Exogenous surfactants commonly used to treat a variety of neonatal respiratory diseases are derived from either bovine or porcine sources. The extent to which parents are aware of this fact is currently unclear, as is the impact that this may have on familial cultural or religious belief systems. Our primary aims were to assess U.S. neonatologists’ utilization of bovine and porcine surfactant preparations, their views on parent disclosure pertaining to the particular animal origins of exogenous surfactant therapy, and their willingness to provide alternative surfactant preparations based on parental religious preferences. An anonymous Web-based survey was provided to 2,137 neonatologists. There was a 46.9% response rate. We found that 63.4% of respondents used only bovine-derived surfactants, 14.9% exclusively used porcine-based surfactants, and 21.7% used combinations. While 74.3% of neonatologists discussed surfactant use with parents, only 2.2% always discussed its animal origins. When asked, 47.9% of neonatologists believed parental preference for religious reasons would not impact their surfactant choice, 19.4% reported it would affect their choice, and 32.7% said it maybe would. Access to only one surfactant was a major barrier to communication. Results showed that many neonatologists may be open to being inclusive of parents regarding surfactant therapy. Carrying different surfactant types on hospital pharmacy formularies and encouraging physician–parent communication may achieve a more family-centered approach to neonatal care.