Materiały źródłowe

• #1

  https://www.healthychildren.org/English/health-issues/conditions/Cleft-Craniofacial/Pages/Cleft-Lip-and-Palate-Parent-FAQs.aspx

  One in every 700 babies is born with a cleft lip, a cleft palate, or both making it one of the most common birth defects. Babies born with a cleft lip and/or palate need special care from a team of different health professionals. Their care must be well managed because of the difficult medical, surgical, dental and social factors important to treatment decisions. […] The type of cleft lip and/or palate a child has will determine the kind of care that he or she needs. […] In general, babies with a cleft palate either as cleft lip with cleft palate or cleft palate alone, suck weakly and need a special bottle to feed. Support from a feeding therapist, certified lactation consultant, and/or nurse experienced in feeding children with cleft palate is recommended for parents. […] Various specialists will care for your child at different times and stages. The cleft/craniofacial team usually includes nurses, social workers, nutritionists, audiologists, speech-language pathologists, geneticists, pediatricians, dentists, orthodontists and pediatric surgeons (otolaryngologists, oral and maxillofacial surgeons, and plastic surgeons).

• #2

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut3193

  Cleft lip and cleft palate are fairly common birth defects that often occur together. […] Cleft lip happens when the tissues of the upper jaw and nose don’t join properly as a baby develops. This causes a split (cleft) in the lip. In most cases, a cleft lip does not cause feeding problems or other health problems. […] Cleft palate happens when the roof of the mouth (palate) doesn’t develop normally during pregnancy. This leaves an opening that may go through to the nasal cavity. It may affect any part of the palate, including the front part of the roof of the mouth (hard palate) or the small tag of tissue that hangs down from the soft palate (uvula). Some babies with cleft palates have problems sucking and swallowing, so feeding may be a challenge. […] Both of these conditions are treated with surgery. Cleft lip is repaired in the first few months of a child’s life; the timing depends on how bad it is. Cleft palate is usually fixed before 12 months of age. It often takes more than one surgery. Sometimes a cleft palate needs treatment before surgery. This may include special dental splints or soft dental moulding inserts.

• #3 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Cleft lip and cleft palate are separations in the upper lip and mouth that occur while a fetus develops in the uterus. Treating cleft lip and palate involves surgery and may include speech therapy and dental work. Your childs medical care team is there to support you each step of the way. […] Surgery can repair a cleft lip and/or cleft palate. […] Treatment for cleft lip and cleft palate begins at birth. Surgical treatment begins as early as 3 months and can last until the teen years. […] Surgery treats cleft lip and/or cleft palate. The exact details of treatment depend on the extent of the cleft, your childs age and other special needs or health conditions. Your child will have surgery at a hospital, under general anesthesia, so theyll be asleep during the procedure. […] A cleft lip repair may require one or two surgeries. The first surgery usually occurs when your baby is between 3 and 6 months old. This surgery closes their lip. The second surgery, if necessary, is usually done when your child is 6 months old.

• #4 Cleft Palate With Cleft Lip (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/cleft-palate-cleft-lip.html

  A cleft of the lip or palate happens when a baby is born with an opening in the upper lip or the roof of the mouth (the palate). These orofacial clefts are some of the most common birth defects. […] A cleft lip can be: on one side of the lip (a unilateral cleft lip). This type is more common. on both sides of the lip (a bilateral cleft lip). […] It’s important to correct a cleft palate with cleft lip with surgery while a child is young. […] A plastic surgeon will repair the baby’s cleft lip first, usually when the baby is about 3 months old. This is done with a surgery called cheiloplasty. […] A cleft palate usually is repaired with surgery called palatoplasty when the baby is 10-12 months old. […] Cleft lip and cleft palate can cause problems with: feeding, growth and development, ear infections and hearing, speech development.

• #5 Cleft Lip/Cleft Palate | Birth Defects | CDC

  https://www.cdc.gov/birth-defects/about/cleft-lip-cleft-palate.html

  Cleft lip and cleft palate are birth defects that occur when a baby’s lip or mouth don’t form properly. […] Service and treatment needs can vary depending on the size of a cleft. […] If the orofacial clefts are not surgically repaired, children with these conditions have problems with feeding and speaking clearly. They may also more often have ear infections and hearing problems, or problems with their teeth. […] Services and treatment for children with orofacial clefts can vary depending on: The severity of the cleft, The child’s age and needs, The presence of associated syndromes or other birth defects. […] Surgery to repair a cleft lip usually occurs in the first few months of life. It is recommended within the first 12 months of life. Surgery to repair a cleft palate is recommended within the first 18 months of life, or earlier if possible.

• #6 Cleft Palate – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563128/

  A cleft palate is a common congenital craniofacial condition characterized by an opening or split in the roof of the mouth due to incomplete tissue fusion during fetal development. This condition can affect infants’ feeding and breathing and children’s speech, as the anomaly impairs the separation between the nasal and oral cavities. Infants with a cleft palate often struggle with nasal reflux, forming a secure latch for feeding, and may tire easily during feeding due to increased effort. […] Treatment typically involves an interprofessional approach, including early intervention for feeding challenges and long-term support for speech and hearing. Surgical repair usually occurs within the first year of life, aiming to restore normal function by closing the cleft and enhancing speech and swallowing abilities.

• #7 Cleft lip and cleft palate – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cleft-palate/symptoms-causes/syc-20370985

  Cleft lip and cleft palate care at Mayo Clinic. […] If your baby has symptoms of a submucous cleft palate, make an appointment with your child’s healthcare professional. […] After a baby is born with a cleft, parents could be concerned about whether they’ll have another child with the same condition. […] Consider genetic counseling. […] Take prenatal vitamins. […] Don’t use tobacco or alcohol. […] One concern right away after birth is feeding. […] Babies with cleft palate are especially at risk of developing middle ear fluid and losing hearing. […] If the cleft extends through the upper gum, teeth may not develop properly. […] Because babies use the palate to form sounds, a cleft palate can affect the usual development of speech. […] Children with clefts may face social, emotional and behavioral problems due to differences in how they look and the stress of medical care.

• #8 Cleft Lip and Cleft Palate Nursing Care Management

  https://nurseslabs.com/cleft-lip-cleft-palate/

  Cleft lip and cleft palate can be emotionally challenging for affected individuals and their families, necessitating comprehensive and multidisciplinary care from healthcare professionals. […] A complete and thorough process of care should be undergone by the newborn with cleft lip and cleft palate. […] One primary concern in the nursing care of a newborn with a cleft lip and cleft palate is the emotional care of the newborn’s family. […] Based on the assessment data, the major nursing diagnoses are: Compromised family coping related to visible physical defect, Anxiety of family caregivers related to child’s condition and surgical outcome, Deficient knowledge of family caregivers related to care of child before surgery and the surgical procedure, Risk for aspiration related to a reduced level of consciousness after surgery, Ineffective breathing pattern related to anatomical changes, Risk for deficient fluid volume related to NPO status after surgery, Acute pain related to surgical procedure, Risk of injury to the operative site related to newborn’s desire to suck thumb or fingers and anatomical changes.

• #9 Pediatric Cleft Lip & Palate Care | MaineHealth Barbara Bush Children’s Hospital | MaineHealth

  https://www.mainehealth.org/barbara-bush-childrens-hospital/care-services-mainehealth-barbara-bush-childrens-hospital/pediatric-cleft-lip-palate-care-mainehealth-barbara-bush-childrens-hospital

  MaineHealth Pediatric Specialty Care – Cleft Lip and Palate – Scarborough provides comprehensive care for pediatric cleft lip and palate disorders. We take a team approach to care. You and your child will meet with a multi-disciplinary team of specialists at one time, in one location. Working together, our team will evaluate your childs progress and recommend an ongoing treatment plan. […] Your childs care team may include: […] Nurse team coordinator: A nurse practitioner specializing in the care of children with cleft lip and palate who works with the team to manage your childs care, and is available when you have questions or concerns. […] After your appointment, the team meets to review your childs progress and agree on the best plan for the coming year. We will send that plan to you and to your childs doctor. The clinic nurse team coordinator is available to you and your family by phone or email to provide support, answer questions and assist with coordinating care between clinic visits.

• #10 Cleft Lip and Cleft Palate Nursing Care Management

  https://nurseslabs.com/cleft-lip-cleft-palate/

  Cleft lip and cleft palate can be emotionally challenging for affected individuals and their families, necessitating comprehensive and multidisciplinary care from healthcare professionals. […] A complete and thorough process of care should be undergone by the newborn with cleft lip and cleft palate. […] One primary concern in the nursing care of a newborn with a cleft lip and cleft palate is the emotional care of the newborn’s family. […] Based on the assessment data, the major nursing diagnoses are: Compromised family coping related to visible physical defect, Anxiety of family caregivers related to child’s condition and surgical outcome, Deficient knowledge of family caregivers related to care of child before surgery and the surgical procedure, Risk for aspiration related to a reduced level of consciousness after surgery, Ineffective breathing pattern related to anatomical changes, Risk for deficient fluid volume related to NPO status after surgery, Acute pain related to surgical procedure, Risk of injury to the operative site related to newborn’s desire to suck thumb or fingers and anatomical changes.

• #11 Cleft Lip and Cleft Palate Nursing Care Management

  https://nurseslabs.com/cleft-lip-cleft-palate/

  Goal setting and planning must be modified to adapt to the surgical plans; the major goals include: Maintaining adequate nutrition, Increasing family coping, Reducing the parents anxiety and guilt regarding the newborn’s physical defects, and preparing parents for the future repair of the cleft lip and palate. […] Nursing interventions for the patient with cleft lip and palate are: Maintain adequate nutrition, Positioning, Tools for feeding, Promote family coping, Reduce family anxiety, Provide family teaching. […] Major goals for the care of the infant with cleft lip and cleft palate include: Maintained adequate nutrition, Increased family coping, Reduced parents anxiety and guilt regarding the newborn’s physical defects.

• #12 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Cleft Lip Palate Nursing Care Plans and Nursing Diagnosis […] Nursing goals for clients diagnosed with cleft lip and palate include maintaining adequate nutrition, increasing family coping, reducing the parents anxiety and guilt regarding the newborns physical defects, and preparing parents for the future repair of the cleft lip and palate. […] The following are the nursing priorities for patients with cleft lip and cleft palate: […] Feeding Difficulties. Infants with cleft lip and cleft palate may have difficulties in breastfeeding or bottle feeding due to structural abnormalities. Ensuring adequate nutrition and addressing feeding challenges are crucial for their growth and development. […] Speech and Language Development. Cleft lip and cleft palate can affect speech production and intelligibility. Early intervention by speech therapists and regular monitoring of speech and language development are essential to address any potential communication difficulties. […] Dental and Orthodontic Issues. Cleft lip and palate can impact the alignment and development of teeth and jaws. Dental problems, such as malocclusion, missing teeth, and dental decay, may require orthodontic and dental interventions to ensure proper oral health and function. […] Ear Infections and Hearing Problems. Children with cleft palate are more prone to middle ear infections (otitis media) and hearing loss due to the dysfunction of the Eustachian tube. Frequent monitoring and timely intervention are necessary to prevent potential hearing impairment. […] Psychological and Social Well-being. Individuals with cleft lip and cleft palate may face challenges related to self-esteem, body image, and social interactions due to visible facial differences. Providing psychological support and addressing any emotional difficulties can contribute to their overall well-being. […] Facial Aesthetics and Plastic Surgery. Reconstructive surgery plays a vital role in correcting the cleft lip and palate, improving facial aesthetics, and restoring normal function. Surgical interventions are typically staged and performed by experienced plastic surgeons. […] Nasal Resonance and Breathing Difficulties. Cleft palate can affect nasal resonance and lead to nasal airway obstruction. Management may involve speech therapy, nasal surgery, and continuous monitoring of nasal function.

