The endemic problem of prematurity and low birth weight continues in the United States, resulting in many high-risk children surviving extremely premature birth. Using data from the National Institute of Child Health and Human Development Neonatal Research Network, Hintz et al examined the current need for special outpatient services at 19 to 22 months of age in 2315 infants born at less than 28 weeks' estimated gestational age. Nearly all infants (96%) had used at least 1 special service since discharge, 55% had used more than 3, and 19% had used more than 5. Infants who required many services were born at lower gestational ages, more likely to have intracranial hemorrhage or chronic lung disease, and less likely to be living with their mothers at follow-up. These results strongly support the need for proactive outpatient resource planning at the local and national levels and for more focused development of coordinated, integrated care for these complex children.