Nutrition in neonatal care at ESPGHAN 2026
This year’s ESPGHAN congress showcased the rapid evolution of neonatal nutrition research. Across multiple sessions, nutrition emerged as a central theme, with new evidence highlighting its influence on gut health, immune development, the microbiome and long-term outcomes for preterm infants.
We have gathered on this page the scientific highlights of the sessions, as well as interviews from experts, Prof. Miguel Sáenz de Pipaón, Prof. Nick Embleton, and Prof. Magnus Domellöf.
Central themes from ESPGHAN 2026
Nutrition as a cornerstone of neonatal care
From the first days in the NICU to long-term follow-up, presentations highlighted the importance of tailored nutritional strategies to support growth, development and clinical care.
Probiotics in neonatal care
New Swedish real-world data, complemented by additional observational research, continue to expand the evidence base on probiotic use while highlighting the importance of strain selection and implementation.
Balanced DHA + ARA remain a key research focus
Emerging evidence continues to support investigation of balanced DHA and arachidonic acid supplementation, with encouraging findings for severe retinopathy of prematurity, retinal development and brain maturation.
Human milk beyond nutrition
Research continues to uncover the biological complexity of human milk, with growing interest in bioactive components that may contribute to intestinal and immune development.
The microbiome as a common thread
Across neonatal nutrition, lipids, human milk and probiotics, the microbiome emerged as a recurring theme linking early nutrition with immune development and long-term health
Read the scientific highlights
Probiotics: new real world evidence
Among the highest-scoring abstracts at ESPGHAN 2026, Dr. Ayoub Mitha (France) presented new nationwide real-world data evaluating routine use of a three-strain probiotic in very preterm infants born at 28–31 weeks’ gestation.
Following implementation of national recommendations in Sweden in 2020, use of the three-strain probiotic increased steadily, reaching approximately 70% of eligible infants by 2024. In a cohort of around 4,600 infants, supplementation was associated with significantly lower rates of necrotising enterocolitis (NEC), surgical NEC and mortality. The study also reported a lower incidence of the composite outcome of death and/or NEC, while sepsis rates remained unchanged. Importantly, no cases of probiotic-related sepsis were identified, including after direct surveys of participating NICUs. These findings add valuable real-world evidence from routine clinical practice, complementing existing clinical studies in this field.
Dr. Hayriye Gözde Kanmaz Kutman (Türkiye) presented a prospective observational cohort study exploring late initiation of a four-strain Bifidobacterium probiotic after full enteral feeding had been established. Although observational, the study reported improved feeding tolerance and weight gain without additional safety concerns, highlighting that the optimal timing of probiotic supplementation remains an important area of ongoing research.
Together, these studies add to the growing evidence base on probiotic use in preterm infant nutritional care, while highlighting the importance of strain selection, timing of administration and continued evaluation in clinical practice.
Nutrition throughout the neonatal journey
One of the most thought-provoking presentations was delivered by Ms. Moriam Mustapha (United Kingdom), who described preterm birth as a “nutritional emergency.”
Using the case of an infant with severe NEC requiring multiple bowel resections, she demonstrated how nutritional management influences far more than weight gain. Early nutritional strategies affect intestinal adaptation, microbiome development, immune function, brain development and long-term feeding success.
Her presentation also highlighted the lasting consequences of neonatal illness. Feeding difficulties frequently persist beyond NICU discharge, with many former preterm infants experiencing oral aversion, selective eating and growth challenges that require long-term multidisciplinary follow-up.
Importantly, Ms. Mustapha reviewed modifiable risk factors for NEC, discussing the roles of mother’s own milk, careful antibiotic stewardship and probiotics within a comprehensive nutritional approach. Her presentation served as a reminder that nutritional care begins in the NICU but continues to shape health throughout childhood.
Another recurring message came from Dr. Silvia Iacobelli (France), who highlighted the transition from parenteral to enteral nutrition as an often-overlooked period of nutritional vulnerability. She emphasised the need for more structured approaches to prevent protein deficits and support optimal growth during this critical phase.
The congress also highlighted the growing understanding of human milk as a complex biological system. Dr. Yajie Zhang (China) presented translational research on extracellular vesicles and microRNAs naturally present in human milk and their potential role in intestinal maturation, epithelial development and immune regulation. Her work demonstrated that the composition of these bioactive signals changes throughout lactation, illustrating the dynamic biological composition of human milk. Although still hypothesis-generating, the findings highlighted growing scientific interest in how these bioactive components may contribute to infant development beyond their nutritional value.
