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Your baby's cleft lip repairYYour baby's cleft lip repairYour baby's cleft lip repairEnglishPlasticsNewborn (0-28 days);Baby (1-12 months)MouthMouthProceduresCaregivers Adult (19+)NA2021-05-12T04:00:00Z7.4000000000000068.60000000000002371.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Your baby will need two operations to fix their cleft lip. The first operation is to fix the cleft lip and the second is to remove the sutures (stitches) from the first operation. Learn about the two operations and what you need to know before, during and after both surgeries.</p><p>An operation to repair a cleft lip is usually done when your baby is between 3 and 6 months of age. The timing of the operation depends upon the type of cleft, the general health of your baby and if your baby needs orthodontic treatment (an orthodontic plate called a nasal alveolar molding).</p><p>Your baby will need a second operation to remove the sutures (stitches) that were placed in the first operation that fixed the cleft lip.</p><p>For more information on what a cleft lip is, please read <a href="https://www.aboutkidshealth.ca/Article?contentid=380&language=English">Cleft lip and cleft palate in babies</a>.</p><h2>Key points</h2><ul><li>Fixing a cleft lip involves two operations. Your baby will need to stay in the hospital overnight after the first operation.</li><li>After surgery, your baby will eat the same way as before, either breastfeeding or bottle feeding.</li><li>Your baby will need to wear arm restraints after the operation to stop them from putting things in their mouth.</li><li>Your baby will look different after the operation.</li><li>Contact the cleft lip and palate nurse coordinator if you have any questions or if your baby has signs of infection.</li></ul><h2>When to call the doctor</h2><p>When at home, call the Plastic Surgery Unit, your baby's surgeon, or the cleft lip and palate nurse coordinator right away if your baby:</p><ul><li>Is not eating or drinking</li><li>Has a fever</li><li>Has redness or oozing from the suture line</li></ul> <h2>When to check in for your baby’s operation</h2><p>Plan to be at the hospital at least two hours before your baby’s operation so you can check in. You will be asked to fill in some forms with the nurse and your baby will have a final assessment before the operation.</p><h2>Pre-operative bath</h2><p>To help prevent infection, all children will have a pre-operative bath using pre-packaged wipes. You will be given a package of bathing wipes to bathe your baby a final time just before their operation. A nurse will explain this to you.</p><h2>During the operation</h2><h3>A cleft lip repair operation usually takes about three hours</h3><p>During the operation, you can wait in the Surgical Waiting Room. The surgeon will give you an update after the operation is finished.</p><p>When the operation is over, your baby will be taken to the Post-Anaesthetic Care Unit (PACU), also called the recovery room. Your baby may spend one to two hours in the PACU. You may be able to see your baby for a short visit. When your baby is ready, they will be moved to the Plastic Surgery Unit.</p><h2>After your baby's operation</h2><h3>Visiting and staying overnight at the hospital</h3><p>In general, one parent can stay overnight with their baby during recovery. If you plan to stay overnight, you may wish to bring your own sleeping bag and pillow. The parent is responsible for bringing personal items they need during their stay with their baby. If you are unsure, ask the nurse what to bring and what not to bring.</p><h3>Your baby will look different</h3><p>Be aware that your baby will look different after the operation. There may be some swelling and/or bruising around the lip and face. This could increase for up to two days after the operation but will go away within five to seven days. Your nurse and surgeon will answer any questions you may have about the way your baby looks.</p><h3>Pain management after the operation</h3><p>Your baby will have pain after the operation. Pain medicine will be given to help your baby feel more comfortable and feed. Your baby’s pain will generally be managed with a few different medications, including <a href="https://www.aboutkidshealth.ca/Article?contentid=2999&language=English">morphine</a>, <a href="https://www.aboutkidshealth.ca/article?contentid=62&language=English">acetaminophen</a> and <a href="https://www.aboutkidshealth.ca/article?contentid=153&language=English">ibuprofen</a>. Your baby may be given pain medicine every four hours, as needed. You know your baby best. If you have concerns about your baby's pain, speak to the surgical and nursing staff.