For most infants with cleft lip alone, the abnormality can be repaired within the first several months of life (usually when the baby is 10 to 12 pounds). This will be decided by your child's surgeon. The goal of this surgery is to fix the separation of the lip. Sometimes, a second operation is needed. Show
Cleft palate repairs are usually done between the ages of 9 to 18 months, but before the age of 2. This is a more complicated surgery and is done when the baby is bigger and better able to tolerate the surgery. The exact timing of the surgery will be decided by your child's physician. The goal of this surgery is to fix the roof of the mouth so that your child can eat and learn to talk normally. Sometimes, a second operation is needed. Initial visitAt your first visit with the plastic surgeon, he/she will discuss with you the details of the surgery, risks, complications, costs, recovery time, and outcome. At this time, your child's surgeon will answer any questions you may have. After the surgery for cleft lipYour child may be irritable following surgery. Your child's physician may prescribe medications to help with this. Your child may also have to wear padded restraints on his/her elbows to prevent him/her from rubbing at the stitches and surgery site. Stitches will either dissolve on their own or will be removed in approximately five to seven days. Specific instructions will be given to you regarding how to feed your child after the surgery. The scar will gradually fade, but it will never completely disappear. During the surgery, and for a short time after surgery, your child will have an intravenous catheter (IV) to provide fluids until he/she is able to drink by mouth. For a day or two, your child will feel mild pain, which can be relieved with a non-aspirin pain medication. A prescription medication may also be given for use at home. Your child's upper lip and nose will have stitches where the cleft lip was repaired. It is normal to have swelling, bruising, and blood around these stitches. After the surgery for cleft palateThis surgery is usually more involved and can cause more discomfort and pain for the child than cleft lip surgery. Your child's physician may order pain medicine to help with this. As a result of the pain and the location of the surgery, your child may not eat and drink as usual. An intravenous (IV) catheter will be used to help give your child fluids until he/she can drink adequately. Your child will have stitches on the palate where the cleft was repaired. The stitches will dissolve after several days and they do not have to be taken out by the physician. In some cases, packing will be placed on the palate. Do not take the packing out unless you are told to do so by your child's physician. There may be some bloody drainage coming from the nose and mouth that will lessen over the first day. There will be some swelling at the surgery site, which will diminish substantially in a week. For two to three days, your child will feel mild pain that can be relieved by a non-aspirin pain medication. A prescription medication may also be given for use at home. Many infants show signs of nasal congestion after surgery. These signs may include nasal snorting, mouth breathing, and decreased appetite. Your child's physician may prescribe medication to relieve the nasal congestion. Your child will be on antibiotics to prevent infection while in the hospital. Your child's physician may want you to continue this at home. Your child may be in the hospital for one to three days, depending on your child's physician's recommendation. A small amount of water should be offered after every bottle or meal to cleanse the incision. You can continue to rinse this area gently with water several times a day, if necessary. Diet after surgeryYour child's physician may allow breastfeeding, bottle-feedings, or cup-feedings after surgery. Your child should be placed on a soft diet for seven to 10 days after surgery. For older infants and children, age-appropriate soft foods may include strained baby foods, popsicles, yogurt, mashed potatoes, and gelatin. Note: your child should not use a straw or pacifier, as both could damage the surgical repair. Activity after surgeryYour child can walk or play calmly after surgery. He/she should not run or engage in rough play (i.e., wrestling, climbing) or play with "mouth toys" for one to two weeks after surgery. Your child's physician will advise you when your child can safely return to regular play. Follow-up with your child's surgeon and the cleft team is very important. This will be discussed with you. Your child's physician will also be an important part of the child's overall health management after the surgery. You
want the best for your baby, and so do we. If a routine ultrasound shows that your baby will be born with a cleft lip, we are here to help you prepare. We want you to be able to focus on welcoming your baby. You won’t know until birth if your baby will also have a cleft palate. Cleft lip and cleft palate are common conditions and can be repaired. Our expert team will guide you through what may be years of treatment for your child. On
this page, you’ll find what to expect when you have a child with a cleft lip or a cleft palate. After your child’s cleft lip is seen on ultrasound, your prenatal care provider will likely refer you to a specialist to help you plan for your baby’s treatment. At OHSU Doernbecher Children’s Hospital, you will first meet with
our nurse practitioners. They will: Some infants with cleft lip or cleft palate are not able to breastfeed. We may give you custom bottles to help you feed your baby without the need for sucking. After your child’s birthFirst appointmentFor a cleft lip, you will meet your child’s reconstructive surgeon and other care team members within weeks of birth. For a cleft palate, you will meet them within one week. Your care team will include a nurse practitioner, a social worker, and speech and hearing specialists as needed. Your care coordinator will also attend and be your primary contact with us. At this appointment, we may discuss whether your child would benefit from a presurgical treatment called nasoalveolar molding. This approach uses a device similar to a dental retainer to make the cleft smaller before surgery. The treatment requires weekly visits for adjustments. First surgerySurgery for a cleft lip usually takes place when your baby is three to five months old. The surgery takes about three hours. In most cases, your child can go home the same day. The first surgery for a cleft palate usually takes place at around 12 months old. If testing shows your child may have hearing issues, the surgeon may also place tiny tubes in the eardrum. These tubes create an opening to prevent fluid buildup. After one yearOur team will work with you to establish a dental plan for your child, starting at age one. We offer dental and orthodontic work at the OHSU School of Dentistry, or you can choose dentists or orthodontists in your community. Our team will help you find providers close to home and work with them on a treatment plan. Ages 2 to 5If your child has a cleft lip without a cleft palate, you can expect follow-up visits once a year. If your child has speech or hearing problems, you can also expect visits with a speech pathologist or other specialists. Children with cleft palates can expect follow-up visits every six months to prepare for additional surgeries or treatments. Ages 5 to 15You and your child will have access to our craniofacial specialists and OHSU resources during this time. We will tailor ongoing treatment to your child’s specific needs. Our goal is to provide the best possible care as your child grows.
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LocationsParking is free for patients and their visitors. Doernbecher Children’s Hospital Find other locations across Oregon and in southwest Washington. For referring providersWhat does the care of a newborn with a cleft lip and palate before surgical repair include?Your child may have breast milk up to 4 hours and formula up to 6 hours before surgery. All other liquids, semi-liquids and solid foods MUST BE STOPPED 8 hours before surgery. Your child may have CLEAR LIQUIDS up to 2 hours before surgery. After that, they may have nothing else to drink.
What should nursing care for an infant after the surgical repair of a cleft lip include?A complete and thorough process of care should be undergone by the newborn with cleft lip and cleft palate.. Maintain adequate nutrition. ... . Positioning. ... . Tools for feeding. ... . Promote family coping. ... . Reduce family anxiety. ... . Provide family teaching.. What is the management of cleft lip and cleft palate?Children with a cleft lip or palate will need several treatments and assessments as they grow up. A cleft is usually treated with surgery. Other treatments, such as speech therapy and dental care, may also be needed. Your child will be cared for by a specialist cleft team at an NHS cleft centre.
What surgery is performed first to treat cleft palates and cleft lips?A plastic surgeon will repair the baby's cleft lip first, usually when the baby is about 3 months old. This is done with a surgery called cheiloplasty (KY-lo-plass-tee).
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Which does the care of a newborn with a cleft lip and palate before surgical repair include
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