Nursing management of cleft lip and palate

The management of children with cleft lip and palate presents many challenges but. This is the first of two articles looking at dental care for the patient with a cleft lip and palate. Management of cleft lip and palate speech therapy health. Oral clefts are the fourth most common birth defect in the u. Experience of the hospital for rehabilitation of craniofacial. In interviewing the family and collecting data, the nurse must include exploration of the familys acceptance of the newborn. Read on below for an introduction to the various procedures that may be included in the surgical repair of cleft lip and cleft palate at childrens hospital. Most individuals with cleft lip cl, cleft palate cp, or cleft lip and palate clp, as well as many individuals with other craniofacial anomalies, require the coordinated care of providers in many fields of medicine including otolaryngology and dentistry, along with that of providers in speech pathology, audiology, genetics, nursing, mental. The centers for disease control and prevention cdc estimates that each year in the united states about 2,650 babies are born with a cleft palate and 4,440 babies are born with a cleft lip with or without a cleft palate. Jun 16, 2014 cleft lip and cleft palate are abnormalities in closure of the lip or palatine shelf that may occur separately or in combination.

Management of children with cleft lip and palate 15. Ok, so lets just go back through and highlight the key points for this lesson. Objectivesat the end of the teaching students will beable to acquire the knowledeg regardingthe cleft lip and cleft palate and will beable to provide care to the childrensuffering from the cleft lip and cleft palate. Nursing care plan the infant with a cleft lip andor palate continued. Members of a cleft lip and palate team usually include. Cleft lip and cleft palate diagnosis and treatment mayo. Nursing goals for clients with cleft lip and cleft 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 pages list problems and interventions for the child with a cleft lip palate. Make sure you check out all the resources attached to this lesson. Any object your child puts in or around the mouth including little fingers. Increasing number of interventions without scientific proof of longterm benefits substantially increases the burden of care.

Cleft lip and palate affects about one in born in north america and requires a combination of peoples expertise to manage medical, surgical and dental challenges that are required. Most cases of cleft lip and cleft palate are noticed right away at birth and dont require special tests for diagnosis. Feb 21, 2020 orofacial clefts ie, cleft lip cl, cleft lip and palate clp, cleft palate cp alone, as well as median, lateral transversal, oblique facial clefts are among the most common congenital anomalies. Feb 21, 2020 most individuals with cleft lip cl, cleft palate cp, or cleft lip and palate clp, as well as many individuals with other craniofacial anomalies, require the coordinated care of providers in many fields of medicine including otolaryngology and dentistry, along with that of providers in speech pathology, audiology, genetics, nursing, mental health, and social medicine.

Dental care for the patient with a cleft lip and palate. Each year approximately 4,200 babies in the united states are born with cleft lip or cleft palate. The management of cleft lip and palate represents a commitment to the care of the afflicted child over the course of the childs development into adulthood. Management and surgical treatment of the cleft lip and palate. Cleft lip and palate are corrected at separate times, and this can vary from surgeon to surgeon. Incidence is highest in children with a family history of cleft defects, those exposed to. Nasal regurgitation and choking are common because of inability of the palate to separate the nasal and oral cavities. The nature of cleft lip and palate embryology, incidence and aetiology classification anatomy and function facial growth speech characteristics cleft condition associated conditions and syndromes management of the infant and young child with a cleft lip and or palate prenatal diagnosisabnormalities of the fetal lip and palate.

Orofacial clefts, individually known as cleft lip and cleft palate, are the most common birth defects. Our postop nursing care is focused on protecting the incision and monitoring their airway. The most common facial malformations, cleft lip and cleft palate, occur either alone or in combination. A prenatal ultrasound is a test that uses sound waves to create pictures of the developing fetus. Thats it for our lesson on cleft lip and cleft palate. Perioperative management in patients with cleft lip and palate. Jun 15, 2016 one of the immediate problems to be addressed in a newborn with cleft lip palate is difficulty in feeding. A baby born with a cleft palate will need help in achieving a good latch on. Management, especially in the first few months of life, involves many different health care professionals. The case presented here discusses the management of feeding problem in the infant with cleft lip palate. In bottle feeding the tongue compresses the teat against the roof of the mouth. One primary concern in the nursing care of the newborn with a cleft lip and cleft palate is the emotional care of the newborn s family.

Cleft palate is an opening in the roof of the mouth, called the palate. Approximately 1 case of orofacial cleft occurs in every 500550 births. All children born with cleft lip and palate should be assessed for snhl and conductive hearing loss before 12 months of age, by abr and tympanometry. In this article, the authors describe their experience with cleft lip and palate repair. Cleft lip and palate post operative care after a child has had surgery to close a cleft lip andor palate, his or her parents may be concerned about how to look after him or her properly. Because of the number of oral health and medical problems associated with a cleft lip or cleft palate, a team of doctors and other specialists usually works together to develop a plan of care for each patient. At uk, we aim to fix the lip at 23 months of age, although this can be done later depending on how the childs weight gain and growth are progressing. Frequently asked questions cleft lip and palate affects about one in born in north america and requires a combination of peoples expertise to manage medical, surgical and dental challenges that are required. May 22, 2018 cleft lip and cleft palate are openings or splits in the upper lip, the roof of the mouth palate or both. Cleft lip and cleft palate may occur together or individually. During the early part of pregnancy, around week 7 or week 8, the tissues of the mouth and lips begin to form and join. This book the successor to advances in the management of cleft palate edited by margaret edwards and tony watson and published in 1980 but it is different enough for its publishers and editors to feel that its name should be changed. Surgery for both cleft lip and cleft palate require general anesthesia. Cleft lip or palate are the most common of birth defects.

