Bottle-fed infants have a total serum cholesterol of 147 mg/100 ml on the fifth day of life and their stools contain more Escherichia coli than Lactobacilli organisms. The ratio of these bacteria can be reversed by adding bicarbonate or Lactobacilli to feeds. This change is associated with a decrease in total cholesterol to a mean 119 mg/100 ml over the next 3 days. Lactobacilli organisms predominate in the stools when serum cholesterol is low and may play a role in the metabolism of cholesterol.

To examine the in vivo effects of agonists reported to influence bicarbonate flux (JtCO2), microperfusion experiments were carried out on distal tubules of normally fed or overnight-fasted rats. As we previously reported, distal tubules from fed rats reabsorbed no bicarbonate, whereas overnight-fasted rats consistently reabsorbed bicarbonate (JtCO2 10 +/- 3 pmol.min-1.mm-1; P < 0.01). Vasoactive intestinal peptide and isoproterenol infused intravenously (7.3 and 4.0 micrograms.kg-1.h-1, respectively) in fasted rats suppressed JtCO2 and, in the case of vasoactive intestinal peptide, elicited net bicarbonate secretion (JtCO2 -10 +/- 2 and -4 +/- 4 pmol.min-1.mm-1, respectively). In fed rats, angiotensin II infused at a rate of 1.2 micrograms.kg-1.h-1 stimulated bicarbonate reabsorption (JtCO2 16 +/- 3 pmol.min-1.mm-1), while antidiuretic hormone infused at 0.024 micrograms.kg-1.h-1 elicited a similar response (17 +/- 4 pmol.min-1.mm-1), both values being significantly different from control. These results, therefore, demonstrate for the first time that these agonists can modulate JtCO2 at the distal tubule site in vivo and therefore may be potential regulators of systemic acid-base balance.

Adverse effects of mild hypothermia induced for 3 days in asphyxiated newborns were significantly less than expected from previous reports on neonates with accidental hypothermia.

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SummaryBottle-fed infants do not gain weight as rapidly as breastfed babies during the first week of life. This weight lag can be corrected by the addition of a small amount of alkali (sodium bicarbonate or trometamol) to the feeds. The alkali corrects the acidity of cow's milk which now assumes some of the properties of human breast milk. It has a bacteriostatic effect on specific Escherichia coli in vitro, and in infants it produces a stool with a preponderance of lactobacilli over E. coli organisms. When alkali is removed from the milk there is a decrease in the weight of an infant and the stools contain excessive numbers of E. coli bacteria.A pH-corrected milk appears to be more physiological than unaltered cow's milk and may provide some protection against gastroenteritis in early life. Its bacteriostatic effect on specific E. coli may be of practical significance in feed preparations where terminal sterilization and refrigeration are not available. The study was conducted during the week after birth, and no conclusions are derived for older infants. The long-term effects of trometamol are unknown. No recommendation can be given for the addition of sodium bicarbonate to milks containing a higher content of sodium. Introduction Cow's milk differs from human milk in many respects. It has a high protein and phosphate content and produces a firm stool with a preponderance of Escherichia coli organisms. Breast milk, with its high lactose, low phosphate, and low protein load, produces a stool with a relatively low E. coli count (Bullen and Willis, 1971). In addition, it affords protection against gastroenteritis.