Comparison of Cleft Lip and Cleft Palate

Dimension Cleft Lip Only Cleft Palate Only Both Cleft Lip and Cleft Palate
Incidence
1/1000
More common among boys
1/2500
More common among girls
Most common facial malformation
More common among boys
More common among Caucasians than African Americans
Surgical repair
“Cheiloplasty” (Logan bow)

Often done in a single stage
Timing: age 6-12 week
Palatoplasty

Often done in staged repairs
Timing: age 12-18 months
Lip always repaired before palate to enhance parentinfant attachment, bonding
Position postoperatively Never on abdomen Always on abdomen
Feeding postoperatively
No sucking
Use Breck feeder or Asepto syringe
No sucking
Use wide-bowl spoon or plastic cup
Nursing care postoperatively
Elbow restraints
Lessen crying
Croup tent
Elbow restraints
Lessen crying
Croup tent
OK to show parents pictures of “before” and “after" repair
Long-term concerns
Bonding, attachment
Social adjustment - potential threat to self-image
Defective speech - refer to speech therapist
Abnormal dentition - refer to orthodontist
Hearing loss - refer to pediatric eye, ear, nose, throat specialist/ physician