INFANT FEEDING.

1. If the bowel movements are curdy, we may take it as an indication of an excess of proteids.

2. Sour vomiting often indicates too much fat

.

3. Stools that are very watery but without curds may result from too much sugar or too much fat.

4. Vomiting of hard, curdy masses may indicate too much proteids.

5. Should the child seem to do well on its food in every way except that it does not gain in weight, it may be that the sugar is too low.

6. Vomiting may mean that the child has eaten too much.

7. Breast milk is the best infant food.

8. No artificial food can or should be trusted which does not contain the essentials of breast-milk—viz., fat, proteids, and sugar.

9. The elements named are to be found only in milk, cows’ milk being the only one available for general use.

10. Cows’ milk must be modified, because it does not contain the same proportions of the elements named.

CONSTITUENTS OF GOOD MOTHER’S MILK.

Reaction Alkaline.

Contains 3 to 4 per cent. of fat Sp. gravity 1030.

“ 6 to 7 “ “ of sugar

“ 1 to 2 “ “ of proteids

Inorganic materials ¹/₁₀ to ²/₁₀ of 1 per cent. Average percentage, 12 per cent. of solids to 88 per cent. of water.

REGULATING THE COMPOSITION OF MOTHER’S MILK.

The percentage of proteids is increased by Increased frequency of nursing;

Increased liberality of nursing

and insufficient exercise.

The percentage of fat is increased by Deficiency of proteid food;

Excess of fatty foods and fasting.

The percentage of water Increased fluid diets.

is increased by

The percentage of water Saline cathartics and diminished fluid diets.

is diminished by

Percentage of sugar and ash vary little.—Dr. Cotton.

FORMULÆ FOR ARTIFICIAL FEEDING FOR BABIES.

Age.

1. Sugar of milk ℥j From 3d to 14th day.

Sterile water ℥xij

Lime-water ℥ss

Cream ℥ss

Milk ℥ss

2. Sugar of milk ℥j From 2d week to 6th week.

Sterile water ℥xij

Lime-water ℥j

Cream ℥j

Milk ℥j

3. Sugar of milk ℥j From 6th week to 11th week.

Sterile water ℥x

Lime-water ℥j

Cream ℥j

Milk ℥j

4. Sugar of milk ℥j From 11th week to 5 months.

Sterile water ℥viij

Lime-water ℥ss

Cream ℥j

Milk ℥j

5. Sugar of milk ℥j From 5 months to 9 months.

Sterile water ℥vij

Lime-water ℥ss

Cream ℥j

Milk ℥ijss

6. Granulated sugar ℥ss From 9 months to 12 months.

Sterile water ℥v

Cream ℥j

Milk[A] ℥jv

AMOUNT OF FEEDINGS FOR INFANTS.

Age. Twenty-four-hour amount. Number of feedings, amouint and intervals.

1 week 10 to 12 ounces 10 feedings of 1 ounce

at 2 hour intervals.

8 feedings of 1½ ounces

at 2½ hour intervals.

4 weeks 20 ounces 8 feedings of 2½ ounces

at 2½ hour intervals.

7 feedings of 3 ounces

at 3 hour intervals.

4 months 32 ounces 7 feedings of 4½ ounces

at 3 hour intervals.

6 months 36 to 40 ounces 6 feedings of 6 to 6½ ounces

at 3 hour intervals.

9 months 48 ounces 6 feedings of 8 ounces

at 3 hour intervals.

5 feedings of 9½ ounces

at 3 to 4 hour intervals.

First twenty-four hours—Infant should receive only water, and after that water to be given only between feedings, 1 to 2 ounces every four hours.

Water may be sweetened with saccharin.

Normal infant may feed every three or four hours and only one feeding during night.

After eight months old, no feeding after 10 P. M.

Three months’ child may take 5 ounces at one feeding.

Six months’ child may take 7 ounces at one feeding.

Nine months’ child may take 9 ounces at one feeding.

The child should consume the contents of a bottle in twenty minutes.

Orange juice is not a necessary food unless milk is pasteurized or sterilized (boiled) and in case of constipation. Give 1 or 2 teaspoonfuls one hour before feeding. After nine months reduce amount of milk and increase amount of carbohydrates, such as starch gruels, flour ball, barley flour, oatmeal, and vegetable soup. Zwieback or dry toast may be placed in infant’s hand to teach it how to feed itself. Milk allowed in second year, 1 quart in twenty-four hours. Fruit juices may now be given and should form a part of the food after fifteen months of age. Vegetables, such as beets, spinach and carrots chopped fine and squeezed through colander, may be a part of the regular diet in four meals a day. A child two years old may have small quantities of fresh fish, tender chicken, or beefsteak. No green fruits should be given under four years of age. Eggs should be soft-boiled for two minutes or coddled four minutes, and then only one a day if it agrees with the child.

RULES FOR STERILIZING BOTTLES.

