Early Nutrition in Preterm Infants: Effects on Neurodevelopment and Cardiometabolic Health

Abstract

Nutrition provided during a NICU hospitalization and after hospital discharge is a major determinant of infant growth. Nutritional practices for preterm infants have evolved in recent decades, with an emphasis on increasing growth, primarily through greater macronutrient provision. Specific interventions, such as providing specialized preterm formula or fortified breast milk, are effective in increasing weight gain and other measures of growth, both in the NICU and after discharge. Further, substantial evidence supports the long-term benefits of several nutritional interventions on neurodevelopmental outcomes. More recently, data are emerging to suggest that despite the neurodevelopmental benefits of nutritional fortification, augmenting weight gain may come at a cost to cardiometabolic health. In this review, we discuss the evidence base supporting nutritional interventions for preterm infants in relation to effects on early growth. In addition, we examine evidence regarding the impact of early growth and nutrition on long-term outcomes, highlighting that promoting faster growth to optimize neurodevelopment may also have adverse cardiometabolic effects.