Weanling Diarrhea°

Abstract

Editor's Note: Space limitations prevent us from reprinting more of this 30-page article by Gordon, Chitkara, and Wyon, which was so clearly written and so important in its conceptual contributions. Not only was weanling diarrhea defined and placed in the proper context as a condition of unsurpassed international public health importance, but also the health effects of breast-feeding and the synergistic effects of nutrition and infection were emphasized.The diarrheas and the dysenteries that come with the transition of babies from a breastfed existence to a mixed diet are here presented as an epidemiologic entity, weanling diarrhea. The clinical syndrome, for this is a collection of diseases, some identified as to causative agent and some not, is no longer a major health problem of advanced nations. Many factors have contributed to that result: a favorable economy, improved environmental sanitation, technical gains in human nutrition and control of communicable disease, and the development of modem pediatrics.The contrast today with conditions in 1900 is striking. In that year, the death rate in New York City from dysentery, diarrhea and enteritis of children in the first year of life was 5,603.0 per 100,OOO infants; in the then existing registration area of the United States it was 4,523.2. Preschool children of I to 4 years had a rate of 398.7 per 100,OOO

Developmental, diachronic, and demographic analysis of cribra orbitalia in the medieval christian populations of Kulubnarti

“…Clinically, the frequency of iron deficiency shows a further increase with weaning as children are introduced to adult foods and are increasingly exposed to gastrointestinal pathogens (Gordon et al, 1963). The resultant weanling diarrhea leads to further deterioration of nutritional status due to decreased appetite and increased metabolic loss of essential nutrients, including iron and magnesium (Gordon et al, 1963).…”

Acute, infectious diarrhea among children in developing countries

“…The increased incidence of diarrheal disease concurrent with the introduction of weaning foods has been recognized for some time, and the protective effects of exclusive breastfeeding have been demonstrated repeatedly. 32,100 The addition of water, infusions, and other types of milk or solid foods to an infant's diet and the cessation of breastfeeding each is associated independently with a greatly increased risk of developing diarrhea. Exclusive breastfeeding can and should be promoted through existing primary healthcare services.…”

Premastication: the second arm of infant and young child feeding for health and survival?

“…Thus, the sharp rise in diarrhea that occurs when complementary foods are added can be seen as due to a trade-off between meeting nutritional needs and increasing the risk of life-threatening illness through ingestion of contaminated foods. This trade-off is called the 'the weanling's dilemma' (Gordon et al 1963;Rowland 1986). If it is correct that premastication neutralizes contamination, it may be that the 'weanling dilemma' is a consequence of lack of premastication.…”