After cleft lip repair, a baby needs careful care at home for the first weeks so that the lip heals well. In general this means keeping the wound clean as your surgeon advises, protecting the lip from pressure and from fingers and objects, feeding the way the team has shown you, and attending follow-up visits. Your surgical team will give instructions that suit your baby, and they may differ slightly from the general information here. Cleft lip and palate care is available at Newface, Chengannur, Kerala.

Also read: Cleft Lip Surgery in India: Scar Care and Timeline, Cleft Lip and Palate Surgery in Kerala, Microform Cleft Lip

About Cleft Lip and Cleft Palate

Cleft lip and palate are among the more common birth differences. A baby with a cleft lip has a gap in the upper lip, and a cleft palate is an opening in the roof of the mouth. A cleft can make feeding, speech and hearing harder, and the appearance of the lip and nose can affect a child’s confidence as they grow. Many children with a cleft lead healthy lives with the support of a cleft care team. Read more about cleft lip surgery.

What Does Cleft Lip Repair Involve?

Cleft lip repair is done under general anaesthesia, usually at around 3 to 6 months of age, depending on the baby’s health. The surgeon makes small, planned incisions along the edges of the cleft and joins the muscle, skin and lining of the lip. Fine stitches are used, and many are dissolvable. A scar always remains, and the surgeon places it along the natural lines of the lip. Most babies stay in hospital for a day or two.

In Hospital

The nurses and your surgical team monitor your baby’s breathing, feeding, pain and the wound. You will usually be shown how to feed your baby after surgery, how to clean the lip, and how to protect it. Ask any questions before you go home, and make sure you know who to contact if you are worried.

Caring for Your Baby at Home

• The wound: the lip will be red and swollen at first. Keep it clean as your surgeon shows you, and keep crusts from building up, because this helps healing and the stitches. Do not apply creams or other products unless your surgeon advises.
• Protecting the lip: the lip needs to be protected from pressure and injury while it heals. Try to stop your baby from putting fingers, toys or other objects in the mouth. Your surgeon may advise soft arm splints for a time, which are removed regularly under supervision so the arms can move.
• Feeding: your team will tell you how to feed your baby, by breast or bottle or a special feeding method. Feeding is usually restarted soon after surgery. Follow the instructions on which teats, cups or spoons to use.
• Dummies, pacifiers and straws: your surgeon will tell you whether to avoid these, and for how long. Many surgeons advise avoiding them for several weeks.
• Pain relief: give pain medicines as your surgeon prescribes, in the right dose for your baby’s weight.
• Sleeping and handling: your surgeon will advise how to position your baby for sleep. Babies are usually laid on their back, and kept from rubbing the lip against bedding.
• Hygiene: wash your hands before touching the lip, and keep other children’s hands and toys away.

Scar Care

The scar looks red, swollen and bruised at first, and it can become firm or lumpy and feel tight in the early months. This is part of healing, and it usually settles into a flatter, paler scar over several months to a year or longer. Your surgeon may advise gentle massage once the wound has healed, protection from the sun, and in some cases silicone gel or sheets. Use only what your surgeon or cleft team recommends, and avoid buying scar products on your own for your baby. Read more about scar care after cleft lip surgery.

When to Contact Your Doctor

Contact your surgical team or doctor, or go to the nearest hospital, if your baby has:

• Bleeding from the lip that does not stop
• Fever or feels very hot
• Increasing redness, swelling, pus or a bad smell from the wound
• The wound opening or stitches coming apart
• Poor feeding, vomiting, or fewer wet nappies than usual
• Unusual sleepiness, fussiness that you cannot settle, or difficulty breathing

Follow-Up Visits

You will have a follow-up visit not long after surgery so that the team can check healing and remove any stitches that have not dissolved. The cleft team continues to see your child as they grow, for feeding, hearing, speech, teeth and growth. Ask your team about any further operations that may be needed, such as a palate repair.

Looking After Your Own Wellbeing

Caring for a baby after surgery can be stressful. Ask your cleft team about parent support, and talk to your family and doctor if you are struggling.

Risks of Cleft Lip Surgery

As with any surgery, risks include bleeding, infection, scarring that heals poorly, the wound opening, an uneven lip or nostril, and the need for further surgery. Results are not guaranteed and vary from child to child. Your surgeon should explain these before surgery.

Questions to Ask Your Surgical Team

• How should I feed my baby, and for how long should I avoid dummies and straws?
• How should I clean and protect the wound?
• Will my baby need arm splints?
• What warning signs should I watch for, and who do I call?
• When is the follow-up visit?

Frequently Asked Questions

How long does a baby stay in hospital after cleft lip repair?
Most babies stay a day or two, as advised by the surgical team.

How do I clean the wound after cleft lip surgery?
Follow your surgeon’s instructions, which usually involve gentle cleaning and keeping crusts from building up. Do not use creams or other products unless advised.

Can I breastfeed or bottle-feed after cleft lip repair?
Feeding is usually restarted soon after surgery, and your team will show you how to feed your baby safely.

What are the warning signs after cleft lip surgery?
Bleeding that does not stop, fever, increasing redness, swelling or pus, the wound opening, poor feeding or difficulty breathing. Contact your doctor or go to hospital.

Will there be a scar?
Yes. A scar always remains. The surgeon places it along the natural lines of the lip, and it usually becomes flatter and paler over months to a year.

Information provided by: Dr. Mathew P C, [QUALIFICATIONS], Oral and Maxillofacial Surgeon. Registration status: [REGISTERED]. [STATE MEDICAL COUNCIL / NATIONAL MEDICAL REGISTER] registration no.: [NUMBER].

This page provides general health information for education only. It is not a substitute for medical advice and does not promise or guarantee any result. Outcomes vary from person to person.

Newface, 8J4F+X7X, Hatchery Junction, Chengannur, Kerala 689122. Phone: +91 8330077198

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