Abstract
Growth failure caused by undernutrition is considered one of the major causes for
psychomotor delay in extremely preterm infants, and the concept for “aggressive nutritional
approach” is widely accepted worldwide. Based on this, postnatal early catch-up growth
due to sufficient supply of nutrients including sufficient amounts of amino acids
is believed to be essential for a better outcome; however, there is no definitive
evidence of aggressive nutrition on better outcomes in mortality, growth, and neurodevelopment.
On the contrary, epidemiological evidence suggests that low birth weight and a rapid
catch-up growth after birth are major risk factors for insulin resistance and diabetes
in later life; higher protein intake during postnatal period relates to higher cardiovascular
risk in later life. Considering these, optimal nutrition, especially protein administration,
should be reevaluated. In this review, current opinions on the nutrition for the preterm
infants are surveyed. In addition, I propose a new concept for optimized protein amount
for the preterm infants based on the difference of amino acid metabolism between fetuses
and preterm infants.
Keywords
nutrition - amino acid - preterm infants - fetus - urea cycle