</p><h3>Eating and drinking after the operation</h3><p>After the operation, your baby will feed the same way as before the operation (breastfeeding or bottle feeding).</p><p>To make sure your baby is getting enough liquids, your baby will receive special liquids through their <a href="https://www.aboutkidshealth.ca/article?contentid=2451&language=English">intravenous (IV) line</a>. An IV is a small tube that is put in the vein of an arm or leg. The IV will stay in place until your baby can drink and keep liquids down.</p><h3>Milk and other liquids</h3><p>Your baby's first drink will be clear fluids or breast milk. Once your baby can keep this down, they can have formula.</p><p>Your baby may not want to drink at first or may take a longer time to feed following the operation. This may be because there is still some pain and swelling. Your baby may also have to get used to the new shape of their mouth and may need to adjust their suck, swallow and breathe pattern. To help your baby drink, the nurse may give them pain medicine about one hour before feeding. Your nurse, lactation consultant or an occupational therapist (OT) will help you feed your baby if there are problems or if you need help.</p><p>If your baby was wearing an orthodontic plate before the operation, they will no longer need it. It may take a little time for your baby to get used to feeding without the orthodontic plate.</p><p>Over time, feeding gets easier.</p><h3>Solid foods</h3><p>If your baby is eating purées you will need to make sure the suture line is properly cleaned after they have finished eating or drinking. See “Suture care” below for more details.</p><h3>Positioning your baby: Awake and asleep</h3><p>The head of your baby's bed will be raised slightly. This will help reduce swelling around their lip. Your baby will not be able to have time on their tummy because they could rub the suture line and slow down the healing process by causing wound breakdown.</p><h3>Activity</h3><p>Your baby must wear arm restraints after the operation to prevent them from putting their hands or other objects in their mouth. These arm restraints are soft, stiff sleeves that fit over your baby's arms and stop the elbows from bending. The arm restraints are put on your baby by the surgeon right after the operation. Your nurse will teach you how to use them. Your baby must wear these restraints 24 hours a day for up to three weeks after the operation. You may take off the restraints to bathe your baby.</p><h3>Suture care</h3><p>It is important that you keep the suture line clean. It is normal for a small amount of blood to ooze along the suture line for up to 24 hours after the operation. After each feed, you will need to clean the suture line with cotton swabs and water. You will also apply a thin layer of petroleum jelly to the suture line. Your nurse will teach you how to do this. Your baby will feel some discomfort during cleaning, but the baby's crying will not harm the sutures.</p><h3>Nasal stents</h3><p>Your baby may or may not have nasal stents in both nostrils after the operation. A nasal stent is a small, soft tube, about the thickness of a straw, which holds the nostril open. These tubes are usually sutured in place after the first operation. Your surgeon will discuss this with you, and your nurse will show you how to care for them. These sutures and the nasal stent will be removed when you return to the hospital to have the sutures in your baby’s lip removed.</p><h3>Your baby will stay in the hospital for one or two days</h3> <p>Once your baby has recovered from the operation and you feel able to take over their care and they are feeding well, your baby can go home. Before you go home, you will be given the instructions you need to care for your baby and any follow-up appointment will be booked.</p><h2>Preparing for your baby’s operation</h2> <h3>Complete a pre-anaesthesia assessment</h3><p>The pre-anaesthesia assessment is usually done as a phone call. A doctor or nurse practitioner will review your baby’s health issues and develop a plan for the anaesthetic for the surgery. Some babies may need to meet with an anaesthesiologist in the Pre-Anaesthesia Clinic. You will be told which type of appointment your baby needs.</p><h3>Follow the orthodontist’s instructions</h3><p>If your baby is using an orthodontic plate and lip taping to prepare for the cleft lip repair, the orthodontist will give you instructions about when to stop lip taping before the operation. Your baby will need to keep the orthodontic plate in until the operation.