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Dr. Ariel Salas, recent R01 recipient, discusses challenging traditional feeding volume targets in preterm infants. His multi-center trial compares 180-200 versus 140-160 mL/kg/day volumes, examining body composition changes rather than weight alone. Salas emphasizes targeting fat-free mass gains over simple weight gain, as this component associates with better long-term neurodevelopmental outcomes. Body composition analysis reveals compartmental changes invisible to daily weights—distinguishing extracellular versus intracellular water shifts. This outcome provides reasonable compromise between immediate intervention effects and long-term results. Salas advocates acknowledging practice variation as opportunity for equipoise and fair testing, challenging arbitrary standards that persist despite limited evidence supporting them.

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