NAM: Nasoalveolar Moulding Device
Pre-surgery, your surgeon may feel a NAM (nasoalveolar moulding device) will help your baby. The NAM is fitted to the shape of the baby’s mouth and held in by tapes and rubber bands. It helps to move the segments of the gums together and shape the nose prior to surgery and is particularly useful when the cleft is bilateral.
Information on NAMs from Royal Children’s Hospital, Melbourne
Alida says Our surgeon advised he thought that NAM would be beneficial for Noah, as he had such a wide cleft. Noah was born just prior to the Xmas break so he didn’t have his initial appointment until 9 weeks, which I believe is quite late. He had a mould taken of his mouth, and the next week, we had the NAM device ready for lift off. Noah wasn’t particularly phased initially; we taped it in, and it certainly made him more ‘able’ in terms of feeding; we switched over from the Special Needs Feeder (Haberman) where we were essentially squeezing the milk into his mouth, over to a regular ‘non-squeezy’ bottle with a Traz Chu Chu Easy Feed Teat, where Noah was able to press the teat against the NAM device with his tongue and drink quite easily without assistance. I am not going to lie and say that the NAM was easy; we had issues with tape and allergies, and had to have a break for a short period of time where we ‘glued’ in the NAM device (using denture glue) and allowed his cheeks to heal. Noah was extremely adept at pulling off the tape on his cheeks, but we managed to keep the NAM device in for about 3.5 months, at which point, Noah became a bit too clever for his own good and learned to flick the NAM device out with his tongue, even when it was taped and glued in! Our surgeon’s opinion is that the cleft was easier to perform surgery on and the size of the cleft decreased thanks to the NAM device.
It was just unfortunate that Noah learned to pop it out of his mouth a earlier than we would have liked, as ongoing treatment would have rendered an even better result; we only got to do the AM (Alveolar Molding) bit of the NAM; he learned to flick out the device prior to the Naso bit, so I can not comment on the nostril shaping at all. We figured that anything to make the surgery more effective was beneficial, and at 18 months, I feel that Noah honestly has no recollection of the battles to put (and keep!) the device in. It was not an easy path, but I would do it again if the surgeon suggested that it would be advantageous.
Alisha says At 11 weeks old Taj was fitted with NAM (Nasal Alveolar Moulding) This was to help stretch the skin around the top part of his lip and shape his nostrils which in turn would make his surgeon’s job a little easier to get the best result possible. This meant an appointment every Friday up to the Royal Childrens Hospital to have the NAM adjusted as his face grew. He wore this device right up until surgery.
More information on NAMs:
Children’s Healthcare Atlanta
Leo H. Rheam Foundation
Different hospitals may do NAM treatment differently; speak with your surgeon about how it will work for you.