Nursing Management of the Newborn at Risk

Nursing Management of the Newborn at Risk

Acquired and Congenital Newborn Conditions

Mandy just gave birth vaginally to her first child. Mandy and James had attended prenatal classes and had a natural childbirth. They were totally unprepared to see that baby “Rose” has a severe left-sided unilateral cleft lip and cleft palate. James is having a hard time with this and just keeps staring at the baby. Mandy begins to cry and states “I thought I was going to breast-feed my baby and now it’s impossible.” (Learning Objectives 12, 14, and 15)

  1. A. Discuss the implications for bottle feeding and breast-feeding a baby with a unilateral cleft lip. Is it possible for Mandy to breast-feed Rose?
  2. B. What is involved in the surgical correction of the defect? When can she eventually have a “normal” mouth and facial features?
  3. C. What other problems may develop for Rose since she has this type of defect?
  4. D. How can you assist the family bond with Rose?







Nursing Management of the Newborn at Risk




Student’s Name







Nursing Management of the Newborn at Risk

Acquired and Congenital Newborn Conditions

In the monarchy of newborn care, the nursing management of the newborn at risk positions as a beam of hope as dedicated healthcare professionals sail unexplored waters to protect the brittle lives entrusted to their care. Nursing management of the at-risk newborn is essential to equipping infinite and specialized care to vulnerable infants. These infants are born with numerous factors, increasing their susceptibility to health complications and requiring careful monitoring, assessment, and intervention by certified nursing professionals. The main goal of nursing management in this population is to enhance the newborn’s well-being, reduce possible complications, and facilitate their transition to gestation life (Hockenberry & Wilson, 2018). To achieve this, nurses play a crucial role in conducting thorough assessments, executing evidence-based interventions, and partnering with multidisciplinary teams, ensuring the best possible outcomes for these at-risk newborns. By closely observing crucial signs, administering appropriate medications, equipping necessary nutrition, and engaging in family-centered care, nurses contribute crucially to the comprehensive care of the newborn at risk, perfecting their chances for a healthy start in life. This article will explore a case study on nursing management of the newborn at risk, where a couple got a child, and they were unprepared to see that the baby had a severe left-sided unilateral cleft lip and cleft palate. From the case study, the essay will discuss the implications of bottle feeding and breastfeeding a baby with a unilateral cleft lip and if it is potential for Mandy to breast-feed her daughter, what to be involved in the surgical correction of the defect, other problems that may develop for Rose due to her type of defect, and lastly look at the ways of helping the family bond with Rose.

Surgical Correction and Disclosing the Procedure Behind Correcting Defects

The surgical correction of a left-sided severe unilateral cleft lip and cleft palate consists of a series of processes performed by a particularized team of healthcare professionals involving plastic surgeons, oral and maxillofacial surgeons, and speech therapists. The main goal is to restore the cleft lip and cleft palate, permitting enhanced facial appearance, appropriate alignment of the oral structures, and restoration of normal speech and feeding capabilities. Typically, the first surgery to restore the cleft lip is done when the baby is around three to six months old (Shaw et al., 2019). This process involves creating incisions along the cleft edges and then accurately suturing the tissues together to redevelop the lip. The accurate method used may differ depending on the individual case. The cleft palate is customarily restored when the child is around nine to twelve months old (Zajac et al., 2021). This process involves rebuilding the mouth’s roof by closing the slit in the palate using surgical methods. This permits appropriate separation between the oral and nasal cavities, enhancing speech and swallowing abilities. While the surgical correction highlights the structural problems caused by the cleft lip and palate, more treatment may be needed to address connected concerns. These may involve speech therapy to assist the child in creating appropriate speech patterns and methods to overcome speech challenges resulting from the cleft. It is essential to note that each case is distinctive, and the timeline for acquiring a regular mouth facial characteristic can vary. The surgical correction is typically effectual in acquiring crucial enhancement, but more surgeries or processes may be needed as the child grows to refine the outcomes further. The main goal is to equip the child with a functional, aesthetic, and healthy mouth and facial appearance, but it may take numerous years of progressing treatment and support from a multidisciplinary team to acquire this outcome.

The Imputations for Bottle Feeding and Possibility of Breastfeeding for Babies with Unilateral Cleft Lip and the Possibilities of Mandy to Breastfeed Rose

A unilateral cleft lip and cleft palate can indicate problems with bottle feeding and breastfeeding. In Mandy and baby Rose’s case, it is possible for Mandy to breastfeed Rose with some modifications and support. Breastfeeding a baby with a unilateral cleft lip may need additional methods and help because of the baby’s challenges in developing a proper seal around the nipple (Adekunle et al., 2020). The cleft lip can impact the baby’s ability to latch successfully, leading to insufficient milk transfer and possible feeding challenges. Moreover, Mendy can still develop a productive breastfeeding relationship with her baby with appropriate guidance and support. Mandy must work closely with lactation experts and certified health professionals who are experienced in feeding infants with cleft lip and palate. They can equip her with techniques and implements to assist her in developing a better latch and facilitate appropriate milk transfer. For example, using a specialized nipple tool or positioning methods can enhance the baby’s ability to latch effectually. In other cases, supplemental feeding may be appropriate, ensuring the baby receives adequate nutrition. It can be achieved by combining breast milk with specially designed bottles or feeding systems, accommodating the cleft palate and permitting better control of milk flow.

