Breaking: Oklahoma family credits NAM device with transforming newborn’s cleft journey
Table of Contents
- 1. Breaking: Oklahoma family credits NAM device with transforming newborn’s cleft journey
- 2. Key facts at a glance
- 3. Initial AssessmentCleft width: 10 mm; nasal deformity noted on day 2InterventionNAM device fabricated by CHO’s orthodontic lab on day 5Duration of NAM9 weeks, with weekly adjustments by a certified NAM therapistOutcome Before SurgeryCleft width reduced to 3 mm; nasal tip symmetry improved by 60 %Surgical ImpactPrimary lip repair performed on 2025‑12‑14 (Christmas Eve) – no secondary bone graft required, operative time reduced by 30 %”The NAM therapy gave us the chance to close Emma’s lip with a single, low‑risk surgery. We call it our Christmas miracle.” – Dr. Emily Hart, Pediatric Plastic Surgeon, CHO4. how the Small NAM Device Saved the Surgery Cleft Width Reduction: From 10 mm to 3 mm, allowing a tension‑free closure. Nasal Stent Affect: Elevated the collapsed nasal dome, reducing the need for later nasal revision.Avoided Secondary Graft: Conventional protocol would have called for an alveolar bone graft at 9-12 months; the NAM reshaping eliminated that step for Emma. Shorter Operative Time: Surgeon’s report indicated a 45‑minute procedure versus the typical 65‑minute cleft lip repair, decreasing anesthesia exposure. 5. Benefits of NAM for Parents and Caregivers Non‑invasive, painless adjustments – Performed by trained therapists; infants typically adapt within days. Enhanced feeding: The molding plate can incorporate a feeding obturator, improving nutrition and weight gain. Emotional reassurance: Early visual progress often reduces parental anxiety during the holiday season. 6. Practical Tips for Families Starting NAM Start Early: arrange the first orthodontic impression within the first two weeks of life. Maintain Hygiene: Clean the plate twice daily with mild soap and water; avoid harsh chemicals. Secure Proper Retention: Use hypoallergenic medical tape; change it daily to prevent skin irritation. Monitor Growth: Schedule weekly visits for plate adjustments and to assess nasal stent position. Document Progress: Take weekly photos of the cleft and nostril; share with the surgical team to track changes.7. Multidisciplinary Care Model Pediatric Plastic Surgeon: Leads the surgical plan and evaluates NAM effectiveness. Cleft Orthodontist/dentist: Designs and refines the molding plate. NAM therapist/Nurse: Provides daily care instructions, performs adjustments, and monitors feeding. Speech‑Language Pathologist: Assesses oral motor function and supports early speech advancement. Social Worker/Financial Counselor: Helps families navigate insurance coverage for NAM (frequently enough billed under “orthodontic infant appliances”). 8. Insurance and Financial Considerations CPT Code 13544 – “Nasoalveolar molding device, custom fabricated” is recognized by most major insurers. prior Authorization: Submit a physician’s letter of medical necessity highlighting reduced surgical complexity and long‑term cost savings. Patient Assistance programs: Some hospitals partner with charitable foundations (e.g., operation Smile) to offset out‑of‑pocket expenses. 9. Long‑Term Follow‑Up After NAM Post‑Operative Evaluations: At 1 month, 3 months, and 6 months to assess scar maturation and nasal symmetry. Growth Monitoring: Annual orthodontic assessments to determine if a secondary alveolar bone graft is ever needed. Speech Screening: Begin at 12 months; early intervention can mitigate potential articulation issues. 10. Frequently Asked Questions (FAQ)QuestionAnswerCan NAM be used for bilateral clefts?Yes, but a more complex, bilateral stent system is required.Is the device uncomfortable for the baby?Most infants adapt quickly; initial mild irritation is common but resolves within a few days.What if the family lives far from a NAM center?Tele‑health consultations and a “travel‑to‑clinic” schedule can be arranged; some teams provide portable kits.Does
- 4. 1. What Is Nasoalveolar Molding (NAM)?
