A commentary proposes “Goldilocks zone” antibiotic prescribing for preterm infants, calling for precision stewardship that balances the risks of missed sepsis against microbiome disruption and antimicrobial resistance. The framing targets neonatal care decisions where overtreatment and undertreatment both carry long-term consequences. The argument emphasizes moving away from one-size-fits-all duration and intensity toward risk-adapted strategies, potentially combining clinical scores with better microbiologic and biomarker context. The broader goal is to preserve infant gut ecology while maintaining readiness to treat quickly. For neonatal antibiotic programs and clinical trial designers, the piece reinforces an immediate research agenda: how to measure the trade-offs and operationalize stewardship protocols without compromising safety.