<prompt> A 1.5 kg child born at 32 weeks by LSCS presents with moderate respiratory difficulty RR: 70min, Spo2: 92. Which is the next best step?Mechanical ventilationCPAP100 oxygenSurfactant and ventilation  <response>: Ans. B. CPAPThe most common cause of respiratory distress in a preterm infant is neonatal RDShyaline membrane disease.The infant has presented with moderate respiratory distress without any signs of respiratory failure so early continuous positive airway pressure CPAP is the appropriate treatment.CPAP started at birth is the choice for the management of a preterm infant at risk for respiratory distress syndrome RDS. Early nasal CPAP has shown to lower mortality and risk of bronchopulmonary dysplasia.Air is better than oxygen for the resuscitation of preterm infants, and 100 oxygen is also harmful, causing increased oxidative stress.The intubate-surfactant-extubate INSURE on CPAP technique is recommended for surfactant administration when babies showed signs of RDS and needed more than 30 inspired oxygen to maintain saturation in the normal range. 