Hello everybody, I am Praveen, a neonatologist at NCRI neonatal network. I am going to talk about a very common and a serious condition called as respiratory distress syndrome of preterm infants. Most of the preterm infants will have breathing difficulties to varying degrees depending how early they are born. This condition is called as respiratory distress syndrome. Lungs in humans develop in different stages and continue to develop even after birth. The problems faced by the premature infants will depend on the stage of lung development at birth. Lungs are like balloons and have a tendency to collapse, these are kept widely open because of a soapy substance called as a surfactant. This surfactant production becomes adequate only nearer to the time of delivery. Lungs being in early stage of development in the premature infants, along with the lack of surfactant leads to poor air entry into the lungs causing low oxygenation in the body. To reduce the severity of the problem, when there is imminent preterm delivery, mother must be given steroid injections. At the time of the delivery, team of trained professionals like neonatologists, nurses are required along with various equipment to support the life. Many of the premature infants are provided breathing support with a tube called endotracheal tube, which is passed through the throat into the lungs. This tube will aid in providing oxygen directly into the lungs. Some of the infants who are breathing well by themselves are support by providing oxygen via nose called as CPAP, many of them preterm infants need artificial surfactant, which is the soapy liquid instilled directly into the lungs, this decision will be based on the X-ray features and certain blood tests. To support the breathing of the babies they are connected to a machine called ventilator. Ventilator delivers the breathes to the baby at a set parameters decided by the doctors based on the underlying conditions. Most of the times, preterm babies need some kind of a breathing support in the first week of life. During this time, continuous monitoring of oxygen levels in the body is done by monitors and blood tests called as blood gas analysis. Some of the preterm infant need breathing support with a machine called continuous positive airwave pressure or CPAP for many weeks. Most of the times, as the babies start maturing the lungs also will be developing and baby develops the ability to breathe on its own. Some infants will need oxygen even after they reach 36 weeks of age. This condition is called as chronic lung disease.