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Cleft palate repairCCleft palate repairCleft palate repairEnglishPlasticsToddler (13-24 months);Preschooler (2-4 years)MouthMouthProceduresCaregivers Adult (19+)NA2021-07-05T04:00:00Z7.1000000000000070.50000000000002545.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Your child will need an operation to repair their cleft palate. This page tells you about the operation and what you need to know before, during and after the operation.</p><p>An operation to repair a cleft palate is usually done when your child is between 11 and 14 months of age. The timing of the operation depends on the general health of your child. A cleft palate needs to be repaired in order for your child to develop normal speech.</p><p>Many children with a cleft palate have fluid in their <a href="https://www.aboutkidshealth.ca/Article?contentid=833&language=English">middle ears</a>. This can affect the child’s hearing. In order for children to learn how to speak, they need to be able to hear well. For this reason, many children with a cleft palate will also have tubes inserted in their ears to drain the fluid. This will be done at the same time as their palate repair by an ear, nose and throat specialist called an Otolaryngologist.</p><p>For information on what a cleft palate 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 palate involves an operation.</li><li>Your child will need to stay in the hospital for about two days after the operation.</li><li>Your child will need to be able to drink from a free-flowing sippy cup before the operation.</li><li>Your child will need to wear arm restraints after the operation to prevent them from putting things into their mouth.</li><li>Your child will need to eat puréed foods for the first six weeks at home.</li><li>Contact the cleft lip and palate nurse coordinator if you have any questions or if your child has signs of infection.</li></ul><h2>When to call the doctor</h2><p>When at home, call the Plastic Surgery Unit, your child's surgeon, or the cleft lip and palate nurse coordinator right away if your child:</p><ul><li>Is not eating or drinking.</li><li>Has a fever.</li><li>Has a foul smell from the mouth.</li><li>Has fluid leaking from their ears more than four days after the operation.</li></ul> <h2>When to check in for your child’s operation</h2><p>Plan to be at the hospital <strong>at least two hours</strong> before your child’s operation so you can check in. You will be asked to fill in some forms with the nurse and your child 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 child a final time, just before their operation. A nurse will explain this to you.</p><h2>During the operation</h2><p> <strong>A cleft palate repair operation usually takes about three hours.</strong></p><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 child will be taken to the Post-Anaesthetic Care Unit (PACU), also called the recovery room. You may be able to see your child for a short visit. When your child is ready, they will be moved to the Plastic Surgery Unit.</p><h2>Constant Observation Room</h2> <p>Your child will be moved to the Constant Observation Room on the Plastic Surgery Unit. Your child will be closely monitored by a nurse.</p><h2>Visiting and staying overnight at the hospital</h2><p>In general, one parent can stay overnight with their child 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 child. If you are unsure, ask the nurse what to bring and what not to bring.</p><h2>Pain management after the operation</h2><p>Your child will have pain after the operation. Pain medicine will be given to help your child feel more comfortable and feed. Your child’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 child may be given pain medicine every four hours, as needed. You know your child best. If you have concerns about your child’s pain, speak to the surgical and nursing staff.</p><h2>Eating and drinking after the operation</h2><p>Your child may not want to eat or drink after the operation. This may be because they are in pain. It will be important for your child to have pain medicine about one hour before eating.</p><p>About <strong>24 hours after the operation</strong>, your child will only have clear fluids to drink. This will allow the sutures to heal and help prevent infection. Some examples of clear fluid are water, apple juice and clear broth.</p><p>On the <strong>first day</strong> after the operation, your child may have various liquids including clear fluids, milk, strained baby foods, puddings, yogurt and ice cream.