In this study we will compare NCPAP (Nasal Continuous Positive Airway Pressure) with HFNC (High Flow Nasal Cannula) in newborn infants with respiratory distress syndrome (RDS) who will place on one of this method after receiving surfactant and extubation. This will be a prospective Balanced Block Randomization study among 54, 28-34 weeks, newborns with respiratory distress syndrome who are admitted to the NICUs’ at Arash Hospital and Children’s Medical Center. Patients will be excluded with major congenital anomalies, congenital heart diseases, and Apgar score less than 5 in 5 minutes. To avoid misdistribution of gestational age and sex, the patients will systematically be blocked on gestational age and sex using four categories; 28-30 wk males, 28-30wk females, 31-34wk males, 31-34wk females. After ethical approval and explanation for parents and obtaining written informed consent, neonates with indication of exogenous surfactant administration will be intubated, surfactant will be administrated and then they will be extubated within a few hours by physician judgment. After extubation one group of patients will receive NCPAP, and another group will receive HFNC. These patients will be followed closely and monitored for hypercarbia (Pco2≥60) with a pH of <7.25, hypoxemia Pao2<50 with FIO2>0.7, for reintubation. The primary outcome is remaining extubatation for at least 3 days and secondary outcomes is duration of oxygen therapy and hospitalization, and survival. Two groups will finally be compared with each other by student’s t-test for continuous data and x2 test and fisher’s exact test for categorical data.