Protein metabolism in human neonates: nitrogen-balance studies, estimated obligatory losses of nitrogen and whole-body turnover of nitrogen.

1. Aspects of nitrogen metabolism in the human neonate were assessed in one full-term infant and six premature infants by means of nitrogen-balance measurements, estimates of obligatory nitrogen losses and determinations of whole-body nitrogen turnover. 2. Our data indicate that the mean protein requirement for maintenance is 1-1 g of protein day-1 kg-1 and that 3-8 g of protein day-1 kg-1 should be sufficient for adequate growth in healthy premature babies. 3. The mean obligatory urinary, faecal and total nitrogen losses were estimated to be 24, 106, 145 mg day-1 kg-1 respectively. These figures are compared with published values for older infants, and the possible metabolic basis for changes in nitrogen losses during growth and development is discussed. 4. Mean values for whole-body protein synthesis and breakdown were 26-3 +/- 7-0 and 23-8 +/- 7-4 g of protein day-1 kg-1 respectively. Dietary nitrogen intake accounted for 6--18% of the nitrogen flux through the metabolic pool; urea excretion accounted for 2% of the nitrogen flux. 5. The net protein gain, estimated from nitrogen-balanced data, accounted for 9-6% of total daily protein synthesis. 6. These results are discussed in relation to published estimates of whole-body protein synthesis and breakdown at various ages. Their possible significance in the assessment of a "maintenance" requirement for protein and amino acids during the period of rapid growth and development is also considered.