Cleft Lip Adhesion
Cleft lip adhesion is the first step in a two-step process to repair your baby's cleft lip. 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.
Treating Cleft Lip
The Cleft Lip and Palate Center expertly cares for children undergoing the cleft lip adhesion procedure.
The edges of skin (tissue) on both sides of the cleft lip are sewn together. The procedure helps to 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 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 in preparation 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
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The incision site will have a little redness and swelling for about 2 weeks.
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You may gently clean the incision with a moist cotton swab, if needed to remove blood.
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The stitches will dissolve while the incision is healing.
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You do not need to use antibiotic ointment or any creams.
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Clean the nostril conformer inside and around the nostrils after meals and as needed with 1 to 2 drops of nasal saline. Do not 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 your child gets enough fluids if he or she has the same number of wet diapers after surgery as before.
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Your baby should be able to drink and eat the same as before the surgery.
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The upper lip may be sore for several days. Your baby may be fussy at feeding time. It may help to give the prescribed pain medicine about an hour before feeding time.
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Your child may continue to use the same bottle and nipple that was used before surgery.
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Your child can use a pacifier after the surgery.
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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 his back to prevent rubbing the 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. Refer to Helping Hand HH-II-16, Arm Restraints. 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's advice for giving pain medicine.
Medicine Safety Tips
The doctor will order pain medicine to use at home.
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Read the label each time before you give your child medicine.
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Give the exact amount of medicine ordered by your doctor.
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Use a pediatric measuring device (available at the pharmacy) to measure the exact dose of medicine. Do not measure liquid medicines in kitchen spoons.
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Stay with your child until he or she has swallowed the dose of medicine.
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Store all medicine out of the reach of children.
When to Call the Doctor
Call your child’s doctor or the Cleft Lip and Palate Center’s helpline if your child has:
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fever over 101 F when taken rectally, axillary (under the arm) or in the ear.
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increased redness or swelling (or both) along the incision.
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yellow or white bumps (pimples) along the incision.
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new openings or gaps in the incision.
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bleeding or injury to the incision.
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redness, skin sores or unusual drainage around the nostrils.
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pain that does not go away when you give pain medicine.
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trouble drinking or eating.
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a dry diaper for 8 hours or more.
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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.
HH-I-424 7/16 Copyright 2016, Nationwide Children’s Hospital