</p><p>On the <strong>second day</strong> after the operation, your child will be able to eat puréed foods. Your child may have regular food such as pasta, meat, etc. as long as it is blended with the <strong>same consistency as baby food</strong>. Your child should continue on a puréed diet for six weeks after the operation.</p><p>It is important for your child to eat and drink to help with healing. In order to protect the area of operation and allow it to heal:</p><ul><li>Do not give your child raw fruits or vegetables, candy, or anything hard or sticky to eat for six weeks. An example of sticky food includes peanut butter.</li><li>Do not use a bottle or pacifier (soother).</li><li>Do not allow sharp objects such as a fork or straw in your child’s mouth. You may feed your child with a spoon.</li><li>Do not let your child feed themselves or have an older sibling/child feed them.</li><li>Your child may use a free-flowing sippy cup with a short spout, or an ordinary cup.</li></ul><h2>Liquids or food coming out the nose</h2><p>Food or liquids may come out your child’s nose when they are eating or drinking. Do not be alarmed. This is normal and may occur for several weeks after the operation until the incision line is completely healed.</p><h2>Drainage from the mouth</h2><p>There may be some blood and other fluids draining from your child’s mouth. This is normal and may continue for 24 to 48 hours after the operation. Your child will be placed to sleep on their tummy. This will help drain the fluid.</p><h2>Mouth care</h2><p>It is important that you keep the area of the operation clean. You will need to help keep your child’s mouth clean. This means your child will need to take a drink of water after having anything to eat or drink. This includes liquid medicines that your child receives. Your nurse will teach you how to do this.</p><h2>Corners of mouth</h2><p>The corners of your child’s mouth may be reddened and sore after the operation because the mouth has been stretched to help the surgeon see the palate during the operation. To help the area heal you can apply petroleum jelly to the corners of your child’s mouth. This will get better within a few days.</p><h2>Activity</h2><p>Your child must wear arm restraints after the operation to prevent them from putting their hands or other objects into their mouth. These arm restraints are soft, stiff sleeves that fit over your child's arms and stop the elbows from bending. The arm restraints are put on your child by the surgeon right after the operation. Your nurse will teach you how to use them. Your child must wear these restraints 24 hours a day for up to three weeks after the operation. You may take off restraints to bathe your child.</p><h2>Ear tubes</h2><p>If your child had drainage tubes inserted in their ears, there may be some dried blood in the outer ear. This is normal, do not be alarmed. You will be given <a href="https://www.aboutkidshealth.ca/article?contentid=99&language=English">antibiotic drops</a> to put in your child’s ear. Follow the instructions from your nurse or doctor on how to use them. It is important that you finish all the antibiotic drops.</p><h2>Your child will stay in the hospital for two or three days</h2><p>Your child will stay in the hospital for two or three days. Once your child has recovered from the operation and you feel able to take over their care, your child can go home. Before you go home, you will be given the instructions you need to care for your child and any follow-up appointments will be booked.</p><h2>Pre-palate appointments at 9 months of age</h2><p>Your child will have several appointments to prepare for their cleft palate operation. Your child will be booked to see:</p><ul><li> <strong>Plastic surgeon:</strong> Will talk to you about your child’s cleft palate repair.</li><li> <strong>Plastic surgery clinic nurse:</strong> Will talk to you about the pre and postoperative care so you are prepared to take care of your child after the operation.</li><li> <strong>Occupational therapist:</strong> Will provide you with information for <a href="https://www.aboutkidshealth.ca/Article?contentid=968&language=English">transitioning your child from the special bottle to a sippy cup before the operation</a>. Using a bottle or having your baby use suction will be harmful to the area of the palate being repaired.</li><li> <strong>Pediatric dentist:</strong> Will check your child’s teeth and teach you how to care for them. It is important that your child’s teeth are free of cavities before the operation.</li><li> <strong>Speech-language pathologist:</strong> Will assess your child’s communication skills and provide suggestions for supporting speech and language development.</li><li> <strong>Audiologist:</strong> Will check your child’s hearing.