Published today in The Lancet Child & Adolescent Health, the FONDUE trial (“Face mask versus nasal mask device use for initial resuscitation in extremely and very premature infants”) enrolled 151 newborns born between 23 and 31 weeks’ gestation at Monash Children’s Hospital.

Nearly all babies born more than two months early require help breathing immediately after birth. Many of these fragile newborns will take a first breath or let out a cry, but then stop breathing and need urgent help from doctors and nurses to keep oxygen flowing to their tiny lungs. This urgent intervention, known as positive pressure ventilation or “rescue breathing,” is life-saving but can also expose the preterm lung to high inflation pressures that cause damage.

If rescue breathing with a face mask is unsuccessful, clinicians may have to escalate to placing a breathing tube into the lungs via an emergency intubation. It is widely accepted that supporting a preterm baby to continue to breathe spontaneously and avoid intubation will lead to the best long-term outcome.