Some Aspects of Starvation in the Newborn Baby.

Most babies begin to take milk feeds within two or three days of birth and thereafter their intakes of milk steadily increase during the first week and a large proportion of the materials they derive from the digestion of such feeds is retained. This normal process may be hindered by the repeated vomiting exhibited by some premature babies, in the absence of any apparent organic cause except their prematurity, and also by vomiting associated with organic intestinal obstruction by duodenal or jejunal atresia or volvulus of the midgut. Even when the obstruction has been relieved by operation, because of postoperative delay in gastric emptying or intestinal ileus another five or six days may elapse before an intake of milk is achieved; during this time starvation may be almost complete, being relieved only by small quantities of dextrose administered by intravenous infusion, which provide only a small fraction of the total calorie requirements of such babies. There have been few studies of deprivation of this degree, though Rickham (1957) reported a newborn baby who was almost completely starved for 10 days after birth and was submitted to two operations for duodenal cyst and intestinal obstruction. During a series of metabolic studies of newborn babies we have been able to observe a premature baby who, because of vomiting, was not fed milk for 10 days after birth. Another baby, with jejunal atresia and meconium obstruction, was submitted to two operations and was not fed milk for 16 days after birth. Methods