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16
Deductions.
1. An abnormal baby has a great intolerance for fat. This is
no new doctrine.
2. It is impossible to feed all abnormal babies on a percentage
system if the percentages followed are those at present given for
human milk.
3. It is unwise to risk the introduction or increase of fat in the
food of an abnormal baby unless there has been no digestive
disturbance for some considerable time, and not then if the weight
curve is rising satisfactorily without it.
4. The caloric value of the food required by a marasmic baby
is probably more than half as much again as its theoretical value,
or, to put it another way, the same standard of feeding by caloric
values cannot be applied when a baby is exceedingly below its
average weight for its age, even when half as much again is
allowed.
5. It has not been proved that the so-called Truby-King
methods of percentage feeding is the best and only substitute for
breast milk. This is evidenced as follows : (a) That in many of
the cases sent out in good health, resort had to be had to breast
milk to put them 011 the right road. (/>) That gain in weight and
general improvement which was first obtained was lost through
breakdowns during the course of the treatment, and the total gain
in weight was less than would have been otherwise obtained.
(c) That some babies actually suffered in consequence of the
treatment.
6. The difficulty of ascertaining a baby's power of absorption.
This is a vital point, for it may be found that a baby fed on
artificial food, as cow's milk, needs to be given a higher percentage
of some of the food elements because in this form he can
assimilate only a certain proportion of the whole, rejecting a great
deal which is passed in the stools ; whereas in the form the
elements are presented in human milk, although in lower
percentages, practically the whole may be assimilated.
In view of the opinions arrived at by the Medical Officer, the
Honorary Consulting Physician resigned, with the result that the