</li><li> <strong>Otolaryngologist:</strong> Will review your child’s hearing test and check your child’s ears for fluid behind the eardrum. If there is fluid and it is affecting hearing, they will talk to you about inserting tubes in the ears, in the same operation, as the palate repair.</li></ul><h2>Preparing for your child’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 child’s health issues and develop a plan for the anaesthetic for the surgery. Some children may need to meet with an anaesthesiologist in the Pre-Anaesthesia Clinic. You will be told which type of appointment your child needs.</p><h3>Pack a bag for your stay</h3><p>You will need to bring your child’s favourite toy or blanket, sleepers, sippy cups, car seat and a stroller. Bring a comb, soap, shampoo and other toiletry items that you and your child 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 child has any dietary restrictions or preferences, consider bringing puréed food from home (e.g., special formulas, home cooked foods that are blended). Children 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><p>Make sure you bring a sippy cup(s) with a short soft spout that is less than one inch in length. The sippy cup should allow a free flow of contents when turned upside down without your child having to squeeze or suck at the spout.</p><h3>Get your child ready</h3><p>You play an important role in reducing your child’s risk of infection after their operation by bathing them before their operation. Bathing your child reduces the number of germs that can cause an infection at the <strong>site of the operation</strong>. You will need to bathe your child 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 child 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 child fall into a deep sleep, so they will not feel any pain or remember the operation. Your child’s stomach must be empty before they have a general anaesthetic. You must follow the guidelines below to lessen the chance of your child throwing up, which could hurt your child's lungs.</p><ul><li>Your child can have solid food until midnight the night before the operation.</li><li>Your child can have formula up to six hours before the operation.</li><li>Your child 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 child'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><h2>At SickKids</h2> <p>Please bring your child to unit 6B in the Atrium (Surgical Day Care Unit) two hours before the operation. You will fill in some forms with the nurse and your child will have a final assessment before the operation.</p> <p>For general information about your child's stay at The Hospital for Sick Children, please read The Family Guidebook.</p> <p>If you have any further questions, please call the Cleft Lip and Palate Coordinator (416-813-7491) or the Plastic Surgery Unit (416-813-6932).</p> <p>After the operation, your child will spend four hours in the recovery room. Then your child will be moved to the Constant Observation Room on 8C (Plastic Surgery Unit). Your child will be closely watched by a nurse. You can visit your child and sit by their bed. There will be a pull-out bed so that one parent can stay overnight.</p> <p>The morning after the operation, your child may be moved to their room on 8C. In this room, there is a bed available for one parent or guardian to stay overnight.</p>
Fente palatine: chirurgie réparatriceFFente palatine: chirurgie réparatriceCleft palate repairFrenchPlasticsToddler (13-24 months);Preschooler (2-4 years)MouthMouthProceduresCaregivers Adult (19+)NA2011-01-10T05:00:00Z6.0000000000000078.00000000000000Health (A-Z) - ProcedureHealth A-Z<p>Votre enfant a besoin de subir une opération pour corriger sa fente palatine. 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 enfant a besoin de subir une opération pour corriger la fente palatine. Dans la présente page, on vous indique ce que vous devez savoir avant, durant et après la chirurgie.</p> <h2>À retenir</h2> <ul> <li>La correction d'une fente palatine se fait en une opération.</li> <li>Votre enfant doit pouvoir boire à partir d'une tasse.</li> <li>Votre enfant devra demeurer à l'hôpital pendant environ deux jours après l'opération.</li> <li>Votre enfant devra porter un dispositif spécial pour immobiliser ses bras pour l'empêcher de porter des choses à sa bouche.</li> <li>Votre enfant devra manger des aliments mous pendant les premières semaines à la maison.</li> <li>Communiquez avec l'unité de chirurgie plastique si vous avez des questions ou si votre enfant présente des signes d'infection.</li> </ul><h2>À quel moment appeler le médecin</h2> <p>Appelez immédiatement l'unité de chirurgie plastique ou le chirurgien de votre enfant s'il:</p> <ul> <li>ne mange pas ou ne boit pas;</li> <li>a de la fièvre;</li> <li>saigne de la bouche;</li> <li>a très mauvaise haleine.