Neurodevelopment, Growth, and Nutrition of the Newborn

Dear Colleagues,

Improving the health of every neonate is fundamental to advancing the overall health of the global adult population. The dedication of the 2025 World Health Day to maternal and newborn health highlights the global significance of this issue.

Advances in the survival of preterm infants—particularly those born very premature or with life-threatening complications—reflect decades of progress in perinatal medicine and neonatology.

Yet, despite this progress, ongoing debate continues within the neonatal community regarding the extent to which neonatal and preterm nutrition influences long-term growth and neurodevelopment.

Although the latest ESPGHAN guidelines have brought greater alignment on feeding and growth strategies for very preterm infants, significant disagreements persist—especially regarding the exact type and amount of nutrition, as well as the ideal growth trajectory during the neonatal and infant periods.

At the heart of this scientific debate is the question of whether providing intensive nutrition and aiming at neonatal growth following birth percentiles is beneficial for premature neonates. Some neonatologists caution that this approach may lead to a disproportionate increase in neonatal adipose tissue, potentially resulting in adverse long-term metabolic outcomes. However, others, based on their studies, argue that policies of intensive nutrition primarily promote growth through an increase in lean tissue and are therefore critical for healthy development.

In this 3rd era of Neonatology, no universally accepted policy exists for the nutritional management and growth of premature neonates. Even among neonatologists who share common foundational principles, significant variability remains in the practical application of infant feeding strategies.

Progress in preterm infant nutrition requires a multidisciplinary approach, integrating the expertise of neonatologists, nutritionists, nurses, physiologists, biochemists, and geneticists to develop effective strategies.

A central focus of this ongoing work should also be on essential nutrients that may act as limiting factors for adequate parenchymal growth, including key micronutrients and bioactive compounds such as select amino acids, long-chain polyunsaturated fatty acids, choline, iron, and zinc.

The selection of this topic for this Special Issue of the journal Nutrients presents an important opportunity to publish targeted research that can help clarify critical aspects of neonatal nutrition.

Ultimately, the goal of this and other collective efforts must be to define and establish a globally accepted feeding and growth strategy that promotes optimal neurodevelopment in neonates—especially for the very premature neonates, who represent the most vulnerable population.

Prof. Dr. Antonios K. Gounaris
Dr. Rozeta Sokou
Guest Editors

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