Related Experiment Video
Updated: Oct 17, 2026
Neurodevelopmental Reflex Testing in Neonatal Rat Pups
Published on: April 24, 2017
Randomized diet in the neonatal period and growth performance until 7.5-8 y of age in preterm children
1MRC Childhood Nutrition Research Centre, Institute of Child Health, London. morleyr@cryptic.rch.unimelb.edu.au
Insights
Early diet in preterm infants did not impact long-term growth, despite better neonatal growth with preterm formula. The neonatal period is not critical for programming growth performance in these children.
Area of Science:
- Pediatric Nutrition
- Growth and Development
- Neonatal Care
Background:
- Preterm infants face significant risks for suboptimal growth.
- Previous studies indicated improved neonatal growth with preterm formula compared to donor breast milk or standard term formula.
Purpose of the Study:
- To investigate if the neonatal period is critical for programming growth in preterm infants.
- To determine if early diet composition influences long-term growth trajectories.
Main Methods:
- Two parallel randomized trials involving 926 preterm infants assessed neonatal diets (preterm formula, donor breast milk, standard term formula).
- Infants received either exclusive study formula or it as a supplement to maternal breast milk.
- Long-term follow-up of 781 survivors to 7.5-8 years included standardized anthropometric measurements.
Main Results:
- Infants fed preterm formula showed enhanced neonatal growth.
- However, no significant differences in weight, height, head circumference, or skinfold thickness were observed at 9, 18 months, or 7.5-8 years postterm.
- Early diet composition did not influence long-term growth outcomes.
Conclusions:
- The preterm neonatal period does not appear to be a critical window for nutritional programming of growth.
- These findings contrast with evidence from the same trials indicating early diet's influence on neurodevelopmental outcomes.
Background:
Preterm children are at high risk of poor growth performance. In 2 randomized trials, preterm infants fed preterm formula grew better in the neonatal period than those fed banked donor breast milk or standard term formula.
Objective:
Our objective was to test the hypothesis that for preterm infants, the neonatal period is a critical one for programming growth performance and that early diet influences long-term growth.
Design:
A total of 926 preterm infants were recruited into 2 parallel, randomized trials of neonatal diet. In trial 1, infants were fed either banked donor breast milk or preterm formula whereas in trial 2, infants were fed either standard term formula or preterm formula. Within each trial, the allocated milk was the sole diet for some infants (study A), whereas for others it was a supplement to maternal breast milk, given when not enough expressed breast milk was available (study B). We followed up 781 of 833 survivors (94%) to age 7.5-8 y. Trained assessors obtained anthropometric measurements according to a standard protocol.
Results:
Despite significantly better neonatal growth performance in infants fed preterm formula (compared with either banked donor breast milk or standard formula), early diet had no influence on weight, height, head circumference, or skinfold thicknesses at 9 or 18 mo postterm or at age 7.5-8 y.
Conclusions:
These findings suggest that the preterm period is not a critical window for nutritional programming of growth, which contrasts with evidence from these trials showing that early diet influences later neurodevelopment.
