Preterm infants are born at a stage when in-utero brain and body growth is more rapid that at any other time in life. Dramatic increases in cortical brain volume and cerebellar surface area require both a high level of macro- and micro-nutrient intake along with growth factors and other immune-nutrients. Hence, in order to prevent malnutrition preterm infants require high amounts of protein per unit body weight from birth. Intake levels that are either too high, or too low, may adversely impact on brain growth and development.
Adverse outcomes may occur because there is insufficient macronutrient substrate, or because micronutrient co-factors are in poor supply, but may also occur if endocrine systems are not able to produce adequate growth factors.
Focusing on meeting nutrient requirements (especially protein) in preterm babies is likely to improve a range of short and long term outcomes.