Philadelphia, USA

Author Affiliations: Department of Pediatrics, Division of Neonatology, Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141, USA (Schutzman DL, Porat R, Salvador A, Janeczko M)

Corresponding Author: David L Schutzman, 5501 Old York Road, Lifter Bldg., Suite 2601, Philadelphia, PA 19141, USA (Tel: 215-456-6698; Fax: 215-456-6769; Email: schutzmand@einstein.edu)

Background: With increasing survival of extremely premature infants, emphasis is now focused on the quality of these survivors' lives. Possibly the most important factor in the premature's ability to survive in the NICU and thrive is the ability to replicate in utero growth through enteral and parenteral nutrition.

Data Sources: Current literature and review articles were retrieved from PubMed and personal files of the authors.

Results: The use and complications of the various components of total parenteral nutrition (TPN) were reviewed. The composition of appropriate enteral feeds for the premature was reviewed as was the difficulties associated with the establishment of adequate enteral feeds in the premature infants.

Conclusions: Early initiation of amino acids in TPN and timely increases in the components of TPN can improve the caloric intake of prematures. Enteral feeds, particularly of breast milk, may be started within the first few days of life in all but hemodynamically unstable prematures. Newer lipid preparations show promise in reversing the hepatic damage of TPN associated cholestatic jaundice.

Key words: enteral nutrition; infant; parenteral nutrition; premature; newborn

World J Pediatr 2008;4(4):248-253