Optimal nutritional support for the newborn is one of the most relevant task of the neonatologist, because of the short and long term effects on health and well being. While in the past scientific interest was mainly focused on nutritional needs, recently, nutrition has revealed its main role in primary prevention of adult diseases and in the improvement of physical and cognitive potentials. This concept is also expressed by the “programming” theory, which identifies a critical period in life, in which a stimulus or an insult may exert long-term consequences on the structure and functions of the organism. Breastfeeding is still considered the best option for the healthy term infant, and has shown several advantages also for the preterm infant. In several observational studies breastfed infants have, in fact, shown to be at lower risk for cardiovascular disease, hypercholesterolemia, high blood pressure, obesity and type-2 diabetes. The anti-infective properties, the immunomodulatory effect and the favourable influences on intestinal microbiota make mother’s milk the enteral feeding of choice also for the preterm infant. Anyway, the nutritional needs of very low and extremely low birth weight infants (VELBW, ELBW) greatly exceed the content of human milk for protein, minerals and vitamins. The currently available human milk fortifiers are still inadequate for the smallest infants but, perhaps also for commercial reasons, no upgrading of their composition has been made in the last few years. In this perspective, some authors have studied the growth improvement of weight and head circumference of VLBW infants with an adjustable fortification regimen of human milk. The same concept should be valid also for formula feeding regimens, because it is necessary to choose the right product for the specific preterm infant. (...)
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