While doing all of our research before Isla got here, we decided on a pre-surgical technique called a Nasoaveolar Molding Device (NAM), should her cleft be complete and affecting the nose...which it is. What this device does is pull her midgumline back in line with the rest of her jaw and it will also help shape her nose. This is going to hopefully reduce 2-3 surgeries down the road as well as reduce the possibility of bone graft on her gum line by 60%. So, to us...the NAM was a no brainer. It's more work on our end, but what's 3 months of work for your baby to help prevent them from all the pain that they will endure with all the additional surgeries down the road?
Below is a picture of what the NAM will be doing for Isla. Before the NAM, that piece that looks like it hangs off the nose is actually attached to the tip of the nose. So unlike you or me...Isla doesn't have the cartilage in between her nostrils to create a point of the nose. Without the NAM, the repair would make it seem as if her nose was flat, but as you can see from the picture below...the NAM really does wonders for the nose.
The alternative is to let the nose do what it wants and then wait until she's 4 or 5 in order for her to have her first nose job.
Because she is so small and growing so rapidly, this process is only going to take 3 months! Every week we have to go in to see the orthodontist and he adjusts the NAM (which looks just like a retainer that most of wore...there's just no teeth for it to attach to and that's why we have to tape to her face). After the 6th to 8th visit her gumline should be fully aligned with the rest of her jaw and that is when they will put the nose stints in and also begin taping the upper lip to down to elongate it. This process is supposed to only take 4 weeks! So, up until her first surgery, which will be sometime in January/February she will be sporting this look. 
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