• #13 Cleft Lip/Cleft Palate: Feeding Your Child (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/clefts-feeding.html

  When a baby is born with a cleft, it’s important to help the baby feed well to prevent dehydration and make sure they gain weight. Babies born with a cleft may need some special feeding help. […] Babies born with a cleft palate, whether with a cleft lip or without, can’t breastfeed. That’s because they can’t create the pressure needed to suck milk from the nipple. Trying to breastfeed or use a regular bottle system to feed a baby with a cleft palate can lead to poor weight gain and failure to thrive. […] Babies with a cleft palate need to be fed with a specialty bottle system. It provides the proper nutrition without the need for pressure while sucking. […] Feeding challenges put babies with a cleft palate at risk for failure to thrive. Regular weight checks by your baby’s doctor or the cleft team can help make sure your baby is gaining enough weight. […] Feeding a baby with cleft lip/palate can be a challenge at first. But help is available. Look to the cleft team for support and information.

• #14 Feeding Your Baby With Cleft Lip and Palate

  https://www.gillettechildrens.org/your-visit/patient-education/feeding-your-baby-with-cleft-lip-and-palate

  Feeding a healthy baby with a cleft lip and palate can be more challenging. The severity of the cleft lip or palate (or both) affects an infant’s ability to suck and obtain enough nourishment for growth and development. […] A child with a cleft palate or both a cleft lip and palate often takes longer to feed and feedings may be more frequent. If your baby is taking more than 30-40 minutes to feed or feedings are consistently less than two hours apart, your baby may be using too much energy to obtain nourishment and calories for growth. […] Infants with cleft palate usually can be fed more effectively with proper positioning, a combination of feeding techniques, and specialized feeding equipment. […] Cleft palate babies feed better when positioned upright (at a 60-80 degree angle) with chin tilted up, so there is less chance of milk getting into the nose.

• #15 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with cleft lip and cleft palate may include: […] Maintaining Airway Clearance and Preventing Aspiration. Infants diagnosed with a cleft palate cannot suck effectively either because pressing their tongue or a nipple against the roof of their mouth forces milk into their pharynx, possibly leading to aspiration. […] Improving Nutritional Status and Teaching Feeding Methods. Before a cleft lip or palate is repaired, feeding the infant becomes a concern because the infant has difficulty maintaining suction with a bottle or breast; there is evidence of slower growth compared to infants without a cleft disorder. […] Reducing Anxiety and Enhancing Coping. A mothers first reaction to a disfigured newborn is one of shock, hurt, disappointment, and guilt. […] Preventing Injury and Infections. Cleft lip and cleft palate can lead to many complications. Early feeding difficulties limit the infants weight gain and growth and may lead to learning disabilities, speech disorders, recurring upper respiratory tract infections, and chronic ear disease. […] Initiating Patient Education and Health Teachings. Mothers of infants diagnosed with cleft lip and palate may have limited knowledge about feeding their infants and may lack information regarding regurgitation, colic, and swallowing during feedings.

• #16 Cleft Lip and Palate Newborn Care and Feeding: A Primer for Bedside Nursing Providers

  https://www.gavinpublishers.com/article/view/cleft-lip-and-palate-newborn-care-and-feeding-a-primer-for-bedside-nursing-providers

  In the newborn period successful feeding is the biggest concern for infants born with orofacial clefting. Poor feeding for these infants can lead to poor weight gain, dehydration and failure to thrive. Nutrition, oral intake, and growth assessment should be evaluated at all clinic visits. […] It is helpful to know that feeding an infant with a cleft can be messy and time consuming compared to other infants because of the extraoral losses of milk. Feeding takes training, practice, and flexibility for infants and parents to become efficient. […] Bedside providers who are asked to help mothers of newborns with cleft lip and/or palate are encouraged to focus on teaching the basics. Mothers need to know the signs of effective feeding, the expected frequency and duration of feedings, and the expected weight gain over time so they can help monitor their baby’s progress.

• #17 Cleft lip and cleft palate | PPT

  https://www.slideshare.net/slideshow/cleft-lip-and-cleft-palate-132828152/132828152

  Cleft lip and cleft palate Nursing, Care […] Nursing management Preoperative care: Keep the infant NPO for 6 hours before surgery. Administer premedication as per doctors order Physical, physiological, psychological and legal preparation should be done. […] Post operative care Keep the airway clear from accumulation of mucus in the nose and mouth. Mild sedation may be prescribed to prevent infant from crying. Careful positioning (never on the abdomen) Restraining the arms if necessary. The mother and father should be encouraged to remain with their child as much as possible. The infant is fed with a medicine dropper. Clear fluids offers initially, breast milk or formula can be given when tolerated. […] The mouth should be rinsed with water before and after feeding. Do not brush the teeth 1-2 weeks after the surgery. The suture line must be cleaned gently with cotton or gauze-tipped swab dipped in hydrogen peroxide or saline solution and dried carefully several times a day to ensure proper healing. The parents are taught the ways by which injury to the palate can be prevented after discharge and prevention of upper respiratory tract infection. Speech therapy should be given. Encourage the child to socialize with family members and others. […] Preoperative Nursing diagnosis Imbalance nutrition; less than body requirements related to inability to suck. Describe the degree of cleft and impairment of sucking The mother should be encouraged to breast feed their babies and whenever there are feeding problems expressed breast milk may be give. Use special feeding technique if needed In case of failure of breast feeding, artificial feeding has to be substituted When extreme difficulty is encountered with feeding, gavage may become necessary. Burp frequently and hold the infant in a more upright position. Keep an accurate record of Childs growth by using a growth chart. […] Feeding technique: Equipment Description Soft, thin walled nipple – compresses easily, readily available NUK orthodontic nipple – large surface for compression Cross-cut nipple – allows easy flow of milk with compression Ross cleft palate nurser – for infants with weak suck; has soft tube like nipple. Mead Johnson cleft palate nurser -soft, long cross-cut nipple, soft bottle for squeezing Can monitor the milk flow […] If regurgitation occurs, stop feeding and allow infant to cough / sneeze to clear the air way. Place nipple on top of tongue. Nipple insertion may push tongue to the back of mouth. Burp the infant frequently because of increased air ingestion Monitor for distress and fatigue during feeding Limit feeding time to approximately 30 minutes to avoid fatigue Follow feeding with sterile water to clean any rapped food in the cleft Clean mouth and nose. […] Interrupted family processes related to emotional reaction to an infant with a visible defect. Encourage parents to discuss their fears, concerns and negative emotions Encourage touching and holding to prevent delayed attachments. Express acceptance of baby by modeling and close physical contact. Make appropriate referral to a cleft lip and palate team of nurses, physicians and other specialists. […] Parental fear and anxiety related to special care needs and surgery. Use a calm, reassuring, accepting approach with infant and family. Explain all procedures and their rationale including sensations likely experienced by their child. Listen actively to parents and their concerns, encourage verbalization of feelings and perceptions Encourage parents to stay with their child in the immediate pre and post operative periods. […] High risk for respiratory distress or dyspnea related to cleft lip and cleft palate. Assess the respiratory movement Auscultate the lungs Prevent respiratory obstruction, especially on inspiration and when the infant is quiet place the infant in prone so that tongue and jaw fall forward, tilt head back as best tolerated by the infant slightly elevate upper trunk. Provide adequate suctioning in order to remove secretions Administer oxygen as per doctors order. […] Risk for infection related to surgical repair and aspiration. Irrigate the mouth with normal saline solution or water Direct a gentle stream over the suture line using an ear bulb syringe While irrigating held the child in sitting position with his head forward Keep the mouth moist to promote healing and provide comfort Rinse the mouth after each feeding Administer antibiotics as prescribed.

• #18 Feeding Your Baby With Cleft Lip and Palate

  https://www.gillettechildrens.org/your-visit/patient-education/feeding-your-baby-with-cleft-lip-and-palate

  Feeding a healthy baby with a cleft lip and palate can be more challenging. The severity of the cleft lip or palate (or both) affects an infant’s ability to suck and obtain enough nourishment for growth and development. […] A child with a cleft palate or both a cleft lip and palate often takes longer to feed and feedings may be more frequent. If your baby is taking more than 30-40 minutes to feed or feedings are consistently less than two hours apart, your baby may be using too much energy to obtain nourishment and calories for growth. […] Infants with cleft palate usually can be fed more effectively with proper positioning, a combination of feeding techniques, and specialized feeding equipment. […] Cleft palate babies feed better when positioned upright (at a 60-80 degree angle) with chin tilted up, so there is less chance of milk getting into the nose.

• #19 Cleft lip and cleft palate | PPT

  https://www.slideshare.net/slideshow/cleft-lip-and-cleft-palate-132828152/132828152

  Cleft lip and cleft palate Nursing, Care […] Nursing management Preoperative care: Keep the infant NPO for 6 hours before surgery. Administer premedication as per doctors order Physical, physiological, psychological and legal preparation should be done. […] Post operative care Keep the airway clear from accumulation of mucus in the nose and mouth. Mild sedation may be prescribed to prevent infant from crying. Careful positioning (never on the abdomen) Restraining the arms if necessary. The mother and father should be encouraged to remain with their child as much as possible. The infant is fed with a medicine dropper. Clear fluids offers initially, breast milk or formula can be given when tolerated. […] The mouth should be rinsed with water before and after feeding. Do not brush the teeth 1-2 weeks after the surgery. The suture line must be cleaned gently with cotton or gauze-tipped swab dipped in hydrogen peroxide or saline solution and dried carefully several times a day to ensure proper healing. The parents are taught the ways by which injury to the palate can be prevented after discharge and prevention of upper respiratory tract infection. Speech therapy should be given. Encourage the child to socialize with family members and others. […] Preoperative Nursing diagnosis Imbalance nutrition; less than body requirements related to inability to suck. Describe the degree of cleft and impairment of sucking The mother should be encouraged to breast feed their babies and whenever there are feeding problems expressed breast milk may be give. Use special feeding technique if needed In case of failure of breast feeding, artificial feeding has to be substituted When extreme difficulty is encountered with feeding, gavage may become necessary. Burp frequently and hold the infant in a more upright position. Keep an accurate record of Childs growth by using a growth chart. […] Feeding technique: Equipment Description Soft, thin walled nipple – compresses easily, readily available NUK orthodontic nipple – large surface for compression Cross-cut nipple – allows easy flow of milk with compression Ross cleft palate nurser – for infants with weak suck; has soft tube like nipple. Mead Johnson cleft palate nurser -soft, long cross-cut nipple, soft bottle for squeezing Can monitor the milk flow […] If regurgitation occurs, stop feeding and allow infant to cough / sneeze to clear the air way. Place nipple on top of tongue. Nipple insertion may push tongue to the back of mouth. Burp the infant frequently because of increased air ingestion Monitor for distress and fatigue during feeding Limit feeding time to approximately 30 minutes to avoid fatigue Follow feeding with sterile water to clean any rapped food in the cleft Clean mouth and nose. […] Interrupted family processes related to emotional reaction to an infant with a visible defect. Encourage parents to discuss their fears, concerns and negative emotions Encourage touching and holding to prevent delayed attachments. Express acceptance of baby by modeling and close physical contact. Make appropriate referral to a cleft lip and palate team of nurses, physicians and other specialists. […] Parental fear and anxiety related to special care needs and surgery. Use a calm, reassuring, accepting approach with infant and family. Explain all procedures and their rationale including sensations likely experienced by their child. Listen actively to parents and their concerns, encourage verbalization of feelings and perceptions Encourage parents to stay with their child in the immediate pre and post operative periods. […] High risk for respiratory distress or dyspnea related to cleft lip and cleft palate. Assess the respiratory movement Auscultate the lungs Prevent respiratory obstruction, especially on inspiration and when the infant is quiet place the infant in prone so that tongue and jaw fall forward, tilt head back as best tolerated by the infant slightly elevate upper trunk. Provide adequate suctioning in order to remove secretions Administer oxygen as per doctors order. […] Risk for infection related to surgical repair and aspiration. Irrigate the mouth with normal saline solution or water Direct a gentle stream over the suture line using an ear bulb syringe While irrigating held the child in sitting position with his head forward Keep the mouth moist to promote healing and provide comfort Rinse the mouth after each feeding Administer antibiotics as prescribed.

