Nasoalveolar Molding and Burden of Care – Parents Point of View

Background: Individuals with Cleft lip and palate (CLP) undergo surgical and Non-surgical multidisciplinary treatments from birth to adulthood with many visits to a specialized center, loss of school days, loss of work days for parents, and stress. Pre-surgical orthopedic treatment, beginning in the first week of the child`s life and continues for several months, is one alternative for improving the aesthetic results post-surgery.

Aim: Assessing burden of care and satisfaction with aesthetic results by families of children with CLP undergoing Nasoalveolar Molding (NAM) treatment.

Methods: 120 families whose children underwent NAM treatment for cleft lip and palate were given a questionnaire to assess the burden of care and outcome from their perspective.

Results: Questions were evaluated on a Likert Scale. More than 70% were satisfied with the outcome as well as the process of the treatment. At an overall analysis, majority of parents (90%) would also recommend this pre-surgical treatment to others despite the burden of care.

Conclusion: World Health Organization recommends that the burden of care is decreased by shortening the treatment protocol and preventing overtreatment. Infant Orthopedic treatment (including NAM) is still a controversial issue in the cleft lip and palate literature. The opponents for NAM treatment regard it as a cumbersome process which lays a heavy burden of care on the families. However, this study shows that the majority of parents think that NAM treatment adds value to the outcome and are willing to put in the extra effort for a better aesthetic result.