DIET FOR THE YOUNG.
A very large share of the mortality among young children results from dietetic errors which proper knowledge and care on the part of those who have them in charge might commonly avoid. From infancy to the age of twelve or eighteen months, milk is the natural and proper food. Milk contains all the food elements except starch, which cannot be digested by very young children, owing to the insufficient formation of digestive elements of the salivary secretion during the first few months. If the child is deprived of the milk provided by nature, the best artificial food is cow's milk; it, however, requires very careful selection and intelligent preparation. The animal from which the milk comes, should be perfectly healthy and well cared for. The quality of her food should also receive attention, as there is little doubt that disease is often communicated to infants by milk from cows improperly fed and cared for. An eminent medical authority offers the following important points on this subject:—
"The cow selected for providing the food for an infant should be between the ages of four and ten years, of mild disposition, and one which has been giving milk from four to eight weeks. She should be fed on good, clean grain, and hay free from must. Roots, if any are fed, should be of good quality, and she should have plenty of good clean water from a living spring or well. Her pasture should be timothy grass or native grass free from weeds; clover alone is bad. She should be cleaned and cared for like a carriage horse, and milked twice a day by the same person and at the same time. Some cows are unfit by nature for feeding infants."
Milk from the same animal should be used if possible. Changing from one cow's milk to another, or the use of such milk as is usually supplied by city milkmen, often occasions serious results. The extraction of the heat from the milk immediately after milking and before it is used or carried far, especially in hot weather, is essential. While the milk itself should be clean and pure, it should also be perfectly fresh and without any trace of decomposition. To insure all these requisites, besides great care in its selection, it must be sterilized, and if not intended for immediate use, bottled and kept in a cool place until needed. It is not safe to feed young children upon unsterilized milk that has stood a few hours. Even fresh milk from the cleanest cows, unless drawn into bottles and sealed at once, contains many germs. These little organisms, the cause of fermentation and decomposition, multiply very rapidly in milk, and as they increase, dangers from the use of the milk increase.
There is no doubt that cholera infantum and other digestive disturbances common among young children would be greatly lessened by the use of properly sterilized milk. Directions for sterilizing milk, and additional suggestions respecting points to be considered in its selection, are to be found in the chapter on Milk, etc.
Cow's milk differs from human milk in that it contains nearly three times as much casein, but only two thirds as much fat and three fourths as much sugar. Cow's milk is usually slightly acid, while human milk is alkaline. The casein of cow's milk forms large, hard curds, while that of breast milk forms fine, soft curds. These facts make it important that some modification be made in cow's milk to render it acceptable to the feeble stomach of an infant. Cases are rare where it is safe to feed a child under nine months of age on pure, undiluted cow's milk. A common method of preparing cow's milk so as to make it suitable for infant feeding, is to dilute it with pure water, using at first only one third or one fourth milk, the proportion of milk being gradually increased as the child's stomach becomes accustomed to the food and able to bear it, until at the age of four months the child should be taking equal parts of milk and water. When sterilized milk is to be thus diluted, the water should be first boiled or added before sterilizing. A small amount of fine white sugar, or what is better, milk sugar, should be added to the diluted milk. Barley water, and thin, well-boiled, and carefully strained oatmeal gruel thoroughly blended with the milk are also used for this purpose. A food which approximates more nearly the constituents of mother's milk may be prepared as follows:—
Artificial Human Milk No. 1.—Blend one fourth pint of fresh, sweet cream and three fourths of a pint of warm water. Add one half ounce of milk sugar and from two to ten ounces of milk, according to the age of the infant and its digestive capacity.
Artificial Human Milk No. 2.—Meigs's formula: Take two tablespoonfuls of cream of medium quality, one tablespoonful of milk, two of lime water, and three of water to which sugar of milk has been added in the proportion of seventeen and three fourths drams to the pint. This saccharine solution must be prepared fresh every day or two and kept in a cool place. A child may be allowed from half a pint to three pints of this mixture, according to age.
Artificial Human Milk No. 3.—Prepare a barley water by adding one pint boiling water to a pint of best pearl barley. Allow it to cool, and strain. Mix together one third of a pint of this barley water, two thirds of a pint of fresh, pure milk, and a teaspoonful of milk sugar.—Medical News.
Peptonized milk, a formula for the preparation of which may be found on [page 426], is also valuable as food for infants, especially for those of weak digestion.
Mucilaginous Food Excellent in Gastro-enteritis.—Wheat, one tablespoonful; oatmeal, one half tablespoonful; barley, one half tablespoonful; water, one quart. Boil to one pint, strain, and sweeten.—Dietetic Gazette.
Prepared Foods for Infants.—Of prepared infant foods we can recommend that manufactured by the Sanitarium Food Co., Battle Creek, Mich., as thoroughly reliable. There are hundreds of prepared infant foods in the market, but most of them are practically worthless in point of food value, being often largely composed of starch, a substance which the immature digestive organs of a young child are incapable of digesting. Hundreds of infants are yearly starved to death upon such foods.
All artificial foods require longer time for digestion than the food supplied by nature; and when making use of such, great care should be taken to avoid too frequent feeding. It is absolutely essential for the perfect health of an infant as well as of grown people, that the digestive organs shall enjoy a due interval of rest between the digestion of one meal and the taking of another. As a rule, a new-born infant may be safely fed, when using human milk, not oftener than once in every three or four hours. When fed upon artificial food, once in five or six hours is often enough for feeding. The intervals between meals in either case should be gradually prolonged as the child grows older.
Quantity of Food for Infants.—Dr. J.H. Kellogg gives the following rules and suggestions for the feeding of infants:—
"During the first week of a child's life, the weight of the food given should be 1/100 of the weight of the infant at birth. The daily additional amount of food required for a child amounts to about one fourth of a dram, or about one ounce at the end of each month. A child gains in weight from two thirds of an ounce to one ounce per day during the first five months of its life, and an average of one half as much daily during the balance of the first year.
"From a series of tables which have been prepared, as the result of experiments carefully conducted in large lying-in establishments, we have devised this rule:—
"To find the amount of food required by a child at each feeding during the first year of life, divide the weight of the child at birth by 100 and add to this amount 3/100 of the gain which the child has made since birth. Take, for example, a child which weighs 7-1/2 lbs—at birth, or 120 ounces. Dividing by 100 we have 1.2 oz. Estimating the weight according to the rule above given, the child at the end of nine months will have gained 210 oz. Dividing this by 100 and multiplying by 3, we have 6.3 oz. Adding to this our previous result, 1.3, we have 7.5 oz, as the amount of food required at each feeding at the end of nine months by a child which weighed 7-1/2 lbs. at birth. To save mothers the trouble of making these calculations, we have prepared the following table, which will be found to hold good for the average child weighing 7-1/2 lbs. at birth. This is rather more than the ordinary child weighs, but we have purposely chosen a large child for illustration, as it is better that the child should have a slight excess of food than too little.