• #20 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with cleft lip and cleft palate may include: […] Maintaining Airway Clearance and Preventing Aspiration. Infants diagnosed with a cleft palate cannot suck effectively either because pressing their tongue or a nipple against the roof of their mouth forces milk into their pharynx, possibly leading to aspiration. […] Improving Nutritional Status and Teaching Feeding Methods. Before a cleft lip or palate is repaired, feeding the infant becomes a concern because the infant has difficulty maintaining suction with a bottle or breast; there is evidence of slower growth compared to infants without a cleft disorder. […] Reducing Anxiety and Enhancing Coping. A mothers first reaction to a disfigured newborn is one of shock, hurt, disappointment, and guilt. […] Preventing Injury and Infections. Cleft lip and cleft palate can lead to many complications. Early feeding difficulties limit the infants weight gain and growth and may lead to learning disabilities, speech disorders, recurring upper respiratory tract infections, and chronic ear disease. […] Initiating Patient Education and Health Teachings. Mothers of infants diagnosed with cleft lip and palate may have limited knowledge about feeding their infants and may lack information regarding regurgitation, colic, and swallowing during feedings.

• #21 Cleft lip and cleft palate | PPT

  https://www.slideshare.net/slideshow/cleft-lip-and-cleft-palate-132828152/132828152

  Cleft lip and cleft palate Nursing, Care […] Nursing management Preoperative care: Keep the infant NPO for 6 hours before surgery. Administer premedication as per doctors order Physical, physiological, psychological and legal preparation should be done. […] Post operative care Keep the airway clear from accumulation of mucus in the nose and mouth. Mild sedation may be prescribed to prevent infant from crying. Careful positioning (never on the abdomen) Restraining the arms if necessary. The mother and father should be encouraged to remain with their child as much as possible. The infant is fed with a medicine dropper. Clear fluids offers initially, breast milk or formula can be given when tolerated. […] The mouth should be rinsed with water before and after feeding. Do not brush the teeth 1-2 weeks after the surgery. The suture line must be cleaned gently with cotton or gauze-tipped swab dipped in hydrogen peroxide or saline solution and dried carefully several times a day to ensure proper healing. The parents are taught the ways by which injury to the palate can be prevented after discharge and prevention of upper respiratory tract infection. Speech therapy should be given. Encourage the child to socialize with family members and others. […] Preoperative Nursing diagnosis Imbalance nutrition; less than body requirements related to inability to suck. Describe the degree of cleft and impairment of sucking The mother should be encouraged to breast feed their babies and whenever there are feeding problems expressed breast milk may be give. Use special feeding technique if needed In case of failure of breast feeding, artificial feeding has to be substituted When extreme difficulty is encountered with feeding, gavage may become necessary. Burp frequently and hold the infant in a more upright position. Keep an accurate record of Childs growth by using a growth chart. […] Feeding technique: Equipment Description Soft, thin walled nipple – compresses easily, readily available NUK orthodontic nipple – large surface for compression Cross-cut nipple – allows easy flow of milk with compression Ross cleft palate nurser – for infants with weak suck; has soft tube like nipple. Mead Johnson cleft palate nurser -soft, long cross-cut nipple, soft bottle for squeezing Can monitor the milk flow […] If regurgitation occurs, stop feeding and allow infant to cough / sneeze to clear the air way. Place nipple on top of tongue. Nipple insertion may push tongue to the back of mouth. Burp the infant frequently because of increased air ingestion Monitor for distress and fatigue during feeding Limit feeding time to approximately 30 minutes to avoid fatigue Follow feeding with sterile water to clean any rapped food in the cleft Clean mouth and nose. […] Interrupted family processes related to emotional reaction to an infant with a visible defect. Encourage parents to discuss their fears, concerns and negative emotions Encourage touching and holding to prevent delayed attachments. Express acceptance of baby by modeling and close physical contact. Make appropriate referral to a cleft lip and palate team of nurses, physicians and other specialists. […] Parental fear and anxiety related to special care needs and surgery. Use a calm, reassuring, accepting approach with infant and family. Explain all procedures and their rationale including sensations likely experienced by their child. Listen actively to parents and their concerns, encourage verbalization of feelings and perceptions Encourage parents to stay with their child in the immediate pre and post operative periods. […] High risk for respiratory distress or dyspnea related to cleft lip and cleft palate. Assess the respiratory movement Auscultate the lungs Prevent respiratory obstruction, especially on inspiration and when the infant is quiet place the infant in prone so that tongue and jaw fall forward, tilt head back as best tolerated by the infant slightly elevate upper trunk. Provide adequate suctioning in order to remove secretions Administer oxygen as per doctors order. […] Risk for infection related to surgical repair and aspiration. Irrigate the mouth with normal saline solution or water Direct a gentle stream over the suture line using an ear bulb syringe While irrigating held the child in sitting position with his head forward Keep the mouth moist to promote healing and provide comfort Rinse the mouth after each feeding Administer antibiotics as prescribed.

• #22 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with cleft lip and cleft palate may include: […] Maintaining Airway Clearance and Preventing Aspiration. Infants diagnosed with a cleft palate cannot suck effectively either because pressing their tongue or a nipple against the roof of their mouth forces milk into their pharynx, possibly leading to aspiration. […] Improving Nutritional Status and Teaching Feeding Methods. Before a cleft lip or palate is repaired, feeding the infant becomes a concern because the infant has difficulty maintaining suction with a bottle or breast; there is evidence of slower growth compared to infants without a cleft disorder. […] Reducing Anxiety and Enhancing Coping. A mothers first reaction to a disfigured newborn is one of shock, hurt, disappointment, and guilt. […] Preventing Injury and Infections. Cleft lip and cleft palate can lead to many complications. Early feeding difficulties limit the infants weight gain and growth and may lead to learning disabilities, speech disorders, recurring upper respiratory tract infections, and chronic ear disease. […] Initiating Patient Education and Health Teachings. Mothers of infants diagnosed with cleft lip and palate may have limited knowledge about feeding their infants and may lack information regarding regurgitation, colic, and swallowing during feedings.

• #23 16.5 Cleft Lip & Cleft Palate – Nursing Health Promotion

  https://wtcs.pressbooks.pub/healthpromo/chapter/16-5-cleft-lip-cleft-palate/

  Registered nurses develop interventions based on the expected outcomes of the client. Prior to implementation, the nurse must determine if all previously planned interventions are still suitable based on the current situation of the client. […] Educate the family about surgical repair of the cleft lip and/or cleft palate and encourage questions to help reduce parent/caregiver anxiety.

• #24 Cleft lip and palate repair – discharge : MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/patientinstructions/000004.htm

  Your child had surgery to repair birth defects that caused a cleft in which the lip or the roof of the mouth did not grow together normally while your child was in the womb. Your child had general anesthesia (asleep and not feeling pain) for the surgery. […] After anesthesia, it is normal for children to have stuffy noses. They may need to breathe through their mouths for the first week. There will be some drainage from their mouths and noses. The drainage should go away after about 1 week. […] Clean the incision (surgery wound) after feeding your child. […] Some stitches will break apart or go away on their own. The surgeon will need to take others out at the first follow-up visit. Do not remove your child’s stitches yourself unless instructed by your surgeon. […] You will need to protect your child’s incision.

• #25 Cleft Palate Repair: Instructions After Surgery

  https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/cleft-palate-repair-instructions-after-surgery

  Your child’s cleft palate has been repaired. The opening in the roof of the mouth is now closed. Following surgery, there are a few things to know about your child’s care at home. Other than these special instructions, your child should be cared for in the same way as any other child the same age. […] The Cleft Lip and Palate Center expertly cares for children with cleft palate. […] The roof of your child’s mouth (the palate) is still healing and should be protected from injury for about 3 weeks after surgery. […] Your child may not eat as well as before surgery. […] Your child may or may not need to wear arm splints for 3 weeks. […] It is important for your child to take medicines as directed by the doctor. […] Some pain is normal after palate repair. […] Your child may snore and sound congested for several weeks. This will go away when the swelling goes down and there is less drainage. […] Your child should wear long-sleeved shirts under the arm splints. The sleeves will help the splints to stay in place and prevent skin irritation. […] Call your child’s doctor or the Cleft Lip and Palate Center’s helpline if your child has trouble drinking or eating.

• #26 Cleft lip and cleft palate | PPT

  https://www.slideshare.net/slideshow/cleft-lip-and-cleft-palate-132828152/132828152

  Cleft lip and cleft palate Nursing, Care […] Nursing management Preoperative care: Keep the infant NPO for 6 hours before surgery. Administer premedication as per doctors order Physical, physiological, psychological and legal preparation should be done. […] Post operative care Keep the airway clear from accumulation of mucus in the nose and mouth. Mild sedation may be prescribed to prevent infant from crying. Careful positioning (never on the abdomen) Restraining the arms if necessary. The mother and father should be encouraged to remain with their child as much as possible. The infant is fed with a medicine dropper. Clear fluids offers initially, breast milk or formula can be given when tolerated. […] The mouth should be rinsed with water before and after feeding. Do not brush the teeth 1-2 weeks after the surgery. The suture line must be cleaned gently with cotton or gauze-tipped swab dipped in hydrogen peroxide or saline solution and dried carefully several times a day to ensure proper healing. The parents are taught the ways by which injury to the palate can be prevented after discharge and prevention of upper respiratory tract infection. Speech therapy should be given. Encourage the child to socialize with family members and others. […] Preoperative Nursing diagnosis Imbalance nutrition; less than body requirements related to inability to suck. Describe the degree of cleft and impairment of sucking The mother should be encouraged to breast feed their babies and whenever there are feeding problems expressed breast milk may be give. Use special feeding technique if needed In case of failure of breast feeding, artificial feeding has to be substituted When extreme difficulty is encountered with feeding, gavage may become necessary. Burp frequently and hold the infant in a more upright position. Keep an accurate record of Childs growth by using a growth chart. […] Feeding technique: Equipment Description Soft, thin walled nipple – compresses easily, readily available NUK orthodontic nipple – large surface for compression Cross-cut nipple – allows easy flow of milk with compression Ross cleft palate nurser – for infants with weak suck; has soft tube like nipple. Mead Johnson cleft palate nurser -soft, long cross-cut nipple, soft bottle for squeezing Can monitor the milk flow […] If regurgitation occurs, stop feeding and allow infant to cough / sneeze to clear the air way. Place nipple on top of tongue. Nipple insertion may push tongue to the back of mouth. Burp the infant frequently because of increased air ingestion Monitor for distress and fatigue during feeding Limit feeding time to approximately 30 minutes to avoid fatigue Follow feeding with sterile water to clean any rapped food in the cleft Clean mouth and nose. […] Interrupted family processes related to emotional reaction to an infant with a visible defect. Encourage parents to discuss their fears, concerns and negative emotions Encourage touching and holding to prevent delayed attachments. Express acceptance of baby by modeling and close physical contact. Make appropriate referral to a cleft lip and palate team of nurses, physicians and other specialists. […] Parental fear and anxiety related to special care needs and surgery. Use a calm, reassuring, accepting approach with infant and family. Explain all procedures and their rationale including sensations likely experienced by their child. Listen actively to parents and their concerns, encourage verbalization of feelings and perceptions Encourage parents to stay with their child in the immediate pre and post operative periods. […] High risk for respiratory distress or dyspnea related to cleft lip and cleft palate. Assess the respiratory movement Auscultate the lungs Prevent respiratory obstruction, especially on inspiration and when the infant is quiet place the infant in prone so that tongue and jaw fall forward, tilt head back as best tolerated by the infant slightly elevate upper trunk. Provide adequate suctioning in order to remove secretions Administer oxygen as per doctors order. […] Risk for infection related to surgical repair and aspiration. Irrigate the mouth with normal saline solution or water Direct a gentle stream over the suture line using an ear bulb syringe While irrigating held the child in sitting position with his head forward Keep the mouth moist to promote healing and provide comfort Rinse the mouth after each feeding Administer antibiotics as prescribed.

