Bibian van der Voorn

198 CHAPTER 12 20,21 . Similarly in humans, kangaroo mother care is found to be associated with reductions in morbidity and mortality in low birthweight infants 22 . Furthermore, biochemical signals in mother’s milk, which are suggested to offer the newborn information on environmental conditions, might support adaptation processes 8 . GENERAL CONCLUSIONS By exploring different ways of assessing HPA axis functioning, we have identified several factors that have a significant impact on HPA axis development in very preterm newborns, including gender and early life growth. Moreover, we have shown that variations in HPA axis functioning, i.e., genetic predisposition to altered glucocorticoid sensitivity, can act as a mediator of adaptation. This knowledge needs to be engaged in current research in order to achieve improvement of short- and long- term outcomes.