Master Cleft Lip or Palate Interventions with Picmonic for Nursing RN

Mothers may be initially shocked at the appearance of their newborn. Newborns may have other anomalies, such as heart defects, skeletal malformations and urinary or genital malformations. It is important to encourage continuous mother-baby bonding by holding the infant immediately after birth if possible and reinforce that corrective surgeries are available with excellent success rates.

A prosthodontic or orthodontic device may be used and functions as a prosthetic palate in patients with a cleft palate.

Newborns with this condition are either unable to form an adequate seal around the nipple or breast, unable to create adequate suction, or both. Modified nipples allow for a larger portion of the nipple to reside inside the mouth allowing a seal to form further inside the mouth. Mothers who breastfeed can pump and use the modified nipple to give their newborn breast milk.

A poor seal around the nipple or breast creates excessive air ingestion during feeding. Adequate burping is important to expel the additional air.

Repair is performed once an infant weighs approximately 10 pounds and usually at an age of 2-3 months for cleft lip and 6-9 months for cleft palate. Early surgical repair is important to promote normally appearing facial features later in life. Care of the surgical site is important to promote adequate healing.

Post feeding rinsing of the suture line with normal saline decreases the risk of infection. An antibiotic ointment or petroleum jelly may also be applied as directed.

Restraints of the arms/elbow after surgical repair prevents the child from physically touching and causing trauma to the suture sites.

It is important to avoid hard or rigid utensils such as straws, hard sippy cups, or spoons, especially after cleft palate repair. This is indicated to reduce physical trauma to the suture lines.