the United States are high compared with the rates in other industrialized countries. These rates are especially high among disadvantaged groups; for example, LBW and VLBW rates for African-Americans were 12.7% and 2.7%, respectively, in 1987.¹ The use of illegal drugs, especially cocaine, contributes to the problem of low birth weight² and is associated with decreased head circumference.³

Although a majority of the infants who require intensive care are born preterm or very small, others are full-term infants with serious congenital birth defects or with any of a large number of other conditions that require special nutritional management (see Chart 5-1). The wide range of problems and the differences among infants make it essential to set individualized nutrition goals for each child.

Establishing goals for compromised neonates is often a complex process. ^4,5 Nutritional goals for these infants may be substantially different from those for healthy full-term infants because they must be adjusted for