Cleft Lip and Cleft Palate

Tier: NP Clinical focus: Diagnosis, feeding safety, growth surveillance, surgical coordination, complication prevention, family counselling, and long-term interprofessional follow-up. 1. Overview Cleft lip and cleft palate are congenital craniofacial anomalies caused by incomplete fusion of facial/oral structures during embryologic development. Cleft lip forms when upper lip tissue does not fully join, typically during weeks 4–7 of gestation. Cleft palate forms when the palate does not fully fuse, typically during weeks 6–9 of gestation. Cleft lip may occur alone, with alveolar involvement, or with cleft palate; cleft palate may also occur alone, including submucous forms that are sometimes diagnosed later. In the United States, CDC estimates about 1 in 1,031 babies are born with cleft lip with or without cleft palate, and about 1 in 1,563 babies are born with cleft palate alone. 2. NP-Level Pathophysiology The NP should connect the anatomy to the functional problem: Cleft lip mainly affects the infant’s ability to create an effective seal around the nipple. Cleft palate affects the infant’s ability to separate the oral and nasal cavities. The infant cannot generate normal negative pressure/suction,...