Wolfsdorf and Senior (p 1068) clearly document the detrimental effects of low chloride feeding of infants. The cases of alkalosis produced in two infants were due to an error in the manufacture of infant formulas, raising broad questions.
The American Academy of Pediatrics1 has recommended that infants be breast-fed, most recently because of the anti-infective properties of human milk. Yet all mothers cannot or will not nurse their infants, and because of multiple pressures many mothers cannot nurse their infants as long as they would like. Human milk substitutes must be used.
Originally substitutes were largely based on dilutions of animal milks. With better understanding of the infant gastrointestinal system, these milks have been wisely modified so that the fat is replaced with vegetable fat, which is more easily absorbed, the protein and electrolytes have been lowered to more physiological levels, vitamins and minerals have been added, and other