Sir.—The case report by Lozoff and Fanaroff (129:710-711, 1975) and comments by Finberg (129:665, 1975) in the June issue of the Journal emphasize numerous important points about the management of protein malnutrition in this country.
A 9½-month-old infant with striking findings of kwashiorkor was hospitalized at the University of Chicago Wyler Children's Hospital during this past year. The child's protein deficiency was the result of a pure vegetarian diet, with all forms of meat and dairy products excluded from daily intake. Following admission to the hospital, it became apparent that the mother would not allow the child to have any protein supplements in the diet that were derived from either dairy or meat products. Prior to admission, the child's diet had consisted of honey water, small amounts of various kinds of cereals, small amounts of vegetables, bananas and fruit juices, wheat-germ oil daily, and approximately 120 ml of soya