What to expect after surgery:
o Your baby will usually spend 1-2 nights in the hospital. At least one night in the ICU.
o We use what’s called a tongue stitch which is loosely tied and secured to the side of your baby’s cheek. We remove this the day after surgery.
o You may notice that there are new/different sounds when your baby is breathing. It can take some time for the baby to adjust to having a repaired palate and will improve as the swelling goes down and healing takes place.
o Your baby will need to wear elbow restrains (No No’s) unless you are holding them. The palate is numb and it’s easy for your baby to reach up and poke the palate and accidentally cause harm. The No no’s need to be worn for 10 days after surgery.
o No pacifiers or bottles until your surgeon says it is ok.
o You will have a follow up appointment about 1 week after surgery.
Diet:
o No bottles or pacifiers immediately after surgery. A sippy cup or syringe feeds will be used for 1 week after surgery.
o You should start using a sippy cup to feed your baby several months before the palate surgery so your baby is used to it and can start using it right after surgery.
o 1st week: only liquids
o 2nd week: things that can melt in the mouth, baby foods, yogurt, pureed consistency. You should carefully spoon feed these onto your baby’s tongue, but DO NOT let the spoon touch the roof of the mouth.
o Usually by the 3rd week you can return to normal, age-appropriate foods.
o Don’t let your baby put things in his/her mouth. They can poke the palate and cause damage.
Wound Care:
o Wound care is minimal for a cleft palate surgery. A small sip of water at the end of a feed is all you can really do.
o You DO NOT need to try to clean the palate with a towel/rag.
Antibiotics:
o Antibiotics MUST be taken as prescribed. Typically, the course of antibiotics is for 3 days. If your baby develops a rash or other side effect, stop the antibiotic and contact our office.
Bleeding:
o Some oozing of blood is expected after surgery. A small amount makes a lot of saliva look pink/red.
o Sometimes there is some bleeding inside the nose, too.
o The oozing may persist for up to 24 hours.
o If there is persistent bright red bleeding, then please contact our office or go to the emergency room.
Pain Management:
o We put long-acting numbing medicine in the palate that lasts 5-6 hours.
o Some discomfort is expected after surgery. The goal is to minimize the discomfort so that it is tolerable. It is unrealistic to expect zero pain after surgery, but we will work with you to minimize the discomfort as much as possible.
o Usually, your baby will only need over the counter children’s Tylenol and ibuprofen when they go home.
o On occasion a stronger pain medication is prescribed for a couple days.
o Never exceed the maximum daily dose that is described in the over-the-counter instructions.
Swelling:
o Swelling is normal after surgery. It is normal for swelling to increase for the first 2-3 days after surgery and then reach its peak and start to lessen.
Sutures:
o Sutures placed at the surgical site will dissolve/resorb on their own after about 7-14 days. Some stitches need to be removed in the clinic if they aren’t dissolving quickly enough.
o It’s ok if your baby accidentally swallows them as they will simply dissolve in the stomach.