</li> </ul><h2>Une opération de correction de la fente palatine prend habituellement entre deux et trois heures</h2> <p>Votre enfant recevra un médicament pour l'endormir, que l'on appelle aussi <a href="/Article?contentid=1261&language=French">anesthésie générale</a>, pour l'opération. Cela fera en sorte qu'il dormira tout au long de l'opération et qu'il ne ressentira aucune douleur.</p> <h3>Suivez ces directives concernant l'alimentation :</h3> <p>Votre enfant peut manger des aliments solides jusqu'à minuit la nuit précédant l'opération. Votre enfant peut consommer du lait maternisé jusqu'à six heures avant l'opération ou du lait maternel jusqu'à quatre heures avant l'opération. </p> <p>Votre enfant 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 enfant vomisse, ce qui pourrait endommager ses poumons.</p> <p>Si vous ne suivez pas ces lignes directrices, on annulera l'opération de votre enfant.</p> <p>Si vous ne comprenez pas ces directives, veuillez appeler l'infirmier clinique quelques jours avant l'opération.</p><h2>Après l'opération</h2> <p>Après l'opération, on transférera votre enfant vers une salle de réveil où il restera durant environ quatre heures. Vous pourrez rendre visite à votre enfant. Quand votre enfant sera prêt, on le déplacera vers l'unité de chirurgie plastique. </p> <p>Votre enfant passera la première nuit dans une tente à oxygène. Il s'agit d'une tente en plastique transparent que l'on place dans le berceau. L'air à l'intérieur est humidifié afin que votre enfant se sente plus à l'aise et puisse respirer plus facilement. </p> <h2>Traitement de la douleur après l'opération</h2> <p>Si votre enfant ressent de la douleur après l'opération, on lui donnera des médicaments contre la douleur, suivant les besoins. C'est vous qui connaissez mieux votre enfant. Si vous avez des préoccupations concernant la douleur de votre enfant, parlez au chirurgien et au personnel infirmier. </p> <h2>Manger et boire après l'opération</h2> <p>Afin de s'assurer que votre enfant boit 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 enfant puisse boire et garder les liquides. </p> <p>Durant les deux premiers jours après l'opération, votre enfant ne pourra boire que des liquides. Cela permettra aux sutures de guérir et aidera à prévenir les infections. L'eau, le jus de pomme, le lait, la nourriture pour bébés en purée, les poudings, le yogourt et la crème glacée sont des exemples de liquides. Encouragez votre enfant à boire beaucoup. Votre enfant pourrait ne pas vouloir boire parce que sa bouche sera endolorie après l'opération. Pour aider votre enfant, l'infirmier pourrait lui donner des médicaments contre la douleur environ une heure avant qu'il se nourrisse. </p> <p>Le troisième jour suivant l'opération, votre enfant peut manger des choses molles, comme des spaghettis ou des pommes de terre en purée. Ces aliments ne doivent pas comporter de gros morceaux. Il est important que votre enfant mange et boive pour accélérer la guérison. Si vous avez des questions au sujet de ce que votre enfant mangera après l'opération, veuillez les poser à l'infirmier ou au chirurgien de votre enfant. </p> <p>Vous pouvez nourrir votre enfant avec une cuillère, mais ne le laissez pas manger tout seul. Votre enfant peut utiliser une tasse d'entraînement avec un bec court, ou bien une tasse ordinaire. </p> <p>De la nourriture ou du liquide pourrait sortir du nez de votre enfant pendant qu'il mange ou boit. Ne vous inquiétez pas. Cette situation est normale et elle peut se produire pendant plusieurs semaines après l'opération jusqu'à ce que la ligne de suture soit complètement guérie. </p> <p>Veuillez ne pas donner à votre enfant de fruits ou de légumes crus, de bonbons, ou de choses dures à manger à l'hôpital et durant deux semaines après votre retour à la maison. N'utilisez pas de bouteille ou de sucette et ne laissez pas des objets pointus comme une fourchette ou une paille entrer dans la bouche de votre enfant. </p> <h2>Positionnement de votre enfant : éveillé et endormi</h2> <p>La tête du lit de votre enfant sera légèrement surélevée, ce qui aidera à réduire l'enflure dans sa bouche et autour d'elle. Cela facilitera aussi l'écoulement du sang et des autres liquides de la bouche de votre enfant. Ce drainage peut continuer jusqu'à 24 heures après l'opération. </p> <h2>Activité</h2> <p>Votre enfant 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 enfant et empêchent ses coudes de plier. Votre infirmière vous donnera le dispositif et vous montrera comment l'utiliser. Votre enfant devra porter ce dispositif 24 heures par jour durant jusqu'à trois semaines après