This chapter describes general guidelines for staring and maintaining CPAP. Start with nasal CPAP of 5-6 cm and FiO2 0.4-0.5. The initial setting largely depends on the underlying lung condition. Increase CPAP by 1 cm if required every 15 to 20 minutes based on saturations above 90-95%. Chest X-ray is mandatory at this point to see the clearance of the haziness which reflects atelectasis. Reach a CPAP of up to 8 cm in preterm and 9 cm of H2O in term babies. Now increase FiO2 in small steps of 0.05 up to 0.6. Monitor clinical status, arterial blood gas (ABG) and SpO2 for at least 30 min in each step. Do not raise FiO2 before pressure. Early predictors of CPAP failure in VLBW babies include the need for positive pressure ventilation at delivery, alveolar-arterial oxygen tension gradient (A-a DO2) > 180 mm Hg on the first ABG, severe RDS on initial chest X-ray.