What is a primary concern when a newborn exhibits facial asymmetry?

Facial asymmetry in a newborn can be indicative of several potential issues, but the primary concern to consider is congenital torticollis. This condition occurs when the muscles in the neck are tightened or shortened, causing the head to tilt to one side and potentially leading to facial asymmetry as a secondary effect. This asymmetry arises from the different positional pressures on the head and face.

In comparison, dehydration, infection, and blunt force trauma do not typically present primarily through facial asymmetry in newborns. Dehydration often manifests with other signs such as dry skin, decreased urine output, and lethargy, while infections would usually present with systemic symptoms such as fever, fussiness, or respiratory distress. Blunt force trauma may cause facial asymmetry but is usually accompanied by other symptoms such as bruising or swelling. Therefore, congenital torticollis is the most pertinent concern when observing facial asymmetry in a newborn.