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Cleft Lip Repair in Children: What to Expect at Home

Your Child's Recovery

Cleft lip repair is surgery to fix a split (cleft) in the lip. The doctor made a cut (incision) along the edges of the cleft lip extending up into the nose. Then the doctor used stitches to bring the cut edges together to shape the upper lip and nostrils.

Your child may need pain medicine for the first few days after surgery. The area around your child's mouth will be swollen for the first week or two after surgery. Your child may be more fussy than usual.

Most children are back to their usual behaviour about a week after surgery. It usually takes about 3 to 4 weeks for the incision to heal. The incision will leave a pink or red scar. You can expect the scar to feel hard and tight at first. The scar should fade and become softer and flatter in the months and years after surgery.

Your child may need to wear a wire guard across their upper lip. This helps prevent the lip from stretching and protects the stitches from breaking or the skin edges from separating. Your child also may need to wear splints on their arms. The splints keep your child's arms straight so that your child can't rub the incision while it heals. Your child may need to wear the lip guard and arm splints for 10 to 14 days. If your child has a lip guard or arm splints, it is important to wear them for as long as the doctor recommends.

This care sheet gives you a general idea about how long it will take for your child to recover. But each person recovers at a different pace. Follow the steps below to help your child get better as quickly as possible.

How can you care for your child at home?

Activity

Allow your child to slowly become more active. Have him or her rest as much as needed. Make sure your child gets enough sleep at night.
Put your child to sleep on his or her back. This will prevent your child from rubbing his or her lip on a blanket or the crib mattress.
For the first few weeks after surgery:
- Do not allow your child to do activities that could damage the incision.
- Do not use a pacifier or let your child put a hand, toys, or other objects in his or her mouth.

Diet

Follow the doctor's instructions for feeding your child. You may need to use a special bottle or syringe for the first few weeks to give your child breast milk or formula.
Give your child plenty of fluids.
You may notice a change in your child's bowel habits right after surgery. This is common. If your child has not had a bowel movement after a couple of days, call the doctor.

Medicines

Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.
Make sure that your child takes pain medicines exactly as directed.
- If the doctor gave your child a prescription medicine for pain, give it as prescribed.
- If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
If you think pain medicine is making your child sick to his or her stomach:
- Give your child the medicine after meals (unless the doctor has told you not to).
- Ask your child's doctor for a different pain medicine.
Your doctor may prescribe antibiotics. Have your child take them as directed. Do not stop giving them to your child just because he or she feels better. Your child needs to take the full course of antibiotics.

Incision care

If there are strips of tape on the incision, leave the tape on for a week or until it falls off.
If your doctor told you how to care for your child's incision, follow your doctor's instructions. If you did not get instructions, follow this general advice:
- After the first 24 to 48 hours, wash around the incision with clean water 2 times a day. Don't use hydrogen peroxide or alcohol, which can slow healing.
Keep the area clean and dry.

Other instructions

After the incision heals, you can gently massage the scar each day. This may help soften the scar.
Protect the scar from the sun for at least 3 to 4 months. Scars sunburn easily, and sun can make the scar more noticeable. After the cut has healed, apply sunscreen every time before your child goes outside.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

You cannot wake your child up.
Your child coughs up blood.
Your child has severe trouble breathing.

Call your doctor or nurse advice line now or seek immediate medical care if:

Your child has pain that does not seem to get better after you give him or her pain medicine.
Your child has a fever over 38°C.
Your child has signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- Swollen lymph nodes in your neck, armpits, or groin.
- A fever.
Your child has loose stitches, or the incision comes open.
Your child is bleeding from the nose or mouth.
Your child has signs of needing more fluids. These signs include sunken eyes with few tears, a dry mouth with little or no spit, and little or no urine for 6 hours.

Watch closely for changes in your child's health, and be sure to contact your doctor or nurse advice line if your child has any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.