Early postnatal growth of low birthweight infants: what is optimal?

The question as to what is optimal depends on an examination of a number of questions which may be stated as follows: 1) Does physical growth as expressed by height and weight bear any relationship to functional or intellectual development? 2) Should postnatal growth of low birthweight (preterm) infants proceed at their presumed in utero growth rate? 3) Does caloric intake beyond a minimum level influence the growth rate and intellectual development of SGA infants? 4) What is optimal--or do we all need to be the same? These questions imply a projected benefit to nutritional techniques, amounts, and procedures. Against these must be balanced potential hazards which relate to a number of specific factors. These include the effort and expenditure of energies involved in feeding practices. The hazards inherent in gavage, intraluminal, and other forms of forced nutrition. Solute loading and the relationship of solute to free water content. The ommission of specific nutrients from any dietary regimen and the toxicity of other specific contents. A balanced approach combining all of these may best decide what is "optimal".