Does it matter how we feed premature babies?

The multiplicity of dietary regimes available for low birthweight infants is a measure of clinical uncertainty in this field. The reasons for this persisting uncertainty are analysed: few studies have examined whether early diet matters in terms of clinical outcome; instead, management decisions have been based on short-term 'physiological' studies on nutrient accretion, growth and metabolism. Data from this Unit's multicentre outcome trials on nearly 1000 preterm infants, randomly assigned to early diet, are used to demonstrate that whilst diet influences many aspects of the infants 'physiology' in the short term, such physiological responses have limited value in predicting clinical outcome. Preliminary data from the early follow-up of this cohort to 18 months post-term suggest that the diet used in the neonatal period may have persisting consequences in terms of motor and mental development and growth. The longer-term significance of these findings is being investigated.