Bronchopulmonary dysplasia (BPD) is a severe chronic respiratory illness that develops in over half of infants born extremely premature.1 BPD predisposes affected infants to earlier mortality and deficits in cardiopulmonary health, neurodevelopment, and quality of life that can persist through childhood and into adulthood.1 Systemic corticosteroids are one of the few drugs shown in randomized clinical trials or meta-analyses to significantly reduce the risk of developing BPD.2 However, use of these potent medications in neonatology is highly controversial due in part to concerns regarding drug safety.