Complete cleft lip and palate in a preterm infant: An airway management challenge on a neonatal unit

Prematurity combined with bilateral cleft lip and palate presents significant challenges in airway and respiratory management. This case report shares the experience of a neonatal intensive care unit (NICU) team where an instance of unplanned extubation challenged the team to consider solutions in supporting the airway, where standard non-invasive ventilation equipment was unsuitable due to the baby’s facial anatomy. The case focuses on the difficulties encountered, the innovative solutions implemented and the key lessons learned from this experience.

Dr Hannah Rogers
Paediatric Registrar ST5

Dr Sanjeev Rath
Consultant Neonatal Paediatrician

Arrowe Park Hospital, Wirral University Teaching Hospital NHS Foundation Trust

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Keywords

cleft lip and palate; prematurity; respiratory management

Key points

Prematurity combined with bilateral cleft lip and palate presents significant challenges in airway and respiratory management.
Managing a preterm baby with bilateral cleft lip and palate requires understanding of complex facial anatomy and addressing the associated airway management challenges.

Also published in Infant:

VOLUME 22 ISSUE 3/JUNE 2026

ROP screening: A question of how to manage infant pain

Retinopathy of prematurity (ROP) is a vasoproliferative condition affecting the retinal blood vessels of preterm and very low birthweight infants. It is a significant and preventable cause of visual impairment in childhood, so screening is crucial to prevent disease progression. Ophthalmologist examination is required, however, this can be uncomfortable and stressful as premature infants are highly sensitive to procedures. Studies show that inadequately managed pain can have significant consequences; it is important we monitor pain and implement ways to reduce it. This article examines current practice in the UK and the current literature.