The NAM device can be beneficial for a cleft on one or both sides of the face. It works by gradually bringing the two sides of the cleft together and closing the gap in the gum line. It also molds the nose to create symmetry.
NAM Should Start Within First Weeks of Life
Shortly after birth, our craniofacial orthodontist and pediatric plastic surgeons evaluate your infant. If your child will benefit from NAM, a dental impression is taken of your infant’s mouth in the clinic. The process takes a few minutes and is done while your baby is awake. The impression is used to create a custom acrylic device that resembles an orthodontic retainer. The device is placed in your newborn’s mouth and worn for 24 hours a day for the recommended treatment time. Depending on the type and severity of your child’s cleft, the NAM appliance may remain in place for a few weeks or up to six months.
NAM Is Not Always the Answer
NAM may not be necessary for incomplete and/or narrow clefts. Some families may choose not to pursue NAM for personal reasons. We support your family's choice and welcome you to work with our team. Cleft surgery can proceed without NAM.
We Train You to Place, Remove, and Clean the Device
You and your baby’s caregivers will be trained to carefully place, remove, and clean the device. You’ll also learn how to manage any skin or mouth irritations that may occur. Infants may experience some initial discomfort wearing the NAM device but will get used to it quickly.
We Offer Feeding Support
Our speech pathologists work with you and your baby immediately after the NAM device is placed. This is important because some babies have difficulty adjusting to feeding with the new device. However, some babies’ feeding improves with the extra support of the NAM plate, especially if the cleft is very wide. Each baby and situation is different and our speech pathologists can provide education, guidance, and encouragement as your baby begins to feed with NAM. Additional sessions or telephone calls can be arranged to provide more support as needed. We help you every step of the way.
Regular Visits Ensure the Device Is Working
You will bring your baby to our orthodontic office every one to two weeks so we can monitor your baby’s progress and make adjustments. If needed, a small stent is placed in the nose to improve symmetry and shape. Our doctors and speech-language pathologists offer advice between visits.
Noticeable Improvement Over Time
You will see a noticeable difference as the two sides of the cleft come together and the facial structures straighten. Once the best possible results are achieved, your baby will be scheduled for surgery to close the remaining cleft. The NAM device optimizes your baby’s chances of experiencing the best possible outcome in one surgery. It simplifies the surgery, produces better aesthetic and functional results, and can reduce the need for additional surgeries or revisions later on. The goal of our team is to perform the fewest surgeries and provide the best possible result.