What is cleft palate repair?

The roof of the mouth is called the palate. Cleft palate repair is surgery to fix a split (cleft) in the palate. The doctor will make a cut along the edge of the cleft inside your child's mouth. This cut is called an incision. The doctor will use stitches to bring the cut edges together to cover the split. Your child will be asleep during the surgery.

Your child may need more than one surgery to make the repair. The first surgery is usually done before a child is 12 months old.

Most children have a short hospital stay after surgery. It usually takes about 3 to 4 weeks for a child to heal.

After surgery, it will be easier for your child to eat, breathe, and make the sounds needed for speech. Some children need more surgery on their lips, nose, or mouth as they get older to improve their speech.

Activity

• Allow your child to slowly become more active. Have him or her rest as much as needed. Make sure he or she gets enough sleep at night.
• Put your child to sleep on his or her back. This will help your child breathe more easily.
• For the first few weeks after surgery:
  • Do not allow your child to run, play roughly, or do other activities that could damage the incision.
  • Do not use a pacifier or let your child put his or her hand, toys, or other objects in his or her mouth.

Diet

• Follow the doctor's instructions for feeding your child. You may need to use a special bottle or syringe for the first few weeks to give your child breast milk or formula.
• When you start feeding your child soft foods, be careful not to damage the stitches with a spoon or fork.
• Give your child plenty of fluids. But do not let your child drink from a straw.
• You may notice a change in your child's bowel habits right after surgery. This is common. If your child has not had a bowel movement after a couple of days, call the doctor.

Medicines

• Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.
• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
• If you think pain medicine is making your child sick to his or her stomach:
  • Give your child the medicine after meals (unless the doctor has told you not to).
  • Ask your child's doctor for a different pain medicine.
• Your doctor may prescribe antibiotics. Have your child take them as directed. Do not stop giving them to your child just because he or she feels better. Your child needs to take the full course of antibiotics.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child that the surgery will probably make it easier to eat, breathe, and make the sounds needed for speech. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

• A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

Cleft palate repair is surgery to fix a split (cleft) in the roof of the mouth, which is called the palate. The doctor made a cut (incision) along the edge of the cleft inside your child's mouth. Then the doctor used stitches to bring the cut edges together to cover the split.

Your child may need pain medicine for the first few days after surgery. The area around your child's mouth may be swollen for the first 1 to 2 weeks after surgery. Your child may be more fussy than usual.

Your child will have stitches in the roof of their mouth that will slowly dissolve. Many children have a stuffy nose after surgery. If your child has trouble with congestion, your doctor may suggest a nose spray.

Most children are back to their usual behavior about a week after surgery. It usually takes about 3 to 4 weeks for the incision to heal. Your child may need to wear padded arm splints for 1 to 2 weeks after surgery to prevent rubbing the surgery area.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be canceled. If the doctor told you to have your child take his or her medicines on the day of surgery, have your child take them with only a sip of water.
• Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
• Your child may brush his or her teeth. But tell your child not to swallow any toothpaste or water.
• Be sure your child has something that reminds him or her of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by the anesthesia provider. Your child will be asleep during the surgery.
• The surgery will take about 1 to 3 hours.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor his or her condition. The doctor will talk to you about the surgery.
• You will probably be able to take your child home 1 to 2 days after the surgery.