Critically ill neonates hospitalized in ICU, especially thoseundergoing surgery and very low birth weight (VLBW) preterms, areoften kept on parenteral nutrition for a long period of time. While theprevailing thought is this practice minimizes the risk of gastrointestinaltract (GIT) complications during acute phase of illness such asnecrotizing enterocolitis (NEC), on the other hand, NPO predisposes theneonatal gut to consequences of gut atrophy and luminal starvation,depending on the fact that the gut is an experienced organ which isphysiologically active and primed for the activities of food assimilation.This is because the fetus swallows amniotic fluid, which contains avariety of substances and growth factors that stimulate GIT development.Making the newborn withholding feeding creates an abnormalphysiological situation and predisposes the infant to the negativeconsequences of no enteral feeding, as: gut atrophy and luminalstarvation, which will lead to bacterial translocation and impairedimmune function that will lead to more dangerous complications. Thesenegative consequences can be reversed or prevented by early introductionof enteral nutrients including gut priming [Strodtbeck, 2003].In severe surgical conditions and VLBW preterms in which there isno way except NPO, total parenteral nutrition (TPN) has made greatrevolution, however it is not a benign technology with manycomplications as; sepsis, cholestasis, hemorrhage, metabolicderangements, osteopenia, catheter complications in addition to gutatrophy [Hack and Fanaroff, 1999; Thureen et al, 2003].It was found that addition of glutamine to TPN is beneficial, despitethe fact that it is a nonessential amino acid; it is the preferred fuel forenterocytes. It has been shown that it reverses gut atrophy, decreasesintestinal permeability and bacterial translocation; in addition it improvesimmune activities of the gut [Shiphley, 1996; Reeds and Burrin, 2001].Despite all these parenteral interventions still it can be said that withminimal enteral feeding increased gradually whenever we can start withneonates especially preterms is much better with shortening period ofhospitalization. Enteral feeding is the best for the gut processes asphysical, mechanical, physiological and immunological barrier. InVLBW and ELBW with underdeveloped GIT, there are new directionstowards the usage of what is called artificial amniotic fluid due to itsimportance in gut development, and therefore early administration ofenteral feeding with improving of the general condition and shortening ofhospitalization which is very important from the financial point of viewespecially in developing countries [Ross, 2003].