There is evidence that practitioners who are responsible for airway management at newborn resuscitations may place an endotracheal tube incorrectly with confidence. Moving on to the further stages of resuscitation, without managing the airway adequately, and commencing ventilation has the potential for significant harm to the baby. Because primary confirmation is fallible, there is a need for secondary confirmation of correct endotracheal tube placement and effective airway and breathing before moving on to cardiovascular support. Symmetric chest movement, auscultation, exhaled carbon dioxide (CO2), and an increase in heart rate have been suggested as providing secondary confirmation. Measurement of exhaled CO2 is accepted widely as a standard of care in adult and pediatric intensive care and in anaesthetized patients. © 2006 Elsevier Inc. All rights reserved.