The first report of the successful use of TPN in a pediatric patient was in 1944. A 5-month-old infant with severe marasmus demonstrated nutritional improvement after receiving an IV mixture of glucose, casein hydrolysate and lecithin-olive oil homogenate for 5 days. In the late 1960s, Dudrick and coworkers at Mass General Hospital reported the successful use of long-term TPN to support growth in an infant. By the early 1970s, TPN was being used extensively in the nutritional management of infants and children with congenital and acquired surgically correctable lesions of the GI tract, as well as those with intractable diarrhea. Currently, most infants with birthweights < 1500 grams, receive parenteral nutrition for the first several days to weeks of life. The last two decades have seen the evolution of crystalline amino acid mixtures, safe parenteral lipid emulsions, addition of trace minerals and vitamins and improvements in central catheters and infusion pumps.