</p><h3>Pack a bag for your stay</h3><p>You will need to bring your baby’s favourite toy or blanket, sleepers, bottles (if used), car seat and a stroller. Bring a comb, soap, shampoo and other toiletry items that you and your baby will need. If you plan to stay overnight, you may want to bring your own sleeping bag and pillow.</p><p>If you or your baby has any dietary restrictions or preferences, consider bringing these from home (e.g., special formulas, home cooked foods with the texture they are used to). Babies are sometimes picky about their formula or food after the operation. Having something familiar they like can help them recover and go home sooner.</p><h3>Get your baby ready</h3><p>You play an important role in reducing your baby’s risk of infection after their operation by bathing them before their operation. Bathing your baby reduces the number of germs that can cause an infection at the site of the operation. You will need to bathe your baby and wash their hair with shampoo twice before their operation: The first time 48 hours before the operation and the second time 24 hours before the operation.</p><h3>Follow the feeding guidelines</h3><p>Your baby will be given a <a href="https://www.aboutkidshealth.ca/Article?contentid=1261&language=English">general anaesthetic</a> for the operation. This will help your baby fall into a deep sleep so they will not feel any pain or remember the operation. Your baby’s stomach must be empty before they have a general anaesthetic. You must follow the guidelines below to lessen the chance of your baby throwing up, which could hurt your baby's lungs.</p><ul><li>Your baby can have solid food until midnight the night before the operation.</li><li>Your baby can have formula up to six hours before the operation, or breast milk up to four hours before the operation.</li><li>Your baby can have clear fluids up to three hours before the operation. Examples of clear fluids are clear apple juice and water, but not orange juice.</li></ul><p>If you do not follow these feeding guidelines, your baby's operation will be cancelled.</p><p>If you are unsure of these instructions, please call the clinic nurse or cleft lip and palate nurse coordinator a few days before the operation.</p>
Bec-de-lièvre: chirurgie réparatriceBBec-de-lièvre: chirurgie réparatriceCleft lip repairFrenchPlasticsNewborn (0-28 days);Baby (1-12 months)MouthMouthProceduresCaregivers Adult (19+)NA2011-01-10T05:00:00Z7.0000000000000072.00000000000000Health (A-Z) - ProcedureHealth A-Z<p>Votre enfant a besoin de subir une opération pour corriger son bec-de-lièvre. Dans la présente brochure, on vous informe sur l’opération et la façon de préparer votre enfant. On vous indique aussi comment prendre soin de votre enfant quand vous reviendrez à domicile.</p><p>Votre bébé doit subir deux opérations : une pour corriger un bec-de-lièvre, et l’autre pour enlever les points de suture. Dans la présente page, on vous indique ce que vous devez savoir avant, durant et après les <a href="/Article?contentid=380&language=French">deux chirurgies</a>.</p> <h2>À retenir</h2> <ul> <li>La correction d’un bec-de-lièvre comporte deux opérations. Votre bébé devra passer la nuit à l’hôpital après la première opération.</li> <li>Votre bébé se nourrira comme avant l’opération, que ce soit par allaitement au sein ou au biberon.</li> <li>Votre bébé devra porter un dispositif spécial pour immobiliser ses bras pour l’empêcher de mettre des choses dans sa bouche.</li> <li>Votre bébé aura l’air différent après l’opération.</li> <li>Communiquez avec la clinique si vous avez des questions ou si votre bébé montre des signes d’infection.</li> </ul><h2>À quel moment appeler le médecin</h2> <p>Quand vous serez à la maison, appelez l'unité de chirurgie plastique ou le chirurgien de votre bébé immédiatement si votre bébé :</p> <ul> <li>ne mange pas ou ne boit pas;</li> <li>a de la fièvre;</li> <li>présente une rougeur ou des suintements autour de la ligne de suture.</li> </ul> <h2>Une opération de correction d’un bec-de-lièvre prend habituellement entre deux et trois heures</h2> <p>Votre bébé recevra une anesthésie générale avant l’opération qui le fera dormir tout au long de l'opération et ne ressentir aucune douleur.</p> <p>Après l’opération, on emmènera votre bébé vers la salle de réveil ou il restera durant environ une ou deux heures. Pendant ce temps, on vous permettra peut-être de rendre brièvement visite à votre bébé. Quand il sera prêt, on le déplacera vers l'unité de chirurgie plastique.