Taken together, these presentations reinforced that nutrition is more than the delivery of calories or nutrients. It requires careful management throughout the neonatal journey, from the first days in the NICU through longer-term follow-up.
Balanced DHA and ARA: advancing neonatal nutrition research
Long-chain polyunsaturated fatty acids were another major focus of the meeting.
Dr. Sissel Moltu (Norway) reviewed the growing evidence surrounding DHA and arachidonic acid (ARA) supplementation in extremely preterm infants. Her presentation highlighted why high-dose DHA alone has not consistently improved outcomes and, in some studies, has been associated with increased bronchopulmonary dysplasia. More recent research has shifted towards balanced supplementation with both DHA and ARA, aiming to better replicate the physiological fetal supply of these essential fatty acids.
Particular attention was given to retinopathy of prematurity (ROP). Across available studies, combined DHA and ARA supplementation has been associated with a lower incidence of severe retinopathy of prematurity, while also showing promising findings for retinal development, white matter maturation and postnatal growth. Although important questions remain regarding optimal dosing and implementation, these findings were among the most discussed developments in neonatal nutrition research presented at the congress.
Donor human milk enters a new regulatory era
in Europe
Prof. Gitte Zachariassen (Aarhus University Hospital, Denmark) highlighted one of the most significant policy developments discussed at ESPGHAN 2026: the implementation of the new EU Substances of Human Origin (SoHO) Regulation, which will bring donor human milk under a harmonised quality and safety framework from 2027. While the nutritional recommendations remain unchanged—with mother’s own milk remaining the preferred option and donor human milk recommended for very preterm infants when maternal milk is unavailable—the regulatory landscape surrounding donor milk is set to evolve considerably.
Prof. Zachariassen explained that the new regulation will require both milk banks and neonatal units to implement enhanced registration, documentation, quality management and traceability systems. Milk banks will be classified as SoHO establishments, while NICUs receiving and administering donor milk will become SoHO entities, each with specific compliance responsibilities. These changes may include designated responsible personnel, dedicated storage procedures and new mechanisms to trace donor milk from donation to recipient.
Drawing on the Danish experience, she acknowledged that many practical questions remain regarding implementation costs, logistics and the potential impact on donor milk availability. She encouraged neonatal teams to engage early with national competent authorities, collaborate closely with their milk banks and hospital governance teams, and monitor how implementation may influence both access to donor human milk and important neonatal outcomes.
The microbiome remains central to neonatal care
The microbiome was one of the recurring themes throughout ESPGHAN 2026.
Across neonatal nutrition, allergy, inflammatory diseases and infant feeding sessions, researchers highlighted the importance of early microbial colonisation in shaping immune development, gut barrier function and long-term health. Breastfeeding, dietary diversity and overall diet quality were consistently recognised as key modulators of the infant microbiome, while growing evidence continues to support the impact of nutrition during the earliest stages of life.
The microbiome emerged as a common thread linking many of the congress sessions, from probiotics and human milk to nutritional lipids and long-term child health, illustrating the increasingly integrated approach to neonatal nutrition research.
Looking ahead
ESPGHAN 2026 highlighted a clear evolution in neonatal care. The congress reflected a growing recognition among clinicians and researchers of nutrition as a cornerstone of comprehensive neonatal management.
Whether through probiotics, balanced lipid supplementation, human milk bioactives or microbiome-informed nutritional strategies, the field continues to explore approaches that aim to support healthier development from the earliest stages of life.
The congress highlighted a common direction for neonatal research: understanding how early nutrition can shape health not only during the NICU stay, but throughout childhood and beyond.
Expert interviews – Watch now
Prof. Miguel Sáenz de Pipaón
Professor and Chairman of Pediatrics at the Autonomous University of Madrid, Spain
Attending pediatrician and neonatologist in the Neonatology Department at La Paz University Hospital, Madrid, Spain
Prof. Nick Embleton
Hon. Clin. Prof. of Clinical in Neonatal Medicine, Newcastle University, UK
Prof. Magnus Domellöf
Pediatrician, Professor of Pediatrics, Dept of Clinical Sciences, Umeå University Hospital, Sweden
Neonatalogist, NICU of Norrland University Hospital, Sweden
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