Although the incidence of low birth weight births declined from 1977 to 1987, the rate of very low birth weight births remained unchanged. These infants had a relative risk of neonatal death almost 200 times greater than full-term infants. Among survivors, eight percent had evidence of chronic pulmonary disease at forty weeks of age. The Institute of Medicine reported that very low birth weight infants who survived to one year of age were hospitalized for an average of 57 days after birth versus 3.5 days for full-term infants. Up to forty percent of these infants would be re-hospitalized almost two times for an average of 16 days versus 8.7 percent of normal birth weight infants for an average of 8 days.