Grand Rounds

Cleft Lip
Emily O’Brien and graduate classmate
 Tommy
- 1 month old
- Born with a mild unilateral cleft lip
- All other oral structures are normally developing
- Surgery is scheduled for ~10 months of age
- Tommy is underweight and RD is concerned about his nutritional intake
- Tommy’s mother has difficulty breastfeeding, particularly with
maintaining an effective latch. She has also raised concerns about
excessive sputtering during feedings.
Plan of action
LTG: Client will improve breastfeeding efficiency with the introduction of positioning and feeding
strategies as measured by parent report.

STG: Client will maintain lip seal during feeding in 70% of trials with the help of mom’s finger to complete
bilabial closure across 3 data collection days.

STG: Client will avoid signs/symptoms of aspiration during feeding (such as coughing or sputtering) in
80% of trials using positioning techniques to maintain appropriate airway protection across 3 data
collection days.
 Therapy Activities
Will meet 2 times a week for 30 minutes

Parent education/practice

- Want parents to feel confident in feeding their baby

- Body positioning during breastfeeding
- Teach caregivers to position baby in an upright position
- Let down

Lip Closure

- Finger support to help with lip seal

- Provide jaw and chin support by holding baby’s face with other fingers/palm
- Helpful in semi-upright position