Cleft Lip and Cleft Palate Repair
|Infant With Cleft Lip|
|Copyright © Nucleus Medical Media, Inc.|
Reasons for Procedure
- Ear infections—fluid is not able to drain properly from the ear
- Hearing impairment
- Speech problems
- Dental problems such as missing or malformed teeth
- Feeding difficulties—A baby with a cleft lip may have a hard time sucking. A cleft palate can cause milk or formula to enter the nasal cavity.
- Close the separation in the lip.
- Create a curve in the middle part of the upper lip.
- Create the right amount of distance between the upper lip and the nose.
- Allow the lips to close with a tight seal.
- Scars not healing correctly
- Reaction to the anesthesia
- Damage to nerves, blood vessels, muscles, or lungs
What to Expect
Prior to Procedures
- Order tests such as blood tests, urine tests, and x-rays
- Ask about your child’s medical history and do a physical exam
- Give you a chance to ask questions about the surgeries and recovery process
Description of the Procedures
Immediately After Procedures
How Long Will It Take?
- Cleft lip repair—about two hours
- Cleft palate repair—2-4 hours
How Much Will It Hurt?
Average Hospital Stay
- Give your child nutrition and fluids through a vein in the arm, then later by mouth.
- Give oxygen through the nose, if needed.
- Give your child pain medication.
- Use elbow splints to keep your child’s hands away from his incisions.
- Washing their hands
- Wearing gloves or masks
- Keeping your child's incisions covered
- Washing both you and your child's hands often, and reminding visitors and healthcare providers to do the same
- Reminding your child's healthcare providers to wear gloves or masks
- Not allowing others to touch your child's incision
- If your child had cleft lip repair, clean the incision areas throughout the day, especially after feedings.
- Give your child pain medication as needed. If your child had a cleft lip repair, you may need to put ointment on your child’s lip. Your child may also need antibiotics.
- Use elbow splints to keep your child’s hands away from the incision area. You will be able to remove the splints throughout the day while you watch your child closely.
- At first, your baby will be given fluids using a special bottle with a rubber-tip syringe or a spoutless cup. You will then be instructed to resume your baby’s normal breastmilk or formula feedings. If your child had cleft lip repair and is old enough, you will be able to feed them a soft diet using a spoon. If your child had cleft palate repair, start with a liquid diet, because food and utensils could interfere with the healing process.
- Your child will be uncomfortable and irritable. Comfort your child.
- Ask the doctor about how to wash your child's face and when it is safe for your child to bathe or soak in water.
- If your school-age child had surgery, they may struggle with teasing from their classmates. Encourage your child to talk to you. Be there to listen to their concerns. Your child may also benefit from working with a therapist. This can help them cope with their condition and surgeries.
- Apply sunscreen to your child’s face, especially on the healed incision area.
- Be sure to follow the doctor’s instructions.
Call Your Child’s Doctor
- Signs of dehydration —little or no urination, sunken soft spot on head in babies, no tears when crying, dry and cracked lips
- Signs of infection, including fever and chills
- Refusal to drink
- Redness, swelling, increasing pain, or bleeding or discharge from the incision site
- Cough or shortness of breath
- Nausea or vomiting
- Any new symptoms
Birth Defects Centers for Disease Control and Prevention http://www.cdc.gov
National Institute of Dental and Craniofacial Research http://www.nidcr.nih.gov
Birth Defect Research for Children http://www.birthdefects.org
Health Canada http://www.hc-sc.gc.ca
Cleft lip and cleft palate repair. American Society of Plastic Surgeons website. Available at: http://www.plasticsurgery.org/x7352.xml. Accessed August 21, 2013.
Cleft lip and palate. Nemours Kids Health website. Available at: http://kidshealth.org/parent/medical/ears/cleft%5Flip%5Fpalate.html. Updated January 2011. Accessed August 21, 2013.
Cleft lip and palate. Pediatric Plastic Surgery website. Available at: http://smilesforkids.missouri.edu/common%5Fconditions/clp.php. Accessed August 21, 2013.
Rosen H, Barrios LM, Reinisch JF, Macgill K, Meara JG. Outpatient cleft lip repair. Plast Reconstr Surg. 2003;112(2):381-387.
What to expect: cleft lip surgery. University of Missouri Children’s Hospital, Pediatric Plastic Surgery website. Available at: http://smilesforkids.missouri.edu/for%5Fparents/cl%5Fexpectations.php. Accessed August 21, 2013.
- Reviewer: Michael Woods, MD
- Review Date: 09/2013 -
- Update Date: 00/12/2014 -