Original Communication Clinical Relevancy Statement

It has been difficult to meet the Food and Drug Administra-tion (FDA) recommendation of limiting aluminum (Al) expo-sure in preterm infants due to significant Al contamination of additives to parenteral nutrition (PN). Calcium gluconate (CaGlu) and potassium phosphate (KPhos) are major con-tributors to Al contamination, but precipitation studies for neonatal TrophAmine-based PN solutions made with low Al containing calcium chloride (CaCl) and sodium phosphate (NaPhos) have not been available. This article reports the results of precipitation studies for neonatal PN solutions made with TrophAmine, CaCl, and NaPhos, which can be used as a guide for safe compounding of neonatal PN solu-tions to decrease Al exposure in neonatal patients. The article also reconfirms that PN solutions made with CaCl and NaPhos, as opposed to CaGlu and KPhos, can limit Al intake to near FDA recommended intakes