Day One: Recognizing and Communicating a Cleft at Birth
What happens the day Mateo is born: how do we examine the finding, and how do we tell his family?
💡 Day-one care is a careful exam plus clear, humane communication, not a rush to name a cause.
What you will learn
Goal: Students will perform a structured newborn lip-and- exam (inspection plus ), distinguish what is and is not found, and communicate a finding to a family clearly and without obsolete or alarming language.
- A is a congenital (present-at-birth) gap left when parts of the face that normally grow together did not fully join.
- The combines inspection (looking, with a light) and (feeling the with a gloved finger), because some palate defects are felt more reliably than seen.
- The pediatrician checks the whole baby for other findings, because whether a travels alone or with other features shapes everything that comes next.
- The word 'harelip' is obsolete and demeaning; the correct terms are lip, cleft , and cleft lip and palate.
Model: The delivery-room exam and two ways to say the same news
You run the same head-to-toe on Mateo (a composite teaching case, not a real patient) and pay special attention to the lip and the roof of the mouth, writing what you find AND what you do not find. Looking at the lip: a visible gap runs through the upper lip on the LEFT side, up toward the left nostril; the right side is intact. Looking inside with a light: the is open in the and you can see up into the nasal . Palpating the palate (a clean gloved finger along the roof of the mouth): the bony ridge is not continuous, so the gap is real and extends back. Checking the rest of the baby: ears, eyes, jaw size, hands, feet, heart sounds, breathing, and tone are all normal, and you find no other birth defects. You did two things, you looked and you felt, because some palate problems are easier to feel than to see.
Now compare two scripts for telling the family. Script A: 'Your baby has a harelip. It is a serious deformity.' Script B: 'Your baby was born with a lip and . This is one of the most common things a baby can be born with, and there is a whole team and a clear plan to help him. He is breathing well and otherwise healthy.' Script B names the finding plainly, gives a true reassuring fact (clefts are on the order of 1 in 700 births), and points to a plan, without hiding anything.
Explore (work the model before reading on)
- Name every structure you examined on Mateo. Which two did you find a gap in, and which side was the lip on?
- You both looked at and felt the . Why might catch something inspection alone could miss?
- Compare Script A and Script B. List two specific things Script B does that Script A does not, and say how each would land for a frightened parent.
- You found no other birth defects on Mateo's exam. Why is it worth writing down what you did NOT find, not just what you did?
- Predict: if a baby had a only in the soft back part of the , with the lip and gums looking normal, would a quick glance at the face catch it? What does that tell you about how thorough the has to be?
- In one sentence, what does day-one care for a actually consist of?
Guided notes
What a cleft is and how you confirm it
- A is a ______ (present-at-birth) gap that forms when facial structures that should fuse do not fully join.
- The team confirms the finding with a combining inspection (looking) and ______ (feeling the with a gloved finger).
Examining the whole baby
- The pediatrician checks the whole baby for other findings, because whether a travels alone or with others shapes everything next.
- For Mateo, the exam finds the and ______ other birth defects.
Communicating the finding
- The word 'harelip' is ______ and should never be used; the respectful term is lip and/or .
- Good news-giving names the finding plainly, states a true reassuring fact, and points the family to the multidisciplinary ______ and the plan.
Reading the Research
- Skim the title and abstract first to get the gist.
- Circle the one sentence that states the main claim.
- Box the evidence the authors give for that claim.
- Mark one sentence that confuses you, and move on.
Vocabulary (the same words your classes use)
Track your progress today
Check these off as you work through the lesson, then submit. This tells Mr. Mendoza how you're doing so he can help the class. It does not replace turning in your producible.
Use the code Mr. Mendoza gave you, not your name. Saved on this device.
- Read the Model and answered the Explore questions.
- Filled in the guided notes in my own words.
- Defined the new vocabulary with an example.
- Built the producible: Write the two opening lines you would actually say to Mateo's parents in the delivery room, then write the single intake line for his chart (term newborn, left unilateral cleft lip with cleft palate on inspection and palpation, otherwise unremarkable, no other anomalies, family informed, cleft team activated), underlining the words that keep it respectful.
- Wrote my Claim, Evidence, and Reasoning exit ticket.
Exit ticket (Claim, Evidence, Reasoning)
- Claim: Day-one care is mostly about (examining and communicating / naming the genetic cause).
- Evidence: On Mateo, the pediatrician inspected and palpated the ____ and ____, found a left and ____ other anomalies, and told the family using the term ____ instead of an obsolete word.
- Reasoning: Naming a cause comes later; the first hour is for accurate observation and humane communication because ____.
| Criterion | Proficient | Developing | Beginning |
|---|---|---|---|
| Complete | Every required part of the artifact is present and filled in. | Most parts are present, but one is missing or left blank. | Several parts are missing. |
| Accurate | The science and data are correct and match the evidence. | Mostly correct, with a small factual slip. | Key science or data is wrong. |
| Scientific reasoning (CER) | States a claim, backs it with specific evidence, and explains the reasoning. | Has a claim and evidence, but the reasoning is thin or missing. | Gives an answer with no evidence or reasoning. |
| Professional communication | Clear, organized, and labeled the way a clinician or scientist would write it. | Readable but disorganized or missing labels. | Hard to follow. |
| Submitted | Turned in the right way (Schoology for routine work) and confirmed. | Turned in, but in the wrong place or unconfirmed. | Not turned in. |
- CompleteProficient: Nothing is left blank: the model fills every part of "Write the two opening lines you would actually say to Mateo's parents in the delivery room, then write the single intake line for his chart (term newborn, left unilateral cleft lip with cleft palate on inspection and palpation, otherwise unremarkable, no other anomalies, family informed, cleft team activated), underlining the words that keep it respectful.".
- AccurateProficient: Every number and claim matches the case evidence.
- Scientific reasoning (CER)Proficient: It names a claim, cites the specific evidence, and explains the reasoning, not just the answer.
- Professional communicationProficient: It is organized and labeled like a real chart note.
- SubmittedProficient: It would be turned in on Schoology and confirmed.
Where this leads: careers
What's next: We saw and named Mateo's , but 'a cleft' is not precise enough for a chart or a surgical plan. Exactly which structures are split, on which side, and how completely? We need the team's shared language for describing it.