After Cleft Lip or Palate Surgery
Your child recently had surgery to help repair his or her cleft lip, cleft palate, or both. As your child recovers, take these steps to help ensure that he or she heals properly.
Give your child any prescribed pain medicine as directed. It’s best not to wait until pain gets bad to give the medicine. But you may not know when your child is feeling pain. Your child may be in pain if he or she:
Has a high fever
Refuses to eat or drink
Cries a lot
Your child’s healthcare provider will tell you when to give your child medicine. If the pain medicine doesn’t seem to be working, let the healthcare provider know right away.
Your child's healthcare provider will prescribe antibiotics to prevent infection. Be sure to give your child the antibiotics exactly as instructed.
Protecting the wound
To protect your child’s skin and help incision sites heal properly:
Keep the incision sites as dry as possible. Regular, gentle patting of the mouth with a clean cloth can help.
Don’t put any cream or lotion on the incisions unless instructed to do so.
Keep your child’s hands away from the incisions. To do so, you’ll need to use gentle restraints (see below) on his or her arms for 7 to 10 days after surgery. Nursing staff will show you how to safely restrain your child.
Feeding your child
Your child’s healthcare provider will decide the best way for your child to eat after the surgery. Detailed instructions will be given to you so that you can feed your child at home. Follow these instructions closely. You may be told to:
Feed your child by mouth, but only soft or liquid foods for at least 10 days. Avoid straws and crunchy foods.
Give special feedings with a rubber-tipped syringe if needed. This keeps the child from swallowing, which causes the palate muscles to pull apart and open the stitches.
Issues and concerns after surgery
Gentle restraint. After surgery, your child’s arms will to be gently restrained to keep him or her from touching the wound. These soft arm restraints may look odd at first, but they are needed to protect your baby’s mouth.
Eating and drinking. Feeding can be difficult after surgery. Your child’s mouth will be sore and swollen. Also, it will take time for your child to get used to the new shape of his or her mouth. If your child has a cleft palate, he or she will need to relearn how to swallow. The speech pathologist will work with you and your child during this time to be sure your child is able to eat and drink.
Ear infections. A child with a cleft palate is more prone to ear infections, even after repair surgery. To prevent this, tiny ear tubes to help drain fluid from the ear may be put into the child’s eardrums. These tubes are often inserted during repair of a cleft palate. As your child grows, the tubes will likely need to be replaced.
More surgery. Your child may need a number of surgeries to repair the lip, nose, gum, or palate. Your child’s healthcare team will work with you to schedule any additional surgeries.
Emotional support. Your child’s healthcare team will talk to you and your child about any ongoing needs, issues, or concerns related to your child’s cleft. Be sure to ask any questions you may have.
When to call your child's healthcare provider
Call your child's healthcare provider if your child has any of the following:
Fever of 100.4°F (38.0°C) or higher, or as directed by your child's healthcare provider
Increased redness of incisions
Bleeding or drainage from incisions
Darkening or bluish lip or palate
November 19, 2017
Bass, Pat F III, MD, MPH,Kacker, Ashutosh, MD