College of Oral and Maxillofacial Surgeons
of Sri Lanka
Cleft Palate Surgery
This leaflet is designed to help you understand your upcoming treatment and answer common questions. If anything is unclear, or if you would like more information, please speak to your surgeon, nurse, or cleft team.
The Problem
- A cleft palate occurs when the roof of the mouth (palate) does not fully join together during early development in the womb.
- This creates a gap that connects the mouth and nose, which can affect feeding, speech, hearing, and facial growth.
- Cleft palate surgery is carried out to close this gap, helping your child to eat, speak, and grow normally.
- The surgery will be carried out when the baby is around 9 months to 18 months of age
What Does the Operation Involve?
- The surgery is performed under a general anaesthetic, so your child will be fully asleep during the procedure.
- The surgeon carefully repositions and stitches together the muscles and tissues of the palate to close the cleft.
- The stitches used are dissolvable and will gradually disappear over several weeks.
- The procedure usually takes 2–3 hours, depending on the extent of the cleft.
- Occasionally, a small protective dressing (called a palatal pack) may be placed in the mouth to support healing.
After the Operation
- Your child will be monitored in hospital until they are fully awake and comfortable.
- Pain and discomfort are common in the first few days but can be controlled with regular
pain relief. - There may be some swelling inside the mouth, and your child may sound slightly
different when crying or talking. - Small amounts of blood-stained saliva or nasal discharge are normal for a few days.
- The palate repair will look swollen and uneven at first but will smooth out as healing
progresses.
Feeding After Surgery
- Feeding will need to be modified to protect the palate repair.
- Your child will usually be started on liquid or very soft foods such as purées for about 3 weeks.
- Avoid giving hard, lumpy, or crunchy foods until advised by the surgical team.
- Most children can continue to use their usual special cleft feeding bottle or be fed with a spoon.
- Encourage frequent small feeds, as swallowing may be uncomfortable at first.
Mouth Care
- It is important to keep the mouth clean to prevent infection and support healing.
- Gently rinse the mouth after feeds using cooled, boiled water or as instructed by your cleft nurse.
- Do not brush the palate area until it has fully healed.
- Avoid letting your child put fingers or toys into the mouth.
- Some children may be given soft arm splints to prevent touching the surgical area during the early healing period.
Hospital Stay
- Most children stay in hospital for 2–3 days after surgery.
- Your child will be discharged once they are comfortable, feeding well, and healing is satisfactory.
Recovery at Home
- Continue any pain medicine or antibiotics prescribed.
- Encourage your child to drink plenty of fluids.
- Avoid rough play or hard objects in the mouth for at least 3 weeks.
- Swelling and mild nasal discharge should gradually improve.
- The palate takes about 3–4 weeks to heal completely.
Possible Complications
While complications are uncommon, it is important to be aware of possible issues:
- Bleeding: Small amounts are normal; persistent bleeding should be reported.
- Infection: Rare, but antibiotics may be prescribed if there is increased swelling or
discharge. - Wound Breakdown: Occasionally, a small hole (fistula) may develop and may need later
repair. - Feeding Difficulties: Temporary changes are expected; the cleft team will provide
guidance. - Speech Problems: Some children may still develop speech difficulties later, requiring
therapy or further surgery. - Ear Infections or Hearing Issues: Common in children with cleft palate; regular hearing
checks are important.
Follow-Up Appointments
- You will be given follow-up appointments with the cleft surgeon and nurse to check healing.
- The speech and language therapist will assess your child’s speech development as they grow.
- Ongoing care may involve ear, dental, and orthodontic assessments as part of the cleft multidisciplinary team.
If You Have Concerns
If your child develops persistent bleeding, fever, swelling, or difficulty breathing or feeding,
contact your cleft nurse specialist or hospital immediately.
College of Oral and Maxillofacial Surgeons of Sri Lanka