• #27 Cleft lip and palate repair – discharge : MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/patientinstructions/000004.htm

  Your child had surgery to repair birth defects that caused a cleft in which the lip or the roof of the mouth did not grow together normally while your child was in the womb. Your child had general anesthesia (asleep and not feeling pain) for the surgery. […] After anesthesia, it is normal for children to have stuffy noses. They may need to breathe through their mouths for the first week. There will be some drainage from their mouths and noses. The drainage should go away after about 1 week. […] Clean the incision (surgery wound) after feeding your child. […] Some stitches will break apart or go away on their own. The surgeon will need to take others out at the first follow-up visit. Do not remove your child’s stitches yourself unless instructed by your surgeon. […] You will need to protect your child’s incision.

• #28 Cleft lip and cleft palate | PPT

  https://www.slideshare.net/slideshow/cleft-lip-and-cleft-palate-132828152/132828152

  Cleft lip and cleft palate Nursing, Care […] Nursing management Preoperative care: Keep the infant NPO for 6 hours before surgery. Administer premedication as per doctors order Physical, physiological, psychological and legal preparation should be done. […] Post operative care Keep the airway clear from accumulation of mucus in the nose and mouth. Mild sedation may be prescribed to prevent infant from crying. Careful positioning (never on the abdomen) Restraining the arms if necessary. The mother and father should be encouraged to remain with their child as much as possible. The infant is fed with a medicine dropper. Clear fluids offers initially, breast milk or formula can be given when tolerated. […] The mouth should be rinsed with water before and after feeding. Do not brush the teeth 1-2 weeks after the surgery. The suture line must be cleaned gently with cotton or gauze-tipped swab dipped in hydrogen peroxide or saline solution and dried carefully several times a day to ensure proper healing. The parents are taught the ways by which injury to the palate can be prevented after discharge and prevention of upper respiratory tract infection. Speech therapy should be given. Encourage the child to socialize with family members and others. […] Preoperative Nursing diagnosis Imbalance nutrition; less than body requirements related to inability to suck. Describe the degree of cleft and impairment of sucking The mother should be encouraged to breast feed their babies and whenever there are feeding problems expressed breast milk may be give. Use special feeding technique if needed In case of failure of breast feeding, artificial feeding has to be substituted When extreme difficulty is encountered with feeding, gavage may become necessary. Burp frequently and hold the infant in a more upright position. Keep an accurate record of Childs growth by using a growth chart. […] Feeding technique: Equipment Description Soft, thin walled nipple – compresses easily, readily available NUK orthodontic nipple – large surface for compression Cross-cut nipple – allows easy flow of milk with compression Ross cleft palate nurser – for infants with weak suck; has soft tube like nipple. Mead Johnson cleft palate nurser -soft, long cross-cut nipple, soft bottle for squeezing Can monitor the milk flow […] If regurgitation occurs, stop feeding and allow infant to cough / sneeze to clear the air way. Place nipple on top of tongue. Nipple insertion may push tongue to the back of mouth. Burp the infant frequently because of increased air ingestion Monitor for distress and fatigue during feeding Limit feeding time to approximately 30 minutes to avoid fatigue Follow feeding with sterile water to clean any rapped food in the cleft Clean mouth and nose. […] Interrupted family processes related to emotional reaction to an infant with a visible defect. Encourage parents to discuss their fears, concerns and negative emotions Encourage touching and holding to prevent delayed attachments. Express acceptance of baby by modeling and close physical contact. Make appropriate referral to a cleft lip and palate team of nurses, physicians and other specialists. […] Parental fear and anxiety related to special care needs and surgery. Use a calm, reassuring, accepting approach with infant and family. Explain all procedures and their rationale including sensations likely experienced by their child. Listen actively to parents and their concerns, encourage verbalization of feelings and perceptions Encourage parents to stay with their child in the immediate pre and post operative periods. […] High risk for respiratory distress or dyspnea related to cleft lip and cleft palate. Assess the respiratory movement Auscultate the lungs Prevent respiratory obstruction, especially on inspiration and when the infant is quiet place the infant in prone so that tongue and jaw fall forward, tilt head back as best tolerated by the infant slightly elevate upper trunk. Provide adequate suctioning in order to remove secretions Administer oxygen as per doctors order. […] Risk for infection related to surgical repair and aspiration. Irrigate the mouth with normal saline solution or water Direct a gentle stream over the suture line using an ear bulb syringe While irrigating held the child in sitting position with his head forward Keep the mouth moist to promote healing and provide comfort Rinse the mouth after each feeding Administer antibiotics as prescribed.

• #29 Cleft Lip & Cleft Palate Surgery: Repair Steps & Post-op Care

  https://my.clevelandclinic.org/health/treatments/23394-cleft-lip-cleft-palate-surgery

  Your child’s pediatrician will examine them the week before surgery to ensure theyre healthy enough for surgery and go over your childs medical history and allergies. […] The goal of cleft lip surgery is to close the gap in your childs lip and improve the shape and appearance of their upper lip and nose. […] Cleft palate surgery aims to close the opening in the roof of your childs mouth, create a palate that supports normal speech development and prevent food from coming out of their nose. […] Your child may be fussier than normal following surgery. Soft splints or cuffs are placed around your childs arms to prevent them from touching their lip. […] Your child will stay in the hospital for at least one or two days. Some children may need to stay longer depending on their recovery. […] Your child may need pain medicine for the first few days after surgery.

• #30 Cleft lip and palate repair – discharge : MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/patientinstructions/000004.htm

  Young infants should be eating only breast milk or formula. When feeding, hold your infant in an upright position. […] Older infants or young children will need to have their food softened or pureed for some time after surgery so it is easy to swallow. Use a blender or food processor to prepare food for your child. […] Your child may play quietly. Avoid running and jumping until the surgeon says it is OK. […] Your health care provider will refer your child to a speech therapist. The provider may also make a referral to a dietician. Most times, speech therapy lasts 2 months. You will be told when to make a follow-up appointment. […] Contact your surgeon if: Any part of the incision is opening or stitches come apart. […] Your child has problems breathing.

• #31 Cleft Palate With Cleft Lip (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/cleft-palate-cleft-lip.html

  Your child will need a liquid or blenderized (pured) diet for about 3 weeks after surgery before starting to eat foods that are hard or crunchy. You may be asked to keep your baby in special sleeves („no-nos”) that prevent the elbows from bending. This is so your baby can’t put any fingers or hard objects into the mouth, which could make the cleft palate repair come open. […] It’s important to work with a care team experienced in treating children with cleft lip and palate. Besides the pediatrician, a child’s treatment team will include: a patient care coordinator, cleft surgeon (pediatric plastic surgeon or oromaxillofacial surgeon with cleft care experience), ear, nose, and throat (ENT) surgeon (otolaryngologist), orthodontist, speech-language pathologist, audiologist. […] Most kids with cleft lip and palate are treated successfully with no lasting problems. A team experienced in treating children with cleft lip and palate can create a treatment plan tailored to your child’s needs.

• #32 Cleft Lip/Palate Repair Home Care Instructions – University of Mississippi Medical Center

  https://umc.edu/Childrens/Childrens%20Surgery/Plastic-Reconstructive/Resources/cleft-lip-palate.html

  Place no straws, forks, utensils, or fingers in the mouth at any time. […] Clean the outside of the nose with saline gauze or a wet Q-tip. […] Follow up with your plastic surgeon in the Sanderson Tower clinic as scheduled. […] If your child develops increased pain or swelling, redness or drainage around the incisions, fever or chills, an inability to eat or drink, or other worrisome symptoms, please notify the plastic surgery team right away. […] Call us if you see signs of: Infection Fever (temperature higher than 101 degrees), redness, swelling, drainage from lip/nose/palate (Some bloody drainage is normal during the first 24 to 48 hours after surgery, but call if you are concerned about what you see.)

• #33

  https://www.nhs.uk/conditions/cleft-lip-and-palate/

  A cleft lip and cleft palate can cause a number of issues, particularly in the first few months after birth, before surgery is done. […] Most of these problems will improve after surgery and with treatments such as speech and language therapy. […] Cleft lip and cleft palate are treated at specialist NHS cleft centres. […] Your child will usually have a long-term care plan that outlines the treatments and assessments they’ll need as they grow up. […] The main treatments are: surgery an operation to correct a cleft lip is usually done when your baby is 3 to 6 months and an operation to repair a cleft palate is usually done at 6 to 12 months, feeding support you may need advice about positioning your baby on your breast to help them feed, or you might need to feed them using a special type of bottle, monitoring hearing a baby born with cleft palate has a higher chance of glue ear, which may affect hearing, speech and language therapy a speech and language therapist will monitor your child’s speech and language development throughout their childhood and help with any speech and language problems, good dental hygiene and orthodontic treatment you’ll be given advice about looking after your child’s teeth, and they may need braces if their adult teeth don’t come through properly. […] The majority of children treated for cleft lip or palate grow up to have completely normal lives. […] Most affected children will not have any other serious medical problems and treatment can usually improve the appearance of the face and problems with feeding and speech.

• #34

  https://www.nhs.uk/conditions/cleft-lip-and-palate/

  A cleft lip and cleft palate can cause a number of issues, particularly in the first few months after birth, before surgery is done. […] Most of these problems will improve after surgery and with treatments such as speech and language therapy. […] Cleft lip and cleft palate are treated at specialist NHS cleft centres. […] Your child will usually have a long-term care plan that outlines the treatments and assessments they’ll need as they grow up. […] The main treatments are: surgery an operation to correct a cleft lip is usually done when your baby is 3 to 6 months and an operation to repair a cleft palate is usually done at 6 to 12 months, feeding support you may need advice about positioning your baby on your breast to help them feed, or you might need to feed them using a special type of bottle, monitoring hearing a baby born with cleft palate has a higher chance of glue ear, which may affect hearing, speech and language therapy a speech and language therapist will monitor your child’s speech and language development throughout their childhood and help with any speech and language problems, good dental hygiene and orthodontic treatment you’ll be given advice about looking after your child’s teeth, and they may need braces if their adult teeth don’t come through properly. […] The majority of children treated for cleft lip or palate grow up to have completely normal lives. […] Most affected children will not have any other serious medical problems and treatment can usually improve the appearance of the face and problems with feeding and speech.

