Airway management is one of the key aspects of neonatal anesthesia, and an oropharyngeal airway is used in daily intensive care practice to relieve upper-airway obstruction. Cleft palate is among the various congenital malformations that can cause difficult airway management. We describe a syndromic infant with alobar holoprosencephaly, whose long-term airway patency was maintained with a modified infant pacifier. We would like to share our experience and contribute to the literature with the introduction of a readily available and easily-inserted apparatus.