CLEFT LIP& PALATE

CLEFT LIP& PALATE

1. pathophysiology: Craniofacial malformation, results from incomplete fusion of embryonic structures of oral cavity

   • Can see it in utero 4-8 weeks of gestation
   • Structural GI Dysfunction

2. Risk factors: environment, genetic, maternal smoking, mineral & deficiency or excess, low folic acid, alcohol, terotogenic meds

3. incidence: Lip greater in males, palate greater in female, if siblings devp greater chance of devp

4. PRE OP

   • lip before palate surgery, lip surgery 1-2 months of age
   • palate surgery at 16-18months
   • ESSR method (enlarged nipple, stimulate suck rub bottom lip, swallow, rest after each suck
   • position on R side to facilitate drainage

5. POST OP:

   • logan bow or bar
   • elbow/jacket restraints
   • feeding resumes as tolerated, give pured or liquid diet until palate heals, no spoon, no straw put food on tip of mouth and let them suck
   • pain relief
   • suture line should be cleaned, air dried, prescribed antibiotic

6. avoid latex when caring for pt, position for respiratory ease upright to avoid aspiration, suction nose & mouth