Possible Ariboflavinosis in a Premature Infant *

S. M. was born April 1, 1941, one month before the expected date of confinement. Her Negro father and White-and-Indian mother, both 35 years of age, were well except for a reputed, asymptomatic cardiac enlargement in the mother. A 10-year and a 12-year-old sibling were well. There had been no other pregnancies. There was no family disease. The mother's serology was negative. Social Service investigation disclosed a middle-class family in no apparent want and on an adequate dietary, so far as could be determined. Gestation was uneventful save for temporary vaginal bleeding on January 4, 1941, which subsided spontaneously. Labor was of one hour's duration with a left occiput posterior presentation; no forceps were used. The infant, a female premature child, cried spontaneously and seemed to be normal. Her birth weight was 1990 gm.; the head circumference was 32 cm., the chest circumference was 28 cm., and the length was 43 cm. The initial temperature of 36.20 C. (97.20 F.) quickly became normal. Physical examination showed no abnormalities. The Kahn test was negative. Urinalysis was negative. Blood count on the 25th day of life showed: RBC 3 million; Hgb 13 gm.; WBC 17,900; polymorphonuclear cells 37% and lymphocytes 63%o. The child was placed in a Hess bed in an air-conditioned room (temperature 780 F. and humidity 68) and given 1.0 mg. of synthetic vitamin K (Hykinone) subcutaneously. She received frequent oxygen and carbon dioxide inhalations with mouth suction as required. Adequate fluid intake was maintained during the first three days of life by saline clyses. No difficulty with the infant was experienced at any time. On the second day of life, a mixture of one half skimmed milk (cow) with 10%o added Dextri-maltose was begun. The mixture is made up from powdered milk. The initial feeding of 5 cc. every three hours (20 cal.