Frequently Asked Questions

About cleft lip/cleft palate

• Can I breastfeed my baby with a cleft lip or cleft palate?
  • Babies born with a cleft palate are usually unable to breastfeed successfully. They are unable to effectively form a seal and create the suction necessary to draw milk from the breast. Furthermore, these babies will burn more energy trying to feed. Weight gain is a big concern. We encourage moms to pump milk. Babies with an isolated cleft lip may or may not be able to breastfeed depending on the size of the cleft.
• How can my baby with a cleft lip and palate feed?
  • By using special cleft lip and palate feeders. These bottles are specially designed to assist babies in creating and maintaining suction. Our certified speech-language pathologists will evaluate your baby's feeding skills and provide a bottle that best suits your baby's needs.
• As my baby grows, what keeps the cleft lip from getting wider?
  • Depending on the type of cleft, there are several options your surgeon will discuss with you.
  • -Lip taping (DynaCleft®) is a less invasive, non-surgical option that involves taping the two sides of the lip together to prevent expansion. We teach families to do this at home.
  • -A nasoalveolar molding (NAM) appliance is another non-surgical option. It is a custom-made device applied to the baby's mouth to prevent expansion. A NAM is not tolerated by some babies and is sometimes difficult for families as it requires weekly trips for adjustment.
  • -A lip adhesion is a surgical option that is commonly used for wide clefts when families aren't comfortable with the other two options. In a lip adhesion procedure, the plastic surgeon stitches the sides of the lip together until the formal repair can be done.
• Is it normal for food or liquid to come out of my baby's nose?
  • Yes, the opening in the palate and the nose connects, so there is nothing to block the liquid and food from coming out the nose. This should stop after the repairs are completed.
• Is there anything special I need to bring to the hospital when my baby has surgery?
  • We suggest that the family bring any special formula, food, diapers, and any other special items that the baby needs. We usually have supplies on the floor, but normally these are commonly used brands. Also, we suggest bringing anything the baby usually keeps for comfort measures such as favorite blankets, pacifiers, and soft toys. Also, pack and dress your baby in comfortable clothes that either zip up or button up to avoid having to pull them over your baby's head.
• How long do I need to keep the arm splints on?
  • We request that you keep them on at all times for the first two weeks. Exceptions are during bath time and when a parent is physically with the baby watching with undivided attention. Then, for one more week just at night, for a total of three weeks.
• What kinds of foods can my baby eat after surgery?
  • Feed your baby soft foods, such as pureed or mashed foods, Jello® or pudding. Don't use anything hard or crunchy, or anything with sharp edges or that can break into sharp edges. Avoid salty, acidic and spicy foods.
• Can my baby have a pacifier after surgery?
  • Yes! Your baby can also have a bottle as usual and a sippy cup with soft spout. No straws.

About craniofacial conditions

• My baby is being referred for an abnormal head shape? What can I expect?
  • Your child will see one of our pediatric plastic surgery providers. At this visit, he/she will evaluate the shape of your baby's head. This will include measurements, a hands-on examination of your baby's head to check for irregularities. The doctor may take photos. You may be asked about your baby's sleeping positions and when you first noticed anything unusual.
  • Commonly seen conditions are:
  • -Normal head shape
  • -Plagiocephaly: Head shape changes related to lying in one position for too long. This can occur with unchanged sleeping positions, long periods in a car seat or often-used feeding positions. It also can happen when a baby prefers to look to one side. This condition is sometimes treated by cranial remolding helmet therapy.
  • -Craniosynostosis: A congenital condition when one or more of the growth seams in the skull closes too early. This requires surgical intervention. If your doctor suspects craniosynostosis, he or she will order a CT scan and bring you back to clinic to discuss surgical options. You may also meet a neurosurgeon during the follow-up visit.
• Is swelling after surgery normal?
  • Yes, swelling around the eyes is perfectly normal and should go away within a week or so.
• Is it normal for my baby's head to be lumpy and bumpy?
  • Yes, these areas will improve over time as the bones of the skull remodel and heal.
• Is it normal for my baby to have sleep issues after surgery?
  • Yes, some parents report issues with sleep once they get home from the hospital. Your baby's sleep patterns may be affected. They may stay awake at night and sleep during the day. This should return to normal after a couple of weeks.
• When can my baby go back to daycare?
  • Your baby's post-op appointment will be within two to three weeks of surgery. Most families wait until after this visit to take their baby back to daycare.