The author draws on her own family's experience in an exploration of the special--and often precarious--circumstances of preterm babies and their families

Doctors, psychologists, physiotherapists, speech therapists and others whose work is concerned with assessing the performance of children known or suspected to be suffering from a variety of handicaps are becoming increasingly interested in the possible antecedent factors. Among the perinatal factors which are considered to be possibly relevant, low birthweight is prominent: but it is important to know whether the effects of being born too soon carry the same implications as those being born too small, and what may be the effect of associated biological and social factors. This knowledge is important not only as a contribution to the diagnosis, but also as a help in deciding about prognosis and the likelihood of response to a particular form of treatment.

The inspiring story of Juniper, a baby born too soon, gorgeously told by her parents, both award-winning journalists. Juniper French was born four months early, at 23 weeks' gestation. She weighed 1 pound, 4 ounces, and her twiggy body was the length of a Barbie doll. Her head was smaller than a tennis ball, her skin was nearly translucent, and through her chest you could see her flickering heart. Babies like Juniper, born at the edge of viability, trigger the question: Which is the greater act of love -- to save her, or to let her go? Kelley and Thomas French chose to fight for Juniper's life, and this is their incredible tale. In one exquisite memoir, the authors explore the border between what is possible and what is right. They marvel at the science that conceived and sustained their daughter and the love that made the difference. They probe the bond between a mother and a baby, between a husband and a wife. They trace the journey of their family from its fragile beginning to the miraculous survival of their now thriving daughter.

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, 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.

Low birthweight, caused by premature birth, poor intrauterine growth, or both, is known to be a strong predictor of morbidity and mortality risks in the first year of life and beyond. It has to be born in mind, though, that premature infants may need different clinical and nutritional interventions and are at risk for different morbidities than those small for gestational age. This publication focuses on three main subjects: Global epidemiology, catch-up growth, and feeding practices. These topics have been selected to provide a solid contextual basis for the nature and extent of the problem, highlighting changes in prevalence and risk across different healthcare settings: The available data strongly suggest that growth outcomes are dependent on a multitude of environmental factors that interact with nutrient intakes. Epidemiology, modern technology and the latest science are brought together to promote a better understanding of the short- and long-term needs and outcomes of low-birthweight babies, depending on whether they are born too small or too early.

Premature children suffering consequences of their early birth do not grow out of them, and new difficulties may appear as they mature. The sum of negative influences from the time in the Neonatal Intensive Care Unit, eventual problems with interaction, and later a defective or delayed development, can cause continuous problems for premature children. These children can however be protected if we initiate the necessary support. An early effort can prevent the typical consequences of pre-term birth, so that the children will have quite a normal childhood. If the minor difficulties are identified, it is possible to take care of them before they develop into huge problems, and that is just the purpose of this book: to give parents, and professionals close to the child, a possibility to prevent, repair, and rebuild. Born Too Early does not deal with the more usual handicaps but exclusively with the less visible consequences of pre-term birth, which are rarely diagnosed.

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.

The Nutritional Psychology of Childhood is a systematic account of research on the psychological aspects of nutrition in children from birth to adolescence. It deals with two major themes: the development of eating and the effects of malnutrition on the developing child. Robert Drewett discusses the developmental problems that arise with eating and food intake, including nursing and weaning in infancy, the handling of solids and the development of food choice and eating habits. Nutritional problems are considered in children born preterm or small for gestational age, or whose growth is poor, in children who are iron deficient or more generally malnourished, and in children with physical illnesses, including phenylketonuria and cerebral palsy. The development of eating disorders and obesity are also considered. Drawing on research from both developing and industrialised countries, this book will be of interest to students, researchers and professionals in psychology, nutrition and child health.