Factors affecting the use of nasoalveolar molding and feeding appliances among nonsyndromic cleft lip and palate in five countries: a cross-sectional study

Purpose: This study investigates factors influencing the use of Nasoalveolar Molding (NAM) and Feeder Prostheses (FP) in infants with cleft lip and palate (CLP) across five countries: Saudi Arabia, Egypt, Jordan, United Arab Emirates and Pakistan. Methods: Data were collected through structured phone interviews with parents, covering sociodemographic characteristics, medical attention-seeking behavior, and healthcare accessibility. Healthcare accessibility was assessed using a previously validated questionnaire. Results: Higher family income and the presence of associated anomalies were significantly associated with increased NAM use (P = 0.02 and P = 0.013, respectively). Both NAM and FP were more commonly used in infants with unilateral complete CLP, though statistical significance was observed only for FP (P 0.025). Family members with CLP (AOR = 3.035; P = 0.025) and mothers with a mean age (AOR = 1.119; P = 0.001) have a significantly increased AOR of NAM use. Mean severity score significantly increased the AOR of FP use (AOR = 1.529, 95% CI: 1.128-2.072, P = 0.006). On the other hand, a low family income (AOR = 0.133; P = 0.009) significantly decreased the AOR of NAM use, while other factors, including associated anomalies and accessibility, did not show a significant impact on NAM or FP use. Conclusion: These findings highlight the role of socioeconomic and family history in determining treatment modalities for CLP infants. Enhancing early healthcare and financial support ensures equitable care through specialized intervention.