For which infants should parenteral nutrition (PN) be initiated in the NICU?

Parenteral nutrition (PN) is a critical intervention for infants in the Neonatal Intensive Care Unit (NICU) who are unable to meet their nutritional needs through enteral feeding, particularly when they are premature or have specific medical conditions.

In infants under 1500 grams, the likelihood of feeding intolerance and the inability to maintain adequate nutrition increases significantly. These infants often have immature gastrointestinal systems, which can hinder their ability to digest and absorb nutrients properly. Parenteral nutrition provides a way to deliver essential nutrients directly into the bloodstream, bypassing the gastrointestinal tract, and is vital for their growth and development during this critical period.

Infants with congenital heart disease may also benefit from parenteral nutrition if their condition leads to poor feeding tolerance or increases their nutritional requirements. These infants may experience increased metabolic demands due to their heart defect and require supplemental nutrition to support their growth.

Infants with congenital bowel abnormalities often cannot tolerate enteral feeding safely or effectively. These conditions can involve structural defects that prevent normal digestion and absorption, making it necessary to use parenteral nutrition to ensure they receive adequate nutrients while managing their underlying conditions.

Thus, the combination of infants under 1500 grams, those with congenital heart disease, and those with congenital bowel abnormalities