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In premature infants treated with nasal continuous positive airway pressure early after birth, the addition of very early surfactant therapy without mandatory ventilation decreased the need for subsequent mechanical ventilation, decreased the incidence of air-leak syndrome, and seemed to be safe. Reduction in the need for mechanical ventilation is an important outcome when medical resources are limited and may result in less chronic lung disease in both developed and developing countries.

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We performed this randomized trial to determine whether infants receiving skin-to-skin care (SSC) grew more rapidly and had a shorter duration of hospital stay compared with infants held by their parents in a traditional way. Infants who met eligibility criteria (