Feeding advice following cleft palate surgery

Feeding preparation before surgery

In the weeks leading up to your child’s operation it may be helpful to plan some meals that will be suitable for your child after their surgery. Getting suitable foods from the shops and trying out a few meals beforehand can make things a little easier later on. It is good to try to think of ways to adapt the texture of your child’s favourite foods while maintaining the tastes that they are familiar with. For example, mashing foods, or cooking fruits and vegetables, so that they are soft. It is also important for babies to be able to take fluids (milk/water) from an open cup or beaker prior to their surgery.

Babies can resume feeding either by breast or open cup/beaker on demand following surgery. For some babies we may advise against bottlefeeding as the teat can be uncomfortable and may increase the risk of wound breakdown. Your Nurse and Surgeon will advise you if this is required for your baby Babies can resume feeding (breast / bottle feeding) on demand following surgery. It can be helpful to keep a record of what your baby takes in the first few days at home after surgery. Adequate fluids are important and your clinical nurse specialist (CNS) will advise you about the amount to aim for.

Nutrition

It is important that you try to continue to give your child a good variety of foods while keeping to the dietary restrictions.

A balanced diet should consist of:

• protein foods (for example: meat, fish, tofu)
• starchy carbohydrate (for example: potatoes, pasta, noodles)
• fruit and vegetables
• calcium containing foods (for example: milk, yogurt, cheese)
• treats

Immediately after surgery

Babies can resume feeding either by breast or open cup/beaker on demand following surgery. For some babies we may advise against bottlefeeding as the teat can be uncomfortable and may increase the risk of wound breakdown. Your Nurse and Surgeon will advise you if this is required for your baby. It can be helpful to keep a record of what your baby takes in the first few days at home after surgery. Adequate fluids are important and your clinical nurse specialist (CNS) will advise you about the amount to aim for.

Children can be given drinks and suitable foods at their request – this could be in the recovery area or when your child has returned to Ward F3. Fizzy drinks and pure fruit juices are not recommended as they may irritate the wound and surrounding structures. Straws should not be used as they could damage the surgical repair. Any foods, milk or medicines should be followed by water, where possible aiming for 5-10mls each time.

Helpful tips

To supply sufficient calorie intake for healing and to continue to support growth, extra gravy, butter, olive oil, cream, cheese etc can be added to meals. For babies, you may wish to add more breastmilk/formula milk to their puree and cereals to increase fluid intake.

You may wish to offer milk or smoothies, etc between meals to help keep up energy levels.

Please note that there is a limited selection of soft foods available on the ward so you may wish to bring in clearly labelled foods from home for your child. There are fridge / freezer and microwave facilities available on the ward for your convenience.

Listed below are a few foods that your child could eat during the first three weeks following surgery. Please note that these are only suggestions. The list is not extensive but will hopefully make it easier for you and your child to discover something suitable. You might have additional ideas, which we are very happy to discuss with you as well as answer any questions you might have. We recommend avoiding foods that are ‘bitty’ (for example rice, raisins, lentils, cous cous) as pieces can become lodged in and around the stitches as well as foods that are sharp, or hard (for example toast, pizza, crisps, hard fruits such as apple) as they may damage the surgical repair / wound site. Foods that become sticky once chewed such as chocolate and bread should also be avoided until healing is complete.

In the first week after surgery

During this early stage, all foods should be of a soft consistency. Babies can be offered jars or pureed foods. Children can be offered meals of a soft consistency such as shepherd’s pie or cottage pie, cereals softened with milk, flaky fish (no batter / coating), tinned spaghetti, eggs (scrambled / fried / poached), soft fruits (tinned, cooked or mashed), soft cooked vegetables such as broccoli, soups, smoothies and jelly, custard, yoghurt. If your babies usually have ready made pouches and jars of baby food then these can be offered.

In the second week after surgery

Continue to offer soft foods as above, gradually introducing slightly more textured foods. Textures such as soft-cooked pasta in sauces (eg macaroni cheese), pancakes / soft Yorkshire puddings, noodles, slow-cooked / pulled meats.

In the third week after surgery

Firmer, more textured foods can be reintroduced at this stage such as bread, rice, cous cous, well cooked vegetables. Continue to avoid any sharp or bitty foods during this week, gradually returning to a normal diet thereafter.

If you are concerned that your child is not eating well after surgery, please speak to a cleft clinical nurse specialist on 01223 596272.