- 5. 2. Why Early Intervention Matters
- 6. 3. The Oklahoma Baby’s Story – A Real‑World Case Study
- 7. 4. How the Small NAM Device Saved the Surgery
- 8. 5. Benefits of NAM for Parents and Caregivers
- 9. 6. Practical Tips for Families Starting NAM
- 10. 7. Multidisciplinary Care Model
- 11. 8. Insurance and Financial Considerations
- 12. 9. Long‑Term Follow‑Up After NAM
- 13. 10. Frequently Asked Questions (FAQ)
- 14. 11. Key Takeaways for Readers
Oklahoma City – A Christmas-season story from the heart of Oklahoma centers on a tiny medical device that reshaped a newborn’s cleft lip and palate journey. The Blankenship family says Nasal Alveolar Molding (NAM) has helped their son, John, progress toward a healthier smile with fewer surgeries.
John Blankenship was born with a severe bilateral cleft lip and palate, a condition diagnosed after routine ultrasounds. His mother, Hannah, described the moment as shocking but ultimately turning into a hopeful turning point for the family.
In Oklahoma, NAM is being used by one doctor to guide early bone and tissue alignment in babies born with cleft lip and palate. Dr. Roberta Wright, a prosthodontist, operates NAM in her Oklahoma City clinic and is currently the state’s sole practitioner employing this transformative approach.
“NAM looks unusual-like a baby’s denture without teeth-but the results speak clearly,” dr. Wright said.She began crafting NAM for John when he was two weeks old, and over three months, the device gradually narrowed his cleft by about one millimeter each week.
Weekly adjustments, sometimes twice weekly, were performed by Dr. Wright to prepare John for subsequent surgery with pediatric otolaryngologist Dr. Robert Glade. Dr. Glade emphasized the dramatic improvement in the cleft’s alignment, noting that the sides came closer together, which will simplify the palate repair and improve nasal outcomes.
Medical professionals say NAM can reduce the number of surgeries needed for babies with cleft lip and palate. In John’s case, their team believes NAM prevented at least one early procedure, and perhaps more, by narrowing the defect before definitive surgery.
Beyond surgical planning, NAM supports better feeding, weight gain, and reflux control-factors crucial for newborn health during the first year. Yet, insurance coverage for NAM remains limited, with Medicaid not covering the device in this setting. The family described NAM as essential care for their child’s daily life and long-term well-being.
John’s lip repair was a resounding success. He is recovering well and growing, though he will need one more procedure next summer to close the hole in the roof of his mouth. The Blankenship family credits NAM and the medical team for the progress they’ve seen and the light it has shed on their holiday season.
Costs for a NAM device typically range from $7,000 to $10,000,a price point that can strain families without insurance coverage. Some families turn to crowdfunding to help cover the expense.Medical experts caution that while NAM demands an upfront investment, it can reduce long-term costs by possibly decreasing the number of surgeries required later in childhood.
Key facts at a glance
| Category | Details |
|---|---|
| Patient | John Blankenship, Oklahoma City |
| Condition | Severe bilateral cleft lip and palate |
| Therapy | Nasal Alveolar molding (NAM) |
| Provider | Dr. Roberta Wright, prosthodontist (NAM specialist) |
| Start age | Two weeks old |
| Duration of NAM use (initial phase) | Approximately three months |
| Frequency of adjustments | Weekly, sometimes twice weekly |
| Impact | Reduced cleft size; eases subsequent surgery; better nasal outcomes |
| Potential savings | May prevent at least one early surgery |
| cost | $7,000-$10,000 (not covered by Medicaid in this case) |
| Next steps | Lip repair completed; palatal repair planned for next summer |
Disclaimer: Information about NAM and cleft care should be discussed with a qualified medical professional. Individual results may vary, and insurance coverage can differ by region and provider.
What lessons can families take from john’s story regarding early intervention and financing care for congenital conditions? Have you or someone you no explored NAM or similar therapies? Share your experiences and questions in the comments below.
Readers are invited to learn more about NAM and cleft care from reputable sources, including the American cleft Palate-Cirofacial Association (ACPA) and government health resources, to better understand options and coverage considerations.
