Some Phases of the Pathology of Nutrition in Infancy

Abstract

Since the chief function of the infant is growth, it is not surprising that the nutrition of the infant should be the chief concern of those responsible for his welfare. Congenital anomalies of structure, acute and chronic infections, unsuitable food, unhygienic surroundings, too much attention or too little attention, in fact, almost any factor external or internal which can affect the infant at all has an influence on his nutrition. Scarcely any one portion or system of the body may become affected without involving the general nutrition. A growing realization that it is the infant as an organic whole that must be considered, rather than any individual organ, has led to a much broader conception of diseases in infancy and to more rational therapy. This is especially true of those diseases which are associated with gastro-intestinal disturbances. The time has passed when we center our attention exclusively on the alimentary tract and allow the infant to die of a curable derangement of the intermediary metabolism. The nutrition of the infant now claims our chief atten¬ tion. The gastro-intestinal tract concerns us for the reason that any alteration in its function exerts a profound influence on the general nutrition.The great importance of gastro-intestinal diseases as a factor in infant mortality is well recognized. We know that some infants suffer¬ ing from diarrhea develop symptoms suggestive of acute poisoning and succumb within a relatively short time, while others lapse into a chronic state of malnutrition which only too often eventuates in death. We also know that exactly the same symptoms may occur in the case of infants who have not suffered from diarrhea. Czerny recognized this fact and grouped the causes of nutritional disturbances under three main heads : food, infection, and constitution. Granting the importance of these etiologic factors, we are still largely in the dark From the Downloaded From: http://archpedi.jamanetwork.com/ by a University of California -San Diego User on 06/13/2015 as to how each of them acts, as to what causes the symptoms and even as to why such infants suffering from nutritional disturbances should die. Very little information is obtained from the necropsy room.In the great majority of instances the pathologic findings on infants dead of nutritional disturbances are essentially negative.In the absence of anatomic changes we are forced to conclude that some profound alteration in the chemical or physiologic processes in the body must have occurred. This conception has led to much investigation and more speculation as to the nature of these changes, and a popular idea has been that most of the symptoms are referable to toxic substances of metabolic or bacterial origin. Finkelstein 1 and his colleague, Meyer,2 have especially emphasized the conception of "food poisoning" as a cause of nutritional disturbances. They con¬ sider infection and constitutional abnormalities chiefly as contributory factors in that they lower the infant's tolerance for food, that is, the ability to ut...

Dehydration: Physiology, Assessment, and Performance Effects

“…The preferential loss of skin ISF, due to the lower oxygen requirement of skin, likely explains the change in skin turgor (173,214). It is also likely that physical symptoms may be more pronounced in the very young who possess limited physiologic reserves (238).…”

Cerebral Anoxia in Infantile Dehydration

“…On the other hand, one of us (Kerpel-Fronius, 1947) reviewing evidence based on the pioneer work of Marriott (1920), Gamble (1928), and others, emphasized again that toxicosis is primarily a condition similar to medical shock. The failure of circulation may or may not be due exclusively to anhydraemia.…”

“…Marriott (1920) and Utheim (1920), using a calorimetric method, measured a diminished blood flow to the extremities per unit of time in infantile toxicosis. Thus it is to be expected that the blood supply to the brain may also be diminished.…”

The Determination of the Circulating Blood Volume in Infants by the Carbon Monoxide Method

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