It is vital for Mandy to pursue support from a multidisciplinary team containing lactation expertise, pediatricians, and specialists in cleft lip and palate care. They can offer guidance, address concerns, and provide practical solutions to assist Mandy in overcoming the difficulties linked with breastfeeding a baby with a unilateral cleft lip. While breastfeeding may need additional effort and support, it can offer various benefits for Mandy and her baby Rose. Breast milk consists of crucial nutrients and antibodies, improving the baby’s immune system and overall health (Jeurink et al., 2019). In addition, breastfeeding can stimulate bonding and emotional relation between the mother and the baby, encouraging a nurturing environment despite the initial difficulties. It is essential for Mandy and James to communicate their concerns and emotions to each other, as well as pursue emotional support from healthcare professionals, groups that offer support, and counseling programs. This can assist them in sailing through their feelings and adjusting to the new reality while equipping the best care for baby Rose.

Problems May Develop for Rose since she has a Severe Left-Sided Unilateral Cleft Lip and Cleft Palate

Rose may experience various other problems because of her condition besides the cleft lip and cleft palate. One of the biggest concerns is the challenges with feeding. The cleft lip and palate can make it difficult for her to develop an appropriate seal and suck successfully while breastfeeding (Alois & Ruotolo, 2020). This can result in insufficient nutrition and potential development issues if alternative feeding techniques are not established. In addition, Rose may be more permitted to often ear infections because of the abnormal structure of her palate, impacting the function of the Eustachian tubes and the drainage of fluids from the prominent ear. Speech development may also be impacted, as the cleft lip and palate can impede the proper formation of sounds, leading to speech challenges as Rose grows older. Moreover, Rose may encounter social and psychological problems linked to her facial appearance, as the cleft lip can have a visible influence on her physical appearance, possibly resulting in self-esteem issues and social stigma (Al-Namankany & Alhubaishi, 2018). It is essential for Mandy, James, and their healthcare provider team to equip comprehensive care and support, addressing these possible challenges and ensuring Rose’s well-being and growth.

Assistance to the Family Bond with Rose

In such a challenging moment, providing understanding, support, and guidance is essential to assist the family bond with baby Rose. Firstly, it is vital to reassure Mandy and James that their love and care for Rose are what truly matter. It is essential to assure them that despite the first shock and feelings of unpreparedness, they can offer the warmth and nurturing Rose requires. Fostering open communication and empathy between Mandy and James, permitting them to express their emotions and concerns. It is also vital to assist the family in comprehending that baby Rose’s cleft lip and palate can be restored through surgical intervention and offer information about available resources, like groups offering support and specialized healthcare professionals, offering guidance on breastfeeding methods, and accommodating Rose’s condition. By encouraging an environment of love, patience, and knowledge, the family can cautiously adapt and find ways to develop a solid and meaningful bond with Rose, constructing a foundation for her future well-being and growth.


The unexpected birth of baby Rose having a severe left-sided unilateral cleft lip and cleft palate has highlighted serious difficulties for Mandy and James. The status now complicates Mandy’s desire to breastfeed her baby. Moreover, with the appropriate support and resources, it is potential for Mandy to breastfeed Rose. The surgical correction of the defect will include numerous processes and interventions, accordingly resulting in a more normal mouth and facial features for Rose. Additionally, problems may develop for Rose because of her specific type of defect. Despite such challenges, it is vital to help the family bond with Rose, offering them the appropriate emotional support and information to sail this new journey together.



Adekunle, A. A., Adamson, O., James, O., Ogunlewe, O. M., Butali, A., & Adeyemo, W. L. (2020). Breastfeeding practices among mothers of children with orofacial clefts in an African cohort. The Cleft palate-craniofacial journal57(8), 1018-1023.

Al-Namankany, A., & Alhubaishi, A. (2018). Effects of cleft lip and palate on children’s psychological health: A systematic review. Journal of Taibah University Medical Sciences13(4), 311-318.

Alois, C. I., & Ruotolo, R. A. (2020). An overview of cleft lip and palate. Jaapa33(12), 17-20.

Hockenberry, M. J., & Wilson, D. (2018). Wong’s nursing care of Infants and Children-E-book. Elsevier Health Sciences.

Jeurink, P. V., Knipping, K., Wiens, F., Barańska, K., Stahl, B., Garssen, J., & Krolak-Olejnik, B. (2019). Importance of maternal diet in the training of the infant’s immune system during gestation and lactation. Critical reviews in food science and nutrition59(8), 1311-1319.

Shaw, W., Semb, G., Lohmander, A., Persson, C., Willadsen, E., Clayton-Smith, J., … & Williamson, P. (2019). Timing of Primary Surgery for the cleft palate (TOPS): protocol for a randomised trial of palate surgery at 6 months versus 12 months of age. BMJ open9(7), e029780.

Zajac, D. J., Vallino, L. D., Baylis, A. L., Adatorwovor, R., Preisser, J. S., & Vivaldi, D. (2021). Emergence of prevocalic stop consonants in children with repaired cleft palate. Journal of Speech, Language, and Hearing Research64(1), 30-39.

If you are having challenges with writing your nursing essay either because of lack of time or not knowing where to start, you can order your paper here 

Leave a Comment

Your email address will not be published. Required fields are marked *