A.S.P.E.N. and others have recommended early enteral nutrition (EN) as the optimal route for nutrition support. We reviewed our experience with 100 children admitted to a pediatric intensive care unit (PICU) to assess what proportion of children received early EN and whether they achieved their caloric goal (Recommended Dietary Allowance [RDA]) within the first 72 hours of admission to the PICU. By the end of their third day in the PICU, 86% of subjects received some form of nutrition. EN was the predominant form of nutrition support started (72%). However, only half the subjects received ≥50% of RDA by the end of their third PICU day. Subjects who did not achieve 50% of their caloric goal received less total fluid and less fluid with nutritional value than those children who achieved at least half their goal. Attention to nutritional content of total fluids administered and systematic advancement of rate of EN administration is warranted.