Nutrition, growth and clinical outcomes.

Recommendations about the nutritional management of preterm infants, especially of extremely low gestational age (or extremely low birth weight) neonates, have been published by a number of pediatric and nutritional organizations. The objectives of these recommendations are to provide nutrients to approximate the rate of growth and composition of weight gain for a normal fetus of the same postmenstrual age, to maintain normal concentrations of blood and tissue nutrients, and to achieve a satisfactory functional development. Achieving these goals requires an understanding of the intrauterine growth rate to be targeted and of the nutrient requirements of preterm infants. Birth weight-based intrauterine curves should be used to monitor postnatal growth of preterm infants in neonatal intensive care units. Although primarily provided by observational studies or historic control studies, data demonstrate that growth and neurodevelopmental outcomes correlate with nutritional intake. The implementation of standardized feeding guidelines reduces nutritional practice variation and facilitates postnatal growth and improved clinical outcomes.