Total parenteral nutrition - infants
IV fluids - infants; TPN - infants; Intravenous fluids - infants; Hyperalimentation - infants
Total parenteral nutrition (TPN) is a method of feeding that bypasses the gastrointestinal tract. Fluids are given into a vein to provide most of the nutrients the body needs. The method is used when a person cannot or should not receive feedings or fluids by mouth.
Intravenous (IV) lines are often placed into a vein in the hand, foot, or scalp of babies who are too sick to get all of their feedings and fluids by mouth. The belly button also has a large vessel that may be used for intravenous fluids. Sometimes a large IV called a central line or PICC line is placed by sterile technique or by surgery to provide long-term, highly concentrated intravenous fluid.
Information
Sick or premature newborns may be given TPN before starting other feedings. They may also have this type of feeding when they cannot absorb nutrients through the gastrointestinal tract for a long time. TPN delivers a mixture of fluid, electrolytes, sugars, amino acids (protein), vitamins, minerals, and often lipids (fats) into an infant's vein. TPN can be lifesaving for very small or very sick babies. It can provide a better level of nutrition than regular intravenous (IV) feedings, which provide only sugars and salts.
Infants who get this type of feeding must be watched carefully to make sure they are getting the proper nutrition. Blood and urine tests help the health care team know what changes are needed.
HOW IS TPN GIVEN?
An IV line is often placed in a vein in the baby's hand, foot, or scalp. A large vein in the belly button (umbilical vein) may be used. Sometimes a longer IV, called a central line or peripherally-inserted central catheter (PICC) line, is used for long-term IV feedings.
WHAT ARE THE RISKS?
TPN is a major benefit for babies who cannot get nutrition in other ways. However, this type of feeding can result in abnormal levels of blood sugars, fats, or electrolytes.
Problems can develop due to use of the TPN or IV lines. The line may move out of place or clots may form. A serious infection called sepsis is a possible complication of a central line IV. Infants who receive TPN will be closely monitored by the health care team.
Long-term use of TPN may lead to liver problems.
Many children on TPN will have frequent laboratory evaluations to check protein levels in the blood and monitor electrolytes, kidney and liver function.
References
American Academy of Pediatrics (AAP) Committee on Nutrition. Parenteral nutrition. In: Kleinman RE, Greer FR, eds. Pediatric Nutrition Handbook. 8th ed. Itasca, IL: American Academy of Pediatrics; 2019:chap 22.
Bales CB, Liacouras CA. Intestinal atresia, stenosis, and malrotation. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 376.
Poindexter BB, Martin CR. Nutritional support for the preterm infant. In: Martin RJ, Fanaroff AA, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 42.
Version Info
Version: 2.0
Last reviewed on: 4/5/2025
Reviewed by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
