A prospective, blinded study of neonates orally intubated with either standard or "soft" endotracheal tubes included 57 infants in the standard "hard" tube group and 46 infants in the soft tube group. Infants were further divided by birth weights above and below 1,000 g. Palatal grooves were seen to develop regularly after seven days in infants weighing less than 1,000 g. Neither the incidence nor the severity of palatal groove formation was influenced by the use of the soft tube. However, in three cases the soft tube had to be abandoned due to technical difficulties with intubation.