Nutritional support is important in paediatric surgical patients who have requirements for growth and development in addition to maintenance. Sepsis, postoperative period, and surgical complications create a state of hypermetabolism. Children may develop significant morbidity if starvation exceeds 5–7 days. Very low birth weight infants can rapidly become nutrient deficient as the placental transfer of nutrients occurs mainly during the last trimester. Nutrition is best given by using the enteral route; however, in certain conditions, the enteral route is unavailable or cannot be used. In such situations, the parenteral route is used to support nutrition.