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The development of the subscapular, triceps and abdominal (suprailiac) skinfolds was studied in 120 healthy preterm infants with a birth weight below 2500 g at the age of 2 weeks, 1 month and 2 months. The skinfolds developed with the age of the infants, no gestational age related differences being noted. The triceps skinfold was thicker than the subscapular and abdominal skinfolds. The increase of skinfold thickness in identically-fed healthy appropriate-for-gestational-age preterm infants correlated with post-conceptional age. Small-for-gestational-age babies had thinner skinfold thicknesses up to a post-conceptional age of 44 weeks.

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Premature infants are at risk for malnutrition and essential fatty acid deficiency. The authors administered 0.5 g of lipids by parenteral route as an adjuvant to enteral feeding, in 30 healthy premature infants aged 14 days to 6 weeks, with a body weight at birth of 1,879 +/- 325 g, presenting a slow rate of weight gain. This led to a long term improvement of the body weight gain preventing malnutrition. The serum level of total triglycerides, cholesterol, phospholipids and glycemia remained within normal limits.

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The authors prospect the fundus at 69 prematures with birth weight under 1,500 g and at 49 prematures with birth weight over 1,600 g, whose neonatal pathology required intermittent administration of oxygen. The examination were done at the medium age of 5.5-6.9 weeks, when the retinal development is completed. The results show a greater proportion of the nervous systems lesions and of the retinopathy at the prematures with birth weight less than 1,500 g, in similar conditions of oxygen administration and prophylaxis with E-vitamin. It is indicated the opportunity of fundus investigation at all the prematures with very low birth weight and the necessity of prophylactic administration of E-vitamin starting from the first day of life.

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The authors studied the protein and fat metabolism in 2-6-weeks-old premature (100 cases) and "small for date" babies (20 cases), all being artificially fed with isocaloric diets. Weight curves were related to dietary intake of proteins in small for date babies. The premature born infants showed no similar relationship between dietary intake of proteins and weight charts. BUN had superior values in premature babies; it means probably that the kidneys of the small for date infants responded better to a protein charge. The values of both serum total fats and of the cholesterol were related to the dietary intake of fats. In conclusion, the milk formula have to be adapted to metabolic peculiarities of these categories of infants.

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The authors studied cantitative and calitative fat dietary intake in conditions of isocaloric energetic diets and effects on somatic development and on plasma levels of fats in 3 randomized populations of premature infants. They concluded that dietary intake of 3-6.4 g fats/kg b.w./24 hours permitted a satisfactory somatic development (weight, height, cranial circumference). In conditions of isocaloric energetic diets, levels of fat intake of 3g/kg b.w./24 hours delivered only the energy for proteic syntheses and levels of 5.6-6.4 g/kg b.w./24 hours also permitted the constitution of body deposits. The levels of total lipids and cholesterol were related to the dietary intake of fats. In case of dietary supplementation of linoleic acid, the plasma levels of cholesterol were reduced and the plasma levels of HDL were augmented.

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The development of thermoregulation was studied in 14 healthy preterm infants with body weights of 1000-2200 g, appropriate for gestational age and conception ages of 32-46 weeks. Tympan, skin and rectal temperatures were measured under the same conditions three times daily for 7 successive days. The body temperature, the temperature of the tympan, the facial and abdominal skin temperatures did not show oscillations during the day. The temperature of the tympan, rectum and skin increased when the ambient temperature rose over 28 degrees C. The tympan temperature increased with age starting from 39 weeks post conception.

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Neonatal cholestatic disturbances are frequent in premature neonates. An important role in the group of causes which may induce cholestasis is that of hypoplasia of the intrahepatic biliary pathways. Ten cases are described, of prematurely born infants with hypoplasia of the intrahepatic biliary pathways. The children had 980-1,900 g at birth. The diagnosis was made on the basis of the clinical picture, of conjugated hyperbilirubinemia, and of the necropsy findings in 7 of the cases. The incidence and the lethality were high in very small premature infants, in whom compensation responses of the hepatic tissue are rather a particular case. In all the cases the authors noted the presence of malabsorption syndromes, of atrophic enteritis, and a defect in the growth rate.

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The authors have assessed the concentration of sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), zinc (Zn), copper (Cu), manganese (Mn), lithium (Li), cadmium (Cd) and lead (Pb) in the milk of mothers with premature births, during the first month of lactation. The levels of Na, Cu and Mn were decreased and those of K, Ca, Mg, Zn and Li were unchanged. The needs of Na, Ca and Mn for the premature infants are insufficient. Li, present in all the milk samples at a constant level, seems to be a common component. The incidence of Cd in the milk of 7 mothers and of Pb in 4 milk samples indicates their clearance from the mothers' organism.

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The authors have studied the total lipids, triglycerides and cholesterol in the milk of 30 mothers over a lactation period of 4 days to 10 months. The total lipids showed diurnal oscillations with a minimal level in the morning and maximal level (P less than 0.001) at 1 p.m. and a slight decrease in the evening, without reaching the levels found in the morning. The lipid concentration in the milk decreases after 4 months of lactation. The oscillations of the lipids take place on the expense of the triglyceride content (r = 0.99). Cholesterol represented on the average 1.54% of the lipid content, showed a maximum level at a month and decreased after 6 months of lactation. The dynamics of lipid composition of the human milk suggests a physiologic significance in the development of the infant.

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