PHYSIOLOGICAL NEEDS VS. SUPPLY. 125 



fuel-supply serve for the probable increment above basal metabolism 

 caused by the restlessness, crying, and varied muscular activity of the 

 infant throughout the day. It is thus seen that the struggle for 

 existence and the struggle for food begin simultaneously with the new- 

 born infant. Since the food-supply is so obviously insufficient, we 

 may ask why nature does not provide more liberally during the first 

 few days. It is a most striking fact that only human mothers and 

 new-born infants are so entirely dependent upon the care of others. 

 The relationship between this fact and the development of civilization 

 is most interesting and leads one to ask if this scant food-supply is a 

 natural consequence of civilization. 



We may, furthermore, consider whether, in the absence of a suffi- 

 cient natural food-supply to compensate for the energy outgo, it is 

 desirable to supplement the normal supply of colostrum with other 

 food-material until the milk is available in the mother's breast. Pro- 

 vision of material for growth may, without danger to the child's welfare, 

 be delayed for one week until plenty of milk is supplied by the mother. 

 Since this would practically be partial inanition, we may reason from 

 the analogy of the prolonged fasting experiment recently reported 1 

 that the infant may draw upon its own body-reserve for a considerable 

 period of time. 



On the other hand, a delay in the maintenance supply of food suffi- 

 cient to force the infant to subsist upon its own body-reserves may not 

 be without actual detriment. Usually a healthy, well-nourished infant 

 has at birth considerable fat, and, as shown by our study of the respira- 

 tory quotient, a moderate supply of glycogen. It is a well-known fact, 

 however, that even with adults during fasting, particularly when there 

 is a deficiency of carbohydrate available for combustion, an acidosis 

 rapidly develops. This is strikingly shown with fasting adults and 

 with adults fed on a carbohydrate-free diet, 2 and has, indeed, been 

 frequently observed with young children. 3 Is this acidosis dangerous, 

 and if so, how can it be combated? From our experience with adults, 

 apparently the best method of combating acidosis is to feed carbo- 

 hydrate material. If, therefore, supplemental feeding is necessary, it 

 would seem on general principles that the food-material most easily 

 digested and most readily absorbed for oxidation would be a soluble 

 carbohydrate. The carbohydrate possessing these qualities in the 

 greatest degree is dextrose, as it requires no hydrating ferment to 

 convert it into the blood sugar. 



If the infant is to be fed, we may again emphasize the fact that a 

 knowledge of the energy requirement for the first week is rr.o-t impor- 

 tant. Those in charge of the child at this time should therefore have 



'Benedict, Carnegie Inst. Wash. Pub. No. 203, 1915. 

 2 Benedict and Joslin, Carnegie Inst. Wash. Pub. No. 176, 1912, p. 125. 



3 Schlossmann and Murschhauser, Biochem. Zeitschr., 1913, 56, p. 355; see also, Murschhausef, 

 Boston Med. and Surg. Journ., 1914, 171, p. 185. 



