Over 2 weeks of age

• <2/3 expected caloric requirement
  • Fluid restriction ≤160 ml/kg/day
  • <100ml/kg/day P10 or N10 after Day 4 of life
  • <180ml/kg/day enteral feeds in a preterm infant
  • <150ml/kg/day enteral feeds in a term infant
• <10 g/kg/day weight gain for >5days (<38 weeks CGA)
  <20 g per day weight gain for >7days (>38 weeks CGA)
• Significant obstructive jaundice
• Serum phosphorus <1.3mmol/L
• Intolerance to preterm formula or breast milk fortifier
• Intake >200ml/kg/day of preterm formula or breast milk fortifier

Any infant with

• NEC where elemental formula is being considered
• Short bowel syndrome
• Malabsorption
• Chronic lung disease where growth impairment is likely
• Congenital heart disease where growth impairment is likely
• Gastrointestinal anomaly
• Metabolic disorder
• Chylothorax
• Renal failure
• Osteopenia requiring additional calcium and phosphate
• Possible zinc deficiency
• Breastfed baby where there are concerns about maternal nutrition