further referred for neurologic evaluation and electrodiagnostic testing to ensure recovery is monitored appropriately Infants who show poor recovery at year of age may be candidates for surgical intervention