It is essential to start enteral nutrition early to preterm infants by giving small amounts of milk (preferably human milk) to ensure that metabolic homeostasis is kept stable and to limit postnatal growth retardation. Increasing feeding volumes to reach "full enteral feeding" is limited by individual feeding tolerance. Feeding intolerance is extremely common in premature infants. The most frequent signs of a suspect feeding intolerance are the presence of gastric residuals, abdominal distension and the onset of crises of apnea/bradycardia. Gastric residuals are probably a benign consequence of delayed gut maturation and motility in VLBW infants and there are no established normal standards. When gastric aspirates occur isolated they should not immediately induce the neonatologist to withhold feeding. Gastric residual becomes more important when accompanied by other warning signs, such as bilious vomiting, abdominal distension, abdominal wall erythema or ecchymosis, gross or occult blood in the stool, apnoea, bradycardia and temperature instability. Nutrition protocols in preterm infants must take caution when starting and increasing enteral feeding, and pay proper, but not excessive, attention to early signs of food intolerance.

Development of posttraumatic stress disorder (PTSD) in parents of premature neonates has been recently described. Several source of stress have been hypothesized, however causes of PTDS and emotional reaction of the parents of premature birth hospitalized in a neonatal intensive care unit (NICU) remain largely undefined. We demonstrated that alteration of parental role and a history of anxiety have a crucial role in the development of PTSD in the parents of premature neonates. Familiarization with neonatal intensive care unit environment and increasing participation of the parents in the care of neonates during the first weeks of life improves parental role perception. Early involvement of the parents and especially of the mothers in the neonatal care, in particular if the risk of anxiety is consistent, should be considered a primary objective to prevent a PTSD.

This high heritability estimate could suggest using this set of criteria to identify genes that regulate postnatal weight gain or failure.

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pregnancy. Assessment of adrenal function should be preserved for newborns with clinical suspicion of adrenal dysfunction or with risk factors as prematurity or placenta bed pathology.