About cleft surgery: frequently asked questions

The Cleft Lip and Palate Association (CLAPA) parent group at Great Ormond Street Hospital (GOSH) have asked these questions about cleft lip and/or palate surgery.

What time do we need to be at the hospital for?

• The letter confirming the pre operation assessment and the operation date will include the time of admission.
• The day before the operation a member of the team on Puffin Ward will call you to confirm what time you should arrive and the last times your child should have food and drink.

Which ward do we go to before the operation?When will our child go down to theatre, will we have to wait around for a long time?Do we get to stay with our child while they are having the anaesthetic?How long will the operation last?Will we be called to the recovery room before our child wakes up?How long will they have to stay in hospital?What pain relief will our child have?Will we get to take pain relief home?How long will our child need to take pain relief?How will our child look after the lip repair?Which ward will we be staying on after the op?Will we get to talk to our surgeon before and after the operation?Will our cleft nurse be around?How long after the operation will the stitches need removing and where do we go to have them removed?What are the visiting hours?Can both parent stay? If not what accommodation or hotels nearby are available?What facilities are there for the parents for example, beds, showers, kitchen?What food/drink should we bring?What facilities are near to GOSH?What do I need to pack?Are parking permits available?Do I need to bring toys to keep my child entertained or is there a playroom?Can I take my child away from the ward while they are staying?

• Your child will be admitted to Puffin Ward unless stated otherwise on your admission letter.
• We do our best to minimise how much time children wait before going to theatre. The surgical team on the day will be able to give you the best estimate. Occasionally there are delays for events or emergencies outside our control.
• Both parents are able to go to the anaesthetic room but we will ask you to leave as soon as your child is under anaesthetic.
• This varies depending on the specific operation, and the team will be able to give you an answer to this in the clinic when explaining about the operation. The time away from the parents is always longer than the actual operating time.
• The recovery nurses call parents down as soon as their child is ready. This can vary between different children, as some children wake up more slowly than others. The recovery nurses may ask you to take a bottle of your baby’s milk feed down with you.
• Depending on the surgery your child is having, most children stay in hospital one to two nights. Providing they are eating and drinking well and the ward and medical team are happy, your child will be discharged home.
• This varies according to the operation and also whether there are any medicines that your child cannot take. Usually there will be regular ibuprofen and paracetamol, and possibly morphine either through a drip or as a liquid by mouth.
• Yes, the ward provides pain relief on discharge but it is always a good idea to have some paracetamol and ibuprofen already at home.
• Children’s sensitivity to pain varies but it is recommended that you give regular pain relief for one week after discharge but some children may require pain relief for up to two weeks.
• The surgical team will explain this to you in clinic. There will usually be some swelling of the lip, nose and cheeks. There may also be some little dimples around the nose from hidden stitches (these dimples disappear as the swelling goes). There may be a little bit of blood in the nostril or on the lip at first.
• Most of the time your child will go to Peter Pan Ward after the operation, but on occasions you child may go to Sky Ward or Squirrel Ward. If you ask one of the staff on Puffin Ward on the day of the surgery they will be able to tell you. Information about all our wards is available.
• Yes, the surgeons work as a team. You will meet some of the team in the clinic and at the pre-operative assessment. You will also see them when you come in on the day of surgery and again after the operation. The team does a ward round each morning and evening, and there are always members of the surgical team around in case you have any questions.
• One of the cleft nurses will try to visit your child on the ward after their operation. If this is not possible, one of them will visit the next day but not over the weekend.
• If your child has removable sutures you will need to come back to Magpie five to seven days after surgery. „„Your child will need to be fasted (no food or drink) for three hours before the appointment time given to you, in case your child needs to have some sedation to remove the sutures.
• Parents can visit at any time but we prefer other visitors (including your other children) to visit between 10am and 8pm.
• Only one parent is able to stay with your child on the ward. If you contact parent accommodation, they will be able to give you a list of nearby available accommodation. Their telephone number is 020 7405 9200 ext 8151 or 7871
• The ward has a kitchen for parents to make tea, coffee and other drinks but the ward does not provide food for parents.
• Parents have a pull out chair bed if they are in the main ward or a fold up bed if their child is in a cubicle. There is a bathroom that the parents can use on Peter Pan Ward. Talk to the nurse in charge if you are on another ward at GOSH.
• The hospital provides food and drink for your child but if your child has any particular favourite foods then you may like to bring them with you.
• Hospital policy is that you can only bring in unopened cartons, bottles or tins of your child’s formula. If you bring a tin of formula powder, please give it to one of the nurses on the ward and they will send it to the Milk Kitchen to be made up for you.
• If your child is having an operation to their palate they will need to have soft food for two to three weeks after the surgery. Have a look at our food suggestions information sheet about what to give your child after surgery.
• The Brunswick Centre has a Waitrose, Superdrug, Boots, there are also banks, clothes shops and many restaurants.
• Your baby’s bottles and teats.
• Clothes that open up the front – they may get stained from dribbling after the operation so please do not bring anything too new or precious.
• For babies, bring mittens or socks that can go on their hands to stop them putting their fingers in their mouth.
• Parking permits are available from GOSH reception for all appointments, day of admission and day of discharge but not the days in between.
• There are toys on the ward and there is a playroom, but if your child has a favourite toy or comforter, you may wish to bring that in with them.
• Yes, it is usually possible to take your child off the ward, but you will need to check with the ward staff first. They will probably ask for your mobile phone number in case they need to call you back to the ward for any reason.