• #35 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Cleft Lip Palate Nursing Care Plans and Nursing Diagnosis […] Nursing goals for clients diagnosed with cleft lip and palate include maintaining adequate nutrition, increasing family coping, reducing the parents anxiety and guilt regarding the newborns physical defects, and preparing parents for the future repair of the cleft lip and palate. […] The following are the nursing priorities for patients with cleft lip and cleft palate: […] Feeding Difficulties. Infants with cleft lip and cleft palate may have difficulties in breastfeeding or bottle feeding due to structural abnormalities. Ensuring adequate nutrition and addressing feeding challenges are crucial for their growth and development. […] Speech and Language Development. Cleft lip and cleft palate can affect speech production and intelligibility. Early intervention by speech therapists and regular monitoring of speech and language development are essential to address any potential communication difficulties. […] Dental and Orthodontic Issues. Cleft lip and palate can impact the alignment and development of teeth and jaws. Dental problems, such as malocclusion, missing teeth, and dental decay, may require orthodontic and dental interventions to ensure proper oral health and function. […] Ear Infections and Hearing Problems. Children with cleft palate are more prone to middle ear infections (otitis media) and hearing loss due to the dysfunction of the Eustachian tube. Frequent monitoring and timely intervention are necessary to prevent potential hearing impairment. […] Psychological and Social Well-being. Individuals with cleft lip and cleft palate may face challenges related to self-esteem, body image, and social interactions due to visible facial differences. Providing psychological support and addressing any emotional difficulties can contribute to their overall well-being. […] Facial Aesthetics and Plastic Surgery. Reconstructive surgery plays a vital role in correcting the cleft lip and palate, improving facial aesthetics, and restoring normal function. Surgical interventions are typically staged and performed by experienced plastic surgeons. […] Nasal Resonance and Breathing Difficulties. Cleft palate can affect nasal resonance and lead to nasal airway obstruction. Management may involve speech therapy, nasal surgery, and continuous monitoring of nasal function.

• #36 Cleft lip and cleft palate | PPT

  https://www.slideshare.net/slideshow/cleft-lip-and-cleft-palate-132828152/132828152

  Cleft lip and cleft palate Nursing, Care […] Nursing management Preoperative care: Keep the infant NPO for 6 hours before surgery. Administer premedication as per doctors order Physical, physiological, psychological and legal preparation should be done. […] Post operative care Keep the airway clear from accumulation of mucus in the nose and mouth. Mild sedation may be prescribed to prevent infant from crying. Careful positioning (never on the abdomen) Restraining the arms if necessary. The mother and father should be encouraged to remain with their child as much as possible. The infant is fed with a medicine dropper. Clear fluids offers initially, breast milk or formula can be given when tolerated. […] The mouth should be rinsed with water before and after feeding. Do not brush the teeth 1-2 weeks after the surgery. The suture line must be cleaned gently with cotton or gauze-tipped swab dipped in hydrogen peroxide or saline solution and dried carefully several times a day to ensure proper healing. The parents are taught the ways by which injury to the palate can be prevented after discharge and prevention of upper respiratory tract infection. Speech therapy should be given. Encourage the child to socialize with family members and others. […] Preoperative Nursing diagnosis Imbalance nutrition; less than body requirements related to inability to suck. Describe the degree of cleft and impairment of sucking The mother should be encouraged to breast feed their babies and whenever there are feeding problems expressed breast milk may be give. Use special feeding technique if needed In case of failure of breast feeding, artificial feeding has to be substituted When extreme difficulty is encountered with feeding, gavage may become necessary. Burp frequently and hold the infant in a more upright position. Keep an accurate record of Childs growth by using a growth chart. […] Feeding technique: Equipment Description Soft, thin walled nipple – compresses easily, readily available NUK orthodontic nipple – large surface for compression Cross-cut nipple – allows easy flow of milk with compression Ross cleft palate nurser – for infants with weak suck; has soft tube like nipple. Mead Johnson cleft palate nurser -soft, long cross-cut nipple, soft bottle for squeezing Can monitor the milk flow […] If regurgitation occurs, stop feeding and allow infant to cough / sneeze to clear the air way. Place nipple on top of tongue. Nipple insertion may push tongue to the back of mouth. Burp the infant frequently because of increased air ingestion Monitor for distress and fatigue during feeding Limit feeding time to approximately 30 minutes to avoid fatigue Follow feeding with sterile water to clean any rapped food in the cleft Clean mouth and nose. […] Interrupted family processes related to emotional reaction to an infant with a visible defect. Encourage parents to discuss their fears, concerns and negative emotions Encourage touching and holding to prevent delayed attachments. Express acceptance of baby by modeling and close physical contact. Make appropriate referral to a cleft lip and palate team of nurses, physicians and other specialists. […] Parental fear and anxiety related to special care needs and surgery. Use a calm, reassuring, accepting approach with infant and family. Explain all procedures and their rationale including sensations likely experienced by their child. Listen actively to parents and their concerns, encourage verbalization of feelings and perceptions Encourage parents to stay with their child in the immediate pre and post operative periods. […] High risk for respiratory distress or dyspnea related to cleft lip and cleft palate. Assess the respiratory movement Auscultate the lungs Prevent respiratory obstruction, especially on inspiration and when the infant is quiet place the infant in prone so that tongue and jaw fall forward, tilt head back as best tolerated by the infant slightly elevate upper trunk. Provide adequate suctioning in order to remove secretions Administer oxygen as per doctors order. […] Risk for infection related to surgical repair and aspiration. Irrigate the mouth with normal saline solution or water Direct a gentle stream over the suture line using an ear bulb syringe While irrigating held the child in sitting position with his head forward Keep the mouth moist to promote healing and provide comfort Rinse the mouth after each feeding Administer antibiotics as prescribed.

• #37 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Cleft Lip Palate Nursing Care Plans and Nursing Diagnosis […] Nursing goals for clients diagnosed with cleft lip and palate include maintaining adequate nutrition, increasing family coping, reducing the parents anxiety and guilt regarding the newborns physical defects, and preparing parents for the future repair of the cleft lip and palate. […] The following are the nursing priorities for patients with cleft lip and cleft palate: […] Feeding Difficulties. Infants with cleft lip and cleft palate may have difficulties in breastfeeding or bottle feeding due to structural abnormalities. Ensuring adequate nutrition and addressing feeding challenges are crucial for their growth and development. […] Speech and Language Development. Cleft lip and cleft palate can affect speech production and intelligibility. Early intervention by speech therapists and regular monitoring of speech and language development are essential to address any potential communication difficulties. […] Dental and Orthodontic Issues. Cleft lip and palate can impact the alignment and development of teeth and jaws. Dental problems, such as malocclusion, missing teeth, and dental decay, may require orthodontic and dental interventions to ensure proper oral health and function. […] Ear Infections and Hearing Problems. Children with cleft palate are more prone to middle ear infections (otitis media) and hearing loss due to the dysfunction of the Eustachian tube. Frequent monitoring and timely intervention are necessary to prevent potential hearing impairment. […] Psychological and Social Well-being. Individuals with cleft lip and cleft palate may face challenges related to self-esteem, body image, and social interactions due to visible facial differences. Providing psychological support and addressing any emotional difficulties can contribute to their overall well-being. […] Facial Aesthetics and Plastic Surgery. Reconstructive surgery plays a vital role in correcting the cleft lip and palate, improving facial aesthetics, and restoring normal function. Surgical interventions are typically staged and performed by experienced plastic surgeons. […] Nasal Resonance and Breathing Difficulties. Cleft palate can affect nasal resonance and lead to nasal airway obstruction. Management may involve speech therapy, nasal surgery, and continuous monitoring of nasal function.

• #38 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Cleft palate surgery usually occurs when your baby is 12 months old. It creates a working palate and reduces the chances that fluid will develop in your babys middle ears. […] Up to 40% of children with a cleft palate will need further surgeries to help improve their speech. […] Children often need treatment beyond surgery for cleft lip or palate. Some other treatments their healthcare providers may recommend are speech therapy and orthodontic treatment. […] Because of the number of oral health and medical problems associated with a cleft lip or cleft palate, it takes a team of healthcare providers working together to develop a comprehensive care plan. Your childs treatment usually begins in infancy and often continues through their early adulthood. […] Generally, children with clefts have the same dental needs as other children. However, children with cleft lip and palate may also have missing, misshapen or poorly positioned teeth.

• #39

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut3193

  Watch your baby for problems with choking, gagging, or milk coming out through the nose while feeding. You may be able to use a small plastic plate that fits into the roof of the baby’s mouth while feeding. This blocks the opening so the baby can suck properly. […] Be alert for signs of dehydration. This can develop if your baby is not getting enough breast milk or formula. These signs include fewer wet diapers, sunken eyes with few tears, and a dry mouth with little or no spit. […] As your child grows, pay attention to dental care. Be sure to take your child to a dentist regularly starting within 6 months of when your child’s first tooth comes in but no later than age 1. A dentist will watch for dental problems and teach good dental habits. Check with your doctor about how to care for your baby’s mouth before the first dental visit. […] If you need more support, talk with your doctor or see a counsellor. Also, you may want to join a support group. It may help to talk with other parents who have babies with a cleft lip or cleft palate.

• #40 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Cleft Lip Palate Nursing Care Plans and Nursing Diagnosis […] Nursing goals for clients diagnosed with cleft lip and palate include maintaining adequate nutrition, increasing family coping, reducing the parents anxiety and guilt regarding the newborns physical defects, and preparing parents for the future repair of the cleft lip and palate. […] The following are the nursing priorities for patients with cleft lip and cleft palate: […] Feeding Difficulties. Infants with cleft lip and cleft palate may have difficulties in breastfeeding or bottle feeding due to structural abnormalities. Ensuring adequate nutrition and addressing feeding challenges are crucial for their growth and development. […] Speech and Language Development. Cleft lip and cleft palate can affect speech production and intelligibility. Early intervention by speech therapists and regular monitoring of speech and language development are essential to address any potential communication difficulties. […] Dental and Orthodontic Issues. Cleft lip and palate can impact the alignment and development of teeth and jaws. Dental problems, such as malocclusion, missing teeth, and dental decay, may require orthodontic and dental interventions to ensure proper oral health and function. […] Ear Infections and Hearing Problems. Children with cleft palate are more prone to middle ear infections (otitis media) and hearing loss due to the dysfunction of the Eustachian tube. Frequent monitoring and timely intervention are necessary to prevent potential hearing impairment. […] Psychological and Social Well-being. Individuals with cleft lip and cleft palate may face challenges related to self-esteem, body image, and social interactions due to visible facial differences. Providing psychological support and addressing any emotional difficulties can contribute to their overall well-being. […] Facial Aesthetics and Plastic Surgery. Reconstructive surgery plays a vital role in correcting the cleft lip and palate, improving facial aesthetics, and restoring normal function. Surgical interventions are typically staged and performed by experienced plastic surgeons. […] Nasal Resonance and Breathing Difficulties. Cleft palate can affect nasal resonance and lead to nasal airway obstruction. Management may involve speech therapy, nasal surgery, and continuous monitoring of nasal function.

• #41

  https://www.shrinerschildrens.org/en/pediatric-care/cleft-lip

  It is common for self-esteem and emotional health to be impacted as well. […] The cornerstone of cleft care is really the two parts of multidisciplinary care and longitudinal care. […] When a family comes, it’s a very family-centered experience where the family will meet every specialist. […] The focus then is to give the patient the best advice and best surgical planning going forward. […] Each child is met with respect, compassion, and a forward looking approach that supports the best quality of life for the child, by achieving the best possible medical outcome. […] I encourage parents and caregivers to explore the treatment options Shriner’s Children’s offers. […] Cleft lip surgery can correct the separation and improve a child’s facial appearance. […] Typically children with just a cleft lip that is not combined with a cleft palate, will need to have between one and three surgeries to repair their cleft lip.

• #42

  https://www.healthychildren.org/English/health-issues/conditions/Cleft-Craniofacial/Pages/Cleft-Lip-and-Palate-Parent-FAQs.aspx

  One in every 700 babies is born with a cleft lip, a cleft palate, or both making it one of the most common birth defects. Babies born with a cleft lip and/or palate need special care from a team of different health professionals. Their care must be well managed because of the difficult medical, surgical, dental and social factors important to treatment decisions. […] The type of cleft lip and/or palate a child has will determine the kind of care that he or she needs. […] In general, babies with a cleft palate either as cleft lip with cleft palate or cleft palate alone, suck weakly and need a special bottle to feed. Support from a feeding therapist, certified lactation consultant, and/or nurse experienced in feeding children with cleft palate is recommended for parents. […] Various specialists will care for your child at different times and stages. The cleft/craniofacial team usually includes nurses, social workers, nutritionists, audiologists, speech-language pathologists, geneticists, pediatricians, dentists, orthodontists and pediatric surgeons (otolaryngologists, oral and maxillofacial surgeons, and plastic surgeons).

