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Cleft Lip And Cleft Palate Repair

WHAT YOU NEED TO KNOW:

Cleft lip and cleft palate repair is surgery to close the openings in your child's lip and mouth. Your child may have a cleft lip repair, a cleft palate repair, or both.


DISCHARGE INSTRUCTIONS:

Seek care immediately if:

  • Your child's stitches come apart.
  • Your child's stitches are red, swollen, or draining pus.
  • Your child has severe pain.
  • Your child will not eat or drink.
  • Your child cries without tears.
  • Your child's lips, mouth, and tongue are very dry.
  • Your child's eyes look sunken in.
  • Your baby's fontanelle (soft spot on the top of the head) is sunken.
  • Your child urinates very little or none at all.

Contact your child's healthcare provider or specialist if:

  • Your child has a fever.
  • Your child has chills, a cough, or sounds congested.
  • You feel overwhelmed and need help to feed your child.
  • Your child does not eat as well as he or she usually does.
  • Your child acts tired, sleepy, restless, or fussy.
  • Your child has a fever, ear pain, and trouble hearing.
  • You have questions or concerns about your child's condition or care.

Medicines:

Your child may need any of the following:

  • Antibiotics may be given to fight an infection caused by bacteria.
  • Prescription pain medicine may be given. Ask your child's healthcare provider how to give this medicine safely. Some prescription pain medicines contain acetaminophen. Do not give your child other medicines that contain acetaminophen without talking to a healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your child's healthcare provider how to prevent or treat constipation.
  • Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
  • Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.

How to feed your child:

Feeding your child can be difficult. Try to be calm and patient. This will help your child relax as he or she eats. Teach others how to feed your child. This will give you support and help you manage stress. The following tips will help you feed your child:

  • Breastfeeding helps your child suck better because your breast fills the cleft. Breastfeeding also decreases your child's risk of ear infections and helps strengthen the muscles he or she uses to eat.
  • Healthcare providers will work with you to find the best bottles, nipples, and other supplies to feed your child. Ask providers about bottles and nipples made for children who have a cleft. If you cannot find these supplies, look for nipples with wide openings or a cross cut into the nipple. These nipples will help your child get more milk with each suck. You can also use squeeze bottles to help get the milk into your child's mouth. These supplies may help decrease your child's risk of choking.
  • Feed your child in an upright position. His or her head should be higher than the stomach. This will help prevent choking. It will also help keep liquids from coming out of your child's nose or going into his or her ears.
  • Feed your child slowly over 18 to 30 minutes. Burp him or her after every 1 to 2 ounces of liquid to decrease the amount of air swallowed.
  • Do not lay your child down with a bottle. This may increase the risk of choking, ear infections, and cavities.

Speech and nutrition therapy:

Your child may need therapy to help with his or her speech. You may also need to meet with a dietitian to learn the best foods for your child.

Protect your child's incisions:

Your child's mouth needs to be protected for 6 weeks after surgery. It may take this long for your child's mouth to heal. If the stitches are not protected, they could pull or break. This may cause more bleeding, pain, or scarring for your child. Your child may need another surgery if the stitches separate. It is important to watch your child at all times to prevent this from happening.

  • Do not let your child put his or her hands or objects into his or her mouth. Padded arm boards can be used to keep your child's elbows straight. This will help keep your child from rubbing his or her face with his or her hands or upper arms. Long sleeves should be worn under the arm boards to keep them from rubbing on your child's skin. Remove the arm boards 3 to 4 times a day so your child's arms can get exercise. Do not leave your child alone when the arm boards are off.
  • Do not let your child sleep on his or her stomach. Your child should sleep on his or her back or side. This will help prevent your child from rubbing his or her face on the sheets. Dress your child in clothes that snap or button in the front.

Help prevent infection:

  • Keep your child away from people with colds, the flu, or other infections until his or her mouth is healed.
  • Keep the inside of your child's mouth wet. This will help keep the surgery area clean. Sit your child up with his or her head forward to prevent choking. Gently spray water or salt water on the roof of his or her mouth with a spray bottle as directed. Do this after each feeding and at bedtime.

For support and more information:

  • Cleft Palate Foundation
    1504 E. Franklin St, Ste. 102
    Chapel Hill , North Carolina 27514-2820
    Phone: 1- 919 - 933-9044
    Web Address: http://www.cleftline.org

Follow up with your child's healthcare provider or specialist as directed:

Your child may need to return for more tests. He may also need to have his weight measured. Write down your questions so you remember to ask them during your visits.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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