The work of the Medical Research Council Dunn Nutrition Unit, Cambridg
e, on the influence of early diet on the development of preterm infant
s is reviewed. Then further consideration is given to the implication
of the findings. Malnutrition during a sensitive period may result in
disease in adult life, and studies strongly suggest the development of
the brain and retina can be affected. This may be due to the lack of
essential fatty acids, and will particularly involve premature babies
born at a time when cell membrane development is especially vulnerable
. These findings must sometimes be viewed with caution, as genetic and
environmental influences can be paramount. There are many reasons to
favour breast feeding, rather than giving formula feeds, including imp
roved cognition and visual function. For example breast milk contains
docosahexaenoic acid and arachidonic acid, essential for normal brain
development, and often absent or in short supply in formula feeds. Alt
hough the advantages in developmental status may be due, in part anyho
w, to factors such as the mother's ability and education, and to the c
hild being given greater opportunities, the evident importance of the
composition of human breast milk cannot be denied. Formula feeds do co
ntain a higher nutrient value than breast milk, which can result in im
proved height and weight of infants fed in this way; if it is necessar
y to use them the challenge for future research is to improve their co
mposition. Although this may be of more importance for premature babie
s, term babies can also be affected; this has both medical and social
implications. (C) 1997 Elsevier Science B.V.