Reduced-maintenance naso-alveolar moulding (ReMNAM): when less is more

Naso-alveolar moulding (NAM) can be beneficial for infants with cleft lip and palate (CLP). It helps reshape and reposition deformed nasal cartilage and alveolar processes, non-surgically lengthen the columella, and reduce lip tissue tension before surgery. This article proposes a modified version of NAM where appliance activations could be scheduled once every 4 weeks. In our experience, the reduced-maintenance NAM (ReMNAM) is particularly beneficial for families who live far from the hospital and those living in low- (LIN) and low–middle-income nations (LMIN) because it is more achievable for babies to be brought for a monthly rather than bi-weekly review. CPD/Clinical Relevance: NAM can be a beneficial treatment modality for reshaping and repositioning deformed nasal cartilage and alveolar processes in infants born with cleft lip and palate. Awareness of ReMNAM may help to make this intervention more accessible in settings where cost and distance would otherwise make delivery impractical.