The rate at which TPN is given to a newborn is critical: if given too quickly, there is a danger of fluid overload, which can lead to coagulopathy, liver damage, and reduced pulmonary function as a result of fat overload syndrome. If given too slowly, the TPN will run out before the infant needs it. Given these concerns, doctors generally do not give TPN faster than 4-6 ml/kg/hr. However, some studies have shown that giving babies TPN at rates as high as 8-10 ml/kg/hr for several days in a row is safe and may be more effective at promoting weight gain. There has been one case report of an infant who received 15 ml/kg/hr for two weeks without any apparent problems. However, most infants will receive TPN for no longer than three days and some for only one day. Therefore, the majority of cases involving TPN at high rates involve only one or two doses rather than a continuous infusion. When giving TPN at high rates, it is important to monitor the patient for signs of fluid overload such as heavy breathing, flabbiness, blue color of the skin, and rapid heart rate. If these symptoms are noticed, the rate should be slowed down immediately until the effects of the high dose have worn off.