In the NICU – How does C-PAP differ from a ventilator?

Babies who are born preterm (before 37 weeks) may have trouble breathing and need extra help to breathe well. Some babies are put on C-PAP (continuous positive airway pressure) to help them breathe and others are on a ventilator. So, what exactly is the difference?

C-PAP delivers air to a baby’s lungs either through small tubes in the baby’s nose or through a tube that has been inserted into the windpipe. The tubes are attached to a machine, which helps the baby breathe. Babies on C-PAP breathe on their own, the machine does not breathe for them. The steady flow of air with oxygen coming in through the tubes keeps enough pressure in the lungs to prevent the air sacs from collapsing after each breath.  It’s a little extra support to help the lungs do their job.

A mechanical ventilator is a breathing machine that delivers warmed and humidified air to a baby’s lungs. The smallest or sickest babies receive mechanical ventilation, meaning that the mechanical ventilator temporarily breathes for them while their lungs recover or mature enough to breathe on their own. The air is delivered to the baby’s lungs through an endotracheal tube. This is a small plastic tube that’s inserted through a baby’s nose or mouth, down into the windpipe. The amount of oxygen, air pressure and number of breaths per minute, can be controlled to meet each baby’s needs.  The breathing is all done by the ventilator, not by the baby. After the lungs are strong enough the baby may move on to C-PAP, on the way to breathing on their own.

This experience can be scary and overwhelming for families. If you, or someone you know, had a preterm birth and a baby in the NICU who’s on C-PAP or a ventilator, visit  This is March of Dimes’ online community for families. Here you can connect, share and find support from parents who may have a baby in the NICU, or are going through similar experiences with their babies.


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    Our son (third child) was born November 1 at 27 weeks, and was 12 days on the ventilator. They intubated/extubated him three times before he was able to breathe only with the CPAP. Unfortunately, so much time using mechanical ventilation caused severe bronchopulmonary dysplasia (aka chronic lung disease). They gave him corticosteroids (dexamethasone and hydrocortisone) but he is still very fragile and desaturates frequently. We still don’t know what’s ahead and if he will have serious handicaps in the future. Hopefully his lungs will eventually heal. Right now, it’s a stressful roller-coaster ride, with two young children at home and spending several hours a day in the NICU with a very sick baby…

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    Kira my baby was born 29 weeks early ,I have three other babies. I know how you feel. please take it one day one step at a time. Continue to pray daily.God will see you thru it all.

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    Dear Kira,
    We have twin boys who were born at 27 weeks (2 lbs each). Same thing; they were on the ventilator for around 10-12 days and then cpap after that. They both had to be re-intubated at different times during there 3 1/2 month stay in the NICU (two infections, anemia). One had a brain bleed and the other had to have the PDA ligation. The one with the brain bleed also had poor muscle tone and the doctors were concerned about cerebral palsy. I am writing this to encourage you. Our twin boys just turned 12 years old. We went through a lot early on, but they are totally healthy today. The one with the brain bleed and poor muscle tone is now my “super athlete”. He can play any sport well and is a black belt in tar kwon do.
    I pray the same for your little guy; that he will grow into a perfectly healthy boy. I pray that God gives you the strength and faith to persevere through these difficult times in the knowledge that better days are ahead.

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    Yogesh dutta January 29, 2017

    Hi all,
    My baby is born in 39th week but his respiration rate is high around 80, baby is on cpap for last 3 days.please suggest is this normal?

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    Shaquita February 8, 2017

    Hi, my twins were born at 24 wks and 5 days. My daughter is doing great! However im concerned about my son. They keep having to reintubate him and he is suffering from immature GI as well. He stats goes low sometimes but for the most part he okay. Whoever is on this roller coaster too you are not alone. One day at a time and continue to pray.

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    My baby was born 26 weeks. He was on ventilators then switch to CPAP. He is now at week 29. Swollen eyes and sinks on faces caused by masks and strap. Small brain bleed. Infections (serratia – hospital infection), presumed meningitis. Love my boy to death. Only small obstacles to make us stronger.

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    Hi Ali here from India, my wife was on high blood pressure and twin babies were born around 34weeks, both r boy babys, twin 1 is doing fine without any breathing support, twin 2 was on ventilator from the day one of delivery doctor advised on 5th day of the delivery that twin 2 is doing fine and dey removed the ventilator
    Today morning around 4am dey again have given ventilator on 6th day
    But doctor tells he’s on minimum pressure of ventilation, and not to worry but being a FATHER m very much worried
    After going from all ua comments hope my twin2 will also b recovered very soon
    Can someone help me on this situation

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    rakesh May 4, 2017

    Hi yogesh
    I am in the same situation, baby born by c-section in 39th week. Due to high respiration rate , baby is on cpap since last 2 days. Please suggest the way ahead.

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    Paige May 30, 2017

    How is your little one now? We are in the same position now and he is home needin cpap

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    Elizabeth Mabudusha July 3, 2017

    To all the parents of babies nurse in nnicu,good people your babies will all be healed through God’s mercy, those machine are doing wonders to your babies,you are going to take your babies home smiling

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    subhankar paul August 9, 2017

    Hi,I subhankar my baby is born on 29 weeks , first 2 days he was in c pap but now he is given on ventilator I am very worried he was born with weight 1450 grm

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    This is exactly what i my 39th week born, 3 kg boy is facing. On cpap for more than 12 houra now. Unique case here as caesarean born because he did potty inside..doctors operated urgently. Pls share if this unfortunate case with anyone..god bless

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    After reading all coments i m very glad tht one day i will take my DD at home in the lap of her mother. My DD born on 22 August 38 weeks. But after birth nurses take her to Picu. She stay there 3 days than i switched hospital and they put her on ventilator as her respiratory rate is above 80 and saturation rate is below 90. She could not hold the saturation level on its own. I m sitting outside picu and reading these comments to boost up my moral tht i will win and take her to home. Please pray for my Victory and God Help. Imran. Pakistan

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    Howz ur baby now??

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    Kimberly Hechanova Jeanjaquet October 3, 2017

    I delivered my baby at 35weeks.His gut is outside his body and he was ventilated since birth. Now he is 59days and had his surgery on his 56th day, they were able to put his gut back inside. He is still on ventilator but they are now planning to extubate him in 5 days. He has gone through tough times with lots of complications(fluid in his lugs, infections,bleeding) but im happy to say that he was able to go win over those challenges. Just pray, believe in God and trust your medical team. Be involve in your child’s treatment. Be with your child everyday. Be positive everyone.

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    Momo Peggy November 13, 2017

    GM everyone, my grandson was born Oct. 21, 39 week’s, csection. We knew he had a heart defect, doctors had planned to do surgery after his arrival, but his heart was too weak. He was doing fine the first 3 days, but started going down since. He’s coded 3 times, the last for 30 minutes. I was told yesterday that he would never leave the NICU, and wouldn’t come off the ventilator. They have done all they can, and the final resort is a heart transplant, which they don’t believe he’s a candidate, because he’s not tolerating his feeds, and can’t breath on his own. The will evaluate him, and make some calls to different out of State Hospitals. My daughter has been by his side sinc day one, and I’m not sure she understands the severity of his condition, that or she’s in denial. We’ve always believed God for a miracle, and will remain faithful. I just keep reminding myself that how God chooses to heal, may not be the way we expect. My prayers go out to all of you who’s angels are in the care of the amazing men and women working in NICU. They really do an amazing job.. blessings