Nasal obstruction in the newborn.

s of Papers read at 14th Meeting, Bristol, October 18-19, 1968 Nasal Obstruction in the Newborn Peter M. Dunn University of Bristol The relatively narrow nasal passages of the newborn infant create a high resistance to airflow and are readily occluded. Most newborn infants are 'obligatory' nose-breathers for the first few weeks of life, except when crying. Thus the newborn infant is peculiarly vulnerable to nasal obstruction in the newborn period. Attention was drawn to an entity termed 'congenital postural deformity of the nose': 6 infants, each having a nose bent acutely to one side, were encountered among approximately 7000 hospital deliveries; 5 of the mothers were primiparae and all 6 infants presented by the vertex. In 3 infants there was a history of deep engagement of the head within the mother's pelvis for 4, 6, and 9 weeks before delivery. In the remaining 3 cases there was a history of premature rupture of the membranes 1, 6, and 8 weeks before birth. None of the infants had malformations outside the skeletal system; 1 had bilateral dislocation ofhips, 1 had scoliosis, and 1 had flexion deformities of hips and knees with Talipes. It was suggested that all these deformities were caused byintrauterinepressure. 2ofthe 6 infants suffered from severe respiratory distress. One had completely obstructed respiration which could be relieved by opening the mouth or by straightening the nose. The passage of a section of 'endotracheal' tube into one nostril served both to correct the deformity and to maintain the airway in this case. Aspects of Hypoglycaemia in Kwashiorkor Brian A. Wharton University of Bristol Hypoglycaemia (blood glucose less than 40 mg.f 100 ml.) with symptoms was a rare complication of kwashiorkor in Uganda, but when it did occur death was inevitable. It was present in one-sixth of the children who died during this time. Hypoglycaemia without symptoms, however, occurred in one-third of the children, but if the blood glucose remained above 20 mg./100 ml. it had no unduly grave significance. The biochemical origins of the hypoglycaemia, though uncertain, were probably hepatic. There were, however, important clinical associations with hypothermia and severe infection. Relation Between Insulin Levels and Glucose Disappearance in Normal and Diabetic Patients