</p><h2>Traitement de la douleur après l'opération</h2> <p>Si votre bébé ressent de la douleur après l’opération, on lui donnera des analgésiques, suivant les besoins. Vous connaissez votre bébé mieux que quiconque. Si vous avez des préoccupations concernant la douleur de votre bébé, parlez au chirurgien et au personnel infirmier. </p> <h2>Manger et boire après l'opération</h2> <p>Après l’opération, votre bébé se nourrira comme avant l’opération (allaitement ou biberon).</p> <p>Afin de s’assurer que votre bébé obtient assez de liquides, il recevra des liquides spéciaux par son intraveineuse (IV). Une IV est un petit tube installé dans la veine d'un bras ou d'une jambe. L'IV restera en place jusqu’à ce que votre bébé puisse boire et garder les liquides. </p> <h3>Lait et autres liquides</h3> <p>La première chose que votre bébé boira sera des liquides clairs ou du lait maternel. Quand votre bébé pourra garder des liquides clairs, il pourra boire du lait maternisé.</p> <p>Votre bébé pourrait ne pas vouloir boire au début parce que sa lèvre sera endolorie après l’opération. Pour aider votre bébé à boire, l’infirmier pourrait lui donner des médicaments contre la douleur environ une heure avant qu’il se nourrisse. </p> <p>Il pourrait falloir plus de temps qu’avant pour nourrir votre bébé après l’opération. Ce pourrait être parce qu’il ressent encore une certaine douleur et en raison de l’enflure. Votre bébé pourrait aussi devoir s’habituer à la nouvelle forme de sa bouche et devoir ajuster son cycle pour sucer, avaler et respirer. Votre infirmier, votre consultant en allaitement ou un ergothérapeute vous aidera à nourrir votre bébé en cas de problème ou si vous avez besoin d’aide. </p> <p>Si votre bébé portait une plaque obturatrice avant l’opération, il n’en aura plus besoin. Il pourrait falloir un peu de temps pour que votre bébé s’habitue à se nourrir sans la plaque. </p> <p>Avec le temps, il deviendra plus facile de le nourrir.</p> <h3>Aliments solides</h3> <p>Si votre bébé mangeait des céréales pour bébés ou de la nourriture en purée, il ne pourra pas en avaler avant que les points de suture soient enlevés. La nourriture pourrait pénétrer dans la ligne de suture et la rendre difficile à laver. La ligne de suture est la région qui a été refermée avec des points de suture. </p> <p>Il faudra attendre environ une semaine avant que l’on enlève les points.</p> <h2>Positionnement de votre bébé : éveillé et endormi</h2> <p>La tête du lit de votre bébé sera légèrement surélevée, ce qui aidera à réduire l’enflure autour de ses lèvres. Votre bébé ne pourra pas passer de temps sur le ventre parce qu’il pourrait frotter la ligne de suture et ralentir la guérison. </p> <h2>Activité</h2> <p>Votre bébé doit porter un dispositif spécial pour immobiliser ses bras après l’opération afin de l’empêcher de mettre ses mains ou d’autres objets dans sa bouche. Ce dispositif pour immobiliser les bras est constitué de tubes rigides doux qui se placent par-dessus les bras de votre bébé et empêchent ses coudes de plier. Votre infirmier vous donnera le dispositif et vous montrera comment l’utiliser. Votre bébé devra porter ce dispositif 24 heures par jour jusqu’à trois semaines après l’opération. </p> <h2>Visites et séjour durant la nuit à l’hôpital</h2> <p>En règle générale, les hôpitaux laissent un parent rester durant la nuit avec leur bébé pendant qu’il récupère. Le parent doit apporter les effets personnels dont il aura besoin durant son séjour. Si vous avez des doutes, demandez à l’infirmier ce que vous pouvez, et ne pouvez pas apporter. </p> <h2>Votre bébé aura l’air différent</h2> <p>Sachez que votre bébé aura l’air différent après l’opération. Il pourrait présenter une enflure et/ou des ecchymoses autour de la lèvre et du visage. Elles pourraient empirer jusqu’à deux jours après l’opération, mais elles disparaîtront en cinq à sept jours. Votre infirmier et votre chirurgien répondront à toutes les questions que vous pourriez avoir sur l’apparence de votre bébé.</p> <h2>Soins de la ligne de suture</h2> <p>Il est important que vous gardiez la ligne de suture propre. Il est normal qu’une petite quantité de sang s’échappe de la ligne de suture pendant près de 24 heures après l’opération. Après chaque repas, vous devrez laver la ligne de suture avec des cotons-tiges, un savon doux et de l’eau. Vous appliquerez aussi une mince couche de crème antibiotique comme du Polysporin sur la ligne de suture. Votre infirmier vous montrera comment le faire. Votre bébé ressentira un certain inconfort quand vous le laverez, mais les pleurs du bébé n'abimeront pas les sutures.</p> <h2>Endoprothèse nasale</h2> <p>Votre bébé pourrait avoir ou non des endoprothèses nasales dans les deux narines après l’opération. Une endoprothèse nasale est un petit tube souple, environ de l’épaisseur d’une paille, qui garde les narines ouvertes. Ces tubes sont habituellement maintenus en place par des points de suture après la première opération. Votre chirurgien en discutera avec vous et votre infirmier vous montrera comment vous en occuper. Les sutures seront enlevées quand vous reviendrez à l’hôpital pour faire enlever les autres points.