l'opération. </p> <h2>Soins buccaux</h2> <p>Pour aider à garder la ligne de suture propre, donnez à votre enfant de l'eau après lui avoir donné quelque chose à manger ou à boire. Cela comprend les médicaments liquides que votre enfant avale. </p> <p>Les coins de la bouche de votre enfant pourraient être rouges et endoloris après l'opération parce que la bouche a été étirée. Cette sensibilité disparaitra rapidement. Pour aider à réduire la sensibilité, vous pouvez appliquer de la pommade hydratante type Vaseline dans les coins de la bouche de votre enfant. </p> <h2>Mise en place d'un aérateur transtympanique</h2> <p>Si votre enfant s'est fait installer un aérateur transtympanique dans les oreilles pour drainer le liquide, il pourrait y avoir du sang séché dans l'oreille externe. C'est normal. Ne vous inquiétez pas. </p> <p>On vous donnera des <a href="/Article?contentid=1217&language=French">gouttes antibiotiques à mettre dans les oreilles</a> de votre enfant. Pour les utiliser, veuillez suivre les directives de votre infirmier ou de votre médecin.</p> <h2>Votre enfant restera à l'hôpital pendant environ deux jours</h2> <p>Quand votre enfant 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 avez besoin pour prendre soin de votre enfant. Tous les rendez-vous de suivi doivent être prévus avant que vous partiez. </p><h2>Examens et analyses au cours des semaines qui précèdent l'opération</h2> <p>Six semaines avant l'opération, amenez votre enfant voir votre 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 enfant devra aussi subir une analyse sanguine avant l'opération. Votre médecin de famille s'en occupera. </p> <h2>Votre enfant doit pouvoir boire à partir d'une tasse</h2> <p>Avant l'opération, votre enfant doit pouvoir <a href="/Article?contentid=968&language=French">boire à la tasse</a> et ne plus se nourrir au biberon.</p> <h2>Avant d'aller à l'hôpital</h2> <p>La nuit avant l'opération, veuillez donner un bain à votre enfant et lavez-lui les cheveux. Votre enfant passera la nuit à l'hôpital après l'opération. Bon nombre d'hôpitaux laissent un parent rester pendant la nuit. Veuillez apporter des vêtements, des jouets et les articles d'hygiène dont vous et votre enfant aurez besoin pour votre séjour à l'hôpital. Demandez à l'infirmier à quels services vous aurez accès durant votre séjour. </p><h2>À l’hôpital SickKids :</h2> <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.</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> <p>Après l’opération, votre enfant passera quatre heures dans la salle de récupération. Votre enfant sera ensuite transféré dans la salle d'observation constante à l’aile 8C (unité de chirurgie plastique). Votre enfant sera étroitement surveillé par un infirmier. Vous pouvez rendre visite votre enfant et vous asseoir à son chevet. Un lit pliant sera disponible pour qu’un parent puisse rester durant la nuit.</p> <p>Le matin suivant l’opération, votre enfant sera transféré vers sa chambre dans l’aile 8C. Dans cette chambre, un lit est disponible pour un parent ou un gardien pour qu’il y passe la nuit.</p>

 

 

 

 

Cleft palate repair34.0000000000000Cleft palate repairCleft palate repairCEnglishPlasticsToddler (13-24 months);Preschooler (2-4 years)MouthMouthProceduresCaregivers Adult (19+)NA2021-07-05T04:00:00Z7.1000000000000070.50000000000002545.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Your child will need an operation to repair their cleft palate. This page tells you about the operation and what you need to know before, during and after the operation.</p><p>An operation to repair a cleft palate is usually done when your child is between 11 and 14 months of age. The timing of the operation depends on the general health of your child. A cleft palate needs to be repaired in order for your child to develop normal speech.</p><p>Many children with a cleft palate have fluid in their <a href="https://www.aboutkidshealth.ca/Article?contentid=833&language=English">middle ears</a>. This can affect the child’s hearing. In order for children to learn how to speak, they need to be able to hear well. For this reason, many children with a cleft palate will also have tubes inserted in their ears to drain the fluid. This will be done at the same time as their palate repair by an ear, nose and throat specialist called an Otolaryngologist.</p><p>For information on what a cleft palate 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 palate involves an operation.</li><li>Your child will need to stay in the hospital for about two days after the operation.</li><li>Your child will need to be able to drink from a free-flowing sippy cup before the operation.</li><li>Your child will need to wear arm restraints after the operation to prevent them from putting things into their mouth.