Perinatal transition represents a complex process, including onset of breathing which is associated with a clearance of lung fluid and the hemodynamic changes from fetal circulation. Whereas disturbances in postnatal adaptation with a subsequent need for medical support of varying intensity are relatively frequent immediately after parturition, only few infants actually require resuscitation. This article gives an overview of current recommendations on how to prevent problems in adaptation and how to diagnose and treat symptoms of disturbed adaptation. It also covers some special aspects of the current guidelines of the European Resuscitation Council (ERC).