Boil bottles and nipples in 2 per cent. soda solution for five minutes, then in clear water for five minutes. Keep empty bottles and nipples not in use in sterile water or weak boric solution. Plug with raw cotton.

TO PASTEURIZE MILK.

1. Place bottles in vessel of warm water. Heat to 147° F. Keep at that temperature thirty minutes. Take vessel off stove and cover with a heavy blanket. Then pour off hot water and fill vessel with cold water to cool the milk quickly.

2. Put milk in double boiler and raise to a temperature of 150° to 155° F. Let stand at this temperature for twenty to thirty minutes.

Pasteurizing milk does not kill the ferments in the milk, but it kills almost all bacteria except the spore-bearing bacteria, of which the gas bacillus is the most important.

TO STERILIZE MILK.

Boil milk for five minutes and then prepare as for pasteurizing, keeping it at temperature of 147° F. for thirty minutes and cooling it by the same process as given for pasteurization.

Boiling milk kills all bacteria. It is said that heating of milk to this degree impairs its nutritive value.

Note.—Spores develop quickly in lukewarm milk, therefore the necessity of cooling it quickly and placing it in refrigerator.

MODIFIED MILK.

Add water or other substances to cow’s milk to change it to agree with the digestion of the infant. Malted foods when mixed with water are deficient, and by adding milk or cream it becomes modified milk.

All mixtures should be cold when adding milk, and water sterilized when used as a diluent.

Note.—The natural food for the infant is human milk. The breast-fed babies are healthier, more vigorous, and more resistant to disease. (See Rickets and Scurvy.)

SUGARS.

Lactose or milk-sugar is best for normal babies. It may split up in the intestines into acids and when it ferments is likely to be a laxative. Sucrose (cane-sugar) has no advantage over lactose, except that it is cheaper. Do not give sucrose if other sugars are on hand.

Maltose (malt-sugar) is expensive and is never given pure.

Dissolve all sugars in warm sterilized water. Malt extract is more laxative than other milk-sugar preparations. Malt extract should be brought to boiling-point only.

PROPRIETARY FOODS.

Condensed and evaporated milks.

Malted foods, containing starch.

Starchy foods and various dry powders.

Kindolac, a dried milk.

Imperial Granum. Used in the same way as barley flour is prepared.

Eskay’s Food, which is valueless unless mixed with cows’ milk.

Mellin’s Food and Horlick’s Malted Milk.

The difference between Mellin’s and Horlick’s food is that Horlick’s Milk has as its basis a dried milk preparation containing maltose and dextrins. Use proprietary powders in the same way as oatmeal or flour barley.

Note.—Proprietary foods are only given to tide over a delayed feeding of mother’s milk.

CARBOHYDRATE FORMULÆ.

Horlick’s food, 11 teaspoonfuls

Dextrimaltose, 10 “

Mellin’s Food, 11 “

Milk-sugar, 9 “

Barley flour, 15 “

Flour ball, 12 “

Dissolve carbohydrates in sterilized water before adding milk.

All mixtures should be cold when adding milk.

FLOUR BALL.

Four cups of wheat flour; place in muslin bag; place in warm water and boil six hours. After taking out of bag, remove outer part; then break up in chunks, place in radiator or slow oven to dry out. Pulverize by grinding. May use it instead of sugar.

BARLEY GRUEL.

One tablespoonful barley flour; 1 quart of water.

Boil twenty to thirty minutes, then strain.

RICE GRUEL AND OATMEAL GRUEL.

Prepare the same as barley gruel.

Note.—The flours thus made are very good carbohydrate foods. Gruels from this kind of flour settle on standing. To prevent this, add barley, oat, or wheat gruel flour before cooking. In using starch, boil solution one hour.

SKIMMED MILK

is prepared by removing the gravity cream or by a centrifuge.

HOMOGENIZED MILK

is prepared by mixing olive oil and skimmed milk under great valvular pressure.

WHEY.

1.—Boil 1 quart of milk; add 2 teaspoonfuls of rennet. Keep at temperature of 103° F. for thirty minutes. Strain through sterile cloth. To secure a fine soft curd add ½ teaspoonful of chymogen; allow to drain one hour. Sodium citrate softens casein curd.

WHEY FOR SPECIAL INFANT FEEDING.

Add sodium bicarbonate, gr. x, to ½ pint of whey to render it alkaline, and sugar of milk, ʒj, to raise sugar to 6 per cent.

WHEY: ESSENCE OF PEPSIN FORMULÆ.

2.—1 pint skimmed milk; 2 teaspoonfuls essence of pepsin or rennet.

Let milk in double boiler heat to a temperature of 105° F.; add pepsin; stir for a moment and let stand at same temperature for thirty-five minutes. Cut into cubes and raise temperature to 155° or 160° F. to stop action of the rennet or pepsin. Then strain through several thicknesses of gauze and put on ice. Do not use pressure while straining.

RENNET TABLET FORMULA.

Milk, 1 pint;

Rennet or junket tablet No. 1, gr. j.

