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Neonatal parenteral nutrition (PN) administration requires balancing optimal growth with the risks of hypertriglyceridaemia (HTG). Neonatal HTG is increasingly linked to higher rates of retinopathy of prematurity,1 sepsis2 and mortality.3 However, there is a lack of consistent evidence-based guidelines around defining and managing HTG via adjusting intravenous lipid emulsions (IVLEs), leading to heterogeneous practice. This variation confounds further assessment of the risks of both suboptimal growth and HTG.