Cleft palate surgery (1805)

What is a cleft palate?

Cleft means divided or split.  Palate refers to the roof of the mouth.  A cleft palate is a split in the palate.  It happens when the palate tissue does not close all the way as a baby develops in the womb. 

Surgery to repair a cleft palate is normally done once the child is about 9 to 12 months old.  If the child was born prematurely or has other health problems, surgery may be delayed.  The plastic surgeon will decide the best time for your child to have surgery.

What happens before surgery?   

• Your child will need to be weaned off of their bottle before surgery. The plastic surgery clinic nurses will talk to you about what type of cup to use.
• Call your child’s surgeon or nurse if your child is sick before the surgery, or if you have any questions.

How is it done?

• The surgery will take 1½ to 2½ hours.  The surgeon will come to the surgery waiting room to talk with you after the surgery is finished.
• The palate will be closed with stitches which will go away on their own after a few weeks.

What happens after surgery?

• Your child will stay in the hospital for 1 to 3 nights.  Parents can stay overnight with their child.
• Your child may have some discomfort for a few days after the surgery. Pain medicine may be given.  
• At first, your child will have an I.V. in the hospital. It will keep your child from getting dehydrated. It is also used to give medicines.
• Your child’s face may be swollen.  You may see a small amount of bleeding from the mouth and the nose.  
• Soft elbow immobilizers will be put on your child’s arms after surgery.  They keep the elbows from bending and keep the child from putting fingers and objects in the mouth while the palate is healing. Your child must wear the immobilizers 24 hours a day for about 2 to 3 weeks. They may only be taken off one at a time to give your child a bath or to exercise the arms. Watch your child closely when the immobilizers are off. It may be hard to keep them on, but the repair must be protected so it can heal properly.

After surgery continued

Diet

• Your child must eat only soft foods for at least 2 to 3 weeks after surgery.  Please follow your surgeon’s instructions.  No hard, crunchy, or sticky foods are permitted.  
• Use a cup without a cover, or a free-flowing covered cup.  No bottles are permitted.
• No straws are permitted. 
• Feed your child more often.  Offer fluids often during the day. 
• Do not let your child feed themselves the first 2 to 3 weeks after surgery.  This way you will be sure that your child will not harm the palate as it heals.

Home care

• The doctor may write a prescription for a liquid antibiotic medicine.  Give this to your child as directed.  
• Your child may have some discomfort.  Acetaminophen (Tylenol) is very helpful for this discomfort.  The surgeon may give you a prescription for pain medicine.
• Many children get fussy or crabby after going home from the hospital.  They may have problems eating or sleeping.  This is normal and should end within a week or two. 
• Keep the elbow immobilizers on your child at all times except for bathing.  Watch your child closely.  
• Do not let your child suck on fingers or a pacifier.  Do not let your child put anything in their mouth. 
• Limit your child’s play and activities after surgery.  Running or rough play could hurt the surgery area.  The doctor will tell you when your child can be more active again.

Follow Up

Make a clinic appointment to see your child’s surgeon as directed.  Your child will need be seen about 1 to 3 weeks after surgery.