Deficiency of vitamin A (retinol) has been suggested as an important contributing cause in the pathogenesis of bronchopulmonary dysplasia (BPD) in premature newborns with severe lung disease. Although the efficacy of vitamin A supplementation has yet to be clearly confirmed, it is widely employed, at different dosages and schedules, in neonatal intensive care units (NICU). Since in Italy today no suitable formulation of vitamin A is available, the present observational study was designed to define the profile of plasma vitamin A and retinol-binding protein (RBP) concentrations in supplemented infants at risk for BPD admitted to seven Italian NICU. Twelve babies (average 27 weeks of gestation, birth weight 1,008 g), supplemented with vitamin A, were observed with sequential measurements of retinol and RBP up to 28 days of age. At birth retinol and RBP plasma concentrations were both adequate in the infants and half their mothers' levels. During supplementation the levels rose with wide variability according to the differences in dosing and timing in the different units. Plasma levels of retinol and RBP were the same in infants who had BPD and those who did not. A routine standardized therapeutic approach using vitamin A supplementation in Italian NICU will be more than welcome.