Micrognathia

Micrognathia is when your baby’s lower jaw is underdeveloped or smaller than usual. Having a smaller jaw means there’s less room for your baby’s tongue. Their tongue ends up pushed back into their throat. That can make it hard for them to breathe. They may have trouble nursing or feeding. Micrognathia may go away without treatment as your baby grows up. The condition often affects babies who have certain inherited conditions or syndromes. It’s also known as mandibular hypoplasia.

Micrognathia symptoms

Common symptoms in babies and children include:

• Difficulty feeding or nursing
• Loud breathing
• Poor weight gain
• Tossing and turning during sleep

Micrognathia causes

Researchers link this condition to many genetic conditions and syndromes. Some common examples include:

• Beckwith-Wiedemann syndrome
• Cleft lip and palate
• Cri-du-chat syndrome
• Marfan syndrome
• Pierre Robin syndrome
• Treacher Collins syndrome
• Trisomy 18
• Stickler syndrome

Complications

Micrognathia may lead to obstructive sleep apnea. That can happen if your child’s tongue falls back into their throat and blocks their airway while they sleep.

How doctors diagnose micrognathia

Sometimes, prenatal ultrasounds can show micrognathia signs, like an underdeveloped jaw. Typically, healthcare providers diagnose the condition when your baby is born or very soon after birth.

A provider will examine your baby’s face and mouth. Specifically, they’ll:

• Compare the size of your child’s lower jaw against their upper jaw
• Check if your child’s smaller jaw pushes their tongue back toward their throat
• Look for symptoms of conditions that often happen with micrognathia, like cleft lip and palate

They may do tests, including:

• CT scans
• X-rays
• Sleep study

Your child’s provider may refer you to a pediatric ENT for more tests and treatment.

How is micrognathia treated?

Micrognathia may go away on its own a year or so after your baby is born. Your baby’s lower jaw may get bigger as they grow up. But their healthcare provider may recommend treatments if your baby’s symptoms aren’t better when they’re 18 months old.

Most treatments work to fix your baby’s airway so they can breathe more easily. There are several treatments. Some involve surgery. Your child’s treatment will depend on how the condition affects them. Their provider will explain their options. You may feel anxious about treatment, so don’t hesitate to ask for details. Knowing what to expect will help you take care of your child.

Nonsurgical micrognathia treatment

Your child’s provider will try nonsurgical treatments before recommending surgery. The most common ones include:

• Positional therapy: Placing your baby in specific positions while they sleep can help to keep their airway open. For example, putting your baby on their side to sleep moves their tongue forward so it doesn’t block their airway.
• Nasopharyngeal tube: This is a soft tube that goes into your baby’s nose and the upper part of their throat. The tube keeps your baby’s tongue from falling back into their throat.
• Positive airway pressure: Your child may wear a positive airway pressure device when they sleep. The device sends air through a tube and into a mask that fits over your child’s nose. The air pressure keeps their airway open. BiPAP® machines and CPAP machines are examples of positive airway pressure devices.

Surgical micrognathia treatment

Your child may need surgery to make sure their airway stays open. Micrognathia surgeries include:

• Mandibular distraction osteogenesis (MDO): This surgery makes your baby’s jaw longer and opens their airway.
• Tongue-lip adhesion: This is a temporary solution to keep your baby’s tongue from falling into their airway. Their surgeon will use sutures to connect your baby’s tongue to their lower lip. They’ll remove the sutures after your baby’s lower jaw grows.
• Tracheostomy: This procedure makes an opening through your baby’s neck and into their airway so they can get air through a tube.

Surgery can be a scary experience for your baby and for you. Working with a child life specialist may help. They’ll give you and your baby emotional support before and after surgery.

When should I see my child’s healthcare provider?

Talk to your child’s pediatrician if your child’s lower jaw is small or underdeveloped and they have symptoms like noisy breathing or difficulty feeding.

What can I expect if my child has micrognathia?

Treatment, including surgery, may take care of micrognathia. But children with this condition often have genetic syndromes that affect their health. Your baby may need more kinds of medical support even after treatment for micrognathia.

What questions should I ask my child’s provider?

If your child has been diagnosed with micrognathia, you’ll want to learn all you can about the condition. Here are some questions to ask your healthcare provider:

• Do you know why my baby has this condition?
• How severe is it?
• Will they need treatment? If so, what kind?