Helping Low Birth Weight Premature Babies

Each year in the United States, 250,000 infants are born too soon, weighing too little. For these low birth weight, premature infants, the future is uncertain, since they are at risk for a variety of serious medical and developmental problems—including behavioral and learning disorders that may have damaging effects for the rest of their lives. The extent to which a comprehensive early intervention program could improve or prevent these adverse outcomes was examined in the Infant Health and Development Program, a randomized controlled trial involving almost 1,000 infants in eight cities in the United States. This book describes in detail the program, its research methodology, the progress of the program, and the results of the clinical trial. The program was administered by an interdisciplinary team composed of physicians, biostatisticians, child development specialists, and researchers from several disciplines. It was instituted upon the discharge of the infants from the neonatal nursery and was maintained for three years. One-third of the infants were randomly assigned to an intervention group, the remainder to a follow-up group. Infants in both groups received pediatric care and community referral services, but only those in the intervention group participated in a program that included extensive home visits, attendance at a child development center, and group meetings for parents. The results of the program proved to be clinically important; at age three, the children in the intervention group had significantly higher IQ scores, greater cognitive development, and fewer behavioral problems. The implications of the findings for public policy are equally important, for there is increasing interest in the prevention, early detection, and management of developmental disabilities in children, as evidenced by such legislation as the Education for All Children Act. Strategies to minimize the problems of low birth weight children, with their potential for long-term savings through the prevention of disabilities and their attendant costs, could have significant repercussions in such governmental areas as medical care, education, and social welfare.

Despite recent declines in infant mortality, the rates of low birthweight deliveries in the United States continue to be high. Part I of this volume defines the significance of the problems, presents current data on risk factors and etiology, and reviews recent state and national trends in the incidence of low birthweight among various groups. Part II describes the preventive approaches found most desirable and considers their costs. Research needs are discussed throughout the volume.

The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.

Each year in the United States approximately 440,000 babies are born premature. These infants are at greater risk of death, and are more likely to suffer lifelong medical complications than full-term infants. Clinicians and researchers have made vast improvements in treating preterm birth; however, little success has been attained in understanding and preventing preterm birth. Understanding the complexity of interactions underlying preterm birth will be needed if further gains in outcomes are expected. The Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine sponsored a workshop to understand the biological mechanism of normal labor and delivery, and how environmental influences, as broadly defined, can interact with the processes of normal pregnancy to result in preterm birth. This report is a summary of the main themes presented by the speakers and participants.

Our understanding of the management of diseases in the premature infant has changed dramatically in recent years, and it can be quite difficult to remain up-to-date on changes in this highly scientific field. Dr. Brodsky and Ms. Ouellette have worked together to create a comprehensive reference that covers both the pathophysiology and epidemiology of problems occurring in premature babies in the Neonatal Intensive Care Unit, and the management of these problems once the infant has been released from the NICU to a community practice. The book emphasizes specific diseases that affect premature infants and focuses on two primary categories: background and management in the NICU, and management of specific illnesses after discharge from the NICU. Find information quickly using an up-to-date summary of the problems that are likely to affect the premature infant.Review helpful guidelines on feeding and growth, neurologic outcomes, developmental problems, retinopathy of prematurity, bronchopulmonary dysplasia, and much more. Use easy-to-follow management algorithms to help diagnose and manage common issues in premature infants after discharge.Make effective decisions about screening, immunizations, counseling of parents, and more..Help families deal with the emotional impact of caring for a premature infant..Access a list of disease-specific websites for clinicians and families.

The birth of a very premature baby is a shock for parents. The immediate anxiety about whether their infant will survive quickly leads to concerns about their child's future quality of life. In this inspiring and informative book, young people who were born weighing less than two pounds, three ounces provide candid and personal stories about their lives, challenges and accomplishments. Now in their thirties, these men and women were cared for at McMaster University Hospital in Hamilton, Ontario, soon after the introduction of newborn intensive care. Dr. Saroj Saigal, a renowned and award-winning neonatologist at McMaster, adds several chapters that outline the history of neonatology, describes recent medical and technological innovations, and explains how many extremely premature babies go on to enjoy fulfilling lives. Her chapters give the answer of a caring specialist to the inevitable question, "What next?" Written for a lay audience, Preemie Voices will move you to tears of admiration and amazement at the remarkable resilience of these tiny survivors. This unique collection of stories will not only provide encouragement and hope for parents who have given birth to a tiny preemie, but will inspire others who will be in awe at the achievements of these infants - both with and without disabilities - who were born too early. Watch the video documentary of a few participants from Preemie Voices at www.saigalpreemievoices.com...

“This book helps parents to meet the high needs of the premature baby and thereby enjoy the unique rewards of this special type of parenting.” —from the foreword by William Sears, M.D. author of The Birth Book and The Baby Book A comprehensive guide for parents of preemies, from birth and care in the NICU, to how to hold a preemie, deal with feeding issues, growth, health, learning and development. Includes real life stories from parents of preemies and lots of day to day tips.