Planning for What to Expect After Your Child’s Cleft Lip Repair/Revision

Cleft lip repair is initially done at three or four months of age to reconnect the tissue and muscle that is open because of a cleft. Most children with cleft lip use a presurgical orthopedic appliance that helps move the lip, nose and gum line to a better position before surgery. 

The information in this handout will help you plan for what to expect as your child recovers from surgery. 

Your surgeon will repair the skin and muscle tissue of your child’s lip to close the gap created by the cleft. The incision (the place where your surgeon makes a cut) will go all the way to the nose so that all of the structures of the lip line up. Stitches are dissolvable and will resorb (go away) in 1-3 weeks. Stitches do NOT need to be removed. 

You will have a clinic follow up appointment 7-10 days after your repair.

The area around the incision (the cut your surgeon makes) will swell as it heals. The swelling will be the worst the day after surgery and then will gradually go away. 

Your child might have small white strips (steristrip) and a liquid adhesive over the incision to help close the wound. Both of these will fall off in three to seven days. We might recommend you use an antibiotic ointment to keep the incision area moist. Your child may be on an oral antibiotic for three to five days after surgery. 

You might need to use new feeding equipment or change your child’s diet after the surgery. After lip repair or revision, your child can eat as soon as he or she is comfortable. For bottle-fed infants, this means feeding with the specialized nipple they used before surgery. For breast-fed infants, feeding is usually possible if only the lip was involved in the repair. If the palate is still unrepaired, the infant can’t create enough suction to get milk from the breast. Specialized bottles are required until after the palate is repaired (if needed).

Older children can eat their normal diet after lip revision, but should avoid hard, crusty foods that might bother the incision area. We also recommend cutting foods into small bitesize pieces. 

You need to prevent your child from rubbing or scratching the incision. We’ll provide you with no-no sleeves for you to use when you aren’t able to watch your child. The sleeves keep children’s hands away from their mouths. If your child is still able to scratch at the incision, you might have to stop using the sleeves and watch your child closely. You’ll likely be able to stop using the no-no sleeves after a week. 

Use your best judgment to decide when your child should return to child care. Infants can usually return once they are back on a regular feeding schedule and are comfortable. Your child needs to be in an especially safe and clean environment while his or her incision is healing. 

Your nurse or doctor will give you more instructions when you leave the hospital.