Infant feeding practices: a cause for concern.

Cases of infants with life-threatening nutritional deficiencies due to certain strict vegetarian or macrobiotic diets have recently been reported.'-7 It has been suggested that in some instances this should be regarded as a form of child abuse.' We have recently come across infants who have been severely ill as a result of similar nutritionally inadequate diets. During the past 12 months nine have presented to the Hospital for Sick Children, Great Ormond Street, and six to the Queen Elizabeth Hospital for Children, Hackney Road. In these cases the parents, not themselves on exotic diets, have used alternative "milks" for infant feeding in good faith on the basis of publications or on the recommendation of those providing professional advice. We wish to draw attention to the practice of lay, professional, or commercial recommendations of what may often be inappropriate infant feeds. Most mothers interested in vegetarian and other cult diets are keen to breast-feed their infants, and it is only when this is not possible that other feeds are used. Relatively minor problems may arise when infants are inappropriately given supplements to their basic milk feeds or when they are on mixed diets. For example, the frequent use of Complan as an addition to infant feeds has resulted in at least two referrals to this hospital of infants with uraemia, later found to be due to excessive protein intake. The manu-