Proper management of your child’s cleft lip repair is very important to prevent damage to the surgical site. Any complications can lead to additional scarring, a longer healing period, and even increase the possibility that your child will need extra surgeries. This article will explain how to best care for your child after their cleft lip repair, but because all cases are unique, please follow your doctor's instructions if they differ from this document.
Feeding Your Child After Cleft Lip Repair
After your child’s surgery, they will remain in the hospital until they are able to support themselves nutritionally, their pain is well-controlled, and they are finished with necessary intravenous medications or able to take these medications by mouth. Feeding after this surgery can be one of the biggest obstacles you need to overcome in order to take your child home.
You may find that there is a lot of controversy over whether you should breast, bottle, or spoon-feed your child during the time period immediately following surgery (post-op period). The method that you choose will depend on your child's individual circumstances as well as your own personal preferences and your family's needs. Your medical team, including your surgeon and speech-language pathologist, can help you to choose the best feeding technique for your situation. These professionals can also assist you in getting the proper supplies you may need; for example, if you choose to bottle-feed your child, you need to use an approved nipple with the bottle.
Regardless of the method you choose to feed your child, protection of the incision (wound) area is necessary for your child to heal. It is discouraged to have anything hard in your child’s mouth until after the surgical incisions have healed. If you are spoon-feeding, you need to ensure that you are using the side of the spoon for feeding. Do not use forks or other utensils, as they can damage the incision. After each feeding, many health care professionals recommend your child drink about 5-15 milliliters of water. Using water will "cleanse" the area and help to remove food that could potentially lead to an infection.
Protecting Your Child’s Surgical Site After Cleft Lip Repair
After surgery, you may find that your surgeon has used something like the Logan’s Bow (metal bar) or Steri-Strips to help protect the incision. This will remain in place until your surgeon clears the removal of the bar at a follow-up appointment after your child has been discharged from the hospital (generally about 1 week after your child’s discharge date). When you are holding your child, cradling them is preferred to keep them from bumping their lip and nose into your shoulder until they have fully healed. When they are lying down, be sure to keep them off their stomach as well by keeping them in either a side or back-lying position. Pacifiers should also not be used as they will cause extra tension on the surgical site.
After surgery, your child will have soft arm or elbow restraints on to help prevent them from rubbing or messing with their incision. Generally, the restraints will need to be used for approximately 2 to 3 weeks. During this time, it is important for them to wear the restraints as much as possible. While you are supervising them, it is okay to remove the restraints several times a day; however, you will want to make sure to avoid having them rub their lip and nose or suck on their thumb.
When removing the restraints, it is generally recommended that you only remove one restraint at a time. Take this time to move the arms all around to prevent loss of mobility and check to make sure that there are no reddened areas on the arms where the restraints had been.