Caring for Your Child after Cleft Palate Repair HF#4782

What is a Cleft Palate Repair?

 

A cleft palate repair is done to close the opening in the roof of the mouth so that your child is able to eat and speak better.  The tissue is brought together and stitched to close the opening.

 

What to Expect:

• An IV (intravenous line) will provide fluids for your child for the first day or two after surgery, since she will not drink as much as usual.
• Stitches on the roof of the mouth will dissolve.
• The nurses may gently suction secretions from the mouth as needed.
• A sore throat may last for a few days.  Your child may also complain of soreness and pain on the roof of her mouth.  Pain medicine will be given to help.
• Soft arm restraints will need to be worn for a couple of weeks.  They will prevent your child from rubbing the stitches.  The restraints can be removed for short periods of time, but only when an adult is watching your child.  Exercise your child’s arms when restraints are off so that they don’t become stiff.  The restraints should be taken off at least every 4 hours unless the child is sleeping through the night.  The restraints are very soft.  Most of the time children do not mind wearing them.  Any extra irritation to the site can make healing take longer.  Touching the site may cause infection.
• Your child will stay in the hospital for 1-2 days.
• It is best if your child does not use a pacifier until healing is complete.

Pain Relief

 

There is some pain during the first few days.  Your doctor will order medicine to keep your child comfortable.  Pain medicine should be given every 4 hours for the first day or two.  You will be given a prescription for pain medicine to use at home.  It may help to give it ½ hour before feedings to ease pain with eating.  You should not give your child ibuprofen (Advil®, Motrin®) until 1 week after the surgery.  It is okay to give Tylenol® the week after surgery, if you are not using the prescription pain medicine. 

Activity

 

Be sure your child gets plenty of rest the day before surgery.  Also, plan for quiet activities for the first few days after surgery.  Children heal quickly but will need a few days of rest to get better.

 

Mouth Care

• After eating, rinse your child’s mouth out with water to wash away leftover food.  It will also help to prevent a bad taste in the mouth and bad breath.
• Teeth may be cleaned on the outside of the gums using a moistened gauze square.  A toothbrush is not to be used until okayed by your doctor.
• Do not use mouthwash unless it is diluted one to one with water.  Mouthwash may sting.

Position

 

Your child will be able to lie in a crib or in a parent’s arms.  It is best to keep the head up, propped in a sitting position when eating. 

 

Secretions

 

Your child may have trouble blowing the nose for a while.  You may also notice an increase in drooling.

 

Sometimes a small amount of bleeding may occur about 2 weeks after the surgery.  This can happen when small pieces of old tissue come off the healing palate.  If this happens, give your child something cold to drink.  If able, rinse the mouth with water.  Do NOT try to pull off or remove any of this tissue yourself.

 

Comfort and Support

 

You are the child's most important security.  It is common for children to regress (go back to younger type behaviors) after being in the hospital.  If your child was outgoing, he/she may now be shy. If your child was potty-trained, accidents may occur.  This is normal.  Be patient.  This should be temporary.

 

Diet

 

Your child will begin with a liquid diet while in the hospital.  This includes water, juices, and jello.  If your child needs bottle feedings, you may use the nipple you used before the surgery.  At home your child should eat only soft foods.  Toddlers and preschool children should not feed themselves with a spoon until the doctor says it is okay.  They may feed themselves soft finger food (cooked pasta) with an adult watching.  Do not give your child crunchy cereal or foods, spoons, straws or sticks for about 2 weeks.

 

Soft Diet

 

	Foods Allowed	Foods to Avoid
Milk	All milk and milk drinks, mild soups, soft pudding and custard.  Plain ice cream.	Milk products with nuts or seeds
Meat	Pureed meats and meat soups.  Soft cooked eggs.	Whole pieces of meat.  Peanut butter.
Fruits & Vegetables	All fruits and vegetable juices. All pureed fruits or vegetables.  Mash vegetables with added liquid	Fruits and vegetables that are not purees.  Thick gummy mashed vegetables.
Breads & Cereals	Any thinned cooked cereal.  Macaroni and cooked noodles.	Breads and crackers.  Thick gummy cooked cereal and dry cereal.
Fats	Butter and oils.
Miscellaneous	Gelatin desserts and plain sherbets or plain yogurt	Gum and lollipops, hard or sticky candy
Seasonings	Sugar and small amounts of salt	Other spices.

 

 

Your child should stay on this soft diet until the follow up visit with the doctor.  Your doctor will let you know at this time if your child needs to stay on a soft diet.

 

Follow up

 

Your child may have her first follow up visit with the doctor in about 5-7 days.  The second visit should be in about 2 weeks.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 07/29/2011

Copyright © 07/29/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4782

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