Hi, I'm Cathy with Level Up RN. In this video, I will be discussing cleft lip and cleft palate. And at the end of the video, I'm going to give you guys a little quiz to test your knowledge of some of the key points I'll be covering. So definitely stay tuned for that. And if you have our Level Up RN pediatric nursing flashcards, go ahead and pull out your flashcards on cleft lip and cleft palate and follow along with me.
Cleft lip is a birth defect characterized by incomplete formation of the lip. And cleft palate is where we have incomplete formation of the palate, which is the roof of the mouth. Some children are born with both cleft lip and cleft palate. Risk factors that make it more likely that a baby will develop cleft lip and/or cleft palate include smoking, gestational diabetes, the use of certain medications, and a lack of folate during pregnancy. In terms of signs and symptoms, a baby with cleft lip will have an opening in their upper lip, which will vary in size. It may be a small slit, or it may be a large opening into the nose. A baby with cleft palate will have an opening in part or all of their palate, which, again, is the roof of their mouth. Both of these conditions can be diagnosed with a prenatal ultrasound or with visual inspection of the oral cavity at birth. Treatment includes surgical repair. Cleft lip is typically repaired when the baby is between 3 and 5 months of age, and cleft palate is typically repaired a little later, such as when the baby is between 9 and 12 months of age. There are complications associated with cleft lip and/or cleft palate, such as feeding, hearing, speech, and dental issues. So as the nurse, you want to provide appropriate referrals to help manage these complications. You also want to provide important teaching on how to best feed a baby with cleft lip and/or cleft palate.
For a baby with cleft lip who is bottle-fed, a bottle with a nipple that has a wide base is typically recommended. And then squeezing the baby's cheeks together during feeding can help with getting a good lip seal. For a baby with cleft palate, you want to position the baby in an upright position and then a bottle that has a one-way flow valve and a specialty nipple that increases the flow of liquid is typically recommended. And then because babies with cleft palate often swallow a lot of air during feedings, it's important to burp the baby frequently when providing a feeding. After a baby has surgical repair of cleft lip or cleft palate, special precautions need to be taken to protect the operative site. So petroleum jelly should be used along the suture line in order to keep the area moist and to promote wound healing. Elbow immobilizers are typically used to prevent the baby from touching and damaging the operative site. And then pacifiers should be avoided, and feeding the baby with a syringe or dropper may be recommended because sucking, which makes the baby's mouth go like this, can disrupt the suture line.
All right. It's quiz time, and I've got three questions for you.
Question number 1, when feeding a baby with cleft lip, how can you improve their lip seal? The answer is you can squeeze their cheeks together during feeding.
Question number 2, why are elbow immobilizers used after surgery to repair cleft lip or cleft palate? The answer is to prevent the baby from touching and damaging the operative site.
Question number 3, the use of a pacifier is recommended after surgery to repair cleft lip or cleft palate, true or false? The answer is false because sucking can disrupt the suture line.
All right. That is it for this video. I hope you found it to be helpful. Take care and good luck with studying.
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And then a bottle with a one-way flow valve and a specialty nipple.
