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.

The Department of Child and Adolescent Health has developed guidelines on optimal feeding of low birth weight infants in low- and middle-income countries. These guidelines include recommendations on what to feed low-birth weight infants, when to start feeding, how to feed, how often and how much to feed. The guidelines were developed using the process described in the WHO Handbook for Development of Guidelines. Systematic reviews were conducted to answer 18 priority questions identified by the guidelines development group. The population of interest is low-birth weight infants, and the critical outcomes include mortality, severe morbidity, growth and development. The implementation of these guidelines in low- and middle-income countries is expected to improve care and survival of low birth weight infants.

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.

Kangaroo mother care is a method of care of preterm infants which involves infants being carried, usually by the mother, with skin-to-skin contact. This guide is intended for health professionals responsible for the care of low-birth-weight and preterm infants. Designed to be adapted to local conditions, it provides guidance on how to organize services at the referral level and on what is needed to provide effective kangaroo mother care.

Improved conditions of care for premature infants have led to markedly increased survival rates over the last few decades, particularly in very low and extremely low birth weight infants. Nutritional measures play a central role in the long-term outcome, health and quality of life of these premature infants. In this publication, leading experts from all 5 continents present the most recent evidence and critical analyses of nutrient requirements and the practice of nutritional care (with the focus on very low birth weight infants) to provide guidance for clinical application. After the introductory chapters, covering nutritional needs and research evidence in a more general manner, topics such as amino acids and proteins, lipids, microminerals and vitamins, parenteral and enteral nutrition as well as approaches to various disease conditions are addressed. Due to its focus on critical appraisals and recommendations, this book is of interest not only for the researcher who wants to keep up to date, but also for the clinician faced with premature infants in his practice.

The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.