Background: Choline is an essential nutrient for direct synthesis of phosphatidylcholine (PC), the major membrane and secretory phospholipid. It also provides methyl groups for indirect hepatic PC synthesis via methylation of phosphatidylethanolamine, to provide the central nervous system with polyunsaturated fatty acids (PUFA-PC). It is unknown whether current nutritional strategies will supply sufficient amounts of this substrate. A deficient supply could contribute to impaired neurodevelopment observed in preterm infants.