126 PHYSIOLOGY OF THE NEW-BORN INFANT. 



practical experience in supplemental feeding, for a disturbance of the 

 digestion in the first few days after birth is most harmful and may 

 even prove fatal. In discussing this point, Morse and Talbot 1 say: 

 "It is very important, when beginning to feed a new-born baby, not 

 to give it too much food or too strong a food. There is no time in a 

 baby's life in which it is so easy to disturb the digestion or at which 

 it is so difficult to correct the disturbance, if it is once caused." 



PROBABLE 24-HOUR ENERGY REQUIREMENT OF A NEW-BORN INFANT FOR 



MAINTENANCE. 



From a practical standpoint, therefore, we should know not merely 

 the basal metabolism of the infant during the first week of life, but the 

 probable average metabolism. This would include the superimposed 

 metabolism due to varied muscular activity during the day, the infant 

 when studied in the respiration chamber being quiet and with but 

 little, if any, muscular activity. In discussing the results of our 

 research we have laid special emphasis upon the maximum activity, 

 which we have found to vary from the minimum by 4 to 211 per cent, 

 with an average variation of 65 per cent. 2 To form a conception of 

 the true increase above the basal metabolism, an estimate of the general 

 activity of the infant throughout the day is essential. An estimate of 

 the period of time in which the child has been asleep, awake, or crying 

 may be obtained from the report of the nurse, if the infant is in the 

 hospital, or from some responsible member of the family, if in the 

 home. It is even possible that some simple form of recording crib, 

 with graphic attachment, 3 may be used to indicate the degree of mus- 

 cular activity as a help in forming an estimate of the amount of food 

 necessary for the total 24-hour energy requirement. 



Without taking into consideration the question of growth (and in 

 the first week of the child's life, this may be neglected) we may assume 

 that for infants from 1| to 6 days old the basal energy requirement is 

 44 calories per kilogram of body- weight or 12.65 calories per square 

 meter of body-surface per unit of length. Some 10 per cent for the 

 portion rejected as fecal material should be added to this amount, thus 

 making the minimum food requirement approximately 48 calories per 

 kilogram of body-weight. The indefinite but rarely minimum amount 

 of activity of the infant throughout the day would further increase the 

 energy requirement. This may be estimated as about one-half of 

 the average maximum metabolism found in our observations, or 30 

 per cent, which would give an increase of 14 calories. The daily energy 

 requirement, including both the maintenance metabolism and the metab- 

 olism due to activity, would therefore be approximately 62 calories per 

 kilogram per 24 hours this estimate making absolutely no provision 

 for growth. 



'Morse and Talbot, The nutrition and feeding of infants. New York, 1915, p. 125. 



2 See table 17, p. 112. 



3 Benedict and Talbot, Carnegie Inst. Wash. Pub. No. 201, 1915, p. 60. 



