we fix the ET tube with a dynaplast ( an adhesive tape). To prevent injury to the skin, we first stick tegaderm on the upper lip and over it fix the dynaplast. The dynaplast is cut in a 'H' fashion. one limb of 'H' is fixed on the upper lip and wings of the other limb is on the ET tube. It works well and there is no damage to the skin. Even ELBW babies tolerate it well