</li><li>Your child will need to eat puréed foods for the first six weeks at home.</li><li>Contact the cleft lip and palate nurse coordinator if you have any questions or if your child has signs of infection.</li></ul><h2>Caring for your child at home after the operation</h2><p>Once your child returns home, please follow these instructions:</p><ul><li>Keep the arm restraints on your child 24 hours a day, except during bathing, for up to three weeks after the operation.</li><li>Protect your child’s palate from harm:</li><ul><li>Your child must not use a soother. The soother will rub areas of the palate and may cause wound breakdown and poor wound healing.</li><li>Your child must use a sippy cup that has a soft spout that is less than an inch in length. The sippy cup should be free-flowing without having to squeeze or suck at the spout.</li><li>Your child may also use a regular cup.</li></ul><li>Continue on puréed food for a total of six weeks after the operation:</li><ul><li>Do not give your child food that is sticky, hard or in big chunks.</li><li>To keep your child’s mouth clean, give them a drink of water after eating or drinking. Do this for six weeks after your child is home from the hospital.</li><li>After six weeks, your child can eat their usual foods.</li></ul><li>Keep your child comfortable by giving pain medications, as needed.</li><li>It may be helpful for your child to sleep on their tummy for two weeks after returning home.</li><li>If your child has <a href="https://www.aboutkidshealth.ca/Article?contentid=1217&language=English">ear tubes inserted</a>:</li><ul><li>Give antibiotic ear drops as prescribed.</li><li>Do not insert anything in your child’s ear including cotton swabs.</li><li>Your child can have a bath.</li><li>To prevent ear infections, avoid getting soapy water into your child’s ears. To protect your child’s ears, use silicone ear putty or ear plugs during bathing and shampooing.</li><li>Talk to your Otolaryngologist about when your child can swim.</li> </ul></ul><h2>When to call the doctor</h2><p>When at home, call the Plastic Surgery Unit, your child's surgeon, or the cleft lip and palate nurse coordinator right away if your child:</p><ul><li>Is not eating or drinking.</li><li>Has a fever.</li><li>Has a foul smell from the mouth.</li><li>Has fluid leaking from their ears more than four days after the operation.</li></ul> <h2>Follow-up with the surgeon and speech-language pathologist</h2><p>Your child will have an appointment with the surgeon and speech-language pathologist six to eight weeks after going home.</p><p>Your surgeon will check your child’s palate to make sure it is healing properly.</p><p>The speech-language pathologist will assess your child’s communication skills, provide suggestions for supporting speech and language development and refer your child to the Preschool Speech and Language Program where you live.</p><p>Follow-up with the audiologist and otolaryngologist Your child will have an appointment with the audiologist and otolaryngologist six months after the operation.</p><p>If tubes were inserted, it is recommended that your child have a follow-up visit every six months to make sure the tubes are working, and your child is hearing well. It is important for your child to have good hearing in order for them to develop normal speech.</p><p>If tubes were not inserted, your child will have a hearing test at 18 months of age to make sure that your child is hearing well.</p><h2>When to check in for your child’s operation</h2><p>Plan to be at the hospital <strong>at least two hours</strong> before your child’s operation so you can check in. You will be asked to fill in some forms with the nurse and your child 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 child a final time, just before their operation. A nurse will explain this to you.</p><h2>During the operation</h2><p> <strong>A cleft palate repair operation usually takes about three hours.</strong></p><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 child will be taken to the Post-Anaesthetic Care Unit (PACU), also called the recovery room. You may be able to see your child for a short visit. When your child is ready, they will be moved to the Plastic Surgery Unit.</p><h2>Constant Observation Room</h2> <p>Your child will be moved to the Constant Observation Room on the Plastic Surgery Unit. Your child will be closely monitored by a nurse.</p><h2>Visiting and staying overnight at the hospital</h2><p>In general, one parent can stay overnight with their child 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 child. If you are unsure, ask the nurse what to bring and what not to bring.