</p> <h2>Votre bébé restera à l'hôpital pendant un à deux jours</h2> <p>Quand votre bébé aura récupéré de l’opération et quand vous vous sentirez en mesure de vous occuper de lui, il pourra retourner à la maison. Avant que vous retourniez à la maison, on vous donnera les directives dont vous aurez besoin pour prendre soin de votre bébé et tout rendez-vous de suivi sera prévu.</p><h2>Amenez votre bébé voir le médecin en vue d’un examen physique</h2><p>Six semaines avant l’opération, amenez votre bébé voir son médecin de famille ou son pédiatre en vue d’un examen physique général. Votre chirurgien vous donnera des formulaires pour que le médecin de votre enfant les remplisse. Veuillez remplir ces formulaires et les renvoyer immédiatement au bureau de votre chirurgien. Votre bébé devra aussi subir une analyse sanguine avant l’opération. Votre médecin de famille s'en occupera. </p> <h2>Avant d’aller à l’hôpital</h2><p>La nuit avant l’opération, veuillez donner un bain à votre bébé et lavez-lui les cheveux. Votre bébé passera la nuit à l’hôpital après l’opération. Veuillez apporter des vêtements, des jouets et les articles d’hygiène dont vous et votre bébé aurez besoin. Demandez à l’infirmier à quels services vous aurez accès durant votre séjour. </p><h2>Manger et boire avant l'opération</h2><p>Votre bébé recevra un médicament spécial pour l'endormir, appelé <a href="/Article?contentid=1261&language=French">anesthésie générale</a>, pour l'opération.</p><p>Votre bébé peut manger des aliments solides jusqu’à minuit la nuit précédant l’opération. Votre bébé peut consommer des préparations jusqu’à six heures avant l’opération ou du lait maternel jusqu’à quatre heures avant l’opération. </p><p>Votre bébé peut boire des liquides clairs jusqu’à trois heures avant l’opération. Le jus de pomme et l’eau sont des exemples de liquides clairs, mais pas le jus d’orange. </p><p>Vous devez suivre ces directives pour réduire les chances que votre bébé vomisse, ce qui pourrait endommager ses poumons.</p><p>Si vous ne suivez pas ces directrives, on annulera l’opération.</p><p>Si vous avez des doutes concernant ces directives, veuillez appeler l’infirmier clinique quelques jours avant l’opération.</p><h2>À SickKids</h2> <p>Pour la chirurgie et le retrait des points de suture :</p> <p>Veuillez amener votre enfant à l'unité 6B dans l'atrium (unité de soins chirurgicaux de jour) deux heures avant l’opération. Vous remplirez certains formulaires avec l'infirmier et votre enfant subira un dernier examen avant l’opération. Un parent peut rester au chevet de l’enfant après l’opération.</p> <p>Un l'équipement pour "tirer" le lait maternel est disponible à l’unité de chirurgie plastique (8C). Demandez-le à votre infirmier.</p> <p>Pour obtenir des renseignements généraux sur le séjour de votre enfant à l'hôpital The Hospital for Sick Children, veuillez lire le guide à l’intention des familles.</p> <p>Si vous avez d’autres questions, veuillez appeler le coordonnateur des becs-de-lièvre et des fentes palatines (416 813-7491) ou l'unité de chirurgie plastique (416-813-6932).</p>

 

 

 

 

Your baby's cleft lip repair33.0000000000000Your baby's cleft lip repairYour baby's cleft lip repairYEnglishPlasticsNewborn (0-28 days);Baby (1-12 months)MouthMouthProceduresCaregivers Adult (19+)NA2021-05-12T04:00:00Z7.4000000000000068.60000000000002371.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Your baby will need two operations to fix their cleft lip. The first operation is to fix the cleft lip and the second is to remove the sutures (stitches) from the first operation. Learn about the two operations and what you need to know before, during and after both surgeries.</p><p>An operation to repair a cleft lip is usually done when your baby is between 3 and 6 months of age. The timing of the operation depends upon the type of cleft, the general health of your baby and if your baby needs orthodontic treatment (an orthodontic plate called a nasal alveolar molding).</p><p>Your baby will need a second operation to remove the sutures (stitches) that were placed in the first operation that fixed the cleft lip.</p><p>For more information on what a cleft lip is, please read <a href="https://www.aboutkidshealth.ca/Article?contentid=380&language=English">Cleft lip and cleft palate in babies</a>.</p><h2>Key points</h2><ul><li>Fixing a cleft lip involves two operations. Your baby will need to stay in the hospital overnight after the first operation.