Comparison of neonatal management methods for very low birthweight babies.

Abstract

SIR,-Dr E S Steiner and others (8 November, p 1237) have offered a very succinct paper examining the outcome of very low birthweight infants who did not require "special or intensive" care. I am unable to agree with their conclusions and am saddened by their hostility towards intensive perinatal care. Clearly none of their infants required intensive care intervention and those that did died. Thus a population of "well babies" remained, of whom only 52% were normal at school age. Surely these results are disastrous and must indicate that more intensive care facilities are required at this unit. A more useful comparison would be a similar population at University College Hospital or Hammersmith Hospital-that is, very low birthweight infants who did not require intensive therapy after birth and who were managed by minimal handling only. The figures quoted from these other units included babies ventilated for hyaline membrane disease. I would be. very interested to learn whether Dr Pamela Davies at Hammersmith Hospital has been able to differentiate non-ventilated very low birthweight infants in her follow-up studies. G J REYNOLDS