When Luisa Scott found out her unborn daughter Zoey had a cleft lip and palate, she and her husband were uncertain where to seek care. Then, they met the Duke Health Cleft and Craniofacial team and felt confident in their choice to go to Duke. Now, one year after her cleft palate repair surgery, Zoey is happy and healthy. "I love Duke. I had the best experience there," said Luisa.
A Routine Ultrasound Shows Cleft Lip and Palate
Luisa was 20 weeks pregnant when she went to her doctor for a routine ultrasound and learned her baby had a cleft lip. "Three weeks later I had another ultrasound, and they found she had a cleft palate as well," said Luisa. "It was a shock for us because there was no family history."
A cleft lip and palate refers to a separation or gap in the lip, gum line, and palate. “We're all clefted in the womb, but at around five weeks gestation, our face joins from side to side at the middle,” said Alexander C. Allori, MD, MPH, a Duke Health pediatric plastic surgeon. “If anything interferes with that process, you get a cleft.”
Elegir Duke
At first, Luisa struggled with the diagnosis. She was shocked and unsure where to turn for information. "It was hard for me to even think," she said. In contrast, her husband Brandon spent hours researching cleft palate and cleft lip. He found several online groups where parents shared their opinions on where they sought treatment. "There were so many parents who recommended Duke; some even drove from hours away or flew," said Luisa.
While she was still pregnant, they visited Duke, and Luisa felt an instant connection with the team. She also liked Duke’s use of the nasoalveolar molding (NAM) device before palate repair surgery.
Moldeo nasoalveolar
The NAM device is a custom-made orthopaedic appliance that helps narrow the gap between the two sides of a cleft lip or palate before surgery. Duke Health orthodontist Pedro Santiago, DMD, helped develop the device decades ago.
Similar to braces that slowly move the teeth into proper position, the NAM device is adjusted little by little each week for several months. "It gives us a much better starting point at which to do surgery," said Dr. Allori. It also reduces the number of surgeries a baby needs to fix a cleft palate.
Duke’s Team of Cleft Lip and Palate Specialists
More than its use of NAM, Luisa was attracted to Duke Health's Cleft and Craniofacial team because of its coordination among specialists, including plastic surgeons, craniofacial orthodontists, ear, nose and throat (ENT) specialists, audiology and speech therapy professionals, clinical social workers, and others. "The benefit of a multidisciplinary team is not just efficiency, but the effectiveness and coordination of care and proper communication," said Dr. Allori. "When you have disjointed care, problems often occur."
Since so many specialists can be involved in a child’s care, each family has a team coordinator who can answer questions and facilitate scheduling. Luisa said her care coordinator, Carlee W. Jones, played a significant role in her positive experience. “Any time I called Carlee, she was always so nice and happy to help us,” she said.
Lip and Palate Repairs Has Zoey Smiling Big
Zoey wore her NAM device for three months before she had her cleft lip repair surgery in February 2025. In October 2025, she had her palate repair surgery.
Today, Zoey is approaching her second birthday, and Luisa said she is a happy, bubbly child. She continues with speech therapy closer to home and returns to Duke once a year for follow-up visits. "I am so grateful to Duke," said Luisa.
