Weaning preterm infants: an open issue.

Survival rates for very low birth weight (VLBW) and extremely low birth weight infants have substantially increased during the past few decades. Most of these infants pose new and difficult problems related in particular to neurodevelopmental outcome and growth impairment. In fact, a high percentage of very low birth weight infants fail to achieve their growth potential and experience postnatal growth restriction. Because of this in-hospital growth failure and nutrient deficits, correct nutritional intervention after hospital discharge must be instituted to avoid postnatal malnutrition and to correct the acquired deficit. Nutrient-enriched formulas for several months after discharge have shown some benefits, although their clinical value remains unclear. Weaning, which certainly represents a relevant source of nutrients for the preterm infant, has attracted little attention until now. There are no precise guidelines on this topic, and too often weaning practices are left totally to the parents, without considering the specific nutritional needs of the single infant.