MB, ChB, MRCP(E), DCH \s=b\ Very small premature infants with severe respiratory disease were managed with early intermittent orogastric feedings combined with infusions of 10% dextrose.Nine infants weighing less than 1,350 gm at birth (mean, 990 gm) who required endotracheal intubation and respirator therapy and who remained in the hospital for at least 40 days were studied retrospectively.The mean weight gain per day was 10.8 gm for the first 40 days of life, 14.1 gm while an endotracheal tube was in place (sometimes longer than 40 days), and 15.7 gm during the growth phase, after initial weight loss.Individual growth curves compared favorably with those reported by others using total parenteral nutrition.The technique described deserves wider application for initial management of the small premature infant receiving mechanical respiration.