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The case reports of Shroff et al1 document a serious clinical problem with potentially devastating consequences. The tragedy of this situation is that the affected infants are all perfectly healthy and, if we only look for it, the condition is preventable. Local experience of precisely such a case led to the introduction of routine postnatal weight monitoring of infants during the first 2 weeks of life. This policy met with a great deal of resistance on the basis of three unsubstantiated arguments: that inadequately feeding infants can be recognised from other clinical cues, that we don’t know what …
Competing interests: None deilwed.