In addition to determining the type of speech and language treatment that is optimal for individuals with cleft lip and palate, slps consider other service delivery variablesincluding format, provider, dosage, timing, and settingthat may affect treatment outcomes. Ent consultation before surgery is routinely conducted in 52. One primary concern in the nursing care of the newborn with a cleft lip and cleft palate is the emotional care of the newborns family. Cleft lip and cleft palate symptoms and causes mayo clinic. Obstetric ultrasound will reveal cleft lip while the infant is in utero. These defects happen early in pregnancy when the lips and palate do not form properly.

Your priority nursing concepts for a patient with cleft lip and cleft palate are safety, nutrition and human development. The number for our nursing coordinator is 3193563345. Contact the laleche league for the name of a support person. Cleft lip and cleft palate result when facial structures that are developing in an unborn baby dont close completely. The breast needs to be held well into the area where there is palate so that the baby can get a good grip and work at the breast with the tongue. Increasingly, cleft lip and cleft palate are seen on ultrasound before the baby is born. Management and surgical treatment of the cleft lip and. Burden of care is highly relevant in the management of cleft lip and palate children because it demands multiple surgeriesinterventions and a longterm followup. Your surgeon or nursing staff will cleanse the lip at the first visit after surgery. Abnormalities of the fetal lip and palate, sonographic diagnosis. The cleft lip and palate society western australia smiles cleft lip and palate support group.

The management of patients with cleft lip and cleft palate requires prolonged orthodontic and surgical treatment and an interdisciplinary approach in providing them with optimal esthetics. It can affect just one side called a unilateral cleft lip and palate or both sides a bilateral cleft of the lip and palate. The way in which the specialist nurse cares for and supports the mother. Cleft lip and cleft palate nursing case study w ncp. Nursing care plan the infant with a cleft lip and or palate continued goal intervention rationale expected outcome 2. Oct 01, 2017 a complete and thorough process of care should be undergone by the newborn with cleft lip and cleft palate. The role of a qualified surgeon in this population of patients is obvious. Your child recently had surgery to help repair his or her cleft lip, cleft palate, or both. Cleft lip is characterized by a slit or opening that goes through the lip and into the nose on one or both sides of the lip. Management of feeding problem in a patient with cleft lippalate. Plastic surgeon to evaluate and perform necessary surgeries on the lip and or.

A cleft of the lip and palate is an abnormal gap or opening in the upper lip and roof of the mouth which extends from the lip up to the nostril and back through the roof of the mouth. Other treatments, such as speech therapy and dental care, may also be needed. Cleft lip and cleft palate nursing care management nurseslabs. The cleft lip and palate center expertly cares for children with cleft palate. The phone number to contact our cleft and craniofacial clinic is 3193562168. In addition to hospital, clinic, and home health nurses, members of the. Cleft lip and palate diagnosis, causes, treatment national. A unique feature of the book is that it largely consists of longitudinal facial and palatal growth studies of dental casts, photographs, panorexes, and. Cleft lip and cleft palate are facial and oral malformations that occur very early in pregnancy, while the baby is developing inside the mother. Breastfeeding a baby with a cleft palate may work when the cleft is very small or narrow. Treatment consists of surgical repair, usually of the lip first between 6 to 10 weeks of age, followed by the palate between 12 to 18 months of age.

Aug, 2019 children with a cleft lip or palate will need several treatments and assessments as they grow up. Only the lip may be involved, or the defect may extend into the upper jaw or nasal cavity. It has been recently recognized that a child with craniofacial anomaly including cleft lip and palate is at increased risk of sensorineural hearing deficit. Clefting results when there is not enough tissue in. Management of cleft lip and palate in primary care. Orthodontic management of patients with cleft lip and palate. All nurses who provide care to infants with a cleft lip or palate should consult this articles section on finding the right words to help reassure and inform new. Speak with our team the roof of your childs mouth the palate is still healing and should be protected from injury for about 3 weeks after surgery. The multidisciplinary evaluation and management of cleft. Cleft lip deformities can occur unilaterally, bilaterally or rarely, in the midline.

Genetic and environmental factors are believed to be the cause of these tissues. Mar 08, 2018 cleft lip and palate association of ireland. The management of cleft lip with or without cleft palate involves a multidisciplinary team providing comprehensive care of the conditions functional and aesthetic issues from birth into adulthood. Cleft lip and palate repair surgery childrens hospital of. In a breastfed baby the tongue ripples along the base of the breast helping to express the milk out of the nipple. Pdf management of cleft lip and palate researchgate.