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This is an extremely premature male baby born without trauma at 24 weeks gestation, who required perinatal resuscitation. MRI head showed bilateral periventricular infarcts. He had poor postnatal growth and fed via a nasojejunal (NJ) tube due to feeding intolerance. He experienced recurrent episodes of reventilation via endotracheal tube and suffered septic episodes. Persistent chest X-ray changes suggest chronic lung disease of prematurity which has been complicated by excessive respiratory secretions. To limit these secretions, varying concentrations of glycopyrronium bromide (glycopyrrolate) were administered via NJ tube.