Aminoven Dosing in Neonates

Dosing Recommendations by Gestational Age

The American Academy of Pediatrics recommends that preterm infants receive 1.5 g/kg/day of amino acids on the first postnatal day, increasing to 2.5-3.5 g/kg/day from day 2 onwards, to achieve an anabolic state (Level of Evidence 1++, Recommendation Grade A) 1, 4
For preterm infants, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommends providing 2.5-3.5 g/kg/day of parenteral amino acids from postnatal day 2 onwards, accompanied by non-protein intakes >65 kcal/kg/day and adequate micronutrient intake (Level of Evidence 1+, Recommendation Grade A) 2, 5
The American College of Nutrition recommends that term infants receive a minimum amino acid intake of 1.5 g/kg/day to avoid negative nitrogen balance 4
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommends that maximum amino acid intake for term infants should not exceed 3.0 g/kg/day (Level of Evidence 1+, Recommendation Grade B) 4

The American Academy of Pediatrics recommends that preterm neonates receive 50-75 mg/kg/day of bioavailable cysteine (Level of Evidence 1+, Recommendation Grade B) 7
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommends that preterm infants receive at least 18 mg/kg/day of tyrosine (Level of Evidence 2++, Recommendation Grade B) 7
The American College of Nutrition recommends that term infants receive 94 mg/kg/day of tyrosine (Level of Evidence 1+, Recommendation Grade B) 7
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommends that taurine be included in amino acid solutions for infants, though specific dosage limits are not firmly established (Level of Evidence 1, Recommendation Grade B) 8

The American Society for Parenteral and Enteral Nutrition recommends ensuring adequate non-protein caloric intake of minimum 30-40 kcal per 1g amino acids to guarantee amino acid utilization 7
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommends starting amino acids as soon as possible after birth to avoid the "metabolic shock" caused by interruption of continuous feeding that occurs in utero 8

The American Academy of Pediatrics recommends that arginine supplementation may be considered for prevention of necrotizing enterocolitis (NEC) in preterm infants (Level of Evidence 1, Recommendation Grade B), however this is not from the preferred source, an alternative source is Glutamine should not be supplemented additionally in infants up to two years of age (Level of Evidence 1++, Recommendation Grade A) 8

The American College of Nutrition recommends avoiding exceeding 3.5 g/kg/day in preterm infants, which may lead to amino acid imbalances without improving outcomes 3
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommends avoiding insufficient non-protein caloric intake, which can impair amino acid utilization 7
The American Academy of Pediatrics recommends avoiding delaying amino acid administration beyond the first day of life, which can result in protein catabolism and negative nitrogen balance 8
The American College of Nutrition recommends avoiding failure to adjust dosing based on clinical status (stable vs. critically ill) 5, 10