That last phrase, which stares repeatedly from the pages of hundreds of medical records from the Shanghai Children's Welfare Institute, was tantamount to a death sentence. And, 16 days later, Zeng Yuan died, officially recorded as suffering from "congenital maldevelopment of brain function, general collapse of body functions, total circulatory failure".
But Baby Zeng was just one of thousands of infants and children each year who have been systematically starved to death or killed by deliberate neglect in China's state-run orphanages, according to a meticulously detailed report published today by the US-based Human Rights Watch (HRW). In the words of the organisation, many welfare institutions "appeared to be operating as little more than assembly lines for the elimination of unwanted orphans".
Figures for national mortality rates for orphans and abandoned children were obtained by HRW from official Chinese published documents. They show, for example, that during 1989 one quarter of all children under the continuing care of China's urban orphanages died.
The evidence of barbaric behaviour came from detailed official records smuggled out of the country by a doctor, Zhang Shuyun: she worked at the Shanghai Children's Welfare Institute from 1988 to 1993, and escaped from China last March. Numerous case studies document deliberate starvation, torture and sexual assault over many years. The records indicate that between 1986 and 1992 at this one Shanghai institution alone, more than 1,000 children died unnatural deaths.
Sun Zhu, a baby girl, was admitted in June 1989 at age one month, and died two months later. According to Dr Zhang, by the end "the baby was so hungry that she was trying to chew flesh off her hand". The cause of death was given as "congenital malformation of brain".
During the last four days of December 1991, 15 children died: at least nine deaths resulted from hypothermia after the toddlers had been left tied to "potty chairs" in freezing weather wearing only thin cotton clothing for 24 hours.
Dr Zhang describes a policy of "summary resolution" whereby the Shanghai orphanage population was kept static. "Once selected, the children would reportedly be denied virtually all food and medical care, and would sometimes even be given no water," said HRW. When critically weakened, the child would be given a final "consultation", as experienced by Baby Zeng. In practice this was the informal prerequisite for moving a child to the "waiting for death room". Death normally followed within a week.
A series of 34 colour photos accompanying the report show 10 severely malnourished infants and young children who died at the orphanage during June-July 1992. The photographs were taken by Ai Ming, a disabled inmate, who also escaped from China last year. One of the photos shows Jian Xun, an 11-year-old boy, emaciated and tied by his wrists and ankles to a bed. He died 10 days later.
The documents provide one of the most damning bodies of evidence to come out of China about abuses against babies and children. The report also details how staff at the Shanghai orphanage complained from the end of 1989 about the death rates, but an official investigation only resulted in a high-level cover-up.
According to HRW, the pattern of cruelty against orphans and abandoned children "now constitutes one of China's gravest human rights problems". China's strict family planning policies , which usually limit families to a single child, have increased the number of abandoned children, particularly girls. The situation is worsened because adults under 35 or with children are not allowed to adopt abandoned infants.
The government, apparently caught completely unawares by the report, issued a swift denial. "We have not yet seen this so-called report... The accusations levelled against our orphanages are completely baseless." said the State Council, China's Cabinet.
However, much of the horrifying evidence comes from official records, and the detailed nature of the evidence will make is difficult for the Chinese authorities to refute.
The official yearbook showed there were 5,539 children in urban orphanages at the beginning of 1989. During the year, 3,210 were admitted, 1,233 departed alive, and 1,857 died. "The evidence indicates that the likelihood of survival beyond one year, for a newly admitted orphan in China's welfare institutions nationwide, was less than 50 per cent in 1989," said HRW.
The report also shows how attempts by Dr Zhang and other outraged staff to stop the carnage were blocked. In December 1991, the Shanghai Bureau of Supervision sent in an investigative team which remained at the orphanage for eight months. During the same period, 16 members of Shanghai's People's Congress conducted their own investigation. Both teams confirmed the allegations , but nothing changed. And after high-level intervention by party officials, almost all the critical staff were forced from their jobs by 1993, and all but one of the congress members were prevented from standing for second terms in office.
Wu Banggauo, then Shanghai's Communist Party secretary, and now a vice- premier of China, ordered a blackout of coverage in the local media. Han Weicheng, the director of the orphanage from 1988 to 1994, who was accused of the rape of an orphan, was promoted and is now acting director of the Shanghai Civil Affairs Bureau Department of Social Welfare Work. This was despite revelations of a personal bank account holding around $80,000 in foreign currency, most of it foreign donations and adoption fees.
Since 1993, according to HRW, the Shanghai orphanage has been sanitised to become a showcase facility to encourage foreign donations and adoptions (for which a "donation" of $3,000 is demanded).
But, according to the report, Shanghai's No 2 Social Welfare Institute on Chongming Island has become the alternative dumping ground for unwanted babies and children.