Is starting parenteral nutrition appropriate for a mildly dehydrated infant with viral gastroenteritis?

• A. Yes
• B. Only if weight is below a threshold
• C. Only if breastfed
• D. No

Answer: (D)

Starting parenteral nutrition is not appropriate here because the gut should be used for nutrition whenever possible, especially in mild dehydration due to a viral gastroenteritis. The priority is to rehydrate and maintain energy intake through oral or enteral means, such as oral rehydration solutions and continuing breast milk or formula. Parenteral nutrition bypasses the gastrointestinal tract and carries risks like catheter-related infection, metabolic complications, and delays gut recovery; it is reserved for situations where the gut cannot meet nutritional needs or cannot tolerate enteral feeding, not for a mild dehydration episode. The decision is not driven by weight thresholds or whether the infant is breastfed; those factors do not justify starting PN in this scenario.