Macronutrient guidelines for initiation and advancement of parenteral nutrition in children

Age group	Carbohydrate/dextrose^*	Protein/amino acid^¶	Fat/lipid
<1 year	Initial – 6 to 8 mg/kg/min Goal – 10 to 14 mg/kg/min	Initial – 2 to 3 g/kg/day Daily increase – 1 g/kg/day Maximum – 3 g/kg/day	Initial – 0.5 to 1 g/kg/day Daily increase – 1 g/kg/day Maximum – 3 g/kg/day
1 to 10 years	Initial – 10 to 12.5% Daily increase – 5% increments (maximum 15 mg/kg/min)	Initial – 1 to 2 g/kg/day Daily increase – 1 g/kg/day Maximum – 2.5 to 3 g/kg/day	Initial – 1 g/kg/day Daily increase – 1 g/kg/day Maximum – 3 g/kg/day
>10 years	Initial – 10 to 15% Daily increase – 5% increments (maximum 8.5 mg/kg/min)	Initial – 1 to 1.5 g/kg/day Daily increase – 1 g/kg/day Maximum – 1.5 to 2 g/kg/day	Initial – 1 g/kg/day Daily increase – 1 g/kg/day Maximum – 2.5 g/kg/day

* Carbohydrate intake is given as the glucose infusion rate (GIR), in mg/kg/minute. Refer to topic text for explanation of how to calculate the GIR.

¶ Starting protein intake at the low end of the range and then advancing is generally recommended. This is out of caution because there is no good evidence suggesting the need to limit initial protein to less than calculated needs.

Reproduced with permission from: Pediatric Parenteral Nutrition, Baker RD, Baker SS, Davis AM (Eds), Aspen Publishers, Inc, Gaithersburg 2001. Copyright © 2001 Robert D Baker, MD, PhD; Susan S Baker, MD, PhD; and Anne M Davis, RD, CNSD.

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Macronutrient guidelines for initiation and advancement of parenteral nutrition in children