When should TPN be stopped for preterm infants on PN regarding enteral nutrition volume?

Total Parenteral Nutrition (TPN) is a method of providing nutrients directly into the bloodstream, bypassing the gastrointestinal tract, which is often necessary for preterm infants who may have immature digestive systems. The decision to transition from TPN to enteral nutrition (feeding through the gastrointestinal tract) is guided by the infant's tolerance and ability to feed orally or via tube.

Stopping TPN when the enteral nutrition volume exceeds 100 mL/kg/day reflects a standard clinical protocol that balances adequate nutrient intake while minimizing the risks associated with prolonged TPN use. TPN carries potential complications such as infections, liver dysfunction, and metabolic disturbances. By ensuring that infants receive at least 100 mL/kg/day enterally, they are more likely to meet their nutritional needs through enteral feeding, which promotes gut maturation and reduces reliance on IV nutrients.

In clinical practice, it is crucial to allow the infant’s gastrointestinal system to adapt and thrive with enteral nutrition, making 100 mL/kg/day a safe threshold for transitioning from TPN to rely completely on enteral feeding. This approach promotes overall health and prevents complications associated with long-term TPN use.