Resuscitation of the small baby--is there a limit?

Innovations in perinatal care in the last decade, in particular delivery room resuscitations and advanced technologies have probably contributed greatly to improved survival of the small newborns. As a result, progressively smaller and less mature infants are being resuscitated; but some survive with severe neurodevelopmental handicap. There should be guidelines about the lower limits of viability below which no resuscitation should be done. It is the view of many that resuscitation of critically ill small babies should be initiated at birth. Further management will be decided depending on the baby's progress and response. Clinicians have to look into the question of withdrawal of life support in small babies who survive with impairment and chronic illnesses.