Postnatal Oxidative Stress and the Role of Enteral and Parenteral Nutrition

Abstract

Premature infants are vulnerable to the effects of early childbirth, which includes immature defenses against the early novel adaptation to oxygen. Developmental progress initiated early in the life cycle pushes the normal programming sequence in ways we only partially understand. In addition to antioxidant capabilities that are pushed possibly too soon, the exposure to excess oxygen is almost routine for the smaller younger infant. What role nutrition plays in the mosaic of prematurity is not certain, but we do know that what the infant is fed is clinically important perhaps more so than at any other time in the life cycle. Every attempt is made to introduce human milk as early as possible, the only food made by humans for humans. It is clear human milk can be tailored for the premature and perhaps for each and every infant. When the premature is too young for suckling, parenteral nutrition is needed which unexpectedly may increase the oxidative load of the premature infant. Technology while extending the life of many premature infants brings its own problems in need of resolution. The unfortunate creation of free radicals in solution while unintended and in fact only recently recognized creates iatrogenic issues. We describe nutritional advances in feeding the premature infant and the important role of nutrition as medicine has on outcome.