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At UPMC Children's Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this surgery and invite you to participate. Please read the following information to learn about the surgery and how you can help.
Cleft palate is a hole in the roof of the mouth that is present at birth. Early in the development of the baby inside the mother, the left and right sides of the face and the roof of the mouth join together or “fuse.” Sometimes the two sides do not fuse correctly, leaving an opening, or cleft, in the palate. A cleft palate does not mean that the palate is missing, although sometimes it may look that way.
The roof of the mouth is made up of the hard palate in the front, which is made of bone, and the soft palate in the back, which is made up of soft tissue and muscle. When the cleft is in just the back of the soft palate, it is called an incomplete cleft palate. When the cleft runs the length of the palate from the soft palate to just behind the teeth and gums, it is called a complete cleft palate. Because the lip and palate develop separately, it is possible for a child to have only a cleft lip, only a cleft palate, or both a cleft lip and cleft palate.
Left untreated, a child born with a cleft palate will face problems with feeding, growth, development, ear infections, hearing and, most significantly, speech development. It is important to correct the cleft early in a child’s life, usually between 6 and 18 months of age, but sometimes later.
Cleft palate surgery will repair the palate, with the goal of achieving understandable speech. Occasionally, more than one surgery may be needed to completely close the opening in the roof of the mouth or to change the palate to achieve more normal speech. Virtually every child born with a cleft palate is able to lead a healthy, happy life once the cleft has been repaired.
When general anesthesia is needed, there are important rules for eating and drinking that must be followed in the hours before the surgery. One business day before your child’s surgery, you will receive a phone call from a nurse between the hours of 1 and 9 p.m. (Nurses do not make these calls on weekends or holidays.) Please have paper and a pen ready to write down these important instructions. If these instructions are not followed exactly, it is likely your child’s surgery will be cancelled.
The nurse will give you specific eating and drinking instructions for your child based on your child’s age. Following are the usual instructions given for eating and drinking. No matter what age your child is, you should follow the specific instructions given to you on the phone by the nurse.
For children older than 12 months:
For infants under 12 months:
For all children:
Your child’s cleft palate repair will be done at the Same Day Surgery Center at Children’s Hospital in Lawrenceville. When you have checked in at the Same Day Surgery Center, you and your child will be called to an examination room where your child’s health history will be taken and vital signs will be checked.
You will meet with one of the doctors on your child’s surgical team to go over the surgery. He or she will answer any last-minute questions you might have at this time. A member of the anesthesia staff also will meet with you and your child to review his or her medical information and decide which kind of sleep medication he or she should get. As the parent or legal guardian, you will be asked to sign a consent form before the anesthesia is given.
When it is time for your child to go the operating room, you will be asked to wait in the surgical family waiting area.
The most important role of a parent or guardian is to help your child stay calm and relaxed before the surgery. The best way to help your child stay calm is for you to stay calm.
During the surgery, at least one parent or guardian should remain in the surgical family waiting area at all times, in case the family needs to be reached.
While your child is asleep, his or her heart rate, blood pressure, temperature and blood oxygen level will be checked continuously. To keep your child asleep during the surgery, he or she may be given anesthesia medication by mask, through the IV or both. When the surgery is over, the medications will be stopped and your child will begin to wake up.
When your child is moved to the recovery room, you will be called so that you can be there as he or she wakes up.
After the surgery, and for the weeks afterward at home, your child will only be allowed to drink liquids or semi-liquids from a cup. No utensils or straws should be used until your child’s surgeon says it is OK.
A complete list of instructions for taking care of your child at home will be given to you before you leave the hospital. The main things to remember are:
If your child has any special needs or health issues you feel the doctor needs to know about, or if you have any questions, please call 412-692-8650 before the surgery and ask to speak with the nurse practitioner or cleft clinic coordinator. It is important to notify us in advance about any special needs your child might have.
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
UPMC Children’s Hospital of Pittsburgh
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region.
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Interested in giving to Children's Hospital? Support the hospital by making a donation online, joining our Heroes in Healing monthly donor program, or visiting our site to learn about the other ways you can give back.