Early Weight Gain in Infants with Cleft Lip and Palate Treated with and Without Nasoalveolar Molding: A Retrospective Study

Objective: To assess weight gain of infants with cleft lip and/or palate (CL ± P) treated with nasoalveolar molding (NAM). Design: Retrospective, case–control chart review. Setting: Doernbecher Children’s Hospital, Oregon Health & Science University, Portland, Oregon. Patients, Participants: Infants with nonsyndromic CL ± P and noncleft controls. Interventions: Prior to primary lip surgery, NAM was either included (+NAM) or not included (−NAM) in the cleft treatment protocol. Main Outcome Measure(s): Weight gain and percentage weight gain relative to initial weight were compared among +NAM, −NAM, and control groups from birth to 7 months and from birth to 36 months. Results: Comparing +NAM and −NAM groups, no significant difference in weight or percentage weight gain was found in either time window. Compared to controls, from birth to 7 months, both CL ± P groups weighed less ( P < .001), while percentage weight gain was greater for the +NAM ( P < .001) and did not differ for −NAM. From birth to 36 months relative to controls, weight for +NAM showed no significant difference and −NAM weighed less ( P < .01), while percentage weight gain was greater for both CL ± P groups ( P < .001). Conclusions: Comparisons of CL ± P infants treated with and without NAM showed that with the NAM appliance, despite its added complexity, there was no adverse impact on weight gain. Comparisons to noncleft, control infants suggests that NAM treatment may have a beneficial impact on weight gain.