In pediatric patients receiving parenteral nutrition, what percentage of total calories should be provided as fat to prevent essential fatty acid deficiency (EFAD)?

• A. 10% of total calories
• B. 4% of total calories
• C. 20% of total calories
• D. 2% of total calories

Answer: (B)

Essential fatty acids must come from the fat component of parenteral nutrition because the body cannot make them. In pediatric patients, stores are small, so providing enough fat calories is crucial to prevent essential fatty acid deficiency (EFAD). The minimum fat energy needed to prevent EFAD is about 4% of total daily calories. Providing this amount ensures essential fatty acids (like linoleic and alpha-linolenic acids) are supplied. Options much lower than this risk EFAD; higher percentages may meet other energy needs, but the threshold to specifically prevent EFAD is around 4%.