Cleft Palate Post Operative Instructions
WHAT TO EXPECT AFTER SURGERY:
Your child will spend a brief period of time in the recovery room and then will go to a hospital room usually on the 5th floor of Mott hospital. After surgery your child will have a green tube in his/her nose to protect the airway from any swelling. Red drainage from the nose and mouth is very common after surgery. The green tube will be removed prior to leaving the hospital, usually on the 1st day after surgery. He/she will have a pulse oximeter on their finger to measure the blood oxygen levels. Fussiness after surgery is common and your child will be given a pain reliever to help with any discomfort. After cleft palate surgery, there will be sutures on the roof of your child's mouth and will dissolve spontaneously in about 2 weeks (will not have to be removed). You will not be able to see the sutures from outside the mouth. Your child is usually released from the hospital 1-2 days after surgery.
WOUND CARE:
Care must be taken to avoid letting the child place hard objects or his/her hands in his/her mouth. Elbow restraints (called No-no's) will be used to prevent the child from touching or damaging the surgical site. The No-No's will be worn for 2 weeks. You will need to purchase a long sleeve pajama top one size bigger than what your child currently wears. The elbow restraints (No-No's) will be applied, then the pajama top will be placed over the top of the elbow restraints this helps keep the restraints in place and distracts the child. The elbow restraints (No-no's) should be taken off for 1 hour each day (under direct supervision) to allow for your child to exercise their elbows. You can brush their teeth with a small, soft toothbrush, avoiding the surgical area. Apply petroleum jelly (Vaseline) to your child's lips frequently to keep them moist.
DIET:
Follow your physician's recommendation for the best type of feeding method for your child. A sippy cup without a valve is usually recommended. About 2 weeks before the surgery your child should be transitioned from a bottle to a sippy cup without a valve to help them adjust prior to their operation. If the transition to the sippy cup is not successful then the Mead Johnson Nurser with a large cross cut opening (such that there is a steady flow of liquid coming through the opening when the cup is held upside down) can be an alternative feeding method. Every effort should be made to transition to the sippy cup so as to promote optimal healing. Small frequent feeding may be necessary for the first week. Follow each feeding with water to help clean the inside of the mouth. A liquid diet (no ice cream or popsicles) is preferred for 2 weeks, and if all is well after that period your child can be advanced to a soft diet for 4 weeks. Foods to consider are apple sauce, cottage cheese (pureed), and gelatin, and baby food, yogurt without fruit, mashed potatoes and gravy. At 6 weeks he/she can start a regular diet.
PRESCRIPTIONS:
The surgeon may recommend a mild pain reliever such as liquid children's acetaminophen or acetaminophen with codeine for discomfort. The pain reliever should only be taken when you need it. Your child may experience nasal and sinus congestion, but he/she should not blow his/her nose. A saline nasal spray may be used to help with nasal congestion and crusting.
WHEN TO CALL:
If your child starts to run a fever (over 100.5 F) check to make sure they are getting enough liquids. Dehydration can cause the body temperature to rise. If you notice he/she is not taking any food or liquids, has increased fussiness, or vomiting please give us a call.
RETURN TO CLINIC:
Your child will be given an appointment to return to the clinic for a post-operative check before you are discharged from the hospital. This will usually be about two weeks after surgery. Bring any questions you have to this appointment. If you are unable to keep the appointment, please be sure to call and reschedule.
MEDICAL QUESTIONS, PLEASE CALL:
Pediatric Oral and Maxillofacial Surgery Clinic: 8 AM-5 PM (734)-936-5950 or (734)-936-8289 After hours and on weekends, call Hospital Paging at (734)-936-6267 and ask for Oral & Maxillofacial Surgery resident on call.