 
The Information below relates specifically to primary and secondary palate repair which are carried out in infancy. There may be other procedures offered to you, especially if you are seen in our adult clinic. At this point the procedure will be discussed in depth with you.
An operation is performed only when the baby is healthy and not suffering from a cold. It is also important that your baby does not have any vaccinations in the 2 weeks before and after the operation. By 3 months of age, most babies with a cleft lip will be big and strong enough to have it repaired.
The cleft palate is usually between 6 and 10 months of age. The main aim of the operation is to achieve normal muscle union so that the lip and palate work properly. This assists the development of normal speech.
The baby is admitted to the hospital one day before the operation and stays up to three days after the operation. A parent who wishes to stay in the hospital with their baby is welcome to do so, and should inform the ward nurses of their intentions when the baby is admitted. It helps if the baby has some favourite toys in hospital. However, parents are advised to label them with their child's name.
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For babies with cleft lip, the operations will be arranged as soon as the baby has grown sufficiently. Usually the baby is about 3 months of age.
The cleft palate (whether or not there has been a lip cleft) can be left for longer but is usually repaired between 6 and 10 months of age.
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For some babies, a different feeding method may be necessary after surgery, using either a cup, spoon, scoop or spout in conjunction with a squeezy bottle - the nurse will advise you.
Please note that we discourage use of a dummy after an operation on a cleft, and it is best to withdraw its use before your baby is admitted.
During the week before admission we need to check that there are no germs in the nose or throat of your child that would prevent the operation. In the past we have found that live natural yoghurt (not fruit yoghurt), one or two teaspoonfuls twice a day, is helpful in dispelling harmful germs.
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Your baby will be able to have milk feed up to 6 hours before the operation. Clear fluids (such as juice) are allowed up to 2 hours before the operation.
Your baby may be given a sedative an hour or more before, and you may accompany your child to the anaesthetic room, if you wish to do so. The return from the operating theatre will be 2 - 3 hours later.
The main aim of surgery, in both lip and palate cleft, is to achieve union of muscles so that they can work properly, and help to develop normal speech. We also aim for the lip and nose to look almost normal.
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Suppositories of a pain-killing drug initially control pain. From the day after the operation, paracetamol and codeine taken by mouth is effective for most babies. After the operation your baby will soon be glad to have a feed. For 3 weeks after a cleft palate operation, the baby (who is accustomed by now to solids) will have to be fed very sloppy foods, using plenty of milk, gravy etc. After every feed the mouth must be cleaned by drinking a little water.
Stitches in the skin of the lip will be removed under a brief anaesthetic on the 5th day. Your baby will be able to have milk feed up to 6 hours before the anaesthetic. Clear fluids (such as juice) are allowed up to 2 hours before the stitches are removed.
Stitches inside the palate are left to ‘dissolve' which may take a month.
Your baby will stay in hospital for up to 3 days after the operation. It takes several weeks for the muscles to become really supple again, and we shall arrange the date of your clinic appointment with this in mind one month after the lip operation.
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