Cleft palate, cleft lip and cheilo-palato-schizis - Medical Therapy

Neonatal care includes medical therapy and special diet techniques for children with craniofacial defects: cleft palate or cleft.
Neonatal care.A newborn with cleft face three major problems:-Risk of aspiration of liquids through oral communication between the mouth and nose-Airway obstruction and respiratory sequelae that occur if the defect is associated with migrognatia-Difficulty of Food and nasal regurgitation.These three major difficulties are compounded by the frequent association of other defects of craniofacial and neck area.
Feeding children with cleft.Most affected children are born with normal weight. Due to the difficult food and other problems encountered, therefore most frequently encountered in these children is weight loss. Most affected children are not breast fed. Those with cleft palate can not create a negative pressure necessary to suction the oral cavity.Mothers of children with cleft lip unilateral defect coverage can help your child through the breast.
There is no universally correct technique or method suitable for food. Most children finish eating in 18 to 30 minutes. If you need more than 45 minutes, the child struggles to suck and eat too much of their calories, Nelu weight. A child who is breast fed or bottle every 3-4 hours in weight tends to win more than one that is often fed to more than 2 hours for short periods.
Eating one cleft child.If one cleft lip, the child usually does not have eating disorders, besides learning how to keep nipple in the mouth. Children with cleft palate can suck the milk from the nipple through its compression between tongue and a portion of the palace.
It is helpful breast massage and hot compress for 20 minutes before feeding. Mom must press the areola with its finger to help angorjat nipple protrusion. The child should be kept in semi-raised position or football. Mother can maintain itself the breast, to ensure that the child's lower lip and the tongue is in its correct position is under the nipple.
If the child can not keep the nipple in the mouth for more tinp mother can collect the remaining milk with an electric or manual milking bottle meet. It is important to increase the amount of liquid consumed by the mother to increase the amount of milk.
Feeding with human milk from the bottle.For children who have cleft palate and lip bilateral, breast feeding is not possible. Mom can use a breast pump to gather and provide child milk bottle.
Feeding with formula milk bottle.Artificial milk formula that is required to be chosen by a child's pediatricians. Especially for these children are different types of teats and soothers. A soft nipple is more effective than the last one (which can be softened by boiling). You can use a nipple ribbed to prevent slipping. Any nipple can be channeled manually using a knife with teeth. It is important that the striate area to be in contact with the child's language.
String and the bottle must be relaxed, not gathered continuously.Nipple is oriented in the opposite corner of the mouth to the cleft.The child should be allowed a meal a few seconds to sneeze and cough when reflux occurred nose.
Complications of cleft besides eating difficult.
Upper airway obstruction.May be present in children with cleft palate, especially those with hypoplasia Pierre-Robin sequence manidibulara-. Obstruction result from posterior positioning of the tongue, which inspired prolapse into the pharynx. Nasal obstruction can result in tongue protrusion in the nasal cavity.Can be controlled by placing the child in position of pronation to prevent prolapse of the tongue. In severe cases where the obstruction is not resolved by conservative measures, may require a tracheotomy.
Otitis media.It is a common complication of cleft palate and is present in almost all children with cleft uncorrected. Although recurrent suppurative disease can be a problem, the primary complication of middle ear effusions is permanent hearing loss.
Therapeutic protocol used in the treatment of cleft centers include:-At the age of cleft lip repair 3 months, and placement of ventilation tubes-At the age of 6 months of orthodontics prechirurgicale interventions, if necessary, assessment of spoken language-At the age of 9 months to begin therapy, speech therapy spoken language-At the age of cleft palate repair 9-12 months, and placing a ventilation tube-At the age of 1-7 years-orthodontic treatment-At the age of 7-8 years, alveolar bone graftingAge-8 years-continuous orthodontic treatment.