</p><h2>Pain management after the operation</h2><p>Your child will have pain after the operation. Pain medicine will be given to help your child feel more comfortable and feed. Your child’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 child may be given pain medicine every four hours, as needed. You know your child best. If you have concerns about your child’s pain, speak to the surgical and nursing staff.</p><h2>Eating and drinking after the operation</h2><p>Your child may not want to eat or drink after the operation. This may be because they are in pain. It will be important for your child to have pain medicine about one hour before eating.</p><p>About <strong>24 hours after the operation</strong>, your child will only have clear fluids to drink. This will allow the sutures to heal and help prevent infection. Some examples of clear fluid are water, apple juice and clear broth.</p><p>On the <strong>first day</strong> after the operation, your child may have various liquids including clear fluids, milk, strained baby foods, puddings, yogurt and ice cream.</p><p>On the <strong>second day</strong> after the operation, your child will be able to eat puréed foods. Your child may have regular food such as pasta, meat, etc. as long as it is blended with the <strong>same consistency as baby food</strong>. Your child should continue on a puréed diet for six weeks after the operation.</p><p>It is important for your child to eat and drink to help with healing. In order to protect the area of operation and allow it to heal:</p><ul><li>Do not give your child raw fruits or vegetables, candy, or anything hard or sticky to eat for six weeks. An example of sticky food includes peanut butter.</li><li>Do not use a bottle or pacifier (soother).</li><li>Do not allow sharp objects such as a fork or straw in your child’s mouth. You may feed your child with a spoon.</li><li>Do not let your child feed themselves or have an older sibling/child feed them.</li><li>Your child may use a free-flowing sippy cup with a short spout, or an ordinary cup.</li></ul><h2>Liquids or food coming out the nose</h2><p>Food or liquids may come out your child’s nose when they are eating or drinking. Do not be alarmed. This is normal and may occur for several weeks after the operation until the incision line is completely healed.</p><h2>Drainage from the mouth</h2><p>There may be some blood and other fluids draining from your child’s mouth. This is normal and may continue for 24 to 48 hours after the operation. Your child will be placed to sleep on their tummy. This will help drain the fluid.</p><h2>Mouth care</h2><p>It is important that you keep the area of the operation clean. You will need to help keep your child’s mouth clean. This means your child will need to take a drink of water after having anything to eat or drink. This includes liquid medicines that your child receives. Your nurse will teach you how to do this.</p><h2>Corners of mouth</h2><p>The corners of your child’s mouth may be reddened and sore after the operation because the mouth has been stretched to help the surgeon see the palate during the operation. To help the area heal you can apply petroleum jelly to the corners of your child’s mouth. This will get better within a few days.</p><h2>Activity</h2><p>Your child must wear arm restraints after the operation to prevent them from putting their hands or other objects into their mouth. These arm restraints are soft, stiff sleeves that fit over your child's arms and stop the elbows from bending. The arm restraints are put on your child by the surgeon right after the operation. Your nurse will teach you how to use them. Your child must wear these restraints 24 hours a day for up to three weeks after the operation. You may take off restraints to bathe your child.</p><h2>Ear tubes</h2><p>If your child had drainage tubes inserted in their ears, there may be some dried blood in the outer ear. This is normal, do not be alarmed. You will be given <a href="https://www.aboutkidshealth.ca/article?contentid=99&language=English">antibiotic drops</a> to put in your child’s ear. Follow the instructions from your nurse or doctor on how to use them. It is important that you finish all the antibiotic drops.</p><h2>Your child will stay in the hospital for two or three days</h2><p>Your child will stay in the hospital for two or three days. Once your child has recovered from the operation and you feel able to take over their care, your child can go home. Before you go home, you will be given the instructions you need to care for your child and any follow-up appointments will be booked.