CLEFT LIP AND CLEFT

PALATE
PREPARED BY: GEMMA L. TANEDO R.N, MAN
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 INTRODUCTION

 Cleft lip and cleft palate are

openings or splits in the upper
lip, the roof of the mouth
(palate), or both. Although both
conditions can often appear
together, either defect may
appear alone.
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Cleft lip is a condition where there is a gap or split

in the upper lip, often extending upward toward the
nose. This gap can be small or extensive and may
6 occur on one or both sides of the lip.
•Cleft palate, on the other hand, is a condition
where there is an opening or gap in the roof of
the mouth (palate). This gap may extend from
the front of the mouth toward the back, and it
can vary in size and severity.
P
Failure of the maxillary process to fuse with the elevations on the frontal
A
prominence during sixth week of gestation
T
H
O Results is interrupted fusion of maxillary and median nasal
P prominence
H
Y Failure of the tongue to move downward at the correct time will
S prevent the palatine process from fusing
I
O
L Intrauterine development of hard and soft palate is incomplete
O during the first trimester
G
Y Cleft lip and cleft palate
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 Cleft lip occurs in about 1 in 1000 live

Q1
2.0
2.4 births and is more common in males.
4.3

Q2
2.0
 Cleft
4.4 Palate occurs in 1 newborn in 2,500
2.5
more often in females.
3.0
Q3 1.8
3.5
 Cleft plate occurs with cleft lip is about
5.0
Q4 2.8 50%
4.5
of the time, most often bilateral cleft.
- 1.0 2.0 3.0 4.0 5.0 6.0

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CLASSIFICATIONS

e f
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Causes
The incidence of cleft palate is higher in the close relatives of people
with the defect than it is in the general population.

•Hereditary. The mother or the father can pass on genes that cause
clefting, either alone or as part of a genetic syndrome that includes
a cleft lip or cleft palate as one of its signs.

•Environmental. In some cases, babies inherit a gene that makes

them more likely to develop a cleft, and then an environmental
trigger actually causes the cleft to occur.
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c
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a
b
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Presentation

Cleft

Difficulty with feedings

Difficulty swallowing

Nasal speaking voice

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 Medical Management
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 Surgery. Cleft lip repair, usually performed by a

plastic surgeon, is a major part of the treatment of a
newborn with cleft lip, palate, or both.
 Newborn is 1 to 2 months old
 Weighs about 10 lbs, and is gaining weight steadily.
 Dental speech appliance. If surgery must be delayed
beyond the 3rd year, a dental speech appliance may
help aid the child develop intelligible speech.
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Cheiloplas Uranoplas
ty ty

Repair of cleft Lip

 Done in infancy; Surger Repair of cleft
2 to 3 months palate
 Often follows the y  Best done in
“Rule of 10” ten toddlerhood
weeks ,ten lbs in before the
weight and ten speech training
grams in hgb period: 18-36
months
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Speech problems/
Hearing
faulty
speech/speech problem/lo
disturbance ss

COMPLICATIONS

Dental
problem:
malpositio
23 n of teeth
Body image problem infection
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positionin
Maintain g
Tools for Lambs nipple
adequate
feeding
nutrition

Promote NURSING Eyedropper or asepto

syringe
family
coping MANAGE
(verbalize)
MENT
Reduce Provide Simplest and
family family most effective Breck feeder
anxiety method
24 teaching
(Info cleft (routine of
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•Compromised family
coping related to visible physical
Nursing defect.
Anxiety of family
Dx caregivers related to child’s
condition and surgical outcome

Risk for aspiration related

to a reduced level of Deficient knowledge of family
consciousness after surgery. caregivers related to care of
child before surgery and the
•Ineffective breathing surgical procedure.
pattern related to
anatomical changes. •Risk of injury to the
•Risk for deficient fluid operative site related to
volume
25 related to NPO Acute pain related to newborn’s desire to suck thumb
status after surgery. surgical procedure or fingers and anatomical
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