EPIDEMIC DIARRHEA IN THE NEWBORN; THE RELATION BETWEEN BREAST AND BOTTLE FEEDING AND THE EARLY DEVELOPMENT OF THE PROPER INTESTINAL FLORA

Abstract

Abstract 1. 1. Epidemic diarrhea of the newborn is usually attributed to a virus, carried to the nurseries by those coming in contact with the disease, and once there rapidly spreading from infant to infant. 2. 2. A probable cause of the disease is faulty metabolism, in turn caused by lack of proper intestinal flora. Beneficial bacteria in the infant's intestines may serve to combat the pathogenic organisms producing the disease. 3. 3. It has been proved that infants begin to acquire the essential intestinal bacteria at birth and even before, but babies delivered following vaginal antisepsis during labor and at the time of delivery, a routine procedure at the Methodist Hospital, and those born by cesarean section, have been found to have no bacteria in the intestines, either at birth or soon after. The conditions of their subsequent care, sterile water, boiled formula, immaculate surroundings, and so on, make for further difficulty in their establishing the proper flora. 4. 4. Breast feeding is the method of choice for introducing beneficial bacteria into the intestines of these infants. 5. 5. For newborns who cannot be nursed, raw mother's milk and raw certified cow's milk are recommended as richest in beneficial bacteria. The inoculation of the large intestines or the rectum with essential bacteria may also be indicated. 6. 6. An epidemic of 17 cases is reported. There were nine deaths and eight recoveries, a mortality of over 50 per cent. Of the nine who died, eight were bottle fed, the ninth breast fed for only four days. Of the eight who recovered, five were bottle fed, three both bottle and breast fed. 7. 7. In a total of 143 living infants delivered during the month of September, when most of the cases occurred, 116 were both breast and bottle fed, and 27 bottle fed, a proportion of 81 per cent and 19 per cent. In the 17 cases of diarrhea, 13 occurred in the group of bottle-fed infants, with eight deaths; and four in the group of breast and bottle fed, with one death. 8. 8. In this same month there were 33 personal cases. Breast feeding, entirely or partially, was prescribed and carried out in all but three cases, and the only infant to contract diarrhea was bottle fed. These infants were in all the nurseries of the hospital and were not in the care of the pediatricians. 9. 9. During the epidemic, bacteriologic examination of a number of infant stools was made; streptococcus and staphylococcus or both were found in many instances.