Nasal CPAP has become an indispensable part of the primary treatment of newborns with respiratory distress syndrome.

Prenatal steroids, early nasal CPAP combined with early surfactant treatment followed by extubation to nasal CPAP, and if necessary mechanical ventilation is a very effective treatment of respiratory distress syndrome. This treatment package is part of the 'Scandinavian model' for treatment of very-low-birthweight infants which also comprises gentle ventilation at birth; minimal handling; 'neonatal individualized development care and assessment program'; high priority of breast feeding; and use of kangaroo method and which facilitates observation and nursing of sick premature infants and optimizes the possibility for early mother-child contact. The incidence of bronchopulmonary dysplasia seems to be less of a problem in centres preferring nasal CPAP as the primary treatment for respiratory distress syndrome.