PEDIATRICS Vol. 49 No. 5 May 1972, pp. 776-779
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PARENTERAL FEEDING—A NOTE OF CAUTION

COMMITTEE ON NUTRITION

Parenteral feeding in which all nutrients are given intravenously was shown by Wilmore and Dudrick1 to have sustained growth at a near-normal rate in an infant. Height, head circumference, and development progressed at normal rates for 44 days. Normal weight gain and skeletal growth also has occurred in puppies fed intravenously for 10 months.2 A number of studies3-7 have shown that nutritional needs sufficient to promote wound healing, improve general status, cause a gain in body weight, and support positive nitrogen balance can be met for periods in excess of 1 year entirely by parenteral alimentation. The mean daily weight gain in a recent report3 was 18 gm for infants in the first 2 months of life. This rate of gain is at the 5th percentile for normal breast-fed infants during the first 2 months of life.8

The preferred method of infusion has been the insertion of a silastic catheter through either a subclavian or jugular vein into the superior vena cava, with scrupulous attention paid to the prevention of sepsis from skin bacteria.2,5 Insertion into other veins has been associated with a much higher complication rate.9,10 The infused solution2 has provided about 80% of the needed calories as glucose and 20% as either Amigen (a hydrolysate of casein) or Aminosol (a hydrolysate of beef fibrin),* Minerals and vitamins have been added to these solutions. Plasma has been infused in some, but not all, patients 1 to 2 times weekly in an effort to provide essential fatty acids and trace minerals.