Cleft lip and palate repair - discharge
Orofacial cleft - discharge; Craniofacial birth defect repair - discharge; Cheiloplasty - discharge; Cleft rhinoplasty - discharge; Palatoplasty - discharge; Tip rhinoplasty - discharge
When Your Child Was in the Hospital
Your child had surgery to repair birth defects that caused a cleft in which the lip or the roof of the mouth did not grow together normally while your child was in the womb. Your child had general anesthesia (asleep and not feeling pain) for the surgery.
What to Expect at Home
Children will have stuffy noses and may have to breathe through their mouths for the first week. There will be some drainage from their mouths and noses. The drainage should go away after about 1 week.
Clean the incision (surgery wound) after feeding your child.
- Your doctor may give you a special liquid for cleaning the wound. Use a cotton swab (Q-tip) to do so.
- Begin at the end that is closer to the nose.
- Always begin cleaning away from the incision in small circles. Do not rub right on the wound.
- If your doctor gave you an antibiotic ointment, put it on your child's incision after it is clean and dry.
Some stitches will go away on their own. The doctor or nurse will need to take others out at the first follow-up visit. Do not remove your child's stitches yourself.
You will need to protect your child's incision.
- Feed your child only the way your doctor or nurse told you.
- Do not give your child a pacifier.
- Babies will need to sleep in an infant seat, on their backs.
- Do not hold your child with their face toward your shoulder. They can bump their nose and harm their incision.
- Keep all hard toys away from your child.
- Use clothes that do not need to be pulled over the child's head or face.
Young infants should be eating only breast milk or formula. When feeding, hold your infant in an upright position.
Use a cup or the side of a spoon for giving your child drinks. If you use a bottle, use only the kind of bottle and nipple that your doctor has recommended.
Older infants or young children will need to have their food softened or pureed for some time after surgery so it is easy to swallow. Use a blender or food processor to prepare food for your child.
Children who are eating foods other than breast milk or formula should be sitting when they eat. Feed them only with a spoon. Do not use forks, straws, chopsticks, or other utensils that can harm their incisions.
There are many good food choices for your child after surgery. Always make sure the food is cooked until it is soft, then pureed. Good food options include:
- Cooked meats, fish, or chicken. Blend with broth, water, or milk.
- Mashed tofu or mashed potatoes. Make sure they are smooth and thinner than normal.
- Yogurt, pudding, or gelatin.
- Small curd cottage cheese.
- Formula or milk.
- Creamy soups.
- Cooked cereals and baby foods.
Foods your child should not eat include:
- Seeds, nuts, bits of candy, chocolate chips, or granola (not plain, nor mixed into other foods)
- Gum, jelly beans, hard candy, or suckers
- Chunks of meat, fish, chicken, sausage, hot dogs, hard cooked eggs, fried vegetables, lettuce, fresh fruit, or solid pieces of canned fruit or vegetables
- Peanut butter (not creamy or chunky)
- Toasted bread, bagels, pastries, dry cereal, popcorn, pretzels, crackers, potato chips, cookies, or any other crunchy foods
Your child may play quietly. Avoid running and jumping until the doctor or nurse says it is OK.
Your child may go home with arm cuffs or splints. These will keep your baby from rubbing or scratching the incision. Your child will need to wear the cuffs most of the time for about 2 weeks. Put on the cuffs over a long-sleeve shirt. Tape them to the shirt to keep them in place if needed.
- You may take the cuffs off 2 or 3 times a day. Take off only 1 at a time.
- Move your child's arms and hands around, always holding on and keeping them from touching the incision.
- Make sure there is no red skin or sores on your child's arms where the cuffs are placed.
- Your child's doctor or nurse will tell you when you can stop using the cuffs.
Ask your doctor or nurse when it is safe to go swimming. Children may have tubes in their eardrums and need to keep water out of their ears.
Your doctor or nurse will refer your child to a speech therapist. Most times, speech therapy lasts 2 months.
When to Call the Doctor
Call your doctor if:
- Any part of the incision is opening or stitches come apart.
- The incision is red, or there is drainage.
- There is any bleeding from the incision, mouth, or nose. If bleeding is heavy, go to the emergency room or call 911.
- Your child is not able to drink any liquids.
- Your child has a fever of 101 °F or higher.
- Your child has any fever that does not go away after 2 or 3 days.
- Your child has problems breathing.
Arosarena OA. Cleft lip and palate. Otolaryngol Clin North Am. 2007 Feb;40(1):27-60.
Friedman O, Wang TD, Milczuk HA. Cleft lip and palate In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 186.
Reviewed By: David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardens, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.