Cleft Lip and Palate

• Vomiting and diarrhea are common symptoms of GI problems both in children and adults.
• ● Openings or splits in the upper lip, the roof of the mouth, or both.

  ● Results from non-union of the tissue and bone of the upper lip and hard and soft palate during embryonic development.

  ● These defects occur when the facial structures that are developing in the unborn, do not form properly.
• TREATMENT

  SURGICAL TREATMENT:

  1. Cheiloplasty – cleft lip repair, may be done at 2-3 months.

  2. Palatoplasty – cleft palate repair; may be done at 10 to 12 months of age

  ● Surgery is important before speech development occurs at the minimum one surgery is needed to repair the lip and a separate surgery for the palate.

  ○ However, several surgeries may be needed to make the lip appear as normal as possible.
• I. PRE-OPERATIVE INTERVENTIONS — It focuses on proper feeding and nutrition.

  1. Feed upright.

  B. Burp frequently.

  C. Use large-holed nipple, but if unable to suck, drip formula into side of mouth.

  D. Provide small, frequent feedings.

  E. Finish feeding with water.
• II. POST-OPERATIVE INTERVENTIONS— Assures establishing airway, preventing complications such as hemorrhage, and ensuring nutrition as well.

  1. Maintain patent airway.

  B. Assess color, monitor amount of swallowing to detect hemorrhage.

  C. Do not place in prone position or with pressure in cheeks.

  D. Avoid straining, such as crying.

  E. Use elbow restraints, if needed.

  F. Provide liquid diet initially, then soft, then normal