</li><li>After surgery, your baby will eat the same way as before, either breastfeeding or bottle feeding.</li><li>Your baby will need to wear arm restraints after the operation to stop them from putting things in their mouth.</li><li>Your baby will look different after the operation.</li><li>Contact the cleft lip and palate nurse coordinator if you have any questions or if your baby has signs of infection.</li></ul><h2>Helping your baby</h2><h3>Caring for your baby at home after the first operation</h3><p>Once your baby returns home, please follow these instructions:</p><ul><li>Keep the arm restraints on your baby 24 hours a day, except during bathing, for up to three weeks after the operation.</li><li>Gently clean the sutures with warm water and cotton swabs. Clean the sutures after each feed. Apply a thin layer of petroleum jelly.</li><li>Protect your baby’s lip from harm (i.e., bumps and rubs):</li><ul><li>Your baby must not use a soother. The outside ring of the soother will rub the sutures and could cause wound breakdown.</li><li>Your baby must not be on their tummy for three weeks after going home. As the wound heals, it can become itchy. If your baby is on their tummy, they are able to relieve the itch by rubbing the suture line. This can contribute to the breakdown of the sutures and can cause infection, and this can impact the quality of the scar.</li><li>Be mindful when your baby is playing with older children to make sure there is no rough play. Flying objects, such as balls, may hurt your baby’s lip.</li></ul><li>If your baby has nasal stents sutured in, gently clean around them with warm water and cotton swabs after each feed. Apply a thin layer of petroleum jelly.</li></ul> <h2>When to call the doctor</h2><p>When at home, call the Plastic Surgery Unit, your baby's surgeon, or the cleft lip and palate nurse coordinator right away if your baby:</p><ul><li>Is not eating or drinking</li><li>Has a fever</li><li>Has redness or oozing from the suture line</li></ul> <h2>Suture removal operation</h2><h3>Return to hospital to get the sutures taken out</h3><p>Your baby will need to return to the hospital seven days after the operation to have the sutures removed. Removing the sutures is another operation. Both the sutures in your baby's lip and the sutures holding the nasal stents in place will be removed. Like the cleft lip repair operation, your baby will have a <a href="https://www.aboutkidshealth.ca/article?contentid=1261&language=English">general anaesthetic</a>.</p><h3>Follow feeding guidelines</h3><p>As with the first operation, your baby must follow the feeding instructions previously described.</p><p>The operation will be booked for 30 minutes. After the operation, your baby will be taken to the recovery room.</p><p>Your baby may feel pain following the operation. You can give your baby acetaminophen every four hours as needed. Your nurse will give you more information about this.</p><p>Your baby will stay in the hospital for up to four hours from admission to discharge. Once your baby has recovered from the operation and you feel able to take over their care and they have begun to feed, your baby can go home.</p><h3>Caring for your baby at home</h3><p>Once your baby returns home, please follow these instructions:</p><ul><li>Keep the arm restraints on your baby 24 hours a day for two more weeks.</li><li>Clean the incision line after each feed. You should clean the incision line with cotton swabs and warm water. Apply a thin layer of petroleum jelly. Do this for two more weeks.</li><li>Your baby must not be on their tummy for two more weeks.</li><li>Your baby cannot have a soother. Please check with your surgeon at the follow-up clinic visit when a soother can be used again.</li></ul><p>If your baby is using nasal stents, remove them after each feed. Clean them with cotton swabs and warm water, and put them back in. Nasal stents should be worn 24 hours a day. For more information see <a href="https://www.aboutkidshealth.ca/article?contentid=1248&language=English">Nasal stent after cleft lip surgery: Caring for your child at home</a>.</p><h3>A follow-up appointment</h3><p>Your baby will return to see the surgeon three to four weeks after the cleft lip repair. You will be notified of this appointment once you are at home.</p> <h2>When to check in for your baby’s operation</h2><p>Plan to be at the hospital at least two hours before your baby’s operation so you can check in. You will be asked to fill in some forms with the nurse and your baby will have a final assessment before the operation.