Thank you Nancy, for your informative post, putting what we know and what we don't know in perspective. 
Our thanks to the NICU community for all its work to keep very small babies alive and allow them to thrive
under very difficult and also complicated to measure circumstances.

Does anyone know the state of research on which moms are likely to have preterm labor and why,
 what we can do to keep them inside mom for longer, and what are the costs/benefits of whatever 
treatments we use to prevent preterm labor?

A couple of questions about your post:
You say that "to get optimal brain growth  and IQ you need 
18 g/kg/d weight gain, BUT at this level you increase the rate  of obesity, 
heart disease, hypertension."
Clearly this is based on some longitudinal studies, if you can measure obesity, heart disease and hypertension.

How does one measure "optimal brain growth" and how does one weigh that against the problems that arise
like obesity etc.?

Growth is often uneven in prematurity and throughout life. My fear is that when the studies say 18 g/kg/day weight gain, that the folks doing the measuring and caring for these babies may sometimes take that too literally, and base treatments on day by day measurements. This was (maybe still is) true in the birth world where studies that said labor progresses at 1 cm/hour was taken very literally by some, and interventions made if a mom was at 5 cm for more than an hour. Growth, change are uneven, we have spurts and slow periods. Statistics and measurements can be helpful, but you have to know how to use them. Is there research and literature on the range of the course of growth, which puts the bottom line number of 18g/kg/d in perspective?

Thank you,

Naomi

------------------------------------------
Naomi Bar-Yam Ph.D.
Executive Director
Mothers' Milk Bank Northeast

[log in to unmask]
office: 617-527-6263
direct line: 617-340-3600
www.milkbankne.org
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