Pre-term births are common in developing and industrialized countries. Some of the underlying factors include low socio-economic class, inadequate antenatal care, lack of access of mothers to clinical advice and services, and maternal ill-health, infections and undernutrition before and during pregnancy. In many instances no cause can be identifies.

The numerous, serious complications that can affect preterm infants can compromise their prospects for survival and their prognosis for subsequent growth and cognitive development. The high rates of disability, disease and deaths associated with preterm births have a very high cost in terms of health, education and community social services, mainly through governments, and on families and communities. The health costs relate to immediate, clinical care of the affected infant and to his or her long-term management of a range of possible complications. Some of these involve severely affected infants who require long-term institutional accommodation and care. The personal and financial burdens on families can be very substantial.

Prevention of preterm births is obviously of great importance. But treatment of affected infants is crucial in order to enhance their chances of survival, to lessen the possibility of complications, including disabilities, and to increase their prospects of leading high-quality lives. Treatment strategies include skilled transfer to appropriate treatment centers, resuscitation, treatment of infections and management of metabolic complications.

Nutritional treatment is a cornerstone in the management of preterm infants. Recent advances in this important field have helped greatly in achieving better outcomes for these patients. This book brings together many eminent international workers in this field to present their latest findings, review the relevant literature and to discuss these issues in an open forum. The topics are very wide-ranging; they include recommendations for nutrients and energy, the role of specific nutrients such as proteins, carbohydrates, lipids, water and electrolytes, and vitamins and minerals.

There are also chapters on the roles of breast milk, enteral and parenteral nutrition, and, very importantly, a chapter on feeding the infant after hospital discharge and about subsequent growth, development and long-term effects,

There can be a temptation to consider that skilled hospital care and nutritional management of preterm infants closes that chapter in their very young lives. But this is just the beginning of a much longer process that should give these patients the opportunity to lead healthy lives. For some, unfortunately, the outcomes may not be so encouraging and different long-term treatments and strategies will be needed. Pediatricians much play a role in all of these aspects of the care of these patients.

This book presents these highly important issues in a refreshing way by which international authorities on the nutrition of pre-term infants contribute their views and discuss the latest developments in this field.

It should be of great interest to all pediatricians.

Michael Gracey, MD, PhD, FRACP, FAAP (Hon)
President, International Pediatric Association