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DRINK UP! Post Surgical Dietary Restrictions
by Joanne Green
Restrictive diets are a part of oral/maxillofacial surgery. Some doctors are more lenient with their definitions of restrictive, some are very strict. Regardless of what someone else may or may not have been allowed, always follow the instructions of your own surgeon to the letter. When it comes to surgical after care, a good rule of thumb is that it is better to err on the side of caution.
After surgery most parents are told something like this: "When you go home he'll be on a clear liquids diet. Follow that with full liquids and after about a week you can go to soft foods." Right. But what does that mean in the day-to-day life of feeding a hungry child?
Each of the terms above have specific definitions. Each type of food is allowed or disallowed for specific reasons. Each specific diet will be easier or more difficult to adhere to depending on the age of the child. (For instance, it is easy to keep an infant on a full liquid diet. It's all he's ever known. But your preteen may begin to turn hostile at the thought of another liquid meal.)
CLEAR LIQUIDS: "Clear liquids" means anything you can both see through and pour. This includes water, flavored fruit drinks, apple juice, cranberry juice, flat 7-up and clear broth. When a clear liquid diet is prescribed for the sole purpose of inhibiting vomiting, flavored gelatin is also included. For the healing of maxillofacial surgery, a clear liquid diet in the strictest sense would require that the gelatin be unhardened. The purpose of the clear liquid diet is three-fold. First, immediately after surgery your child may have some stomach upset due to anesthesia and swallowed blood. Clear liquids are less likely to cause vomiting. Second, clear liquids are free from any matter that might lodge in the nooks and crannies around the sutures. Therefore a clear liquid diet reduces the risk of infection immediately post surgery. Finally, clear liquids can be consumed with a minimum of tongue motion. It reduces any stress that may be put on the new suture line from the sucking/smacking that we ordinarily do in the process of eating.
Some children stay on clear liquids no more than a day, while others remain on this diet a week. It is entirely up to your doctor.
FULL LIQUIDS. The first logical step past clear liquids is full liquids. Full liquids are defined as anything that you can easily pour. Another definition is that a full liquid is anything that can be easily squeezed through the nipple of a bottle. (Although most doctors will not allow a bottle to be used to feed the child at this point.) Finally, full liquids can be defined as anything that can be easily sucked through a straw. (Again, many doctors do not want your child to be using the suction necessary to use a straw yet.) Most full liquids are delivered through an oral syringe.
The full liquid diet allows your child more nutrition and more variety, but still protects the healing sutures from the smacking and sucking that could disturb them. It also requires far less pressure from the tongue in swallowing. Because there may be matter in the full liquid that could lodge in the sutures, it is best if any full liquid meal be followed with clear water.
When your child is on a full liquid diet you can use your imagination. If your child is a toddler, you can mix her favorite baby food with water, milk, juice or formula until you can pour it. If there are chunks of food in the baby food, mix it in a blender until the chunks are liquefied. As a matter of fact, your blender can open a world of possibilities for your child on the full liquid diet. My 3-year-old daughter's favorite meal during full liquids was canned soup (any and all flavors), mixed with a can of milk and blended into oblivion. People have been known to blend whole meals for the full liquid diet, and as long as the end product is pourable, it qualifies.
Other full-liquid favorites include melted ice cream or sherbet, instant breakfast drinks and diet shakes.
Many doctors require that their patient remain on full liquids until two full weeks after surgery. Some do not require so long a limited diet. Always follow the time line your own doctor lays out for you.
SOFT FOODS. Soft foods require a minimum of chewing and stay in the mouth a minimum amount of time. They are easily masticated and quickly swallowed. If pressed against the palate they will yield and mush up. A soft food is defined as anything you can easily push a fork through. Examples of soft foods include overcooked carrots, mashed potatoes, or pasta cooked long past the al-dente stage.
Most baby foods, with the exception of baby cookies and biscuits, and other hard foods, qualify as soft foods. Puddings, hardened gelatins, fruit yogurt (without added munchies), and soften but still frozen ice creams also qualify. Once again, your blender can convert almost any food into a soft food. While it may not look as appetizing as one would like it, the taste is virtually unchanged. Blended foods that can be spooned are soft foods. Hot cereals qualify as soft foods. Also try blending a cold cereal with sugar and milk, then microwave until warm. My kids love it as an alternative to other hot cereals - even when their diets are not restricted.
The important thing to remember is that these diets are prescribed so that we might optimize our children's healing. Though they might be difficult to follow, they are not permanent changes in eating styles. They are all time limited. To "cheat" the diet would be to jeopardize the healing process. That could mean infections, fistulas, and more surgeries in the future.
Your doctor has valid reasons for requiring a strict diet regimen. Follow his instructions and you and your child will be happier for it.