The use of surfactant replacement, ‘kinder gentler’ modes of ventilation combined with prenatal corticosteroids have all played a role in improved survival rates of very-low-birth-weight infants but have not reduced the prevalence of chronic lung disease. The increased rates of prematurity being observed in the United States along with the increased survival makes the overall problem of treatment of infants with established disease expensive spanning neonatology, pediatric critical care and general pediatrics and involving a myriad of specialists over the life of the surviving infant. However, none of the therapies used over the years have proven to be effective or have long-term adverse effects, nor have they been accepted as methods to prevent chronic lung disease. Although intuitively an appropriate nutritional therapy may be a useful adjunct in the care of the premature sick infant, perinatal malnutrition remains a major problem. The role of nutrition therapy in health and disease as it pertains to the lung will be reviewed.

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