Everything you Need to Know About Cleft Palate Repair Surgery

Preparing for cleft palate repair surgery can be a daunting process for parents. It’s a significant step in addressing a cleft palate, aiming to improve your child’s speech, feeding, and overall quality of life. To help ease your journey, we’ve compiled a comprehensive guide with answers to common questions cleft parents might have before, during, and after the surgery. From understanding what to expect to managing recovery, this blog aims to provide clarity and support for families navigating this important milestone.

Cleft Palate Repair: Essential Questions and Answers

Question	Answer
Pre Palate Repair
How do I wean my baby off of the bottle before palate repair?	Start by gradually replacing bottle feeds with other options like sippy cups or spoon-feeding. You can begin with one bottle feed per day and slowly increase the number of feeds with the new method. Be patient and consistent.
How do I get them to drink from a free flow cup?	Introduce the sippy cup with a small amount of liquid, and let your baby explore it. Choose a cup with a soft spout and a flow that’s not too fast. Offer it regularly, and encourage practice during meal times or when your child is hungry. Other families have also practiced with medicine cups and during bath times to avoid messy clean ups, or while holding their child similiar to bottle feeding.
Which sippy cups do you recommend?	Cups with soft spouts and free-flow features are often recommended. Some popular brands include Reflo Smart Cup, Munchkin 360, and Open Cup Trainer, Re-Play Cup.
What should I bring to the hospital?	Essentials items for baby include comfort items like a favorite blanket, distracting toys, ipad with pre-loaded songs/shows, sippy/free flow cups, familiar pajamas, hair ties, sound machine. Essential items for parents include dark clothing, snacks, personal hygiene items, ipad with shows, comfort blankets. The key is to make sure you are comfortable as a parent. This will ensure that you can support your child as much as possible.
What age do babies have their palate repaired?	Cleft palate repair is typically performed between 9 to 18 months of age. The timing can vary based on the child's development and specific needs as determined by the child's cleft team. We had our palate repair at 10 months.
How do I avoid getting my baby sick ahead of their palate repair surgery?	Focus on maintaining good hygiene by encouraging frequent handwashing and using hand sanitizer, and regularly disinfect high-touch surfaces. Limit exposure to sick individuals and avoid crowded places and child play areas. Consider supplements like elderberry and vitamin C if recommended by your healthcare provider. Change your child’s clothes when they come home to remove any potential germs. Encourage healthy habits such as covering coughs and avoiding face-touching. If your child shows signs of illness before the surgery, contact your healthcare provider, as the surgery may need to be rescheduled to ensure they are healthy for the procedure.

Question	Answer
During Palate Repair
How long is the surgery?	The cleft palate repair surgery generally takes about 2 to 4 hours, depending on the complexity of the repair and the specific techniques used. Our palate repair surgery was 2 hours long.
Can I stay with my child during the surgery?	Typically, parents are not allowed in the operating room, but you can stay with your child before they go into surgery and be there to comfort them after the procedure. Most hospitals provide a waiting area where you can be updated on the progress.
Will ear tubes be placed during palate repair surgery?	Yes, ear tubes are usually placed during cleft palate repair surgery to help with drainage and prevent fluid buildup. This is common but not guaranteed.

