You'll find hundreds of files on cleft lip, cleft palate here on widesmiles.org.

This one is about: Wearing the No-No's (Arm Restraints) After Surgery

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Wearing No-No's After Surgery

Excerpted from Cleft-talk

I have three, and all three had cleft. All three wore the restraints. And all three did fine with them. Since each of my three have distinctive personalities, and yet none of the three had a problem wearing the restraints, I have to believe that something we did across all three children must have worked. For our kids, the restraints were on for two full weeks and off only for bath.

As the Director of WS and the listowner of this list, I have to cover our collective butts here and point out emphatically that neither Wide Smiles nor Cleft Talk can advise you to take those restraints off against your doctor's orders. They are ordered for a reason, and they are a protection for the baby. The fact that many parents do is a matter of individual experience, and I thank parents for sharing their experiences here.

Now - what I did - our experience -- that possibly helped us to keep them one was ----

1) I made certain that the kids wore arm restraints that fit properly. There is no way that a poorly-fitting sleeve is going to work. The restraints should fit from above the elbow to below the armpit, and they should be snug.

2) I ensured comfort. The baby had freedom of movement of the shoulder, the wrist and the hand. The ONLY thing that the baby could not do was bend the elbow to get the hand to the mouth (the elbow did bend - just not enough to get to the mouth). I also used powder under the restraints and a cotton shirt between the restraints and the baby. Since we used a jacket, the restraints were not overly snug. In fact, they fit the baby kind of loose. Pediwraps, though, need to be snug to stay on.

3) (and very possibly most importantly) my own attitude was one of resolution. We had to use the restraints, therefore, we did. They were ordered for the safety of the baby, therefore, they were not negotiable. I have observed that the babies who have the MOST trouble wearing them are the ones whose parents really, REALLY did not want to use them to begin with. I think it is possible that the baby senses a weakness there and reacts accordingly ("If mom and dad think this is a horrible thing, then I sure don't want any part of it!!!")

If my child broke his arm (heaven forbid), I would have his arm casted, and I would not try to remove that cast until the arm healed. I don't know any parents who would have a problem with that. Their mind-set is one of resolution, and the children tend to simply accept that resolution. We also should go into this experience resolved that arm restraints are a part of the program.

It is true that some doctors do not order the use of the restraints. It gets back to the issue of trade-off. Those who do use them are not doing so just to heap punishment upon the parents and baby. They know that the restraints afford protection. Those who don't order them feel that the parents wouldn't use them anyway. I personally have experience with parents who either chose not to use them, or who were not ordered to use them, and the repair was compromised. Most are not compromised. But I cannot tell you how horrifying it is to try and help calm a mother whose child's incision is bleeding - stitches prematurely popped -- because of an accident that happened "that fast".

But worse than the threat of trauma is the threat of infection if dirty little hands can make their way to that healing wound. And I also have experienced moms whose child's lip was infected after repair, and it is not pretty.

Will a child touch something that hurts??? You bet they will. How many kids do you know who will pick at a healing sore? All of mine will. Can you keep your tongue off a broken tooth??? Even after the tip of your tongue is sore from touching it? I can't (very easily, anyway). And how about that itchy stage of healing? Which is stronger? The urge to ignore a pain, or the urge to scratch an itch? People who say that a child will not touch the wound because it hurts have not thought this through. It makes sense in theory, but our children are not theoretical.

So -- WS policy is -- follow your doctor's orders. If he says restraints, then restraints it is. Get the best, make sure they fit and they work. If baby can wiggle out of them, fix it so he can't. Take them off only for bath time and for whatever time the doctor allows, but do not take chances when the loser could be your baby.

My kids actually did not mind them at all. They made my children a bit awkward to hold, but we managed. Jacob was a tummy sleeper, but he managed. It is only two weeks out of your child's life (usually). You will both get through it, but you will get through it most easily if you simply tell yourself that it is necessary and accept is as a protection and not as a torture device. Once again -- we do it FOR our child, not TO our child.

Joanne


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