Extrauterine growth restriction is a common finding among extremely low birth weight infants at discharge from neonatal intensive care units. It has been associated with significant caloric and protein deficits that accumulate during the hospitalization and with slower growth velocity observed with major neonatal morbidities. Recommendations to provide early nutritional support, both parenteral and enteral, have evolved in response to concern about the impact of poor in-hospital growth on growth and neurodevelopmental outcomes in early childhood. This paper will review the evidence supporting the provision of early nutritional support to extremely preterm infants by examining the outcomes associated with such practices.
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