Foreword

Summary

Neonatology as a subspecialty was established in 1975. There have been adventures and misadventures. There have been advances and declines. However, with a greater understanding of normal development and physiology, the improvements in technology and the utilization of evidence-based medicine, our subspecialty continues to thrive. Much of our success has been due to the better use of ventilation techniques and the development of newer antibiotics to treat infectious conditions.

However, it was known early on that nutrition was an essential part of our equation for success. With the increasing survival of premature and extremely premature infants and the increasing incidence of prematurity, nutrition as an adjunct to the care of the tiny premature infant is of paramount importance. Appropriate nutritional therapy should allow for maximum growth without adverse effects and evidence suggests that infants who grow at the highest quartiles have better neurocognitive outcomes. It is also well recognized that extrauterine growth restriction due to other morbidities and inadequate nutritional intervention can lead to poor outcomes. The full-term infant and late-preterm infant have multiple avenues available to provide adequate nutrition for growth. However, the preterm and especially the extremely low birthweight infant (ELBW) still present great challenges.

This monograph entitled “Nutritional Strategies for the Very Low Birthweight Infant” presents a method to understand the complexity of nutrition in this gestational age and weight group and to provide “strategies” for therapy. The chapters discuss energy, the basic components of nutrition (carbohydrate, protein, fat), vitamins, minerals and trace elements. In addition, there is information regarding human milk, infant formulas and influences on neurodevelopmental and growth outcomes.