Cleft Lip/Cleft Palate Repair: Discharge Instructions

The incision may appear to become wider and redder for 6 to 8 weeks following surgery. The incision will shrink lengthwise and the lip may be pulled upward. These changes are due to the normal tightening of the scar as it heals and are to be expected.

Over time, the lip will relax vertically and the scar will narrow, appear more like the child’s normal skin color and blend with the normal skin folds of the upper lip. All these changes will take place over the next 6 to 12 months.

The roof of your child’s mouth will be a little swollen and the stitches will be visible. Unlike cleft lip repair, where the stitches need to be removed in 5 to 6 days, the stitches in the cleft palate repair will slowly dissolve over the next 2 months.

At home, observe your child for signs and symptoms of infection. When checking for the following symptoms, please be sure to rule out any common childhood illness that can be referred to primary care physicians. Call Telehealth Nursing at 651-229-3890 if you notice any of the following:

• Excessive bleeding or warmth at the site of infection
• Red streaks near the incision
• Thick yellow or green drainage
• Foul odor from the incision
• Increased pain or tenderness not relieved by pain medication
• Fever of 101.5 F or higher

• Keep incision clean and dry.
• Do not rub at the incision to clean it. Do not clean vigorously. Just gently blot with a soft cloth moistened in warm water.
• Do not pick at the scabs or incision.
• Use NO-NO splints at night or when the child is unattended to keep the child from picking at the incision. Remove the splint every 4 hours to check for skin breakdown, areas of redness and to allow the child to exercise his/her arms to prevent stiffness. NO-NO splints are to be used for the first 1 to 2 weeks after surgery.

• Do not pick at the scabs or incision.
• Use NO-NO splints at night or when the child is unattended to keep the child from picking at the incision. Remove the splints every 4 hours to check for skin break down, areas of redness, and to allow the child to exercise his/her arms to prevent stiffness. The NO-NO splint should be used for 1-2 weeks following surgery.
• Do not allow the child to place any objects in the mouths, including pacifiers, teething rings or hands.

• Oral cares.
• Have your child drink water following meals to clean the mouth.
• It is OK to use a soft cloth to clean the teeth, if your child will tolerate it.
• Do not use a toothbrush in the mouth for two weeks following surgery.

Infants may go back to breastfeeding or drinking formula from a bottle following cleft lip repair.

Use soft spout sippy cup/plain cup following cleft palate repair. Bottles as directed by your Gillette health care provider.

We discourage use of straws, pacifiers or teething rings for 3 weeks following either surgery.

Children with cleft palate repair should have a full liquid diet and strained foods “without chunks” for two weeks. This will prevent pieces of food from becoming lodged in your child’s incision, promoting infection. (Vanilla yogurt, Jell-O, pudding, Cream of Wheat, strained baby foods, ice cream and any type of liquid are OK to serve.)

If your child is more than 12 months old, Pediasure, Kindercal or Carnation Instant Breakfast may help to add nutritious calories to your child’s diet. You also can add 3 tablespoons of nonfat dry milk powder to all strained foods to add extra calories and protein.

Twenty-four hours following surgery, most children are taking fluids well and pain is often controlled with plain Tylenol. Your children will be sent home with an antibiotic to be taken for five days following surgery to help prevent infection.

Return to clinic in _____ days to see your Gillette health care provider.

Contact Telehealth Nursing at 651-229-3890 if any of the following occurs:

• Fever over 101.5 F
• Throat irritation
• Severe pain