Question	Answer
Post Palate Repair
How long is the hospital stay?	Most children stay in the hospital for about 1 to 3 days after cleft palate repair surgery. The exact duration can vary based on the child's recovery progress and any additional care needs.We stayed in a post-recovery room at the hospital for 1 night.
How can we make ourselves comfortable during our hospital stay?	Opt for an adult bed instead of a crib in the recovery area to allow for better sleep while someone is up holding your baby. Bring snacks, dark clothing, gum, hair ties, and personal hygiene items.
What can I use to keep my babies hands away from their mouth post palate repair?	No-nos (arm restraints) are commonly used to prevent your baby from touching their mouth. You can also purchase a Cozeecoo or similar product designed for this purpose.
How can I encourage my baby to feed after palate repair?	Start with a syringe for feeding and transition to a cup as they become more comfortable. Distract them with toys or change the scenery to make feeding easier. Remain patient and avoid showing frustration, as your baby can sense your emotions.
When will their sleep routine return to normal?	Sleep patterns can be disrupted after surgery due to discomfort and changes in routine. Most children begin to return to their normal sleep routine within 4 weeks.
Is it normal for fluid (milk, water, purees, etc) to come out of the nose after palate repair?	Some fluid coming out of the nose can be normal as your child adjusts and heals. Understand the way your cleft surgeon completed the repair. Many surgeons leave a small gap/holes between the soft and hard palate for a future repair. This would cause liquids to come out of their nose occasionally.
Is it normal for blood to be coming out of their nose and mouth after palate repair?	It's not uncommon to see some blood or blood-tinged mucus coming from the nose and mouth after palate repair surgery. This can be due to the surgical site healing. However, if you notice excessive bleeding or if it continues beyond a few days, contact your child's cleft surgeon immediately.
Is it normal for the palate to collapse or sag after repair?	It is not common for the palate to collapse or sag significantly after repair. Some swelling and temporary changes in appearance are normal, but if there are noticeable issues or concerns, consult with your child's surgeon.
Is it normal for my babie's breath to smell after palate repair?	It’s not uncommon for your child's breath to have a slightly unpleasant odor after surgery due to the healing process and the presence of blood or mucus. If the smell is unbearable, please contact your cleft team. Do not attempt to clean the area.
What did you do to manage pain post palate repair?	Manage pain by alternating between ibuprofen and Tylenol every 4 to 6 hours, even if your child seems to be feeling better. Stick to this routine to be proactive, as pain can come on suddenly. Avoid relying solely on your child's apparent comfort level; maintaining consistent pain management is crucial.
How long does it take for your baby to heal?	Full recovery from cleft palate repair can take several weeks. Initial healing of the surgical site may take around 2 to 3 weeks, but complete healing can take about 6 weeks. Follow-up cleft team appointments will help monitor progress. We started to see our child's mood become normal within a few days, but we made sure she took regular pain medication every 4-6 hours to manage her pain well. Her sleep schedule, however; did not return to normal until about 6 weeks.
How much time did you take off of work?	Parents typically take about 1 to 2 weeks off from work to manage their child’s immediate post-surgery needs and recovery. The exact time may vary depending on the child’s condition and the parent's work situation. I took off 1 week from work, but I did not allow my child to return to her normal routine (daycare) until after 2 weeks.
What are signs of complications I should watch for?	Signs of complications can include excessive bleeding, high fever, difficulty breathing, or severe pain, sagging, excessive fluids coming out of the nose. If you notice any of these symptoms or other unusual signs, contact your cleft team immediately.
When can my child return to normal activities?	Light activities can usually be resumed after a 2 weeks, but avoid strenuous activities until your child’s surgeon gives the go-ahead. Follow-up visits will help determine when it’s safe to return to regular activities. We started to see our child's mood become normal within a few days, but we made sure she took regular pain medication every 4-6 hours to manage her pain well.
What should I expect during a hearing test after palate repair?	Hearing tests are typically conducted to assess any impact the surgery may have had on hearing. Expect routine testing to check for any fluid in the ears or changes in hearing, which can be common after surgery.
Will there be speech therapy needed after the repair?	Many children benefit from speech therapy following cleft palate repair to help with articulation and speech development. Your healthcare team will assess if therapy is needed and provide referrals. We have had 2 speech evaluations at 15 months and 18 months and were told speech therapy is no recommended at this time.
Are there any dietary restrictions after surgery?	Initially, your child may need to stick to soft or pureed foods and avoid anything too hot or hard. Use our guide for ideas on what to feed your baby as the begin to heal.
How can I prepare myself for post-op palate repair care?	Prepare by organizing meal trains with friends or family, having oversized shirts for comfort, and creating a chart to track medication times. This preparation will help manage your child's post-op care and your own needs more effectively.
How can I support my child’s emotional well-being during recovery?	Offer extra comfort and reassurance, maintain a comforting routine, and be patient with any changes in behavior.

This detailed guide should help address many of the questions and concerns parents may have about cleft palate repair surgery, making the process smoother and less stressful. If you have more questions or need further assistance, don’t hesitate to reach out!