As a parent, it is normal for you to feel a lot of anxiety and fear when you see a small cleft on your newborn's upper lip or a cleft on the roof of the mouth. But don't worry, this is a condition that can often be successfully corrected. In medical science, this is called a `(Congenital disorder)`, which means that it occurs while the baby is still in the mother's womb. Today, we will talk about everything in simple terms.
Simply put, what is cleft lip and cleft palate?
To understand this exactly, let's look at these two separately.
- Cleft Lip: Imagine, this condition occurs when the two parts that should form the upper lip don't connect together properly while the baby is growing in the womb. It's just like a small crack in the upper lip. Sometimes this crack can be small, sometimes it can spread to the gums, even the nostril.
- Cleft Palate: This is a gap in the top part of the baby's mouth, which is what we call the "palate." This can be in the hard part of the mouth at the front (hard palate) or the soft part at the back (soft palate).
Most often, both conditions are seen together, but some babies may have only a cleft lip or a cleft palate.
What actually happens with these surgeries?
The main goal of both surgeries is to restore the function and appearance of the baby's lips and mouth, as these clefts can cause some health problems.
These surgeries greatly help the baby's ability to eat, drink, breathe, hear, and speak.
Your doctor will explain these two surgeries to you.
- Cleft Lip Repair: Here, the surgeon makes small incisions on either side of the cleft, reconnects the muscles and skin of the upper lip, and stitches them together. This corrects the shape of the lip and nostril.
- Cleft Palate Repair: This involves reshaping the tissue on either side of the palate, bringing it into the center to close the cleft, and stitching it together.
At what age is this surgery performed on a baby?
The timing of this surgery is very important.
- Cleft lip surgery: This surgery is usually performed when the baby is between 3 and 6 months old . Sometimes, lip taping or nasoalveolar molding (NAM) may be used to help position the lip and palate tissue before surgery.
- Cleft palate surgery: This is usually done before the baby starts talking, which is around 12 months of age. If the baby also has a cleft lip, that surgery is usually done first. Sometimes more than one surgery may be needed to completely repair the cleft palate. Surgery involving the gums or jaw may be postponed until the baby is around 10 years old.
What do you need to know before surgery?
You are not alone on this journey. A team of surgeons, speech therapists, otolaryngologists, and dentists are there to help your baby.
About a week before the surgery, your pediatrician will check your baby to make sure he is healthy enough for the surgery. He may also ask you to stop taking certain medications before the surgery.
The most important thing is that the baby's stomach should be empty on the day of the surgery. That's for anesthesia. Follow the doctor's instructions exactly. These are some of the instructions that are usually given.
| Food/drink type | Minimum time to stop before surgery |
|---|---|
| Solid foods, formula, cow's milk | Stop 6 hours before surgery. |
| Breast milk | It is usually allowed up to 4 hours before surgery. |
| Clear liquids (water, apple juice) | Permission is granted up to 3 hours before surgery. |
Talk to the doctor about any questions or concerns you may have and clear your doubts.
What will I have to face after the surgery?
It's normal for the baby to be a little sick and upset after surgery.
After cleft lip surgery
After the surgery, the baby will be given soft splints to stop him from putting his hands in his mouth. This can be a little uncomfortable for the baby. The baby will be able to start breastfeeding after a while. However, it may be a little difficult at first, so fluids will be given through a saline `(IV)`.
After cleft palate surgery
The baby will need to stay in the hospital for a day or two. After the surgery, the baby can only be given liquids from a cup. Do not use spoons or straws for any reason. The stitches in the mouth will remain for a few weeks, but they are the type that dissolve. A little bleeding and swelling from the mouth and nose is normal.
How do you take care of the baby after you get home?
Your attention is very important after you get home. Follow the doctor's instructions exactly.
| Tips for caring for your baby at home | |
|---|---|
| After Cleft Lip Surgery | |
| Food and drink | Give baby food diluted with water from a cup. Do not use straws. You may need a special bottle or syringe to give milk. Ask your doctor about spoon feeding. |
| Wound care | Clean the area around the incision with warm water and keep it dry. The stitches will dissolve in 1-2 weeks. After that, a pink/red scar will be left. Apply a cream recommended by your doctor. Apply sunscreen to the scar every time you go out in the sun. |
| After Cleft Palate Surgery | |
| Food and drink | For a few weeks, give only liquids from a cup . Don't give anything solid or chewy. Give mashed, soft foods. Also ask your doctor about spoon feeding. |
| Pain and healing | You will be given painkillers and an antibiotic to prevent infection. Your baby's mouth may be swollen for a few weeks, and you may have a runny nose and snoring. This is normal. |
Under what circumstances would you need to see a doctor suddenly?
If you notice any of the following symptoms, call your doctor immediately .
- A fever of more than 101.4 degrees Fahrenheit (38.55 Celsius) that is not reduced by medication.
- Difficulty breathing or blue/pale skin.
- Excessive bleeding from the mouth or nose (pink mucus or saliva is normal).
- Signs of infection , such as pus draining from the wound.
- Signs of dehydration - loss of tears when crying, sunken eyes, dry mouth, not urinating for at least 6 hours.
- Severe redness or swelling around the incision.
- If the stitches have come loose or the incision has opened.
If you have to go to the hospital in this situation, take the baby to the Emergency Treatment Unit (ETU) of the nearest hospital.
It can take about 4 weeks to fully recover from the surgery. Your love and affection are very important to your baby during this time.
Take-Home Message
- Cleft lip and cleft palate are common conditions seen in babies. Don't worry about this.
- Surgeries to correct this condition are very successful.
- It is essential for the baby's recovery to follow the doctor's instructions carefully before and after surgery.
- Your love, care, and patience are a great source of strength for the baby during this time.
- After these surgeries, most children live healthy, normal lives without any long-term problems.
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