Cleft Lips And Cleft Palate -hare lip

Cleft Lips And Cleft Palate | hare lip


Cleft Lips And Cleft Palate

  • Cleft lips and Cleft palate is congenital anomalies that occur as a result of the failure of soft tissue or bony structure to fuse during the embryonic periods.
  • Cleft lips and palate may be complete and partially.
  • Cleft lips are also known as “hare lip
Cleft Lips And Cleft Palate
Cleft Lips And Cleft Palate

Cleft Lips(hare lip)

  • Also known as CHEILOSCISIS
  • Cleft lips occur when the maxillary process is failed to fuse with the medial nasal process
  • It may be unilateral or bilateral
  • It occurs during 5-12 weeks of gestational age
  • Incidence is 1 in 800 live births

Cleft Palate

  • Also known as Palatoschisis
  • Cleft palate occurs when the lateral palatine process is failed to fuse
  • The severity of cleft palate is involve Uvula to the nasopalatine foramen
  • It occurs during 12-14 weeks of gestational age
  • Incidence 1 in 2000 live birth

    Cleft Lips And Cleft Palate | hare lip
    Cleft Lips And Cleft Palate | hare lip

Etiology of cleft lip and palate

  • Maternal smoking and exposure to passive smoke
  • Drugs – Accutane, Phenytoin, Warfarin, ethanol etc.
  • Maternal folic acid deficiency
  • Hereditary and environmental factors
  • Exposure to radiation and rubella virus.
  • Chromosomal abnormalities
  • Teratogenic factors
  • Prolonged Maternal Anemia

Clinical features of cleft lip and palate

  • Failure to weight gain
  • Feeding problem
  • Poor Growth
  • Repeated ear infection and speech difficulty
  • Dental abnormalities
  • Middle ear fluid buildup and hearing loss
  • Psychological problem

Management Cleft Lips And Cleft Palate

  1. Medical Cleft Lips And Cleft Palate hare lip

  • Firstly nurse assesses the physical Examination for cleft lips and gloved fingers use for cleft plate
  • Assess the ability to suck, swallow, and breathe
  • Slow and small quantity feeding is provided
  • Palade spoon, Medicine dropper, and syringe with catheter etc, use for feeding.
  • Intermittent burping during the feeding
  • Provide rest
  • Baby, semi upright position provide during feeding and side lateral position after feeding.
  • Bulb syringe or suction apparatus keep near to bed side.

2. Surgical Cleft Lips And Cleft Palate hare lip

  1. Cheiloplasty – For Cleft lips
  2. Palatoplasty- For Cleft plate


  1. Cheiloplasty –

  • It is a plastic surgical procedure for repair the cleft lips
  • The procedure is done at 3-6 months
  • There is minimally invasive surgical procedure
  • Z shape suturing use in cheiloplasty to minimize the changes of separation of a suture.
  • Use 10 “rainbow” (C-shape) after the surgery to minimize the pressure on suture.
  • The prone position should be avoided in cheiloplasty-treated children. Only lateral and semi-upright positions provide
  • After feeding, the suture line is cleaned with NS sterile water, etc.
  1. Palatoplasty –

  • Palatoplasty is a surgical procedure for the correct the palate with cleft palate person.
  • Palatoplasty procedure done at 6-18 months of age.
  • Palatoplasty procedure fill the gap of palate by MUCO PERIOSTEUM FLAP
  • Oral packing should be done after the surgery.
  • Prone position recommended for palatoplasty patient.
  • Complication
  • Recurrent Otitis media (Hearing loss) – due to dysfunction of Eustachian tube.
  • Feeding problem
  • Speech Problem
  • Recurrent Respiratory tract infection
  • Nursing Management
  • Nurse should carefully perform the head to toe assessment and assess the cleft lips and cleft palate deformity.
  • Nurses assess the client lips by visually and cleft palate by gloved figures.
  • Nurse assess the feeding pattern of the child
  • Assess the need for the surgical correction
  • Airway clear and provide proper position
  • Nurse encourage the parents to accept the child condition
  • Provide the complete immunization before the surgery
  • Elbow and jacket restrain provide after the surgery
  • Avoid the use of oral suctioning, Tounge depressor, oral temp., thermometer etc.
  • Don’t allow the child to brush and do not allow hard food to baby
  • Avoid the contact of the sharp object to the suture line.


  • The maxillary process is failed to fuse with the medial Nasal process is known – Cleft lips
  • Cleft palate Occur during the – 12-14 weeks of gestational age
  • Priority Nursing management in cleft lips and cleft palate – Clearance of airway
  • Which type of restrain use in the cleft plate and the cleft lips – Elbow and jacket Restrain
  • Which position is provided during the Feeding baby with Cleft lips and cleft Palate – Semi-upright Position
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