How Is NAM Performed for Cleft Lip?

How Is NAM Performed for Cleft Lip?

Understanding the NAM process helps parents know what to expect. Here is a step-by-step overview.

Nasoalveolar molding (NAM) is performed over several months, starting in the first weeks of life. Here is how the process works.

• Step 1: Initial appointment (first 1–2 weeks of life)
• The NAM specialist (orthodontist or pediatric dentist) takes impressions of the baby's mouth
• This is done carefully to avoid any distress
• The appliance is custom-fabricated

• Step 2: Fitting and first adjustment
• The appliance is fitted to the baby's mouth
• It covers the upper gum like a retainer
• Tapes are placed on the baby's cheeks to guide tissue
• Parents learn to remove, clean, and reinsert the appliance

• Step 3: Weekly adjustments
• The baby visits the NAM specialist every 1–2 weeks
• The appliance is adjusted to gradually move the gum segments
• The nasal stent is adjusted to reshape the nostril
• Tapes are changed to apply the right amount of tension

• Step 4: Maintenance
• The appliance must be worn 24/7 (except for cleaning)
• Removed and cleaned 2–3 times per day
• The baby's skin where the tapes stick needs special care

Parent Role

• Parents are essential to NAM success. You will:
• Remove and insert the appliance
• Change tapes every 1–2 days
• Clean the appliance
• Keep appointments

Clinical Guidance

NAM is performed through weekly adjustments starting in the first weeks of life. The appliance is worn 24/7 and gradually reshapes the gums, lip, and nose. Parents play a key role in daily care. NAM continues until cleft lip repair surgery at 3–6 months.