• #43 Parameters of Care – ACPA

  https://acpacares.org/parameters-of-care/

  The American Cleft Palate Craniofacial Associations (ACPA) Parameters of Care (ACPA Parameters) for Evaluation and Treatment of Individuals with Cleft Lip/Palate (CL/P) and/or Other Craniofacial Differences aims to provide an up-to-date summary to help guide the care of individuals with cleft-craniofacial conditions. […] The healthcare needs of children with CL/P and/or other craniofacial differences are best managed by an interdisciplinary cleft and/or craniofacial team. […] The ACPA Parameters provide a framework for care delivery which, in conjunction with local standards, regulations, policies, and procedures, helps inform high quality care. […] Interdisciplinary Teams reviews key elements of team care for patients with CL/P and other craniofacial differences. Establishing Care with the Cleft / Craniofacial Team outlines the clinical needs of neonates, including airway management, sleep, feeding, growth and nutrition and other topics. Longitudinal Evaluation and Care provides information on various components of cleft and craniofacial care after the initial contact and an initial treatment plan is established. The ACPA Parameters conclude with a description of Transition to Adult Care.

• #44

  https://www.healthychildren.org/English/health-issues/conditions/Cleft-Craniofacial/Pages/Cleft-Lip-and-Palate-Parent-FAQs.aspx

  One in every 700 babies is born with a cleft lip, a cleft palate, or both making it one of the most common birth defects. Babies born with a cleft lip and/or palate need special care from a team of different health professionals. Their care must be well managed because of the difficult medical, surgical, dental and social factors important to treatment decisions. […] The type of cleft lip and/or palate a child has will determine the kind of care that he or she needs. […] In general, babies with a cleft palate either as cleft lip with cleft palate or cleft palate alone, suck weakly and need a special bottle to feed. Support from a feeding therapist, certified lactation consultant, and/or nurse experienced in feeding children with cleft palate is recommended for parents. […] Various specialists will care for your child at different times and stages. The cleft/craniofacial team usually includes nurses, social workers, nutritionists, audiologists, speech-language pathologists, geneticists, pediatricians, dentists, orthodontists and pediatric surgeons (otolaryngologists, oral and maxillofacial surgeons, and plastic surgeons).

• #45 Pediatric Cleft Lip and Palate Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/995535-treatment

  A team for the multidisciplinary treatment of a child with an orofacial cleft includes the following specialists: Pediatrician, Nurse practitioner, Plastic surgeon, Pediatric dentist, Otolaryngologist, Geneticist, Genetic counselor, Speech pathologist, Orthodontist, Maxillofacial surgeon, Social worker, Psychologist. […] No single treatment concept has been identified, especially for CLP. The timing of the individual procedures varies in different centers and with different specialists. […] The following is the most common treatment protocol currently used in most cleft treatment centers: Newborn – Diagnostic examination, general counseling of parents, feeding instructions, palatal obturator (if necessary); genetic evaluation and specification of diagnosis; empiric risk of recurrence of cleft calculated; recommendation of a protocol for the prevention of a cleft recurrence in the family.

• #46 Pediatric Cleft Lip & Palate Care | MaineHealth Barbara Bush Children’s Hospital | MaineHealth

  https://www.mainehealth.org/barbara-bush-childrens-hospital/care-services-mainehealth-barbara-bush-childrens-hospital/pediatric-cleft-lip-palate-care-mainehealth-barbara-bush-childrens-hospital

  MaineHealth Pediatric Specialty Care – Cleft Lip and Palate – Scarborough provides comprehensive care for pediatric cleft lip and palate disorders. We take a team approach to care. You and your child will meet with a multi-disciplinary team of specialists at one time, in one location. Working together, our team will evaluate your childs progress and recommend an ongoing treatment plan. […] Your childs care team may include: […] Nurse team coordinator: A nurse practitioner specializing in the care of children with cleft lip and palate who works with the team to manage your childs care, and is available when you have questions or concerns. […] After your appointment, the team meets to review your childs progress and agree on the best plan for the coming year. We will send that plan to you and to your childs doctor. The clinic nurse team coordinator is available to you and your family by phone or email to provide support, answer questions and assist with coordinating care between clinic visits.

• #47 Cleft Lip and Palate Center | Spokane, WA | Providence

  https://www.providence.org/locations/wa/spokane-cleft-lip-and-palate-center

  When your child needs care for a cleft lip, cleft palate or other facial birth defect, we know how concerned you feel. Our team of maxillofacial specialists provides the support, answers, diagnosis and treatment you and your family need to ensure your child can eat and communicate well. We are also focused on making sure that your child grows and thrives throughout their treatment. […] Our team coordinates your childs care among many doctors and therapists to meet their medical and social needs. We work together with you and your child to: […] We work with hundreds of children each year with cleft lip, cleft palate and related conditions. We focus on family-centered care to help your child reach the best emotional and developmental outcomes. […] When your family comes to our program, you are paired with a team nurse coordinator who will:

• #48

  https://www.healthychildren.org/English/health-issues/conditions/Cleft-Craniofacial/Pages/Cleft-Lip-and-Palate-Parent-FAQs.aspx

  A newborn should see their cleft/craniofacial team within one week (or as soon as possible) from the day they first leave the hospital. In the beginning, the team will make sure the baby is feeding and growing well. […] Surgical repair of a child’s cleft is one part of the care that the cleft/craniofacial team provides. […] The AAP recommends initial reconstructive surgeries for cleft lip or cleft palate occur within the first year of life. […] Children with cleft lip and/or cleft palate often need additional surgeries and treatments as they grow. For example, they may need braces during childhood. Each child will need different numbers and types of surgeries why individualized coordination of care is so important. Most children born with clefts will need regular visits to their cleft/craniofacial team until they are adults.

• #49 Pediatric Cleft Lip and Palate Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/995535-treatment

  Age 3 months – Repair of CL (and placement of ventilation tubes). […] Age 6 months – Presurgical orthodontics, if necessary; first speech evaluation. […] Age 9 months – Speech therapy begins. […] Age 9-12 months – Repair of CP (placement of ventilation tubes if not done at the time of CL repair). […] Age 1-7 years – Orthodontic treatment. […] Age 7-8 years – Alveolar bone graft. […] Older than 8 years – Orthodontic treatment continues. […] Gaining weight and preventing aspiration and ear infections are the most important parts of caring for neonates with a cleft during their first days and weeks of life.

• #50 Cleft Lip & Palate Association

  https://www.clapa.com/treatment/timeline/

  Contact by Cleft Team within 24 hours of referral, usually by the Clinical Nurse Specialist (CNS). […] Parents will be offered a visit from the CNS at an appropriate time and place. […] Visit from Cleft Nurse within 48 hours of birth, and ongoing support, assessment and advice following discharge home. […] Specialist feeding assessment, advice and support in the use of special feeding bottles or a nasogastric (NG) feeding tube if needed. […] Preventative dental advice and treatment in consultation with Cleft Unit. The aim is for the child to have dental health just as good as other local children without a cleft. […] Clinical Psychology Support – parents will have access to a psychologist, counsellor or nurse who can help them cope with any feelings or concerns they have related to their child’s cleft. This is available at all points along the care pathway.

• #51 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Cleft lip and cleft palate are separations in the upper lip and mouth that occur while a fetus develops in the uterus. Treating cleft lip and palate involves surgery and may include speech therapy and dental work. Your childs medical care team is there to support you each step of the way. […] Surgery can repair a cleft lip and/or cleft palate. […] Treatment for cleft lip and cleft palate begins at birth. Surgical treatment begins as early as 3 months and can last until the teen years. […] Surgery treats cleft lip and/or cleft palate. The exact details of treatment depend on the extent of the cleft, your childs age and other special needs or health conditions. Your child will have surgery at a hospital, under general anesthesia, so theyll be asleep during the procedure. […] A cleft lip repair may require one or two surgeries. The first surgery usually occurs when your baby is between 3 and 6 months old. This surgery closes their lip. The second surgery, if necessary, is usually done when your child is 6 months old.

• #52

  https://www.shrinerschildrens.org/en/pediatric-care/cleft-lip

  A Shriners Children’s plastic surgeon will perform a cleft lip repair shortly after birth, usually when a child is 3 to 4 months old. […] A nurse/nurse practitioner will teach you how to care for the repaired cleft lip and the stitches that are in place. […] Some children, school age or older, may benefit from a scar touch up procedure (lip revision surgery) or a surgical procedure to help the appearance of their nose (rhinoplasty). […] Patients who have a cleft palate in addition to a cleft lip, will need additional procedures and services as they get older. […] The procedure replaces missing bone in the upper gum and helps support the child’s teeth.

• #53 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Cleft palate surgery usually occurs when your baby is 12 months old. It creates a working palate and reduces the chances that fluid will develop in your babys middle ears. […] Up to 40% of children with a cleft palate will need further surgeries to help improve their speech. […] Children often need treatment beyond surgery for cleft lip or palate. Some other treatments their healthcare providers may recommend are speech therapy and orthodontic treatment. […] Because of the number of oral health and medical problems associated with a cleft lip or cleft palate, it takes a team of healthcare providers working together to develop a comprehensive care plan. Your childs treatment usually begins in infancy and often continues through their early adulthood. […] Generally, children with clefts have the same dental needs as other children. However, children with cleft lip and palate may also have missing, misshapen or poorly positioned teeth.

• #54 Cleft Lip & Cleft Palate Surgery: Repair Steps & Post-op Care

  https://my.clevelandclinic.org/health/treatments/23394-cleft-lip-cleft-palate-surgery

  Cleft palate repair is surgery to fix a separation or opening in the roof of your childs mouth. Their surgeon detaches and rearranges the tissues on the roof of their mouth. Stitches are used to bring the left and right sides of the cleft together. […] Cleft lip and cleft palate surgery help restore function to your childs lips and mouth and correct their appearance. Cleft lips and palates are associated with health problems like hearing loss, dental problems and speech problems. […] Surgery helps improve your childs ability to eat and drink, breathe, hear, and speak. […] Several healthcare providers are involved in your childs care, including surgeons, speech therapists, otolaryngologists (head and neck surgeons) and dentists. Your childs surgeon will meet with you to evaluate your childs cleft palate or cleft lip and determine the best surgical treatment.

• #55 Cleft Lip & Palate Association

  https://www.clapa.com/treatment/timeline/

  The Cleft Team will be able to help parents prepare for surgery, as well as give advice and support regarding aftercare. […] The Cleft Team will be able to help parents prepare for surgery, as well as give advice and support regarding aftercare. […] Speech and Language Therapy Assessment – This usually takes place at around 18 months. Treatment will be offered if necessary, but the need may not become apparent until the child is older. […] Psychological Support for families if requested prior to school entry. […] Full assessment by Cleft Team – a child with a cleft should receive a full assessment by all specialists in the cleft team at age 5, to ensure that any ongoing or emerging issues are being dealt with appropriately. […] Speech and Language Therapy – This will be provided by local therapists in consultation with the specialist from the Cleft Team. The aim is for all children to have good quality, intelligible (understandable) speech by age 5-6. […] Adults may re-enter the cleft service at any time for a consultation about any aspect of their care, including psychological support, genetic counselling and specialist dental treatment, which is all available on the NHS if it is deemed necessary.

• #56 An introduction to the UK care pathway for children born with a cleft of the lip and/or palate | British Dental Journal

  https://www.nature.com/articles/s41415-023-5998-z

  Following birth, the CNS will visit the family within 24 hours, which may be while they are still in hospital or following discharge home. The CNS has a key role in supporting parents, particularly with feeding in the early days, which is considered to be one of the major concerns for parents. […] The parent(s) and the baby will meet the cleft surgeon, along with other members of the MDT, during the first outpatient appointment. For a child with a UCLP, the first surgical procedure is the lip repair, which is typically completed at between the age of 3-6 months. […] The aim of the palate repair is to provide an intact palate with normal velopharyngeal function to enable speech development. […] These early years following palate repair are critical for speech development and the child will be monitored closely by the cleft team, particularly the cleft specialist speech therapists.

