Recommended nutrition for preterm infants-on track, but more research is needed.

In this issue of Pediatric Research, Naseh, et al. document that extremely to very preterm infants fed recommended macronutrient intakes using early parenteral nutrition and early and reasonably rapidly advanced enteral feeding of supplemented maternal and donor milk have relatively common outcomes of brain size and morphology at term gestational age and cognition at 2 years of age. Growth rates, ranges of data, and data for individual infants would have been helpful to better assess the impact of the feeding approaches and macronutrient intakes on growth and development of the study infants, but the success of Naseh, et al.'s feeding approaches and meeting recommended macronutrient intakes is encouraging. IMPACT: Preterm infants who are fed recommended macronutrient intakes using early parenteral nutrition and early enteral feeding of supplemented maternal and donor milk have relatively common brain size and morphology at term gestation and cognition at 2 years. These results expand the literature documenting that following rational feeding guidelines produces more optimal nutritional outcomes of preterm infants. Early enteral feeding helps produce more optimal nutrition for preterm infants. More research is needed to produce more optimal intravenous amino acid and lipid products and more optimal feeding approaches, and assess longer term growth, neurodevelopment, and cogniation.