Intravenous nutrition and postnatal growth of the micropremie

This article reviews what is known and theorized about minimal, maximal, and optimal administration of each of the major substrates in total parenteral nutrition (TPN) used in extremely low-birth weight infants. It also highlights controversial or poorly understood issues that would benefit from further investigation. The few studies that have been done to test for safety and efficacy of TPN in extremely low-birth weight infants are reviewed. in this article, it is assumed that TPN should be initiated in the first hours after birth and given in conjunction with initially small, and then increasing, enteral feedings beginning on the first or second day of life. TPN is considered a means to achieve rapid, maximal nutrition and that of early enteral feeding is to prime the gut and stimulate normal hormonal homeostasis.