I was happy to read the report from Greer et al.1 This biochemically confirms the clinical observation that the majority of children who develop clinical rickets are breast-fed. During the ten years, 1970-1979, I have seen six cases of clinical rickets. All of these infants were breast-fed.2 The only exception has been the rickets of prematurity. I should like to commend, again, the report from the Department of Pediatrics and Biochemistry of the University of Wisconsin.
I was most interested to read the article "Acetaminophen Poisoning and Toxicity" by Rumack and Matthew.1 This article is well worth reading by any pediatrician who prescribes acetaminophen. I should like to call your attention particularly to the description of the clinical course of overdose reactions. I was struck with the similarity between this and the description of the findings in Reye's syndrome. Is it possible that many of the children seen with Reye's syndrome were actually reacting to this drug? I should think that this possibility would be well worth considering.
A WORKSHOP MEETING of the Committee on Fetus and Newborn and Consultants was held in Chicago on October 22, 1966, to consider standard terms for the classification of newborn infants with respect to duration of gestation, birth weight, and intra-uterine growth. INTRODUCTION Liveborn infants have usually been classified according to weight at birth because of the close association between ponderal size and the risk of death in the first hours and days of life. This simple classification has been useful in developing uniform national and international vital statistics and the data have been used to plan public health programs aimed at reducing the incidence and the high mortality of neonates who are small at birth. However, the classification based on weight alone and the international definition of prematurity (≤2,500 gm), which equated birth size and fetal age, have had the effect of obscuring medically important differences between likesize infants of dissimilar gestational ages. In view of the evidence indicating that many of the neonates included within the limits of the international definition are not born prematurely (<37 weeks), the Expert Committee on Maternal and Child Health of the World Health Organization recommended that the concept of "prematurity" in the definition should give way to that of "low birth weight." Although the primary axis of classification (birth weight) remained unchanged, the new recommendation emphasized the need to use terms which make a clear distinction between size at birth and duration of gestation. In the past few years careful appraisal of newborn infants has revealed a growing number of associations between specific disorders in the neonatal period (e.g., antenatal infections, hypoglycemia, chromosomal abnormalities, respiratory distress syndrome) and either gestational age or aberrant intra-uterine growth.
The statement on "Sterilization of Milk Mixtures for Infants," by the Committee on Fetus and Newborn, was concerned with giving advice that would provide maximum safety for the largest number of children. The Committee recognized that each physician must give advice concerning sterilization based on his knowledge of specific circumstances. It is clear that there is considerable variation in the levels of hygiene and mothercraft in households throughout the country. Consequently the Committee sought to reassert certain principles rather than to issue a fiat.