The use of 20% albumin infusion in the management of neonatal hypoalbuminaemia remains controversial as there is a paucity of evidence-based guidelines. Neonatal hypoalbuminaemia is associated with various adverse clinical conditions, including necrotising enterocolitis, sepsis and respiratory distress syndrome.1^–4 A meta-analysis by Vincent et al showed that decreased serum albumin is an independent risk factor for mortality and morbidity.5 Clinical benefit was demonstrable in four studies with an attained albumin level of more than 30 g/l.5 Specifically, in these studies with …