Parenteral Protein in Extremely Preterm Infants — More Is Not Better

This editorial discusses the challenges of nutritional management in extremely preterm infants, focusing on the risks and benefits of high protein intake via parenteral nutrition. While adequate protein is essential for growth and development, excessive delivery (beyond 3.5 g/kg/day) in the first postnatal days may lead to adverse outcomes, including metabolic disturbances and poorer neurodevelopmental scores at 2 years of age. The article reviews findings from a recent trial by Bloomfield et al., which demonstrated no improvement in survival without neurodisability with higher protein intake but noted potential risks such as cognitive delay and language deficits. The author emphasizes the need for balanced nutritional strategies tailored to preterm infants' unique metabolic and developmental needs, advocating for further research to optimize protocols.

This editorial discusses the challenges of nutritional management in extremely preterm infants, focusing on the risks and benefits of high protein intake via parenteral nutrition. While adequate protein is essential for growth and development, excessive delivery (beyond 3.5 g/kg/day) in the first postnatal days may lead to adverse outcomes, including metabolic disturbances and poorer neurodevelopmental scores at 2 years of age. The article reviews findings from a recent trial by Bloomfield et al., which demonstrated no improvement in survival without neurodisability with higher protein intake but noted potential risks such as cognitive delay and language deficits. The author emphasizes the need for balanced nutritional strategies tailored to preterm infants' unique metabolic and developmental needs, advocating for further research to optimize protocols.