Nasal alveolar molding (NAM) therapy is the preferred pre-surgical treatment for newborns with cleft lip and palate

Nasal Alveolar Molding

If your newborn is diagnosed with cleft lip or palate, it is important that you pursue coordinated and comprehensive treatment. The condition—which consists of a split in the lips or a split in the palate inside the mouth—is usually corrected with repair surgery, but only once it is safe to do so. If left untreated in the time before surgery, the condition can prevent favorable facial development.

Nasal alveolar molding (NAM) therapy is the preferred pre-surgical treatment for newborns with cleft lip and palate. NAM therapy significantly reduces the severity of the cleft condition, brings the mouth and lips to a near-normal shape, and rebalances the facial and tongue muscles, allowing the baby’s face to develop normally in the time before the cleft lip or palate repair surgery. The NAM device is like a retainer that is fitted to shape the gums and nose prior to the first surgery, which is done to repair the lip and shape the nose.

What to Expect During Your NAM Visit

All procedures are done in our outpatient office setting. On your first visit to the craniofacial orthodontist, we will collect your baby’s intraoral impressions and photos. Following your first visit, the orthodontist will custom fabricate an intraoral device that will be fitted to your baby’s mouth during your second visit. At that time, the orthodontist will teach you how to place the facial tape and handle the device at home.

Our orthodontist will work with you to ensure the device is very comfortable for your baby to wear at all times, including during feeding and sleeping. It is uncommon for the device to cause irritation inside the mouth, thanks to the customized fit and personalized training we provide. The device is held in place with facial tape and can be easily removed and re-inserted in your baby’s mouth at any time. Skin irritation sometimes occurs because of facial taping, but it can be easily managed and will not leave any permanent scars.

The device provides a solid surface that protects the sensitive areas of the cleft and helps the baby squeeze the nipple of the bottle more effectively using normal jaw movement. The therapy will also help the baby develop important oral activities such as swallowing and tongue positioning in a more normal fashion.

What to Expect After Your NAM Visit

For the first several follow-up visits, you will see the orthodontist once a week to check your baby's progress. Depending on the progress, follow-up visits can be scheduled at longer intervals until the lip repair surgery is done. Each follow-up visit usually takes approximately 30 to 45 minutes.

The cleft lip repair surgery is typically scheduled after three to four months of NAM therapy. Immediately following the repair surgery, the intraoral device and facial tape are no longer needed. Your baby will be able to eat without the help of NAM device after the surgery.