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Purpose Many infants with cleft lip and/or palate (CL/P) have airway issues that make supine, flat-surface sleep challenging.1 Prior studies indicate that alternative positioning may reduce obstructive events,2 and early sleep-disordered breathing can affect later development.3 Despite this, caregivers of infants with craniofacial differences rarely receive tailored sleep guidance, and no evidence-based, condition-specific recommendations currently exist.4,5 Methods This single-site, cross-sectional study evaluated sleep practices, caregiver education, and barriers to adherence among parents of children (< 3 years) with CL/P treated at CHKD’s Craniofacial Program. Eligible caregivers (n=117) were identified via query of the electronic medical record by CHKD Data Governance and invited to complete an anonymous REDCap survey assessing demographics, sleep environment, counseling, and understanding of safe-sleep recommendations. Results & Conclusions Of the 11 caregivers who completed the survey, 91% reported crib sleep, though several also used beds, couches, or floor beds. Four caregivers (36%) expressed concern about breathing during sleep, citing apnea, poor sleep quality, frequent waking, or snoring; three reported increased anxiety related to their child’s sleep. Only five caregivers reported receiving safe-sleep counseling from their medical team, all describing standard messaging about supine positioning and firm, uncluttered surfaces. Although caregivers endorsed adherence and trust in medical guidance, only one infant regularly slept on their back. These findings suggest a disconnect between counseling and actual practices in families of infants with CL/P, highlighting the need for condition-specific guidance integrating safe-sleep principles with strategies to support comfortable, effective breathing, informing future development of tailored educational resources within craniofacial care programs.