What should VLBW infants on TPN do to prevent intestinal atrophy?

The correct choice is starting trophic feeds with human breast milk (HBM) to prevent intestinal atrophy in very low birth weight (VLBW) infants on total parenteral nutrition (TPN). Trophic feeding refers to the practice of providing small amounts of enteral nutrition, which can help stimulate the gastrointestinal tract. This stimulation is crucial because it encourages the development and maintenance of the intestinal mucosa, preventing atrophy that can occur when the intestine is not being used for digestion.

Entering small volumes of HBM provides not only nutrition but also bioactive components that support gut health, promote growth, and reduce the risk of gastrointestinal complications. This contrasts with the other methods listed, which do not contribute directly to intestinal development in the same way.

For instance, engaging in physical therapy does not provide the necessary nutrients that directly influence gut health, while waiting for natural feeding capabilities does not address the immediate needs of the VLBW infant’s intestine. Increasing fluid intake alone does not specifically stimulate the intestinal lining or support its function, making trophic feeds the most effective approach for maintaining gut integrity in these vulnerable infants.