مولود خديج في الأسبوع ٣٠، وُلد بعملية قيصرية طارئة ولم تأخذ أمه كورتيزون قبل الولادة. عمره ساعتان، وعنده أنين مع الزفير، ورفرفة أنف، وانسحاب بين الضلوع، والتنفس ٧٢، وتشبع الأكسجين ٨٦٪. ما الإجراء الأولوية؟

A preterm infant born at 30 weeks by emergency caesarean, whose mother received no antenatal steroids, is 2 hours old with expiratory grunting, nasal flaring and intercostal recession. RR 72, SpO2 86%. What is the priority action?

1. Support breathing with oxygen or CPAP; notify provider
2. Place under the radiant warmer and observe later
3. Reassure the parents this is normal in preterms
4. Bottle-feed to calm him and reduce crying

Answer: A) Support breathing with oxygen or CPAP; notify provider. Preterm infants are at risk of respiratory distress syndrome from surfactant deficiency. Oxygen and breathing support come first; no oral feeding while distressed.