Part 59

The farinaceous foods have value, but they cannot replace good milk, which should be almost the sole food of the child to at least the age of ten months, and the principal nutrient to the age of two years.

When a baby is nursed, and its mother has an abundance of milk, it takes nothing else during the first ten or twelve months of life. When a baby is artificially fed, this fact should be borne in mind. The important thing is to attain as nearly as possible to the standard that nature has set.

Biedert's cream mixture and the whey mixture are valuable for young infants and those which for any reason do not thrive on milk.

=Amount for Each Meal.= A child is nourished, not by what it swallows, but by what it digests. Giving too much or too concentrated milk is very unwise, for the delicate system cannot manage it, and too frequently the meal becomes a source of pain rather than of strength. Each individual babe will require a little different treatment in this respect from every other.

In general, for the first six weeks from two to four tablespoons at a feeding may be given; from that age to six months, from four to eight tablespoons, gradually increasing the amount to twelve tablespoons at one year.

=Dilution.= Cow's milk is more easily digested when diluted with water, and we are more likely to dilute too little than too much. The amount of water used should vary with the age and strength of digestion of the child. As a rule the new-born infant should have two parts water to one of milk; at four months equal parts of milk and water; at ten months one part water and two parts milk. When digestion is particularly feeble, it may be necessary to dilute milk with six or eight times its bulk of water.

=Manner of Giving.= It is best to give milk from a bottle so constructed that suction is necessary, for it induces the flow of the digestive juices. Use the plain rubber nipple; those with tube attachments which extend into the bottle are to be avoided, on account of the difficulty of making them perfectly clean inside. Cultures from these tubes always give large numbers of bacteria, as do also those made from the nipples, unless they are boiled.

The intervals of feeding will vary somewhat with the age of the child. Once in two or two and a half hours during the day for the first six months, and every three hours from the sixth to the twelfth month, is the general rule.

The temperature of the meal should be 100° Fahr.

A babe needs less variety in its food than older children, and they in turn require less than grown persons; but both must have a certain proportion of the five essential food principles.

There is an impression in the minds of many that children should not have fat. This has perhaps sprung from the fact that mother's milk has a watery, thin appearance. It seems not rich; nevertheless it has a due proportion of fat, and it is extremely important that this be maintained when cow's milk is diluted, for this cream is the best addition.

Fat is needed not only for the growth of brain and nerves, which is very rapid in children, but also for the perfect formation of other tissues.

The following table is that given by Dr. Louis Starr as a guide for feeding:

GENERAL RULES FOR FEEDING.

Age. Intervals of Average Am't Average Am't Feeding. each Meal. in 24 hours. First week 2 hours 2 tablespoons 1¼ pints Second to sixth week 2½ hours 3-4 tablespoons 1½-2 pints Sixth week to sixth month 3 hours 6-8 tablespoons 2½-3 pints At six months 3 hours 12 tablespoons 4½ pints At ten months 3 hours 16 tablespoons 5 pints

For the First Week; One Feeding

1 Tablespoon of whey. 1 Tablespoon of water. ⅔ Tablespoon of cream. ⅙ Teaspoon of sugar.

Or Biedert's cream mixture:

1 Tablespoon of cream. ¼ Teaspoon of milk-sugar. 3 Tablespoons of water.

Or,

1 Tablespoon of milk. ¼ Teaspoon of milk-sugar. 3 Tablespoons of water.

If it is desirable to make at once a sufficient quantity of Biedert's cream mixture for several feedings, the above rule multiplied by eight will furnish enough for eight bottles, and is as follows: one cup of cream, three cups of boiling water, and one tablespoon of milk-sugar. Mix all together; put the mixture in equal portions into eight feeding-bottles, and plug each with cotton. Either sterilize it or put it immediately on ice to keep.

After the First Week, and Until the Sixth Week

Use either the cream mixture, the whey mixture, or the following:

2 Tablespoons of cow's milk. 4 Tablespoons of water. 1 Teaspoon of Mellin's food. ⅓ Teaspoon of milk-sugar.

From the Sixth Week to the Sixth Month

Water and milk in equal quantities, with a little cream and milk-sugar, and some attenuant, such as Mellin's food or barley jelly.

2 Tablespoons of cow's milk. 2 Tablespoons of water. 1 Tablespoon of cream. 1 Teaspoon of Mellin's food. ⅜ Teaspoon of sugar.