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Studies in Infantile Malnutrition

II. Effect of Protein and Calorie Intake on Weight Gain¹

British American Hospital, Lima, Peru

The effect of different levels of protein and calorie intake on the weight gain of severely malnourished infants 6 to 30 months of age was studied in relation to the weight deficit. In the most severely underweight, 175 kcal/kg/day were necessary to establish an adequate rate of gain; intakes of more than 2.0 g of protein/kg/day were apparently superior to lower levels. In the less severely malnourished, progressively decreasing caloric intakes were necessary and 2.0 g of protein/kg/day or even less, evenly distributed throughout all feedings, were not inferior to higher levels, particularly if the source was milk. In the least severely under-nourished or those well advanced in their recovery, a good mixture of vegetable proteins or a mixture of wheat and fish proteins appeared to be as efficacious as milk. These results were similar in marasmic infants or in cases of marasmic kwashiorkor after diuresis — confirming previous suggestions that there is no proven advantage to levels of protein intake above the usual and that on the other hand caloric requirements are directly proportional to the severity of the malnutrition. The practical implications of this study in the planning of feeding programs are discussed.

Manuscript received 29 April 1963.