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Cleft lip

What is a cleft lip?

A cleft lip is a lip that did not come together evenly in the early months of fetal development. The cleft may extend into the palate (roof of the mouth) and/or into the nose, or may just involve the lip.

The cleft can occur on one or both sides of the lip. Surgery is done to repair it, usually within 3 to 6 months after birth. Some babies need a molding device made by a specially trained pediatric orthodontist. It is designed to bring the cleft edges into better position and shape the nose before surgery.

How can my baby eat?

Your baby's feeding plan will be determined by the severity of the cleft. Feeding options may include breastfeeding with some modifications (see the education sheet "Breastfeeding an infant with cleft lip"), bottle-feeding with special bottles or nipples, or using a feeding tube. The doctor and nurses will teach you how to use the feeding aid that will best fit the needs of your child.

What can I expect after surgery?

The anesthesiologist and surgeon will prescribe and explain the medicine that will be used to keep your child comfortable. Your child will have an intravenous line (IV) to provide fluids, pain medicines, and antibiotics.

A monitor will be used to observe your child's heart rate and breathing patterns while receiving IV pain medicines.

Your baby will not have anything to drink until fully awake from anesthesia. This is usually 1 to 4 hours after surgery, depending on the doctor's orders. When able to drink, your baby will be fed by a method similar to before surgery (either breast or bottle) depending on the type of cleft. At first, your baby will be fed glucose (sugar) water, then progressed to breast milk or formula. When feeding, be careful not to rub against the incision.

A pain reliever such as acetaminophen (Tylenol® or another brand) will be given for discomfort about every 4 to 6 hours. This is often a frustrating time for you and your child, and extra comfort and holding during this time may be helpful.

How do I care for the incision?

___ If the incision is covered by Steri-Strips®, no cleaning is needed. The Steri-Strips® will be removed at the surgeon's office.

___ Your incision may have been closed with liquid surgical glue. Liquid surgical glue is a sterile, liquid topical skin glue. It is used to hold closed skin edges of wounds from surgical incisions. If liquid surgical glue has been applied to your child's incision, you will notice a film over the incision site.

  • DO NOT apply liquid or ointment medications or other substances to the incision after it has been closed by liquid surgical clue, as these substances can weaken the film and allow the incision to reopen.
  • DO NOT pick at the film covering the incision. This can disrupt its adhesion to the skin and cause skin edge separation.
  • The liquid surgical glue film with naturally flake off in 5 to 10 days.
  • DO NOT scrub, soak, or expose the site to prolonged wetness until the film has flaked off and you have had a post operative exam by your surgeon.

How can I care for my child?

It is very important to protect the incision after surgery.

Do not give your child a pacifier or change the feeding method until you are instructed by the doctor.

Babies should sleep in an infant seat on their back.

Do not hold your baby with the face toward your shoulder. It is very easy for your baby's head to "bob" and bump your shoulder.

Your child will need to wear arm cuffs at all times to prevent rubbing on the incision line. Use a long-sleeved shirt under the arm cuffs to protect the skin. The arm cuffs can be taped to the pajama top so they don't slide off. Do not tape them to your child's skin.

Take off the arm cuffs, one arm at a time, to exercise arms and hands 2 or 3 times a day. Check for red or tender areas in the armpit
or wrist area.

Use the arm cuffs until your baby sees the surgeon again (see your Discharge Instruction sheet). At that time, the surgeon
will decide how long to continue to use them.

When should I call the surgeon?

  • any break or opening in the incision
  • temperature higher than 100.5° F (38° C) under the arm
  • incision is red, swollen, or draining

What else do I need to know?

Financial aid may be available through Services for Children with Handicaps or TEFRA. For more information, contact the hospital social worker or your local county social worker. Other resources include:

American Cleft Palate Foundation
1829 E. Franklin St. Suite 102
Chapel Hill, NC 27514-2820
1-800-24-CLEFT
www.cleftline.org

Cleft and Craniofacial Clinic
Children's Hospitals and Clinics
2525 Chicago Avenue South
Minneapolis, MN 55404
612-813-6888

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please call the doctor.

Children's Hospitals and Clinics of Minnesota
Patient/Family Education
2525 Chicago Avenue South
Minneapolis, MN 55404
Last reviewed 8/2015 ©Copyright

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Family Resource Center library, or visit www.childrensmn.org/educationmaterials.

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