|
Cleft Lip
WHAT YOU SHOULD
KNOW
Cleft lip---failure of a baby's upper lip to join in the
middle---happens once in every 700 to 800 births. The cleft can
range from a small notch in the red part of the lip to a gap
that goes all the way up to the nose. The baby's palate (the
roof of the mouth) may also be split.
A cleft lip develops when there isn't enough skin and
muscle in the developing baby's mouth to allow the lip to grow
together. If only the lip is involved, the problem can be
repaired with surgery when the baby is about 2 months of age.
If the palate is also split, the operation may have to be
delayed until the baby has grown larger---usually between 6 and
24 months of age. A second operation is sometimes
necessary.
Many parents react with sorrow or anger when they
discover this condition. Others feel guilty. It's important to
remember that nothing you did caused the problem, and that
there was nothing you could have done to prevent it. To ease
your feelings, talk about them with your doctor or someone
close to you. You can also join a support group for parents of
babies with cleft lips. Ask your doctor for information.
Be prepared for some degree of shock or surprise when
friends and family see the baby for the first time. You can get
past this by telling them ahead of time about the cleft lip, or
showing them a picture before the baby comes
home.
Causes
Although the tendency for cleft lip runs in families, the
reason why a particular baby develops the problem is
unknown.
Risks
A cleft lip can interfere with an infant's ability to
suck and gain nourishment. Later, if the cleft lip is not
repaired, the baby could have problems talking, and have teeth
come in the wrong way.
Of course, there are also risks in surgery. The child
could bleed more than usual, get an infection, suffer a
breathing problem, or develop clots in blood vessels. However,
doctors and nurses are prepared to deal with such problems, so
the operation is generally safe.
WHAT YOU SHOULD
DO
To overcome feeding problems, you'll need to learn
special techniques. You may also need special bottles, nipples,
and other supplies.
-
You may need to feed the baby
with a soft bottle. Gently squeeze the bottle so milk comes
slowly out of the nipple.
-
There are many kinds of
bottle nipples. Your doctor will work with you to find the
best one for your baby.
-
Hold your baby in a sitting
position during feedings. This helps to keep liquid from
going into the nose, where it can be inhaled or spread into
the ears. If saliva and milk get into the baby's ears, they
could cause an infection.
-
Feed your baby slowly. A baby
with a cleft lip can swallow a lot of air when feeding, so
burp the baby frequently---after each 1 to 2 ounces of
liquids.
-
Don't keep taking the nipple
in and out of the baby's mouth during feedings. This can
upset the baby---and crying during feedings can cause the
baby to inhale the formula.
IF YOU'RE HEADING FOR THE
HOSPITAL...
Before You Go
-
The Weeks Before Surgery:
-
The child will need to wear
padded elbow boards for a while after the operation. If the
baby is old enough, you can prepare him or her by showing
how the boards work. Put them on the child's arms and let
him play with them for a short time. After the surgery,
they'll seem less frightening.
-
Older children should be
taught in advance to drink from a cup, the side of a spoon,
or a rubber-tipped syringe. Then, in the stressful time
after the operation, it won't be necessary to
learn.
-
You'll probably need to take
the child in for blood tests prior to the
operation.
-
Check with your doctor before
giving the child any over-the-counter drugs in the days
before the operation.
-
The Night Before Surgery:
-
The child may be given
medicine to help bring on sleep.
-
The child should not eat or
drink anything---including water---for several hours before
the operation. Your doctor will tell you when to stop
feeding.
-
Call Your Doctor If...
-
Your child gets a cold or flu
or runs a high temperature. The surgery may need to be
postponed.
When You
Arrive
-
Check with your doctor before
giving the child insulin, diabetes pills, or any other
medicine.
What to Expect While You're
There
You may encounter the following procedures and equipment
during the child's stay.
-
Taking Vital Signs: These include your baby's
temperature, blood pressure, pulse (counting the
heartbeats), and respirations (counting the breaths). A
stethoscope is used to listen to the baby's heart and
lungs. Blood pressure is taken with a cuff around the
arm.
-
Blood Tests: Blood samples are usually needed for
tests. The blood can be taken from a vein in the hand or
the bend in the elbow.
-
Emotional Support: The child will feel safer in the
hospital when you're nearby. You'll be encouraged to stay
as long as you can.
-
Chest X-ray: The doctor will check this picture of
the lungs and heart to make sure there are no problems
before surgery. X-rays can also reveal signs of infection
such as pneumonia.
-
Heart Monitor: (Also called an electrocardiogram
[e-LEK-tro-KAR-di-o-gram] or EKG.) To check the baby's
heart, nurses will position 3 to 5 sticky pads on different
parts of the body. The pads are connected to a TV-like
screen or a small portable box (telemetry unit) that shows
a tracing of each heartbeat.
