1 Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY 10032
In Reply.
Dr Raiha is correct. Our data1 do not necessarily "refute" the concept of the LBW infant's metabolic immaturity. However, they raise the issue of the clinical significance of the well-documented developmental delays in hepatic activities of several enzymes involved in metabolism of amino acids. Specifically, these data suggest that enzymatic immaturities are of limited clinical significance with respect to the LBW infant's tolerance of parenterally administered amino acids. No differences in plasma amino acid pattern were observed between LBW infants weighing less than 1,250 g at birth and those weighing more than 1,250 g, between the LBW infant population1 and the population of term infants and older children studied earlier,2 or between LBW infants who received a typical peripheral vein regimen and those who received a typical central vein regimen.