Cleft Lip, Cleft Palate Surgery

Care After

Surgery for a cleft lip is done to close the the gap (cleft) in the child's upper lip. Surgery for a cleft palate is done to close the the gap in the roof of the mouth. The gap in the lip or the mouth might have been a small notch or a wide opening. This can make it hard for the child to eat or speak. Sometimes it affects breathing. Children with a cleft palate are prone to ear infections. The condition affects the child's appearance. Surgery to close the gap (reconstructive) is the first step toward fixing these conditions.

Here is what happened during the surgery.

  • For a cleft lip:

  • The skin and muscle on both sides of the cleft were stitched together.

  • The goal was to close the gap and restore the alignment of the lip and improve the symmetry of the nose.

  • For a cleft palate:

  • Tissue and muscles on the roof of the child's mouth were repositioned (moved).

  • The area was then stitched closed.

  • If the child had many ear infections, tubes might have been put in the ears. The tubes will help the ears drain. The child should have fewer ear infections.

HOME CARE INSTRUCTIONS

  • Before your child goes home from the hospital, be sure to ask how the incision area should be cleaned.

  • Make sure your child takes any medication that the surgeon prescribes. Follow the directions carefully.

  • Only give your child over-the-counter or prescription medicines for pain, fever, or discomfort as directed by your caregiver.

  • Your child's mouth and face may be swollen. This will go away. But, it might take a week.

  • Incisions on the face are usually cleaned to keep food and debris off the incision. You will be given instructions on how to wash the incision.

  • Keep your child out of the sun until any wounds on the face are healed.

  • Some children need arm splints to keep them from touching the incision. Arm splints also keep them from sucking their thumb. The splints may be taken off for bathing or changing, but someone will need to watch your child very closely to make sure the child's hands stay away from the mouth.

  • Do not let your child use a pacifier for several weeks after the surgery, or until the surgeon says it is OK.

  • Eating may be difficult after this type of surgery. Ask your child's healthcare team for instructions and advice. You might be given a special bottle to help feed your child. Or, you might use a a plastic device like a needle (syringe). This lets you push liquid or very soft food into the child's mouth. If your child has had cleft palate surgery, they will usually need a soft diet. They will not be allowed to have hard foods such as crackers, chips, or pizza.

  • For the first week or so after the surgery, the child might be more fussy than usual. Sleeping also might be difficult.

  • The child will have stitches. Sometimes the stitches go away (dissolve) on their own. Other times, they must be taken out by your child's healthcare provider. Ask which type your child has so you know what to expect.

  • Be sure to take your child to all follow-up appointments.

SEEK MEDICAL CARE IF:

  • You notice blood or fluid leaking from the incision. Or, the area around it becomes red or swollen.

  • Your child is not eating or drinking comfortably.

  • Your child has trouble making sounds appropriate for a child of that age.

  • Your child throws up for more than 2 days after going home from the hospital.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child has trouble breathing.

  • Your child is extra fussy and cannot be comforted.

  • Your child seems to be in pain.

  • Your child who is younger than 3 months develops a fever.

  • Your child who is older than 3 months has a fever or persistent symptoms for more than 72 hours.

  • Your child who is older than 3 months has a fever and symptoms suddenly get worse.