Which of the following is NOT a reason postoperative and critically ill neonates have lower energy needs?

• A. Absence of growth
• B. Decreased activity
• C. Reduction of insensible losses
• D. Increased metabolic rate

Answer: (D)

The main idea is that energy needs in postoperative and critically ill neonates tend to be lower because the body’s growth and energy losses are reduced, not because it burns more calories. When growth is paused, there’s less anabolic demand to support tissue accretion, so maintenance energy suffices. Decreased activity means less energy spent on movement and thermogenesis from activity. Reduction of insensible losses—such as skin evaporation and respiratory losses—lowers the energy needed to maintain body temperature and hydration. Increased metabolic rate, however, would raise energy expenditure due to the stress response from surgery or illness, making energy needs higher rather than lower. So the option that does not fit as a reason for lower energy needs is increased metabolic rate.