Improving growth outcomes of VLBW infants: how to start?

In 1977, the American Academy of Pediatrics Committee on Nutrition first stated that the goal of nutritional management of VLBW infants should be to permit the rate of extrauterine growth and the composition of weight gain to approximate that of a normal fetus of the same postmenstrual age, if the infant had remained in utero(1). However, it has become clear that such a goal is more often not reached, especially by ELBW infants(2). The paper by Saluja and colleagues published in this issue of Indian Pediatrics(3) is the first report to confirm that observation on the Indian subcontinent. Although not an unsurprising finding, this report enumerates several issues that should be considered by investigators studying growth of VLBW infants.