Letter: Breast-feeding in Harrow.
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Biomedical subjects
Publications and source records attributed to H B Valman.
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Twelve children who have survived resection of more than 45 cm of ileum (eight during the neonatal period and four later in childhood) have been reassessed at periods ranging from 3 to 16 years. No child had persistent diarrhea for longer than one year after a resection, and only two children had a restricted fat intake for more than two years. These two children showed no advantage in growth compared with the ten who had normal diet within two years of the resection. The weights of individual children are appropriate for their heights. Their heights tend to be less than those of their siblings, but only two are less than the third percentile compared to height expected in relation to that of parents. The older children still have marked steatorrhea but no diarrhea, and serum levels of vitamins A, D, and E are normal. These observations suggest that two years after extensive resection ileum some children may tolerate a normal diet and grow well despite persisting defects in absorption. Infants with more extensive resections are now surviving and may require special diets and vitamin supplements for longer periods of time.
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Serum 25-hydroxycholecaliciferol levels and x-rays of the wrist were normal in children who had had extensive resections of ileum and no supplementary vitamin D for considerable periods. These results suggest that normal vitamin D status occurs in the absence of the ileum and that supplementary vitamin D is unnecessary.
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Two balance studies were performed on each of five infants of low birth weight. About 230 ml/kg/day of S.M.A. S26 milk was given during one study and 180 ml/kg/day during the other. The proportion of nitrogen, fat, and calories retained was similar in the two studies, suggesting that the larger weight gains on the high-volume feeds were due to growth rather than retention of water or excessive deposition of fat.
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