Long-term total parenteral nutrition results in atrophy of small intestinal structure and function. Maintenance or re-establishment of enteral nutrition can prevent or redress this loss. Paradoxically, the fetus develops in a total parenteral nutrition environment, but at the same time must achieve appropriate levels of gastrointestinal maturation in readiness for enteral feeding soon after birth. The fetus swallows large amounts of fluid during life in utero and growth is arrested if fetal ingestion is impaired. It is possible therefore that enteral nutrition provided by fetal swallowing is just as important in ensuring normal gastrointestinal homeostasis and growth in the fetus as it is in the adult.