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Each year, more than one-half million premature babies are born in the United States, meaning they come into the world after less than 37 full weeks in the womb. They are tiny and fragile and often have underdeveloped lungs and weak immune systems. They can have problems digesting food and gaining weight, and many develop necrosis or sepsis, a type of blood poisoning. When these babies are born in rural or remote towns, often hours away from the nearest neonatal intensive care unit, the situation is even more dire. The doctors who care for these babies are faced with extremely difficult and complex decisions about how to treat them, whether to transport them, and how best to monitor their condition and stave off infection.