Aftercare in severe neurological impairment

Modern neonatal intensive care has major emphasis on the resuscitation and management of infants born at the limits of viability. An additional significant group of infants are those, born at or close to term, who present with major neurological disease. This is a heterogeneous group of infants who have major care needs due to the continuing neurological abnormalities into the postneonatal period. Re-admissions to hospital are frequent and long-term developmental progress is poor. In this group of infants, there is a high early mortality. The recurrent admission of infants in this group for active resuscitation and/or intensive care may not always be the wisest management, and important medical, ethical and legal dilemmas are faced by families and carers of these infants.