Objective: To evaluate the effect of withholding feeds during transfusion on transfusion associated acute gut injury (TRAGI). Study design: Data were collected on 125 preterm infants before and after the practice of withholding feeds for 12–24 h during transfusion was instituted. Logistic regression was used to examine effects of withholding feeds on TRAGI rates. Results: A total of 19 (15%) infants developed NEC; 6/19 (32%) had TRAGI. Postnatal hydrocortisone use was associated with TRAGI (OR 8.97; 95% CI 1.17–68.46, p = 0.034). There was no difference in NEC rates (15.8 vs. 14.7%) and the proportions (22.2 vs. 40%) of TRAGI in the two time periods before and after instituting the standardized feeding regimen and practice of holding feeds during transfusion. Conclusion: No significant decrease was noted in the rates of TRAGI after feeds were withheld during transfusion. Further studies are warranted to explore the relationship between feeds during transfusion and NEC.