CLEFT LIP PALATE (PEDIA)

A congenital defect caused by failure of fusion of facial structures during embryonic development.

cleft lip and cleft palate

What is the major problem in infants with cleft lip and palate?

Feeding difficult

Why? Cannot create adequate suction, milk may enter the nose

While assessing a newborn with cleft lip, what will MOST likely be compromised?

Sucking ability

Why do infants with cleft palate have difficulty breastfeeding?

They cannot generate enough suction because the oral cavity is not sealed.

What is the BEST feeding method for infants with cleft lip/palate?

Special nipple with enlarged opening or cross-cut nipple

What position should be used when feeding an infant with cleft palate?

Upright

What is the most common complication of cleft palate?

Otitis media (ear infection)

What developmental problem is associated with cleft palate?

Speech problems

What is the usual timing of cleft lip repair?

Around 3 months

Rule of 10s:

• 10 weeks old

• 10 pounds weight

• Hemoglobin 10 g/dL

What is the usual timing of cleft palate repair?

Around 9–18 months

What device may be used after cleft lip repair to prevent touching the incision?

Elbow restraints (No-no’s)

Which vitamin deficiency is associated with cleft lip/palate risk?

Folic acid deficiency

Which medication is classically associated with congenital limb defects and may be asked as a teratogen?

Thalidomide

A newborn with cleft palate is admitted. What is the priority nursing diagnosis?

Impaired nutrition: less than body requirements related to inability to suck effectively

When should elbow restraints be introduced?

Pre-operative

Before surgery, which condition requires immediate notification of the surgeon and may suspend surgery?

Nasopharyngitis