</p><h2>Pre-operative bath</h2><p>To help prevent infection, all children will have a pre-operative bath using pre-packaged wipes. You will be given a package of bathing wipes to bathe your baby a final time just before their operation. A nurse will explain this to you.</p><h2>During the operation</h2><h3>A cleft lip repair operation usually takes about three hours</h3><p>During the operation, you can wait in the Surgical Waiting Room. The surgeon will give you an update after the operation is finished.</p><p>When the operation is over, your baby will be taken to the Post-Anaesthetic Care Unit (PACU), also called the recovery room. Your baby may spend one to two hours in the PACU. You may be able to see your baby for a short visit. When your baby is ready, they will be moved to the Plastic Surgery Unit.</p><h2>After your baby's operation</h2><h3>Visiting and staying overnight at the hospital</h3><p>In general, one parent can stay overnight with their baby during recovery. If you plan to stay overnight, you may wish to bring your own sleeping bag and pillow. The parent is responsible for bringing personal items they need during their stay with their baby. If you are unsure, ask the nurse what to bring and what not to bring.</p><h3>Your baby will look different</h3><p>Be aware that your baby will look different after the operation. There may be some swelling and/or bruising around the lip and face. This could increase for up to two days after the operation but will go away within five to seven days. Your nurse and surgeon will answer any questions you may have about the way your baby looks.</p><h3>Pain management after the operation</h3><p>Your baby will have pain after the operation. Pain medicine will be given to help your baby feel more comfortable and feed. Your baby’s pain will generally be managed with a few different medications, including <a href="https://www.aboutkidshealth.ca/Article?contentid=2999&language=English">morphine</a>, <a href="https://www.aboutkidshealth.ca/article?contentid=62&language=English">acetaminophen</a> and <a href="https://www.aboutkidshealth.ca/article?contentid=153&language=English">ibuprofen</a>. Your baby may be given pain medicine every four hours, as needed. You know your baby best. If you have concerns about your baby's pain, speak to the surgical and nursing staff.</p><h3>Eating and drinking after the operation</h3><p>After the operation, your baby will feed the same way as before the operation (breastfeeding or bottle feeding).</p><p>To make sure your baby is getting enough liquids, your baby will receive special liquids through their <a href="https://www.aboutkidshealth.ca/article?contentid=2451&language=English">intravenous (IV) line</a>. An IV is a small tube that is put in the vein of an arm or leg. The IV will stay in place until your baby can drink and keep liquids down.</p><h3>Milk and other liquids</h3><p>Your baby's first drink will be clear fluids or breast milk. Once your baby can keep this down, they can have formula.</p><p>Your baby may not want to drink at first or may take a longer time to feed following the operation. This may be because there is still some pain and swelling. Your baby may also have to get used to the new shape of their mouth and may need to adjust their suck, swallow and breathe pattern. To help your baby drink, the nurse may give them pain medicine about one hour before feeding. Your nurse, lactation consultant or an occupational therapist (OT) will help you feed your baby if there are problems or if you need help.</p><p>If your baby was wearing an orthodontic plate before the operation, they will no longer need it. It may take a little time for your baby to get used to feeding without the orthodontic plate.</p><p>Over time, feeding gets easier.</p><h3>Solid foods</h3><p>If your baby is eating purées you will need to make sure the suture line is properly cleaned after they have finished eating or drinking. See “Suture care” below for more details.</p><h3>Positioning your baby: Awake and asleep</h3><p>The head of your baby's bed will be raised slightly. This will help reduce swelling around their lip. Your baby will not be able to have time on their tummy because they could rub the suture line and slow down the healing process by causing wound breakdown.</p><h3>Activity</h3><p>Your baby must wear arm restraints after the operation to prevent them from putting their hands or other objects in their mouth. These arm restraints are soft, stiff sleeves that fit over your baby's arms and stop the elbows from bending. The arm restraints are put on your baby by the surgeon right after the operation. Your nurse will teach you how to use them. Your baby must wear these restraints 24 hours a day for up to three weeks after the operation. You may take off the restraints to bathe your baby.