State of the science: achievements and challenges across the spectrum of care for preterm infants.

The spectrum of care for preterm infants includes the perinatal and immediate neonatal periods, the initial hospitalization period including neonatal intensive care, transition to discharge, and from discharge through the first year of life. Care issues are sometimes lifelong. Advances and achievements of the past 20 years, particularly during the perinatal period and in neonatal intensive care, have resulted in significant increases in survivability of even the smallest and least mature infants. Challenges remain, particularly in establishing evidence-based standards of nursing practice in areas such as transition to oral feedings, breastfeeding in the intensive-care nursery, and developmentally based care, and in reducing short- and long-term morbidities in children born prematurely. This article illustrates achievements and challenges across the spectrum of care for preterm infants in the 1st year of life.