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Book and Media Reviews
May 2, 2007

Baby at Risk: The Uncertain Legacies of Medical Miracles for Babies, Families, and Society

Author Affiliations

Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Fishbein Fellow.

JAMA. 2007;297(17):1928-1931. doi:10.1001/jama.297.17.1928

Baby at Risk is a narrative of the perils and promises of neonatal intensive care. The goal is to give a more balanced account of the “successes” of neonatology. The thesis is that with a more nuanced appreciation of the miracles and the complications, parents and physicians would make better collaborative decisions for premature infants and other children born with serious health problems that compromise the transition from fetus to infant.

The book begins on a positive note, telling the story of Clara, a child born with a diaphragmatic hernia who is still receiving extracorporeal membrane oxygenation (ECMO) 20 days postoperatively. A young physician suggests that 2 weeks is the standard time-limited trial for ECMO and that it may be time to withdraw therapy. The nurses and parents encourage the attending physician to try other maneuvers, and 1 week later the ECMO is discontinued and the infant is quickly weaned from the ventilator. At age 11 years, Clara is a miracle baby or, as her dad suggests, more like a “double miracle.”