Nasoalveolar molding (NAM) is a nonsurgical technique that has revolutionized the treatment of children with large clefts of the lip and palate. In the past, a large cleft required multiple surgeries during a child’s growth years (birth to 18), which put the child at risk for psychological and social adjustment problems.
Now, within a few weeks of birth, babies can be fitted with a painless, custom-made molding plate that looks like a dental retainer and that gently directs the growth of gums, lip and nostrils. This is possible due to the high levels of maternal estrogen present for several months after birth.
Because the plate causes no pain, babies adjust to its presence in a few days and can wear it 24 hours a day, seven days a week, even while feeding. The orthodontist adjusts the molding plate every week or two, depending on the progress.
By lessening the severity of the cleft lip or palate before surgery, NAM helps surgeons get a better result from the first surgery, which means fewer surgeries later in childhood.