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Protein Requirements of Infants: 2. Marasmus

1949; BMJ; Volume: 24; Issue: 120 Linguagem: Inglês

10.1136/adc.24.120.250

1468-2044

W. F. Young, Erin Bishop, E. M. Hickmans, Y Williams,

Neuroscience of respiration and sleep

Failure to gan or actual loss of weight is a common condition in young infants which has been a subjec of disussion for centuries, and m the past there was a tendency to regard wasting as a clinical entity.This conception is entirely wrong (Parsons, 1924); it is but a symptom of some underlying condition and i in this respect comparable wnth odter common symptoms such as vonming, con- vulions, and diarrhoea, none of which is regarded as a diseae sui generis.The causes of severe wasting may be classified under two main headings, (a) insufficient food, and (b) presence of infection.nsufiient food may be due to quantitative or qualtative defects m the diet or it may be the result of inpaired absorption from the ahmentary tract due to disease or diarrhoea.It may also be due to insuffiEent food reaching the intesine, as in abnormal conditions of the oesophagus or of the stomach, for example, pyloric stenosis.It is dilicult in some cases to separate lack of food from the presence of infection as the cause of wasting, because vomitingand diarrhoea and intolerance of food may be the result of infection and so introduce the starvation factor.Conversely, the infant who is not receiving adequate food is more liable to infection than the one whose nutrition is normal.In treating states of malnutrition it is always xnessary to discover the underlying cause, for unl this is removed, the measures desgned to arrest the progress of wasting will probably fail.Recent studies have shown that gross protein depktion may occur in wasted subjects.Starvation deprives the body of the protein which is normally retaned by growing infants, and it may be assumed that infection and injury accelerate protein meta- boism in infants as has been described in adult man and in animal (Cuthbertson, 1944;Himsworth, 1946), ca the weil recognized association