Conservation‐withdrawal reaction in infancy? An underdescribed entity

Summary. Conservation‐withdrawal is considered a biological non‐pathological process subserving survival in circumstances which pose an extreme threat to an infant, child or adult. Although initially described in an infant, its reported frequency in that age group seems sparse. Four infants are described, three of whom presented with weight loss. Despite their mothers' assertions that their breast feeding was adequate, the three infants gained weight rapidly on complementary feeding and became more responsive. Previously they had passively accepted sub‐optimal intakes, crying little and sleeping excessively. When their initial crying and objection went unheeded, they seemed to pass into a conservation‐withdrawal state, conserving their energies, biologically adapting to their mothers' inability to provide adequate nutrition. These infants did not appear ill and investigations proved normal. With adequate feeding, rapid improvement was observed in their weight gain, activity and responsiveness with normal development. Their mothers' selective denial of their own inadequate breast supply resulted in their inability to perceive their infants appropriately, depriving them of their nutritional needs. Additional factors of emotional deprivation and neglect may have occurred in the fourth infant. The responses of these infants observed during their period of severe stress, may appropriately be characterised by Engel's conservation‐withdrawal state.