</p><h2>Pre-palate appointments at 9 months of age</h2><p>Your child will have several appointments to prepare for their cleft palate operation. Your child will be booked to see:</p><ul><li> <strong>Plastic surgeon:</strong> Will talk to you about your child’s cleft palate repair.</li><li> <strong>Plastic surgery clinic nurse:</strong> Will talk to you about the pre and postoperative care so you are prepared to take care of your child after the operation.</li><li> <strong>Occupational therapist:</strong> Will provide you with information for <a href="https://www.aboutkidshealth.ca/Article?contentid=968&language=English">transitioning your child from the special bottle to a sippy cup before the operation</a>. Using a bottle or having your baby use suction will be harmful to the area of the palate being repaired.</li><li> <strong>Pediatric dentist:</strong> Will check your child’s teeth and teach you how to care for them. It is important that your child’s teeth are free of cavities before the operation.</li><li> <strong>Speech-language pathologist:</strong> Will assess your child’s communication skills and provide suggestions for supporting speech and language development.</li><li> <strong>Audiologist:</strong> Will check your child’s hearing.</li><li> <strong>Otolaryngologist:</strong> Will review your child’s hearing test and check your child’s ears for fluid behind the eardrum. If there is fluid and it is affecting hearing, they will talk to you about inserting tubes in the ears, in the same operation, as the palate repair.</li></ul><h2>Preparing for your child’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 child’s health issues and develop a plan for the anaesthetic for the surgery. Some children may need to meet with an anaesthesiologist in the Pre-Anaesthesia Clinic. You will be told which type of appointment your child needs.</p><h3>Pack a bag for your stay</h3><p>You will need to bring your child’s favourite toy or blanket, sleepers, sippy cups, car seat and a stroller. Bring a comb, soap, shampoo and other toiletry items that you and your child 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 child has any dietary restrictions or preferences, consider bringing puréed food from home (e.g., special formulas, home cooked foods that are blended). Children 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><p>Make sure you bring a sippy cup(s) with a short soft spout that is less than one inch in length. The sippy cup should allow a free flow of contents when turned upside down without your child having to squeeze or suck at the spout.</p><h3>Get your child ready</h3><p>You play an important role in reducing your child’s risk of infection after their operation by bathing them before their operation. Bathing your child reduces the number of germs that can cause an infection at the <strong>site of the operation</strong>. You will need to bathe your child 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 child 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 child fall into a deep sleep, so they will not feel any pain or remember the operation. Your child’s stomach must be empty before they have a general anaesthetic. You must follow the guidelines below to lessen the chance of your child throwing up, which could hurt your child's lungs.</p><ul><li>Your child can have solid food until midnight the night before the operation.</li><li>Your child can have formula up to six hours before the operation.</li><li>Your child 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 child'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><h2>At SickKids</h2> <p>Please bring your child to unit 6B in the Atrium (Surgical Day Care Unit) two hours before the operation. You will fill in some forms with the nurse and your child will have a final assessment before the operation.</p> <p>For general information about your child's stay at The Hospital for Sick Children, please read The Family Guidebook.</p> <p>If you have any further questions, please call the Cleft Lip and Palate Coordinator (416-813-7491) or the Plastic Surgery Unit (416-813-6932).</p> <p>After the operation, your child will spend four hours in the recovery room. Then your child will be moved to the Constant Observation Room on 8C (Plastic Surgery Unit). Your child will be closely watched by a nurse. You can visit your child and sit by their bed. There will be a pull-out bed so that one parent can stay overnight.</p> <p>The morning after the operation, your child may be moved to their room on 8C. In this room, there is a bed available for one parent or guardian to stay overnight.</p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/cleft_palate_repair.jpg" style="BORDER:0px solid;" />Cleft palate repairFalse

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