(EPN group, n = 44). Demographic data, anthropometric and laboratory parameters were extracted from the electronic record system. Results: The mean age of PN initiation was LPN = 47.3 hours versus EPN = 14.3 hours. Biochemical parameters analysed during the first week of life revealed a reduction in hypernatraemia (12.7% versus 6.8%) and non-oliguric hyperkalemia (12.7% versus 6.8%) in EPN, with no significant differences in acidosis and urea levels between the two groups. Hyperglycemia >12 mmol/L in <1000g was higher in EPN. Nutritional parameters in 81 babies who survived/stayed in the unit up to a corrected gestational age (CGA) of 34 weeks (40 in LPN and 41 in EPN), revealed a reduction in metabolic bone disease (osteopenia of prematurity [OOP], 17.5% versus 7.3%) and the need for phosphate supplementation (22.5% versus 7.3%) in the EPN group. There was no increase in acidosis or cholestasis. No difference was noted in albumin levels, time to full feeds, time to regain birthweight and mean weight gain per day till 34 weeks corrected CGA. Conclusion: EPN in VLBW newborns is well tolerated and reduces hypernatraemia, non-oliguric hyperkalemia, OOP and the need for phosphate supplementation. Early versus Late Parenteral Nutrition in VeryLow Birthweight Neonates A retrospective study from Oman 1 They are traditionally started on a dextrose infusion and graded to parenteral nutrition (PN) over several days. The goal of EPN is to provide an intravenous substrate that promotes protein deposition and increased lean body mass that approximates fetal growth rate and accretion. In recent years, early introduction and aggressive advancement of PN have been shown to be safe and effective.2,3 Protein delivery of 3 gm/kg beginning on day one (D1) of life is safe and associated with plasma AA concentrations similar to those of second and third trimester fetuses. 4 In the absence of iatrogenic causes of electrolyte and acid base derangements, significant individual variations in nutritional requirements of preterm neonates from PN are rare. 5 Hypothesising that premature infants might benefit from the anabolic effects of EPN without metabolic derangement, we investigated the benefits of EPN in VLBW neonates. The objectives of our study were to compare the following between the EPN and LPN groups: 1) Biochemical disturbances in the first week of life; 2) Weight gain/day, mean weight at 34 weeks corrected gestational age (CGA), time to full feeds and time to regain birth weight, and 3) Incidence of osteopenia, the need for phosphate supplementation, cholestasis and albumin levels. The study included all inborn VLBW babies between and including gestational age 25-32weeks and weighing ≤1500 g; those that survived >7days for assessing biochemical parameters; infants who survived/stayed in the NICU until corrected gestational age (CGA) of 34 weeks for assessing nutritional parameters, and who received PN for >5 days. Excluded from this study were infants with chromosomal and major congenital anomalies; those on PN for >4weeks; ba...