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# Malformations ## Cleft Palate * **Teaching:** Teach parents feeding techniques and encourage use of special nipples. * **Surgical repair:** Typically between 12 and 18 months. ## Cleft Lip * **Repaired:** Before 6 months. * **Teaching:** May use elbow restraints to avoid scratching of the inci...

# Malformations ## Cleft Palate * **Teaching:** Teach parents feeding techniques and encourage use of special nipples. * **Surgical repair:** Typically between 12 and 18 months. ## Cleft Lip * **Repaired:** Before 6 months. * **Teaching:** May use elbow restraints to avoid scratching of the incision. * **Feeding:** A syringe with a rubber tip, a long nipple with a large hole attached to a squeeze bottle, or a medicine dropper can be used to feed the infant formula or breastmilk. * **Important Considerations:** Avoid sucking motions to keep from applying tension on the suture line. Do not place infant on abdomen. Eat in upright position. # Malformations ## Hip Dysplasia * **Manifestations:** * Limited abduction of the leg on the affected side * The knee on the affected side is lower, and the skin folds of the thigh are deeper and often asymmetrical * When the infant is in a prone position, one buttock appears higher than the other. * **Treatment:** Begin immediately on detection of the dislocation. The hips are maintained in constant flexion and abduction for 4 to 8 weeks to keep the head of the femur within the hip socket. * **Treatments (based on age):** * Pavlik harness - infants 1-6 months * Spica cast - several months **Figure 14.9** depicts early signs of dislocation of the right hip: A) Limitation of abduction B) Asymmetry of skin folds C) Shortening of femur (From Ross)