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Abstract Preterm infants are those born before 37 weeks of pregnancy are completed, and an estimated 15 million are born worldwide each year. Preterm birth is the leading cause of death in children under five, and many survivors face lifelong disabilities. Total parenteral nutrition (TPN) is a feeding method used when preterm infants cannot receive food or liquids by mouth. It bypasses the gastrointestinal tract and provides essential nutrients via intravenous administration of fluids. It’s contains fatty acids, dextrose, amino acids, electrolytes, vitamins, minerals, and trace elements. The choice of lipid emulsion in TPN can affect clinical outcomes, and conventional soy-based lipid emulsion has many complications. Neonatal infections are common in preterm infants, and studies have associated intravenous lipid emulsion with outbreaks of bacteremia in neonatal intensive care units (NICUs). Fish oil-containing lipid emulsions such as SMOFlipid are an alternative to traditional lipid emulsions. SMOFlipid emulsion in preterm infants reduces sepsis incidence, potentially minimizing costs associated with longer hospital stays, additional treatments, and higher mortality rates. In Alexandria, Egypt, many pediatricians are not including SMOFlipid emulsion in the TPN in NICU. Probably, because their unawarness about the benefits of this regimen. The utility of this nutritional regimen has not been well studied in developing countries with limited resources. In our study, we hypothesize that preterm infants receiving total parenteral nutrition without lipid emulsion will have a higher incidence of septicemia, increased length of stay (LOS) in the NICU and associated higher costs than those receiving total parenteral nutrition without SMOFlipid emulsion. The aim of this study was to assess the impact of the use of SMOFlipid on the incidence of septicemia, LOS in the NICU and associated costs in preterm infants. |