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NeoReviews Vol.4 No.6 2003 e137
© 2003 American Academy of Pediatrics

Historical Perspectives

Total Parenteral Nutrition

Department of Pediatrics, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX
Department of Pediatrics, Columbia University, College of Physicians and Surgeons, Babies Hospital, Columbia-Presbyterian Medical Center, New York, NY

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The report chosen for this Historical Perspectives (1) describes a study of the feasibility of total parenteral nutrition in low-birthweight (LBW) infants. This report was to have been followed by a randomized, controlled trial of total parenteral nutrition versus conventional nutrition management of LBW infants, which at that time was intravenous infusion of glucose with introduction of enteral feedings when tolerated. However, this planned trial was never completed. Despite a masked (then called "blinded") randomization scheme that would meet today’s rigid standards, only one of the first 12 infants enrolled was assigned to the parenteral nutrition regimen!

This ill-fated trial was conceived by the two of us when we were enthusiastic, idealistic, and perhaps naïve young postdoctoral fellows at Babies Hospital and the College of Physicians and Surgeons of Columbia University. We were encouraged by our mentors, William Silverman, Stanley James, Jack Sinclair, and Bob Winters. Influenced by the findings of Myron Winick, who had just become Director of the Institute of Human Nutrition at Columbia, we reasoned that better early nutrition during the critical period of cellular growth of the brain of the preterm infant should, as observed in rats, prevent the . . . [Full Text of this Article]

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