Box 1.

Clinical assessment of feeding intolerance

Nutrition	Has the patient received any formula feeds? Is the infant receiving more than trophic feeds (>25 mL/kg/d)?
Motility	Are the bowel sounds hypoactive or absent? Are there visible bowel loops? Is there abdominal distension with discoloration? Has the infant had an increase in abdominal girth? Has the infant had constipation? Has the infant had a bloody stool?
Ischemia	Is the infant’s urine output low? Is the infant receiving support with vasopressors? Is the infant’s lactate high? Is the infant showing signs of hypotension?
Sepsis	Is the infant experiencing abnormal heart rate characteristics? Has the infant had a relative increase in oxygen requirement? Is the infant having more apneas and bradycardia?