5 year-old male with long-term HPN dependence secondary to short bowel syndrome is seen for routine follow-up. Enteral tolerance is currently maximized. PN currently providing energy 45 kcal/kg/day, protein 1.3 gram/kg/day, IV soybean lipids 1 gram/kg/day, glucose infusion rate 10 mg/kg/minute. There has been no weigh gain for 3 consecutive outpatient visits. Z-score as follows: Weight -2, Height -2.5, BMI -0.5. All labs are stable, including micronutrients and inflammatory markers. What is the next appropriate step?
A. Increase protein to 2 grams/kg/day to increase calories by 10%
B. Increase IV lipids to 2 grams/kg/day to increase calories by 10%.
C. Increase glucose infusion rate by 2 mg/kg/minute to increase calories by 10%.
D. No PN change. Continue to monitor weight tren