. (1976). Archives of Disease in Childhood, 51, 377. Calcium, phosphorus, and magnesium concentrations in plasma during first week of life and their relation to type of milk feed. Serial changes in plasma levels of calcium, phosphorus, magnesium, alkaline phosphatase, and total proteins have been investigated in 138 healthy, term Caucasian infants. Blood samples were obtained for each infant from cord blood and on day 1 and day 6. The infants were studied in three groups according to whether they were breast fed, received 'Ostermilk No. 1' or 'Cow and Gate V' formulas.Levels of calcium, phosphorus, magnesium, alkaline phosphatase, and total proteins did not differ between the groups at birth or on day 1. By day 6 calcium levels were higher and phosphorus levels lower in the breast-fed infants compared with either of the artificially-fed groups. Phosphorus levels were lower in the V Formula group compared with the Ostermilk group but the mean calcium levels of these two groups did not differ significantly. However, only 2 * 8 % of the V Formula group developed hypocalcaemia compared with 18 2% of the Ostermilk group. The only infant developing clinical tetany belonged to the group fed Ostermilk. Evidence is also given which suggests that those infants with low calcium levels on day 1 who were fed the high-solute milk tended to show a fall in calcium by day 6. This did not apply to the two other groups. It is concluded that the use of adapted cows' milk preparations for infant feeding should lead to a reduction in the incidence of neonatal tetany.

No abstract

SummaryThe serum concentrations of tri-iodothyronine (T3), thyroxine (T4), and thyrotrophin (TSH) were measured in 10 term newborn infants between birth and the age of 2 days by radioimmunoassay.The mean concentration of T3 in maternal serum was 1-62 ,tg/l, and it increased from the low cord blood level of 0 63 ,tg/l to the peak value Hypothyroidism is a graded phenomenon; at one end of the spectrum the symptoms and clinical features are overt, at the other end they may be so mild as to escape clinical detection. In paediatric practice a good case can be made for the desirability of detecting early hypothyroidism of the mildest degree but hitherto lack of specific symptoms and the fact that conventional tests of thyroid function may be normal for a variable period of time have delayed the diagnosis.Recently it has become possible to assay the serum thyroid stimulating hormone (TSH) concentration (Hall, 1972), and it is now accepted that patients with mild hypothyroidism have a raised serum TSH. Conversely, thyroid insufficiency can be confidently excluded if the serum TSH concentration is normal.Normal serum TSH values range from undetectable to 4 FU/ml (Hall and Evered, 1973) but since this is a relatively new assay, laboratories must determine the specificity and accuracy of the test in their hands as well as establish their range of normal values. There are, however, no significant differences in TSH levels in men, women, or children after the neonatal period. High values for serum TSH almost certainly reflect a reduction in the circulating levels of thyroxine (T4) and triiodothyronine (T3) but by an instant reciprocity the increased TSH output may maintain, at least for a time, T4 and/or T3 levels within the range which will prevent a state of overt hypothyroidism.

Secretary and Treasurer. The titles of the clinical demonstrations were as follows: Conradi syndrome. A. J. Keay. (Edinburgh Northern Group of Hospitals.) Chronic airway obstruction. J. Syme. (Edinburgh Northern Group of Hospitals.) Replacement of mitral and tricuspid valves following severe rheumatic pancarditis.