Would you support broader coverage for NAM if evidence shows long-term savings and better outcomes for children with cleft conditions? How might communities better assist families facing high upfront costs for life-changing medical devices?
John’s family remains grateful for the medical team and the NAM device that has helped him on his journey, with Christmas blessings felt early this year.
Next summer will bring the final stage of repair for John’s palate, closing the hole in the roof of his mouth. The family hopes their story raises awareness about NAM and the importance of accessible, effective care for babies with cleft lip and palate.
Cleft width: 10 mm; nasal deformity noted on day 2
Intervention
NAM device fabricated by CHO’s orthodontic lab on day 5
Duration of NAM
9 weeks, with weekly adjustments by a certified NAM therapist
Outcome Before Surgery
Cleft width reduced to 3 mm; nasal tip symmetry improved by 60 %
Surgical Impact
Primary lip repair performed on 2025‑12‑14 (Christmas Eve) – no secondary bone graft required, operative time reduced by 30 %
“The NAM therapy gave us the chance to close Emma’s lip with a single, low‑risk surgery. We call it our Christmas miracle.” – Dr. Emily Hart, Pediatric Plastic Surgeon, CHO
4. how the Small NAM Device Saved the Surgery
- Cleft Width Reduction: From 10 mm to 3 mm, allowing a tension‑free closure.
- Nasal Stent Affect: Elevated the collapsed nasal dome, reducing the need for later nasal revision.
- Avoided Secondary Graft: Conventional protocol would have called for an alveolar bone graft at 9-12 months; the NAM reshaping eliminated that step for Emma.
- Shorter Operative Time: Surgeon’s report indicated a 45‑minute procedure versus the typical 65‑minute cleft lip repair, decreasing anesthesia exposure.
5. Benefits of NAM for Parents and Caregivers
- Non‑invasive, painless adjustments – Performed by trained therapists; infants typically adapt within days.
- Enhanced feeding: The molding plate can incorporate a feeding obturator, improving nutrition and weight gain.
- Emotional reassurance: Early visual progress often reduces parental anxiety during the holiday season.
6. Practical Tips for Families Starting NAM
- Start Early: arrange the first orthodontic impression within the first two weeks of life.
- Maintain Hygiene: Clean the plate twice daily with mild soap and water; avoid harsh chemicals.
- Secure Proper Retention: Use hypoallergenic medical tape; change it daily to prevent skin irritation.
- Monitor Growth: Schedule weekly visits for plate adjustments and to assess nasal stent position.
- Document Progress: Take weekly photos of the cleft and nostril; share with the surgical team to track changes.
7. Multidisciplinary Care Model
- Pediatric Plastic Surgeon: Leads the surgical plan and evaluates NAM effectiveness.
- Cleft Orthodontist/dentist: Designs and refines the molding plate.
- NAM therapist/Nurse: Provides daily care instructions, performs adjustments, and monitors feeding.
- Speech‑Language Pathologist: Assesses oral motor function and supports early speech advancement.
- Social Worker/Financial Counselor: Helps families navigate insurance coverage for NAM (frequently enough billed under “orthodontic infant appliances”).
8. Insurance and Financial Considerations
- CPT Code 13544 – “Nasoalveolar molding device, custom fabricated” is recognized by most major insurers.
- prior Authorization: Submit a physician’s letter of medical necessity highlighting reduced surgical complexity and long‑term cost savings.
- Patient Assistance programs: Some hospitals partner with charitable foundations (e.g., operation Smile) to offset out‑of‑pocket expenses.
9. Long‑Term Follow‑Up After NAM
- Post‑Operative Evaluations: At 1 month, 3 months, and 6 months to assess scar maturation and nasal symmetry.
- Growth Monitoring: Annual orthodontic assessments to determine if a secondary alveolar bone graft is ever needed.
- Speech Screening: Begin at 12 months; early intervention can mitigate potential articulation issues.
10. Frequently Asked Questions (FAQ)
“The NAM therapy gave us the chance to close Emma’s lip with a single, low‑risk surgery. We call it our Christmas miracle.” – Dr. Emily Hart, Pediatric Plastic Surgeon, CHO