• #57 An introduction to the UK care pathway for children born with a cleft of the lip and/or palate | British Dental Journal

  https://www.nature.com/articles/s41415-023-5998-z

  Access to advice from a paediatric dentist is available as the deciduous teeth begin to erupt. […] The second of the four audit clinics occurs at age 10 and follows the same format as the age five audit clinic. […] The majority of cleft patients will require orthodontics in adolescence, which may include exposing and bonding unerupted canines to assist with their eruption into the ABG site. […] After being discharged from the cleft pathway, adults may return to any of the cleft MDT teams at any stage if any concerns arise. […] Dentistry is key to many aspects of cleft care, and specialist and general dentists alike will often be involved with the ongoing management of cleft patients throughout their professional career.

• #58

  https://childrens.wvumedicine.org/cleft-lip-and-cleft-palate

  A speech therapist will closely monitor your childs development to spot signs of impairment. Regular checkups with a pediatric dentist can help address common dental problems, such as missing teeth, extra teeth, or cavities. […] The repair of a cleft lip or palate is a process. Each phase of treatment builds on the treatment before. We monitor your childs progress continually. We address complications if they arise and keep you informed at every stage. […] Treatment usually beings with some form of nonsurgical molding. This is either nasoalveolar molding (NAM) or lip taping in the first few weeks after birth. […] It is common for children with cleft palate to have a procedure to insert ear tubes in the middle ear. These tubes help drain fluid to improve hearing and prevent infection.

• #59 Cleft Lip/Cleft Palate: Feeding Your Child (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/clefts-feeding.html

  When a baby is born with a cleft, it’s important to help the baby feed well to prevent dehydration and make sure they gain weight. Babies born with a cleft may need some special feeding help. […] Babies born with a cleft palate, whether with a cleft lip or without, can’t breastfeed. That’s because they can’t create the pressure needed to suck milk from the nipple. Trying to breastfeed or use a regular bottle system to feed a baby with a cleft palate can lead to poor weight gain and failure to thrive. […] Babies with a cleft palate need to be fed with a specialty bottle system. It provides the proper nutrition without the need for pressure while sucking. […] Feeding challenges put babies with a cleft palate at risk for failure to thrive. Regular weight checks by your baby’s doctor or the cleft team can help make sure your baby is gaining enough weight. […] Feeding a baby with cleft lip/palate can be a challenge at first. But help is available. Look to the cleft team for support and information.

• #60 Cleft Lip / Cleft Palate Feeding | Advice for New Parents

  https://www.cincinnatichildrens.org/health/c/cleft-feeding

  For any infant, poor weight gain can be a sign of a feeding issue. With the right interventions, infants with cleft lip and/or palate are able to meet standard feeding and growth goals. Your primary care provider and your craniofacial care team will watch your baby’s weight closely to ensure his or her feeding needs are being met. […] Whether breastfed or bottle fed, babies with cleft lip and/or palate can have difficulty latching on or maintaining an adequate strength of compression and suction. […] Babies with a cleft palate typically have additional challenges with breastfeeding due to decreased suction. Your care team will work with you through these challenges and help develop a feeding plan to meet your infant’s feeding needs. […] Some common challenges for parents when feeding an infant with a cleft are lengthy feeding times, more frequent feedings, and small volumes with feeding that do not meet nutritional needs.

• #61 Cleft Lip / Cleft Palate Feeding | Advice for New Parents

  https://www.cincinnatichildrens.org/health/c/cleft-feeding

  Feeding is a strong reinforcement for bonding and interaction between you and your infant. […] It is important for caregivers to understand these cues and respond to reinforce the infant’s needs. […] Your care team can help you choose a feeding method to best meet your baby’s needs. […] It is best that you continue with the same feeding system once your infant has established a feeding routine. […] Like all other aspects of feeding infants, positioning infants for successful feeding is important. […] In general, it works well to hold infants with a cleft in an upright or semi-upright position for feedings. […] Your care team will work with you to help you find the holding position that works best for your child. […] We will work with you individually to help you become successful at bottle feeding your infant.

• #62 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Cleft Lip Palate Nursing Care Plans and Nursing Diagnosis […] Nursing goals for clients diagnosed with cleft lip and palate include maintaining adequate nutrition, increasing family coping, reducing the parents anxiety and guilt regarding the newborns physical defects, and preparing parents for the future repair of the cleft lip and palate. […] The following are the nursing priorities for patients with cleft lip and cleft palate: […] Feeding Difficulties. Infants with cleft lip and cleft palate may have difficulties in breastfeeding or bottle feeding due to structural abnormalities. Ensuring adequate nutrition and addressing feeding challenges are crucial for their growth and development. […] Speech and Language Development. Cleft lip and cleft palate can affect speech production and intelligibility. Early intervention by speech therapists and regular monitoring of speech and language development are essential to address any potential communication difficulties. […] Dental and Orthodontic Issues. Cleft lip and palate can impact the alignment and development of teeth and jaws. Dental problems, such as malocclusion, missing teeth, and dental decay, may require orthodontic and dental interventions to ensure proper oral health and function. […] Ear Infections and Hearing Problems. Children with cleft palate are more prone to middle ear infections (otitis media) and hearing loss due to the dysfunction of the Eustachian tube. Frequent monitoring and timely intervention are necessary to prevent potential hearing impairment. […] Psychological and Social Well-being. Individuals with cleft lip and cleft palate may face challenges related to self-esteem, body image, and social interactions due to visible facial differences. Providing psychological support and addressing any emotional difficulties can contribute to their overall well-being. […] Facial Aesthetics and Plastic Surgery. Reconstructive surgery plays a vital role in correcting the cleft lip and palate, improving facial aesthetics, and restoring normal function. Surgical interventions are typically staged and performed by experienced plastic surgeons. […] Nasal Resonance and Breathing Difficulties. Cleft palate can affect nasal resonance and lead to nasal airway obstruction. Management may involve speech therapy, nasal surgery, and continuous monitoring of nasal function.

• #63 Cleft lip and cleft palate – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cleft-palate/symptoms-causes/syc-20370985

  Cleft lip and cleft palate care at Mayo Clinic. […] If your baby has symptoms of a submucous cleft palate, make an appointment with your child’s healthcare professional. […] After a baby is born with a cleft, parents could be concerned about whether they’ll have another child with the same condition. […] Consider genetic counseling. […] Take prenatal vitamins. […] Don’t use tobacco or alcohol. […] One concern right away after birth is feeding. […] Babies with cleft palate are especially at risk of developing middle ear fluid and losing hearing. […] If the cleft extends through the upper gum, teeth may not develop properly. […] Because babies use the palate to form sounds, a cleft palate can affect the usual development of speech. […] Children with clefts may face social, emotional and behavioral problems due to differences in how they look and the stress of medical care.

• #64 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Cleft Lip Palate Nursing Care Plans and Nursing Diagnosis […] Nursing goals for clients diagnosed with cleft lip and palate include maintaining adequate nutrition, increasing family coping, reducing the parents anxiety and guilt regarding the newborns physical defects, and preparing parents for the future repair of the cleft lip and palate. […] The following are the nursing priorities for patients with cleft lip and cleft palate: […] Feeding Difficulties. Infants with cleft lip and cleft palate may have difficulties in breastfeeding or bottle feeding due to structural abnormalities. Ensuring adequate nutrition and addressing feeding challenges are crucial for their growth and development. […] Speech and Language Development. Cleft lip and cleft palate can affect speech production and intelligibility. Early intervention by speech therapists and regular monitoring of speech and language development are essential to address any potential communication difficulties. […] Dental and Orthodontic Issues. Cleft lip and palate can impact the alignment and development of teeth and jaws. Dental problems, such as malocclusion, missing teeth, and dental decay, may require orthodontic and dental interventions to ensure proper oral health and function. […] Ear Infections and Hearing Problems. Children with cleft palate are more prone to middle ear infections (otitis media) and hearing loss due to the dysfunction of the Eustachian tube. Frequent monitoring and timely intervention are necessary to prevent potential hearing impairment. […] Psychological and Social Well-being. Individuals with cleft lip and cleft palate may face challenges related to self-esteem, body image, and social interactions due to visible facial differences. Providing psychological support and addressing any emotional difficulties can contribute to their overall well-being. […] Facial Aesthetics and Plastic Surgery. Reconstructive surgery plays a vital role in correcting the cleft lip and palate, improving facial aesthetics, and restoring normal function. Surgical interventions are typically staged and performed by experienced plastic surgeons. […] Nasal Resonance and Breathing Difficulties. Cleft palate can affect nasal resonance and lead to nasal airway obstruction. Management may involve speech therapy, nasal surgery, and continuous monitoring of nasal function.

• #65 Cleft lip and cleft palate – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cleft-palate/symptoms-causes/syc-20370985

  Cleft lip and cleft palate care at Mayo Clinic. […] If your baby has symptoms of a submucous cleft palate, make an appointment with your child’s healthcare professional. […] After a baby is born with a cleft, parents could be concerned about whether they’ll have another child with the same condition. […] Consider genetic counseling. […] Take prenatal vitamins. […] Don’t use tobacco or alcohol. […] One concern right away after birth is feeding. […] Babies with cleft palate are especially at risk of developing middle ear fluid and losing hearing. […] If the cleft extends through the upper gum, teeth may not develop properly. […] Because babies use the palate to form sounds, a cleft palate can affect the usual development of speech. […] Children with clefts may face social, emotional and behavioral problems due to differences in how they look and the stress of medical care.

• #66

  https://www.nhs.uk/conditions/cleft-lip-and-palate/

  A cleft lip and cleft palate can cause a number of issues, particularly in the first few months after birth, before surgery is done. […] Most of these problems will improve after surgery and with treatments such as speech and language therapy. […] Cleft lip and cleft palate are treated at specialist NHS cleft centres. […] Your child will usually have a long-term care plan that outlines the treatments and assessments they’ll need as they grow up. […] The main treatments are: surgery an operation to correct a cleft lip is usually done when your baby is 3 to 6 months and an operation to repair a cleft palate is usually done at 6 to 12 months, feeding support you may need advice about positioning your baby on your breast to help them feed, or you might need to feed them using a special type of bottle, monitoring hearing a baby born with cleft palate has a higher chance of glue ear, which may affect hearing, speech and language therapy a speech and language therapist will monitor your child’s speech and language development throughout their childhood and help with any speech and language problems, good dental hygiene and orthodontic treatment you’ll be given advice about looking after your child’s teeth, and they may need braces if their adult teeth don’t come through properly. […] The majority of children treated for cleft lip or palate grow up to have completely normal lives. […] Most affected children will not have any other serious medical problems and treatment can usually improve the appearance of the face and problems with feeding and speech.

• #67 Pediatric Cleft Lip & Palate Care | MaineHealth Barbara Bush Children’s Hospital | MaineHealth

  https://www.mainehealth.org/barbara-bush-childrens-hospital/care-services-mainehealth-barbara-bush-childrens-hospital/pediatric-cleft-lip-palate-care-mainehealth-barbara-bush-childrens-hospital

  MaineHealth Pediatric Specialty Care – Cleft Lip and Palate – Scarborough provides comprehensive care for pediatric cleft lip and palate disorders. We take a team approach to care. You and your child will meet with a multi-disciplinary team of specialists at one time, in one location. Working together, our team will evaluate your childs progress and recommend an ongoing treatment plan. […] Your childs care team may include: […] Nurse team coordinator: A nurse practitioner specializing in the care of children with cleft lip and palate who works with the team to manage your childs care, and is available when you have questions or concerns. […] After your appointment, the team meets to review your childs progress and agree on the best plan for the coming year. We will send that plan to you and to your childs doctor. The clinic nurse team coordinator is available to you and your family by phone or email to provide support, answer questions and assist with coordinating care between clinic visits.

