Abstract :
Background: Infants with cleft lip and palate face feeding challenges due to anatomical disruptions, leading to complications like nasal regurgitation, choking, and poor nutrition. Nasoalveolar molding (NAM) appliances, traditionally made from polymethyl methacrylate (PMMA), reduce the severity of cleft before surgery, help seal the oronasal opening and improve feeding. PMMA’s rigidity limits adaptability, potentially reducing feeding efficiency. Polyamide, a crystalline polymer with higher flexibility and reduced thickness may provide a better anatomical adaptation, enhancing feeding performance.Aim: To evaluate the feeding effectiveness of NAM appliances made from PMMA versus polyamide in newborns with unilateral cleft lip and palate.Materials and Methods: A clinical trial (2020–2024) at two Indian hospitals enrolled 76 infants, randomized into Group A (PMMA) and Group B (polyamide). After attrition, 58 infants remained. NAM appliances were activated biweekly. Bottle-feeding volumes were measured three days before and after NAM placement and at weeks 4 and 8. Weight was recorded at baseline (T0), Day 3 (T1), Weeks 4 (T2), 8 (T3), and 12 (T4) respectively. Results: Group B had significantly higher feeding volumes on Day 3 (662 ml and 627.87 ml, p = 0.001) and over the three-day average (627.12 ml and 608.5 ml, p = 0.040). No significant difference was noted at Week 4 (p = 0.103), but Week 8 showed improvement in Group B (1141.25 ml and 1110 ml, p = 0.045). Weight gain was significantly higher in Group B at T1 (0.16 kg, p = 0.047), T3 (0.32 kg, p = 0.0003), and T4 (0.35 kg, p = 0.0482). Conclusion: Polyamide NAM appliances demonstrated superior feeding effectiveness and weight gain, supporting their use when feasible.
Keyword :
Cleft lip and palate, Feeding, Naso alveolar molding, Polymethyl methacrylate, Polyamide, Randomized controlled trial