Measure milk in double boiler and raise to temperature of 98° or 100° F. Dissolve tablet in cold water, ℥ss to one tablet. Stir rennet through milk and let stand at same temperature for thirty or forty minutes. Cut into cubes and raise to temperature of 155° or 160° F. to stop the action of the rennet. Strain through gauze and put on ice. Do not use pressure in straining.

MILK ALBUMEN.

Milk, 1 quart;

Chymogen, 1 dram;

Buttermilk, 1 pint.

I. Boil milk for five minutes.

II. Cool to temperature of 100° to 105° F.

III. Add chymogen (dissolved in ℥j of cold water) and let

stand for one hour at temperature of 100° to 105° F.

IV. Let drain through cheese-cloth for one and a half hours,

and then throw out the whey.

V. Press the curd through the colander twice, adding

the buttermilk as the curd is pressed through.

VI. Make up the quart by adding sterile water.

When the food is to be given to the baby, heat only enough to take off the chill, as more vigorous heating will cause the curd to clump at the bottom of the bottle in large curds.

If there is any clumping, shake the bottle well before giving to the baby.

Never put the baby directly from a milk diet to a milk-albumen diet, but give one intervening feeding of barley water before giving milk-albumen diet.

CHYMOGEN USED INSTEAD OF RENNET.

Boil milk two minutes. Cool to temperature 100° F. Add 60 grains of chymogen to the quart. Let stand until clabber forms. Then drain curds.

ALBUMEN-WATER.

White of one egg;

Water, ℥viij;

Pinch of salt.

Add white of egg to cold boiled water and pinch of salt. Shake thoroughly or break with fork and strain through one thickness of gauze to remove froth.

LACTOSE SOLUTION.

To each ounce of milk-sugar add 1½ ounces of water (boiled).

Heat until all the sugar is dissolved.

Filter, put in a sterile bottle, plug with sterile absorbent cotton, and put on ice.

Use ℥iss for every ounce of sugar ordered.

Subtract this amount from the total amount of water ordered.

PARTIALLY PEPTONIZED MILK.

Milk, Oj;

Water, ℥ij;

Peptonizing powder, 1 tube.

Put milk and water into a bottle and add the peptonizing powder. Shake well and place bottle in warm water from 105° to 115° F., and leave about ten minutes at that temperature. Shake from time to time.

COMPLETELY PEPTONIZED MILK.

The process is exactly the same as the partially peptonized milk, except that it is continued for two hours, which is required for the conversion of all the proteins into peptones. For older children the bitter taste may be covered by lemon-juice and cane-sugar, one even teaspoonful of cane-sugar and two teaspoonfuls of lemon-juice being added to ℥iv of milk.

BUTTERMILK.

To 1 quart of fat-free milk add 8 ounces of sterile water. Crush tablet of lactic acid bacilli into the mixture; allow to stand for twenty-four hours at room temperature, then place on ice.

DIRECTIONS FOR MAKING BUTTERMILK FROM LACTONE TABLETS.

Fresh skimmed milk, 1 quart;

Hot water, 1½ to 2 cupsful;

Salt, ½ teaspoonful;

Lactone tablet, 1.

Add hot water to milk; then salt; then the lactone tablet, well crushed. Stir well, cover with clean towel, and leave at ordinary room temperature. When the milk becomes thick and fermented set in ice-box for use. Before using heat the buttermilk until perfectly smooth.

BARLEY JELLY.

Three tablespoonfuls of barley to 1 pint of water. Cook two hours.

OAT-JELLY.

Oat flour, 2½ tablespoonfuls to 1 pint of water.

Cook four hours and strain.

Oatmeal, prepare same as oat flour.

For a feeding, dilute with baby’s milk; season with a little salt.

Do not use sugar, then the child will not acquire the taste for sweetened cereals.

Note.—To cook cereals use a fireless cooker.

BEEF JUICE.

I. Cut meat into one-inch cubes; broil slightly and press out juice with meat-press or lemon-squeezer. One pound of meat will make 2 or 3 ounces of juice.

Serve warm or cold with a little salt.

Do not heat enough to coagulate albumen in juice.

II. Cold method:

Finely chopped beef, 1 lb.;

Water, ℥viij.

Put in covered jar; allow to stand on ice from six to twelve hours; then squeeze out by twisting in coarse muslin.

Season with salt and serve as above.

This contains a smaller amount of extractives.

It may be served with sherry wine or celery salt.

If added to milk in the proportion of 2 or 3 tablespoonfuls to the feeding, the taste will not be noticed.

The milk should not be heated over 100° F., as the albumen will coagulate.

No. I. contains twice the amount of extractives as No. II. If the stronger juice is desired, No. II. may be made by adding only ℥iv of water instead of ℥viij.

VEGETABLE SOUP FOR BABIES.

1 handful of spinach;

1 beet;

2 carrots.

Chop fine and boil two hours in 1 quart of water.

Strain through gauze and add sterile water to make up deficiency to 1 quart.