• #68 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Following a thorough assessment, a nursing diagnosis is formulated to specifically address the challenges associated with cleft lip and cleft palate based on the nurses clinical judgment and understanding of the patients unique health condition. […] Goals and expected outcomes may include: […] The infant will maintain a clear airway as evidenced by clear breath sounds and the absence of cyanosis. […] The infant will display a respiratory rate of 20 to 30 breaths per minute, absence of retractions, and respiratory distress. […] The neonate will exhibit adequate nutritional status to maintain growth and healing. […] The family will report decreased anxiety levels concerning the infants condition. […] The family will demonstrate problem-solving skills and the use of resources effectively. […] The family will increase coping ability concerning the infants condition and care needs. […] The parents will verbalize that they believe there will be a positive outcome for the infant. […] The parents will demonstrate coping behaviors evidenced by holding and helping with infant care. […] The family will obtain an increased knowledge about the infants preoperative and postoperative care. […] The family will verbalize understanding of the disease process and treatment regimen. […] The family will identify possible complications that necessitate medical attention. […] The infant will not experience injury from the incision. […] The infant will be free of trauma, accumulation of substances, and infection. […] The infant will be free of signs and symptoms of ear infection. […] The parents will verbalize understanding of the importance of early treatment. […] The parents will list signs of diminished hearing. […] The parents will verbalize appropriate agencies for support and guidance.

• #69 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with cleft lip and cleft palate may include: […] Maintaining Airway Clearance and Preventing Aspiration. Infants diagnosed with a cleft palate cannot suck effectively either because pressing their tongue or a nipple against the roof of their mouth forces milk into their pharynx, possibly leading to aspiration. […] Improving Nutritional Status and Teaching Feeding Methods. Before a cleft lip or palate is repaired, feeding the infant becomes a concern because the infant has difficulty maintaining suction with a bottle or breast; there is evidence of slower growth compared to infants without a cleft disorder. […] Reducing Anxiety and Enhancing Coping. A mothers first reaction to a disfigured newborn is one of shock, hurt, disappointment, and guilt. […] Preventing Injury and Infections. Cleft lip and cleft palate can lead to many complications. Early feeding difficulties limit the infants weight gain and growth and may lead to learning disabilities, speech disorders, recurring upper respiratory tract infections, and chronic ear disease. […] Initiating Patient Education and Health Teachings. Mothers of infants diagnosed with cleft lip and palate may have limited knowledge about feeding their infants and may lack information regarding regurgitation, colic, and swallowing during feedings.

• #70 Cleft Lip and Cleft Palate Nursing Care Management

  https://nurseslabs.com/cleft-lip-cleft-palate/

  Cleft lip and cleft palate can be emotionally challenging for affected individuals and their families, necessitating comprehensive and multidisciplinary care from healthcare professionals. […] A complete and thorough process of care should be undergone by the newborn with cleft lip and cleft palate. […] One primary concern in the nursing care of a newborn with a cleft lip and cleft palate is the emotional care of the newborn’s family. […] Based on the assessment data, the major nursing diagnoses are: Compromised family coping related to visible physical defect, Anxiety of family caregivers related to child’s condition and surgical outcome, Deficient knowledge of family caregivers related to care of child before surgery and the surgical procedure, Risk for aspiration related to a reduced level of consciousness after surgery, Ineffective breathing pattern related to anatomical changes, Risk for deficient fluid volume related to NPO status after surgery, Acute pain related to surgical procedure, Risk of injury to the operative site related to newborn’s desire to suck thumb or fingers and anatomical changes.

• #71 5 Cleft Lip and Cleft Palate Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cleft-lip-cleft-palate-nursing-care-plans/

  Cleft Lip Palate Nursing Care Plans and Nursing Diagnosis […] Nursing goals for clients diagnosed with cleft lip and palate include maintaining adequate nutrition, increasing family coping, reducing the parents anxiety and guilt regarding the newborns physical defects, and preparing parents for the future repair of the cleft lip and palate. […] The following are the nursing priorities for patients with cleft lip and cleft palate: […] Feeding Difficulties. Infants with cleft lip and cleft palate may have difficulties in breastfeeding or bottle feeding due to structural abnormalities. Ensuring adequate nutrition and addressing feeding challenges are crucial for their growth and development. […] Speech and Language Development. Cleft lip and cleft palate can affect speech production and intelligibility. Early intervention by speech therapists and regular monitoring of speech and language development are essential to address any potential communication difficulties. […] Dental and Orthodontic Issues. Cleft lip and palate can impact the alignment and development of teeth and jaws. Dental problems, such as malocclusion, missing teeth, and dental decay, may require orthodontic and dental interventions to ensure proper oral health and function. […] Ear Infections and Hearing Problems. Children with cleft palate are more prone to middle ear infections (otitis media) and hearing loss due to the dysfunction of the Eustachian tube. Frequent monitoring and timely intervention are necessary to prevent potential hearing impairment. […] Psychological and Social Well-being. Individuals with cleft lip and cleft palate may face challenges related to self-esteem, body image, and social interactions due to visible facial differences. Providing psychological support and addressing any emotional difficulties can contribute to their overall well-being. […] Facial Aesthetics and Plastic Surgery. Reconstructive surgery plays a vital role in correcting the cleft lip and palate, improving facial aesthetics, and restoring normal function. Surgical interventions are typically staged and performed by experienced plastic surgeons. […] Nasal Resonance and Breathing Difficulties. Cleft palate can affect nasal resonance and lead to nasal airway obstruction. Management may involve speech therapy, nasal surgery, and continuous monitoring of nasal function.

• #72 Cleft Lip & Palate Association

  https://www.clapa.com/treatment/timeline/

  The Cleft Team will be able to help parents prepare for surgery, as well as give advice and support regarding aftercare. […] The Cleft Team will be able to help parents prepare for surgery, as well as give advice and support regarding aftercare. […] Speech and Language Therapy Assessment – This usually takes place at around 18 months. Treatment will be offered if necessary, but the need may not become apparent until the child is older. […] Psychological Support for families if requested prior to school entry. […] Full assessment by Cleft Team – a child with a cleft should receive a full assessment by all specialists in the cleft team at age 5, to ensure that any ongoing or emerging issues are being dealt with appropriately. […] Speech and Language Therapy – This will be provided by local therapists in consultation with the specialist from the Cleft Team. The aim is for all children to have good quality, intelligible (understandable) speech by age 5-6. […] Adults may re-enter the cleft service at any time for a consultation about any aspect of their care, including psychological support, genetic counselling and specialist dental treatment, which is all available on the NHS if it is deemed necessary.

• #73

  https://www.nhs.uk/conditions/cleft-lip-and-palate/

  A cleft lip and cleft palate can cause a number of issues, particularly in the first few months after birth, before surgery is done. […] Most of these problems will improve after surgery and with treatments such as speech and language therapy. […] Cleft lip and cleft palate are treated at specialist NHS cleft centres. […] Your child will usually have a long-term care plan that outlines the treatments and assessments they’ll need as they grow up. […] The main treatments are: surgery an operation to correct a cleft lip is usually done when your baby is 3 to 6 months and an operation to repair a cleft palate is usually done at 6 to 12 months, feeding support you may need advice about positioning your baby on your breast to help them feed, or you might need to feed them using a special type of bottle, monitoring hearing a baby born with cleft palate has a higher chance of glue ear, which may affect hearing, speech and language therapy a speech and language therapist will monitor your child’s speech and language development throughout their childhood and help with any speech and language problems, good dental hygiene and orthodontic treatment you’ll be given advice about looking after your child’s teeth, and they may need braces if their adult teeth don’t come through properly. […] The majority of children treated for cleft lip or palate grow up to have completely normal lives. […] Most affected children will not have any other serious medical problems and treatment can usually improve the appearance of the face and problems with feeding and speech.

• #74

  https://www.shrinerschildrens.org/en/pediatric-care/cleft-lip

  Our pediatric specialists provide more than just surgery for a baby’s cleft lip. […] Our experienced teams of specialists work together in coordinated, one-day team appointments, to repair a baby’s cleft lip and guide parents along each step of the medical and emotional journey. […] Cleft lip repair at Shriners Children’s is done by our trained pediatric surgeons. Other members of your child’s care team, such as speech therapists, audiologists, dentists and dental radiologists, know how to care for any related needs and concerns with a child’s teeth or hearing, and you’ll work with them as needed, to help your child reach their full potential. […] The cleft teams at Shriners Children’s understand that the repercussions of cleft lip and cleft palate often run much deeper affecting breathing, hearing, speaking and eating.

• #75

  https://www.nhs.uk/conditions/cleft-lip-and-palate/

  A cleft lip and cleft palate can cause a number of issues, particularly in the first few months after birth, before surgery is done. […] Most of these problems will improve after surgery and with treatments such as speech and language therapy. […] Cleft lip and cleft palate are treated at specialist NHS cleft centres. […] Your child will usually have a long-term care plan that outlines the treatments and assessments they’ll need as they grow up. […] The main treatments are: surgery an operation to correct a cleft lip is usually done when your baby is 3 to 6 months and an operation to repair a cleft palate is usually done at 6 to 12 months, feeding support you may need advice about positioning your baby on your breast to help them feed, or you might need to feed them using a special type of bottle, monitoring hearing a baby born with cleft palate has a higher chance of glue ear, which may affect hearing, speech and language therapy a speech and language therapist will monitor your child’s speech and language development throughout their childhood and help with any speech and language problems, good dental hygiene and orthodontic treatment you’ll be given advice about looking after your child’s teeth, and they may need braces if their adult teeth don’t come through properly. […] The majority of children treated for cleft lip or palate grow up to have completely normal lives. […] Most affected children will not have any other serious medical problems and treatment can usually improve the appearance of the face and problems with feeding and speech.

• #76 Cleft Lip/Cleft Palate | Birth Defects | CDC

  https://www.cdc.gov/birth-defects/about/cleft-lip-cleft-palate.html

  Surgical repair can help restore function to the lips and mouth. It may help improve breathing, hearing, and speech and language development. Children born with orofacial clefts may also need special dental or orthodontic care or speech therapy. […] With treatment, most children with orofacial clefts do well and lead a healthy life. Some children may have issues with self-esteem if they are concerned with visible differences between themselves and other children.

• #77

  https://www.nhs.uk/conditions/cleft-lip-and-palate/

  A cleft lip and cleft palate can cause a number of issues, particularly in the first few months after birth, before surgery is done. […] Most of these problems will improve after surgery and with treatments such as speech and language therapy. […] Cleft lip and cleft palate are treated at specialist NHS cleft centres. […] Your child will usually have a long-term care plan that outlines the treatments and assessments they’ll need as they grow up. […] The main treatments are: surgery an operation to correct a cleft lip is usually done when your baby is 3 to 6 months and an operation to repair a cleft palate is usually done at 6 to 12 months, feeding support you may need advice about positioning your baby on your breast to help them feed, or you might need to feed them using a special type of bottle, monitoring hearing a baby born with cleft palate has a higher chance of glue ear, which may affect hearing, speech and language therapy a speech and language therapist will monitor your child’s speech and language development throughout their childhood and help with any speech and language problems, good dental hygiene and orthodontic treatment you’ll be given advice about looking after your child’s teeth, and they may need braces if their adult teeth don’t come through properly. […] The majority of children treated for cleft lip or palate grow up to have completely normal lives. […] Most affected children will not have any other serious medical problems and treatment can usually improve the appearance of the face and problems with feeding and speech.

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