Nearly 425,000 babies are born prematurely each year in the United States, including an increasing number of multiples caused by fertility treatments. Nearly 55,000 of these babies -- called "preemies" -- are born with extremely low birth weights (less than 3 pounds, 4 ounces), according to the National Center for Health Statistics (NCHS).

The long term prognosis for these babies is uncertain. According to an article in Pediatrics, 25 percent of these babies do not survive the first year of life. Of the ones that survive, many have moderate to severe disabilities.

Now, two states are addressing the issue of when to pull out all the stops for these babies' care and when it's best to let nature take its course. Wisconsin's Guidelines for the Responsible Use of Intensive Care Project issued a report in November after studying the issue for three years. The section on preemies articulates the need to establish a protocol for dealing with complex medical decisions while fully involving the parents of the baby. Colorado, the state with the highest rate of low birth weight babies, has taken the issue a step further. It's become the first state where a community has attempted to establish a guide for making choices when a preemie's life is in jeopardy.

The Colorado guidelines, spearheaded by the Colorado Collective for Medical Decisions, suggest that in babies born at 26 weeks and older, medical intervention is in their best interest. However, in babies less than 24 weeks, they state that "a decision not to resuscitate is medically and ethically appropriate and in the best interests of the child."

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