</p><h3>Suture care</h3><p>It is important that you keep the suture line clean. It is normal for a small amount of blood to ooze along the suture line for up to 24 hours after the operation. After each feed, you will need to clean the suture line with cotton swabs and water. You will also apply a thin layer of petroleum jelly to the suture line. Your nurse will teach you how to do this. Your baby will feel some discomfort during cleaning, but the baby's crying will not harm the sutures.</p><h3>Nasal stents</h3><p>Your baby may or may not have nasal stents in both nostrils after the operation. A nasal stent is a small, soft tube, about the thickness of a straw, which holds the nostril open. These tubes are usually sutured in place after the first operation. Your surgeon will discuss this with you, and your nurse will show you how to care for them. These sutures and the nasal stent will be removed when you return to the hospital to have the sutures in your baby’s lip removed.</p><h3>Your baby will stay in the hospital for one or two days</h3> <p>Once your baby has recovered from the operation and you feel able to take over their care and they are feeding well, your baby can go home. Before you go home, you will be given the instructions you need to care for your baby and any follow-up appointment will be booked.</p><h2>Preparing for your baby’s operation</h2> <h3>Complete a pre-anaesthesia assessment</h3><p>The pre-anaesthesia assessment is usually done as a phone call. A doctor or nurse practitioner will review your baby’s health issues and develop a plan for the anaesthetic for the surgery. Some babies may need to meet with an anaesthesiologist in the Pre-Anaesthesia Clinic. You will be told which type of appointment your baby needs.</p><h3>Follow the orthodontist’s instructions</h3><p>If your baby is using an orthodontic plate and lip taping to prepare for the cleft lip repair, the orthodontist will give you instructions about when to stop lip taping before the operation. Your baby will need to keep the orthodontic plate in until the operation.</p><h3>Pack a bag for your stay</h3><p>You will need to bring your baby’s favourite toy or blanket, sleepers, bottles (if used), car seat and a stroller. Bring a comb, soap, shampoo and other toiletry items that you and your baby will need. If you plan to stay overnight, you may want to bring your own sleeping bag and pillow.</p><p>If you or your baby has any dietary restrictions or preferences, consider bringing these from home (e.g., special formulas, home cooked foods with the texture they are used to). Babies are sometimes picky about their formula or food after the operation. Having something familiar they like can help them recover and go home sooner.</p><h3>Get your baby ready</h3><p>You play an important role in reducing your baby’s risk of infection after their operation by bathing them before their operation. Bathing your baby reduces the number of germs that can cause an infection at the site of the operation. You will need to bathe your baby and wash their hair with shampoo twice before their operation: The first time 48 hours before the operation and the second time 24 hours before the operation.</p><h3>Follow the feeding guidelines</h3><p>Your baby will be given a <a href="https://www.aboutkidshealth.ca/Article?contentid=1261&language=English">general anaesthetic</a> for the operation. This will help your baby fall into a deep sleep so they will not feel any pain or remember the operation. Your baby’s stomach must be empty before they have a general anaesthetic. You must follow the guidelines below to lessen the chance of your baby throwing up, which could hurt your baby's lungs.</p><ul><li>Your baby can have solid food until midnight the night before the operation.</li><li>Your baby can have formula up to six hours before the operation, or breast milk up to four hours before the operation.</li><li>Your baby can have clear fluids up to three hours before the operation. Examples of clear fluids are clear apple juice and water, but not orange juice.</li></ul><p>If you do not follow these feeding guidelines, your baby's operation will be cancelled.</p><p>If you are unsure of these instructions, please call the clinic nurse or cleft lip and palate nurse coordinator a few days before the operation.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/cleft_lip_repair.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/cleft_lip_repair.jpgYour baby's cleft lip repairFalse

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