The Primary Care Pediatrician and the Care of Children With Cleft Lip and/or Cleft Palate

Abstract

Orofacial clefts, specifically cleft lip and/or cleft palate (CL/P), are among the most common congenital anomalies. CL/P vary in their location and severity and comprise 3 overarching groups: cleft lip (CL), cleft lip with cleft palate (CLP), and cleft palate alone (CP). CL/P may be associated with one of many syndromes that could further complicate a child's needs. Care of patients with CL/P spans prenatal diagnosis into adulthood. The appropriate timing and order of specific cleft-related care are important factors for optimizing outcomes; however, care should be individualized to meet the specific needs of each patient and family. Children with CL/P should receive their specialty cleft-related care from a multidisciplinary cleft or craniofacial team with sufficient patient and surgical volume to promote successful outcomes. The primary care pediatrician at the child's medical home has an essential role in making a timely diagnosis and referral; providing ongoing health care maintenance, anticipatory guidance, and acute care; and functioning as an advocate for the patient and a liaison between the family and the craniofacial/cleft team. This document provides background on CL/P and multidisciplinary team care, information about typical timing and order of cleft-related care, and recommendations for cleft/craniofacial teams and primary care pediatricians in the care of children with CL/P.

Glue Ear in Children with Cleft Lip and Palate: An Update

“…Compared to healthy children, children with CLP are more susceptible to OME [4,5]. Even though the vast majority of patients (approximately 80%) do not have OME at birth [6], statistics have shown that OME occurs at least once before the first birthday in up to 90% of the infants born with CLP [3,7]. Furthermore, as many as 97% of the infants born with CLP suffer concurrent OME within the first two years of life [8].…”

Nursing Care of an Extremely Preterm Infant with Sodium Taurocholate Cotransporting Polypeptide Deficiency: A Case Report

“…Thus, the growth and development of an infant with a cleft palate was lower than the standard [21]. Furthermore, the early feeding of children with cleft palate is correlated with the success of surgery and the patient's prognosis [22]. Therefore, it is very important to master the correct feeding method to maintain the normal growth and development of patients.…”

The transition of breastfeeding children with cleft palate and lip among women

“…Individuals affected by the CLP and their families suffer a great impact in the life quality and psychosocial wellbeing, as this alteration could lead to repercussions on speech, respiration, feed and dental problems. [8][9][10][11] Given the complex context which involves the care for the child with CLP and, specially, the breastfeeding process, it proposes to discuss the maternal transition in the process of breastfeeding child with cleft lip and/or palate, in view of the transition theory.…”