-
IV: A tube placed in your child's vein for giving
medicine and liquids. The IV will be capped or connected to
tubing and liquid.
-
Pulse Oximeter (oks-IH-mih-ter): A clip placed on
the baby's ear, finger, or toe will be connected to a
machine that measures the oxygen level in the
blood.
-
General Anesthesia: This will keep the child
completely asleep and pain-free during the operation. It
may be given as a liquid in the IV, as a gas through a face
mask, or through an endotracheal (end-o-TRAY-kee-ull) tube
or "ET tube" inserted through the child's
mouth.
During Surgery
The surgeon will make an incision in the lip, then use
the skin and muscle next to the cleft to fill the gap. When the
operation is finished, the incision will be sewn
up.
After Surgery
-
Activity:
-
Your child should not get out
of bed until the doctor says it's OK. If the youngster is
in a crib keep the side rails up at all times for
safety.
-
The child's mouth will need
protection after surgery. Padded boards will keep the
elbows straight and prevent the child from putting things
into his mouth. Take the restraints off 3 or 4 times a day
to exercise the child's arms, 1 arm at a time. Do not leave
the youngster alone when the restraints are
off.
-
Sucking, blowing bubbles,
laughing, and crying can put stress on the lip. Holding,
cuddling, and talking will help to keep the child calm and
happy. To minimize crying, also be sure to keep the child
fed, dry, and rested.
-
It's OK for the child to
sleep on his stomach.
-
Eating:
-
Your child can start drinking
liquids right after surgery. Use a cup, the side of a
spoon, or a rubber-tipped syringe. Do not use a bottle or
straw.
-
The doctor will tell you when
to start feeding your child soft foods that need not be
chewed. Applesauce, custard, pudding, or other mashed foods
are all good choices. Limit the diet to soft foods for
about 1 month. Don't give the child lollipops, or let him
feed himself. This could damage the surgery.
-
Intake and Output: The doctor may need to know how
much liquid your child is getting and how much he or she is
urinating. This is often called "I&O."
-
When the doctor says it's OK,
encourage the child to drink as much water as the doctor
allows. If the child is on I&O, keep a record of the
amount the child drinks.
-
Ask your doctor if it's OK to
flush the child's urine down the toilet, and whether you
should save the diapers.
-
Medicines:
-
Antibiotics: These medicines may be prescribed to
help fight bacterial infection. They may be given by IV, as
a shot, or by mouth.
-
Pain Medicine: This may be given in the child's IV,
as a shot, or by mouth. Tell your doctor or nurses if the
youngster's pain won't go away or keeps coming
back.
-
Anti-Nausea Medicine: If the pain medicine proves
upsetting, the doctor can prescribe additional drugs to
settle the stomach and control vomiting.
-
Oxygen: If extra oxygen is needed, the youngster may
be placed in a clear plastic mist tent or a high humidity
room to help ease breathing. Don't shut off the oxygen
supply without asking a doctor. This could leave the child
dangerously oxygen-deprived.
After You
Leave
-
Keep the stitches clean with
a cotton-tipped applicator and the liquid your doctor
recommends. Gently pat dry. You may use an antibiotic or
petrolatum after drying. You do not have to put on a
bandage.
-
Always give your child
medicine exactly as directed. If it doesn't seem to be
helping, tell the doctor, but don't quit giving it on your
own. If the doctor has prescribed antibiotics, be sure to
use them up even if the child seems to feel
better.
-
If the child's mouth is kept
moist, it will be more comfortable. Rinse it after each
feeding and at bedtime. To prevent choking, have the child
sit up with head thrust forward.
-
To reduce the risk of
infection, keep the child away from people with colds, flu,
or other diseases until the surgery has
healed.
Call Your Doctor
If...
-
The child develops itchy,
swollen skin or a rash. This could be a sign of allergy to
a medicine.
-
The child is running a high
temperature.
-
The child's pain gets worse
or won't go away.
-
You see pus coming from the
stitches, or the area around them is red and swollen. These
are signs of infection.
-
The stitches come
apart.
-
You have problems feeding the
baby.
Seek Care Immediately
If...
-
The child suddenly can't
breathe; or has blue lips, fingernails, or toenails. The
airway may be blocked, or the child could be having an
allergic reaction. Either way, this is an emergency.
Call (0) operator or 911 to get help right
away.
Return to top
|
|
Answer questions, check symptoms, find resources
Take action, achieve goals, resolve a problem
|
Email this page
Printer friendly
Bookmark this page
