Editor—The neonatal unit at St George’s hospital, London, recently reported their findings of nasal trauma associated with nasally applied treatment using continuous positive airway pressure (NCPAP).1 They reported that 20 per cent of the very low birthweight infants treated in this way developed nasal injury. The equipment used was the Infant Flow system.

These figures are shocking and inconceivable. For many years NCPAP has been used extensively with this technique at the neonatal units in our hospitals, the Karolinska Institute, Stockholm, Sweden, and the county hospital in Östersund, Sweden. NCPAP has been given …