Abstract

Neonatal intensive care for infants born extremely preterm (<28 weeks’ gestation) has changed dramatically over the past 60–70 years. From little care being available and few infants surviving in the first half of the 20th century, more intensive care and rapidly increasing survival rates followed in the second half, and have continued to rise into the 21st century. However, mistakes were made along the way. The purpose of this article is to recollect some of the pivotal changes in neonatal intensive care of infants born extremely preterm, and the consequences of those changes. Changes in attitudes, the physical environment, staffing, and basic treatments, such as oxygen and assisted ventilation, and evidence-based care are all discussed. Neonatal intensive care will continue to evolve, but in so doing we must learn from past mistakes in order to avoid repeating them.

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