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SUMMARY A group of 32 children (20 boys, 12 girls) who weighed less than 1251g at birth and whose gestation was 31 weeks or less was followed-up for a minimum of five years. In all cases the birth weight was appropriate for gestational age. At the age of five years 10 of the children were completely normal, and growth for the whole group was adequate in all dimensions, the mean height, weight and head circumference being at the 40th to 50th percentiles. Recurrent respiratory tract infections occurred in 16 children and accounted for one death. Vision was normal in 24 children, but in two others there was significant retrolental fibroplasia. One child had mild conductive hearing loss associated with chronic otitis media. Speech defects occurred in 13 boys and four girls and were predominantly due to delayed maturation of both receptive and expressive ability. One child had spastic diplegia and another had epileptic attacks, an incidence of 6 per cent of major neurological abnormalities. Minimal brain dysfunction was diagnosed in nine other children, and 16 children had abnormal EEG tracings, mainly diffuse and non-specific. The mean IQ was 88 for the boys and 92 for the girls. Perceptuo-motor difficulties were diagnosed in 10 children, seven of whom were doing poorly in school. RESUME L'amelioration du devenir des petits nouveaux-nes prematures Une etude prospective de 32 nourrissons de poids normal pour le terme, nes prematurement depuis 1959 et avec des poids de naissance inferieurs a 1251g a ete conduite durant un minimum de 5 ans et les resultats ont ete compares a des etudes similaires sur des enfants prematures nes avant 1960. L'etude comprend 20 garcons et 12 filles. Les moyennes de taille, poids et tour de tete se situaient entre le 40eme et le 50eme percentile. Les infections des voies respiratoires inferieures etaient habituelles et ont ete cause d'un deces. Les defauts de langage on ete notes chez 14 garcons et 4 filles. Deux enfants presentaient des troubles neurologiques graves et 9 avaient un Q1 de 80 ou moins; 10 enfants (6 garcons et 4 filles) etaient tout a fait normaux. ZUSAMMENFASSUNG Die verbesserte Prognose fur das kleine Fruhgeborene Die Ergebnisse einer prospektiven Studie uber mindestens funf Jahre an 32 altersentsprechend entwickelten Fruhgeborenen, die nach 1959 mit einem Geburtsgewicht unter 1215g geboren wurden, wurden mit ahnlichen Untersuchungen an Fruhgeborenen, die vor 1960 geboren wurden, verglichen. Die Studie umfasste 20 Jungen und 12 Madchen. Die Mittelwerte fur Gewicht, Grose und Kopfumfang lagen zwischen der 40iger und 50iger Percentile. Infektionen des Respirationstraktes waren haufig und in einem Fall die Todesursache. Bei 14 Jungen und 4 Madchen fand man Sprachstorungen. 2 Madchen hatten schwerwiegende neurologische Symptome und 9 hatten einen IQ von 80 oder darunter. 10 Kinder (6 Jungen und 4 Madchen) waren ganz gesund. RESUMEN Las perspectivas de mejoria en ninos nacidos prematuramente pequenos Se realizo durante un minimo de 5 anos un estudio prospectivo de 32 ninos nacidos antes de termino de acuerdo con la cronologia, desde 1959 y con peso de nacimiento de menos de 1251grs. Los resultados se compararon con estudios similares realizados en ninos nacidos antes de termino con anterioridad a 1960. El estudio comprendio 20 varones y 12 hembras. Los promedios de peso, estatura y perimetro craneano estaban entre los percentiles 40 y 50. Infecciones del tracto respiratorio bajo eran corrientes y ocasionaron una defuncion. Se hallaron defectos de lenguaje en 14 chicos y 4 ninas. Dos ninos tenian anormalidades neurologicas mayores, nueve menores y nueve tenian un CI de 80 o menos. Diez ninos (6 varones y 4 hembras) eran completamente normales.

This prospective study examined the relation of neonatal sucking to later feeding, postnatal growth, maternal postpartum depression, and feeding practices. Healthy infants of at least 37 weeks gestational age were recruited. At 1 week of age, a strain-gage device was attached to the infant's cheeks during sucking to identify sucking efficiency. Two-hundred and two infants (100 males, 102 females; mean age 39.6 weeks, SD 1.1 weeks) with efficient sucking and 207 (101 males, 106 females; mean gestational age 39.4 weeks, SD 1.2 weeks) with inefficient sucking were identified. Growth was measured at 2, 6, 10, and 14 months. Mothers completed a feeding questionnaire and the Edinburgh Postnatal Depression Scale at the same testing points. While 18 infants (5%) showed a downward shift in growth, their clinical picture did not present as non-organic failure to thrive (NFTT). Inefficient neonatal sucking did not predict postnatal growth, later feeding difficulties, nor maternal feeding practices, but concurrent inefficient feeding did. Maternal depression did not affect feeding practices, infant feeding abilities, nor growth, suggesting that the importance of maternal postpartum depression in association with feeding may be less than previously assumed. The term NFTT, therefore, merits reexamination and a more focused definition.