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THE PURPOSE of this communication is to call attention to the occurrence of hypoglycemia in infants with moderate or severe erythroblastosis fetalis. This observation has been reported previously 1-3 but we believe that it has not received sufficient attention. Infants severely affected with erythroblastosis fetalis often have symptoms of apnea, respiratory distress, cyanosis, limpness, poor feeding, and tremors. These symptoms, while nonspecific, are also commonly found in neonatal hypoglycemia. 4 Since we adopted a liberal policy of doing blood glucose determinations in the nursery for any of the above symptoms, we have encountered three cases of hypoglycemia in infants with erythroblastosis fetalis due to Rhesus factor (Rh) incompatibility. The clinical details of these cases are summarized below and the Figure summarizes the course of the blood glucose concentrations observed. Report of Cases Case1.—A 3,030 gm (6 lb 10½ oz) girl was born to a 24-year-old, gravida 3, para 2

Eight of 16 newborn infants dying after varying periods of artificial ventilation had starch granules in their lungs. In seven of the eight, a cellular reaction was present with starch granules within macrophages or giant cells in four of these cases. Duration on the respirator did not correlate with the presence of starch. The granules were probably introduced into the lungs from sterile powdered gloves during tracheal toilet. No fibrosis or granulomas were observed in this series, although they have been reported in other anatomic sites. Although the clinical significance of these findings is uncertain, surgical glove powder is a foreign substance, and care should be taken to exclude it from the lungs of newborn infants.