The goal of this clinical trial is to learn whether giving surfactant through a thin endotracheal catheter to extremely premature babies shortly after birth reduces the number of them who are ventilated in the first 3 days of life.
The main question it aims to answer is:
Do fewer babies who receive prophylactic thin catheter surfactant under video laryngoscopy shortly after birth go on to be ventilated within 72 hours of birth?
Extremely premature babies who are receiving breathing support through a face mask will either:
* Receive surfactant through a thin catheter that is inserted into their windpipe (trachea) under video laryngoscopy at or after 5 minutes of life, have the catheter removed immediately, and return to face mask breathing support; or * Continue on face mask breathing support.
All babies will be closely watched to see whether they are ventilated for breathing support in the first 72 hours of life.
Infants of any sex born before 28 weeks of gestation
Clinicians plan to provide intensive care
Consent for their participation provided by parent(s)/guardian(s) before their birth
None