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At birth there is a statistically significant correlation between the maternal blood sugar and the umbilical venous and arterial blood glucose. The glucose concentration in the mother is higher than in the umbilical vein, and in the latter higher than in the umbilical artery. The free fatty acids also show a falling gradient from the mother to the umbilical vein and artery. This supports the assumption that glucose and FFA pass the placenta from the mother to the foetus. Insulin concentration is significantly higher in the mother than in the cord blood. There is however no difference between umbilical venous and arterial plasma insulin. A statistically significant correlation between glucose and insulin is only demonstrable in the maternal blood. Glucagon levels are about the same in maternal and umbilical arterial blood, but are significantly higher in umbilical venous blood. These results are consistent with the supposition that insulin and glucagon do not cross the placenta to a significant extent and can be synthesised by the foetus. In the first few hours after birth, a fall of glucose and a rise in FFA occur at the same time. Insulin tends to be lower than at birth and glucagon rises.

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The metabolic effects of short term administration of human growth hormone were studied in four infants two weeks to 2½ months old and three children 11 months to 3¼ years of age. They responded qualitatively in the same way as older children and hypopituitary dwarfs. Quantitatively the infants responded to a lesser extent than older subjects. The most constant findings are in order of decreasing response: Fall in urinary creatine, urea nitrogen and total nitrogen excretion and decreasing blood concentration of urea and residual nitrogen. An increase in α-amino-nitrogen excretion is also a fairly common finding. There is only a slight rise in the fasting level of free fatty acids in the serum in response to HGH injection in the infants. In the children this effect is already more pronounced. A fall in urinary sodium, potassium and phosphorus does not occur as regularly as in older subjects. An increase in ketone bodies in the urine was observed in some infants and children. The possible mechanisms and significance of the diminished response of infants to exogenous growth hormone are discussed.

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