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Calorie requirements of full-term and premature infants in the neonatal period: A Formula, its Uses and Limitations

1941; BMJ; Volume: 16; Issue: 87 Linguagem: Inglês

10.1136/adc.16.87.166

1468-2044

Helen Mackay,

Clinical Nutrition and Gastroenterology

Member of the Staff of the Medical Research Council.Medical students and nurses in children's hospitals are now taught how to ,alculate the calorie needs of babies past the neonatal period, and ever text- book on paediatrics deals with the subject: but of the day to day needs of the first weeks of life of babies, varving in birth-weight from 2 lb. to 10 lb. and more, textbooks gi'e meagre and conflicting information.Some current teaching on quantitative food requirements in the first two weeks of life Some examples, chosen almost at random, of the teaching furnished in textbooks are g'ven below.Von Reuss (1921) in his book on ' Diseases of the Newborn,' which is still a standard work, gives numerous examples of the widely different quantities of breast milk taken by healthy babies in the neonatal period: he states that a volume providing 50 calories per kilo. (23calories per lb.) body-weight per day is sufficient for the first eight to ten days.This figure for the average daily intake, derived as it is from a period of rapid change in the quantity of milk secreted.is not, however, very helpful in ordering each day's supply of food.Von Reuss also quotes a formula of Finkelstein's for the first days needs:-(day of life -1)x70 to 80 gn.This formula, it will be observed, takes no account of body-weight.It provides a total of about 50 calories on the second day of life (assuming the calorie value of the milk to be 20 per fluid oz.), and an increase of about 50 calories daily, presumably reaching 350 calories on the eighth day.Supposing average birth-weight to be approximately 7 lb., this would represent an allowance of 50 calories per lb.birth-weight on the eighth day of life, or an average intake of 25 calories per lb.per day during the first eight days.Most British textbooks ggixe no information as to the quantity of food required by full-term babies in the neonatal period, but Paterson and Forest Smith (1938) say that 25 calories per lb.birth-weight should be given on the second day, and furnish a table of instructions for artificial feeding according to which approximately 50 calories per lb.birth-weight would be given by the fourth day of life instead of the eighth, as in Finkelstein's formula.On this basis the allowance for the whole of the first eight days would average 39 calories per lb.per day, a figure 70 per cent.higher than that (23 calories per lb.) given bv von Reuss (1921), and the allowance for ten days would be 45 calories per lb.per day, or nearly double son Reuss's figure.Contrast with this the ads-ice 166on August 10,