Cleft Palate Surgery - Postoperative Instructions

Cleft palate is a common and—fortunately—correctable birth defect. Surgery is required to close the gap in the palate, or "roof" of the mouth. This is a simple operation, but the lifetime benefits are immeasurable. Our skilled plastic surgeon and the surgical team at Golisano Children's Hospital will do their best to ensure your child's comfort and safety, as well as your peace of mind during the procedure. Often, it helps to know what to expect following surgery.

What to Expect

General

• For a week or two after surgery, your child may need extra attention and understanding. Don’t worry about “spoiling” your child during this time. It is OK to respond to your child’s need for extra holding and comforting.
• After surgery, your child will be sleepy for several hours. Your child will have an IV in place for giving fluids and pain medicines. It is common for children to have blood-tinged saliva for a day or two after surgery. If your child has any vomiting after the surgery this too may have blood in it, which is normal.

Feeding

• Your child’s palate is repaired with dissolving stitches, but the repair is delicate for several months after surgery. In order for the repair to heal well, you and your child should avoid putting anything hard in the mouth.
• Your child can use the same bottle and nipple as before surgery. Older children can use a cup with or without a lid, as long as the spout is very short and soft. If your child uses a sippy cup with a hard spout, it is safest to bring this to the office for the team to see and approve before hand. Do not use sports bottles, forks, or straws.
• It is OK to resume full liquids 2-3 days after surgery. This includes yogurt, thin cooked cereals, puddings, ice cream, creamed soups, thin pureed foods, or stage 1 baby foods. Use only a soft spoon and do not allow the spoon to enter deep into the mouth.
• It is OK to resume soft foods a few days after surgery. This includes soft cooked fruits and vegetables, noodles, cereal soaked in milk, bananas, etc. Use only a soft spoon and do not allow the spoon to enter deep into the mouth. No hard or crunchy food is allowed for 6 weeks after surgery. This includes no chips, hard cereals, cookies, or toast.
• It is not uncommon for children to not eat as much as usual for days or even a week or two after surgery. Most children eat more and “catch up” once they are feeling better. It is important, though, that your child gets enough liquids every day to stay hydrated. Signs your child is getting enough to drink include having a moist mouth, tears in the eyes when crying, and urinating regularly.

Activity

• For 6 weeks after surgery it is important to ensure that all play is supervised so that no hard toys are at risk of damaging the repair. Only soft toys or cloth toys should be used.
• Generally, most children are ready to return to daycare about 2 weeks after surgery. If you have concerns or questions about when your child can return, discuss these with the team. It is important to review the diet and activity restrictions with the daycare to make sure they have the supervision to enable a safe environment for healing.

Pain

• Your child may have some mild discomfort at home. We recommend alternating acetaminophen (Tylenol) and ibuprofen (Motrin) every 3 hours. If your infant is irritable and not feeding well, despite giving Tylenol and Motrin, he or she may need something stronger for pain. Your child will be prescribed a pain medication called Oxycodone. This should be given every 4-6 hours as needed for breakthrough pain. It is important to take all medications exactly as prescribed.
• If your child’s pain is not controlled on the above medications, please call our office to discuss this.
• Try to schedule a dose of pain medicine around bedtime, especially for the first few days at home. This will help your child sleep better

Constipation

• Keep track of your child’s bowel habits. He or she should return to previous bowel habits. If not, he or she may be constipated.
  • Call your child’s pediatrician or the Plastic Surgery team if you think your child is constipated.

Skin and Wound Care

• The incision is closed with absorbable sutures. You may offer your child a small amount of water after eating or drinking to wash out the mouth and keep things clean. Otherwise no wound care is needed.
• You can bathe your child in the tub as usual.

Follow-up

• Please make a clinic appointment for 2-3 weeks after surgery for a follow-up visit.
• After this visit, you will likely be seen again in about 3 months.
• When to call your child’s doctor or nurse

If your child:

• has redness, increased swelling, drainage, or bleeding from the incision;
• has separation of the suture line;
• has a fever higher than 101.5°F degrees (taken under the arm);
• has pain that doesn't get better after pain medicine is given;
• is not drinking liquids or is vomiting;
• has trouble breathing.

If you have any questions or concerns, call the office at (585)-275-1000 and someone will assist you.