Cleft Lip Adhesion

Cleft lip adhesion is the first step in a 2-step process to repair your baby's cleft lip (Picture 1). The goal of the surgery is to narrow the cleft in your child’s lip and gums and to set the nose in a more normal position. It is a simple surgery usually done at about 3 months of age. 

The edges of skin (tissue) on both sides of the cleft lip are sewn together. The procedure helps make the gum line straight and reposition the nose. After 3 to 4 months, the lip, nose, and gums will be molded into a better position.

When healed, the tissues of the lip will be less tight for the next surgery. Less tension or pulling on the second surgery cut (incision) will mean that your child may have a better result and a smaller scar. The second surgery will close the cleft lip completely.

Your baby will be sent home with a soft, silicone device inside each nostril. It is held in place by a stitch. The nostril conformer helps lengthen the tip of your child’s nose to prepare for the second surgery. It will be removed during the second surgery.

There are a few things to know about care at home after lip adhesion surgery. Other than these special instructions, take care of your baby like any other baby the same age.

Care After Surgery

• The incision site will have a little redness and swelling for about 2 weeks.

• You may gently clean the incision with a moist cotton swab, if needed to remove blood.

• The stitches will dissolve while the incision is healing.

• You don't need to use antibiotic ointment or any other creams. These can cause problems with the surgical glue.

• Clean the nostril conformer inside and around the nostrils after meals and as needed with 1 to 2 drops of nasal saline. Don't remove it at any time. The nose should be kept clear of blood and mucous.

Feeding

After surgery, it is most important to make sure that your baby stays hydrated. You will know if they're getting enough fluids if they have the same number of wet diapers after surgery as they did before.

• Your baby should be able to drink and eat the same as before the surgery.

• The upper lip may be sore for a few days. Your baby may be fussy at feeding time. It may help to give the prescribed pain medicine about 1 hour before feeding time.

• Your child may keep using the same bottle and nipple they used before surgery.

• Your child can use a pacifier after the surgery.

• After each feeding, give your baby 1/2 ounce of water to rinse his mouth.

Sleeping

While the incision is healing, your baby should sleep on their back to prevent rubbing their upper lip on the bed.

Arm Splints

Arm splints are used to keep the baby from accidentally hurting the lip. Use them until your baby's checkup, for 3 weeks if possible. Be sure you know how to put the splints on before you go home. The nurse can show you how.

Pain

Some pain is normal after going home. Follow your baby’s doctor or health care providers' advice for giving pain medicine.

Medicine Safety Tips

Your baby's doctor or health care provider will order pain medicine to use at home.

• Read the label each time before you give your child medicine.

• Give the exact amount of medicine ordered.

• Use a pediatric measuring device (available at the pharmacy) to measure the exact dose of medicine. Never measure liquid medicines in kitchen spoons.

• Stay with your child until they have swallowed the dose of medicine.

• Store all medicine out of the reach of children and pets.

When to Call the Doctor

Call your child’s doctor, health care provider, or the Cleft Lip and Palate Center’s helpline if your child has:

• Fever over 101° Fahrenheit (F) or 38.3° Celsius (C) when taken rectally, axillary (under the arm) or in the ear.

• Increased redness or swelling (or both) along the incision.

• Yellow or white bumps (pimples) along the incision.

• New openings or gaps in the incision.

• Bleeding or injury to the incision.

• Redness, skin sores, or unusual drainage around the nostrils.

• Pain that doesn't go away when you give pain medicine.

• Trouble drinking or eating.

• A dry diaper for 8 hours or more.

If your child has taken too much medicine or the wrong medicine, first call the Central Ohio Poison Center at (800) 222-1222, ITTY (866) 688-0088. They will tell you what to do.

Cleft Lip and Palate Center Hotline

During regular business hours 8am to 5pm, Monday to Friday, call (614) 722-6299.

After hours, on weekends, or holidays, call (614) 722-2000. Ask to speak with the plastic surgeon on call.

Follow-up Appointment

Your child will return to the Cleft Lip and Palate Center 2 to 3 weeks after surgery. For follow-up appointments at the Cleft Lip and Palate Center, call (614) 722-6537.

If you have any questions, be sure to call your doctor or call the Hospital Operator at (614) 722-2000 and ask for the surgeon on call for your doctor.

Team Care Post-op

The Cleft Lip and Palate Center at Nationwide Children’s Hospital cares for patients with cleft lip and/or palate and related craniofacial conditions. We believe team care is the best care. Our team includes:

This team works closely to make a personal care plan for your child that works as they grow. We believe that starting team care early is the best way to support your child's development.

You can expect your child's first team visit to start at about 15 to 18 months of age. Please call (614) 722-6537 or send us a message on MyChart^® to schedule your child's first team visit.

Cleft Lip Adhesion (PDF), Spanish (PDF)

HH-I-424 • ©2016, revised 2023 • Nationwide Children's Hospital