PHYSIOLOGICAL NEEDS VS. SUPPLY. 121 



exact degree of the muscular repose of the infant. It is not improbable 

 that the chilling effect of too low a temperature and exposure during a 

 bath may produce shivering and, indeed, crying, as the child attempts 

 temperature regulation by increased muscular activity. The low 

 metabolism induced by the low temperature may therefore be more 

 than compensated by an increase in the metabolism due to the efforts 

 of the infant to maintain the temperature by muscular movements. 



Since the metabolism is so profoundly affected by the influence of 

 various factors upon the body-temperature, it would appear logical 

 that some means should be found for compensating for the defective 

 temperature regulation of the new-born infant a deficiency frequently 

 resulting in a disturbed katabolism. 



METHODS FOB REDUCING THE ENERGY Loss. 



Various methods for preventing an excess energy output during the 

 first days of an infant's life are used in ordinary practice. Every good 

 nurse, whether trained or untrained, knows that an infant must be 

 kept warm and comfortable and does everything in her power to make 

 him so, thus instinctively conserving the energy. Excess katabolism 

 is, for the most part, due to muscular activity. At birth the infant 

 emerges from warm surroundings in which the temperature was 37 C. 

 (98.6 F.) into air which is many degrees colder, presumably 26.7 C. 

 (80 F.) ; the shock of the cold air causes him to cry. This crying, 

 however, is necessary for his future welfare, as it expands his lungs with 

 air and prepares them for their future work. The preliminary fit of 

 crying comes naturally to most infants and is usually induced with 

 others. 



After this fit of crying every legitimate effort should be made, espe- 

 cially during the first days of life, to reduce the muscular activity to a 

 minimum, and thus prevent a waste of energy. The more time the 

 infant spends in quiet sleep, the less will be the katabolism. When a 

 healthy, new-born baby is awake, crying, and active, it is usually 

 uncomfortable and it cries from an instinct of self-preservation. This 

 discomfort may be due to chilling, improperly adjusted clothing, wet or 

 soiled diapers, too high a temperature of the hot-water bottles, hunger, 

 indigestion, or a few pathological processes. 1 The infant should be made 

 comfortable by attention to such minor details as dry diapers, a comfort- 

 able bed, protection from glaring sunlight, and similar precautions. 



When too low a temperature environment produces chilling, the 

 infant instinctively attempts to raise the body-temperature by physical 

 activity and thus compensate for the loss of heat. For energy con- 

 servation a warm environment is imperatively necessary and all undue 

 exposure must be avoided. Since there must in consequence be more 



'Since this monograph deals only with the normal, healthy infant, it is not necessary to speak 

 further of the possible diseases which may cause an infant to cry. 



