The cleft of the palate is repaired around 9-13 months. The aim is to repair the muscles of the soft palate to help in feeding and speech development and to repair the cleft in the hard palate.
You will be asked to attend a pre-operative appointment a week or so prior to surgery. For patients at the Oxford Centre, this is usually held at the Oxford Surgical clinic. For patients at the Salisbury centre, this may be at either the Salisbury Surgeon’s clinic or Salisbury Early Years clinic.
Coming into hospital
Your baby will be admitted the day before or the day of the operation. You will meet the nurse, doctor and anaesthetist who will all explain what will happen during your stay in hospital.
A routine hearing test will be performed prior to your baby’s cleft palate repair. Photographs are taken as a baseline for follow-up and audit records. Your baby may also need to have a routine blood test.
Day of operation
Parents are welcome to accompany their baby into the anaesthetic room. Your baby can be away from the ward for up to 4 hours. If you wish, you can accompany the nurse to the recovery room to collect your baby when they are ready to return to the ward.
Your baby will not be without food and drink for more than 4-6 hours. More detailed instructions will be explained to you at the time
After a palate repair, your baby may sound different due to the closure of the cleft. You will quickly get used to this but it will seem strange at first.
Feeding after the operation
Your baby will return to the ward with a drip and this will be continued until they are taking adequate drinks and diet. A milk feed using your baby’s normal bottle and teat can be offered as soon as wanted. Occasionally, a nasogastric tube is used for the first 24 hours to complement bottle feeding.
Some babies may be reluctant to drink and prefer solids. A soft puree diet will be introduced up to 24 hours following surgery. To help keep the mouth clean you will need to rinse with water following feeds and medication. Your ward nurse and nurse specialist will help support you in feeding your baby.
Your baby’s feeding routine will be slightly disrupted initially and you will find that it can take between 2-3 weeks to return to normal.
Will my baby be in pain?
Local anaesthetic and pain killers are given throughout the operation and every effort is made to reduce any pain or discomfort afterwards. Your nurse and anaesthetist will discuss and decide upon appropriate pain killers for your baby.
On discharge you will be given pain killers to give at home which may be needed for up to two weeks. Your nurse specialist will be on hand to advise you.
It is important to prevent your baby from putting any objects, including fingers into his / her mouth. Puree / soft diet (if applicable) needs to be continued for four weeks. Continue to give water after feeds for two weeks. Dummies may be discouraged, depending on your surgeon’s preference, but if your baby has been used to one they can be re-introduced two weeks after surgery.
The stitches in the palate are dissolvable and can take a month or more to disappear.
Following the operation, your clinical nurse specialist will make home visits as necessary. There will also be a post-operative review six weeks after the operation to assess the surgery and healing process, and to discuss next steps. This takes place at the early years clinic for your centre (see Oxford Surgical clinic or Salisbury Early Years clinic) for more details, including clinic location, who you will see and what to expect).
Some children require a further operation on their palate after the initial repair. See cleft palate re-repair. This can happen for a number of reasons and the team will discuss this with you as needed.