Characterizing NICU Admissions and Clinical Interventions in Neonates With Cleft Lip and/or Palate: A Multicenter Analysis

Cleft lip and/or palate (CL/P) is among the most common congenital anomalies, often requiring multidisciplinary care beginning in the neonatal period. While the long-term surgical and developmental outcomes of CL/P are well studied, little is known about the clinical interventions provided to neonates with CL/P who require admission to the neonatal intensive care unit (NICU). This multicenter study utilized the Pediatric Health Information System (PHIS) database to characterize NICU interventions among 923 neonates with CL, CP, or CLP across 49 children's hospitals in the United States. Infants with cleft lip were more likely to be premature and have lower birth weights, while those with cleft palate or both cleft lip and palate had longer hospital stays and higher utilization of feeding and respiratory interventions. Swallow evaluations, feeding therapy, and anti-infective medications were among the most frequently used interventions, reflecting common challenges in nutrition and airway management. The findings underscore the complexity of neonatal care in this population and reveal critical opportunities to improve standardized care protocols, enhance anticipatory guidance for families, and support multidisciplinary resource planning. This study provides a comprehensive analysis of NICU care in infants with CL/P and offers a foundation for future clinical guidelines aimed at optimizing early outcomes.