did not reduce all-cause mortality. When compared with infants receiving the animal-derived surfactants beractant and poractant alfa, infants receiving lucinactant were found to have similar rates of mortality and morbidity from respiratory distress syndrome. More analysis is needed before the findings from lucinactant studies can be generalized because of questions about early trial closure and limited statistical power. Moreover, the metabolic fate of lucinactant and its component chemicals and potential risks introduced by the requirement to convert the lucinactant gel into a liquid using a special warming cradle immediately before instillation need additional study '. 3 So that takes us back to where we started with the 'warming cradle' rather than the 'water bath'.Finally, I agree with the American Academy of Pediatrics when it says 'new synthetic surfactants with surfactant protein-like activity are promising new treatments for surfactant-deficiency disorders' 3 and I hope that such a product is approved for treatment of RDS in the United States and Europe in the near future.