TABLE FOR INFANT FEEDING

We now offer a monthly schedule—a table which is the result of our experience in feeding hundreds of babies in various sections of Chicago. It is not a schedule for the sick baby, but it is a carefully tabulated outline for the normal, healthy, average child ranging from one week to one year in age. In offering this table we remind the mother, if the baby is six months old and not doing well on the food it is getting and a change is desired by both mother and physician, that it is far better to begin with the second or third month's prescription and quickly work up to the sixth month's. This change may often be accomplished in two or three days.

In all large cities there are to be found milk laboratories which make it their business to fill prescriptions for the modification of milk under the direction of baby specialists. This milk can be absolutely relied upon. In specialized diet kitchens in many large hospitals, these feeding prescriptions also may be filled.

ARTIFICIAL FEEDING SCHEDULE

Age	Baby's Weight	Whole Milk	Cane Sugar	Wheat Flour	Boiled water	Lime Water	Amount at Feeding	Number of Feedings	Interval Between Feedings	Fruit Juices	Soups and Broths	Total Daily Calories
	Pounds	Ounces	Level Tablespoon	Level Tablespoon	Ounces	Ounces	Ounces	in 24 Hours	Hours
1 week	7½	2½	1		5	½	1	8	3			112
2 weeks	7½	4½	1½		9	½	2	7	3			184
3 weeks	7¾	7	2		10	½	2½	7	3			267
4 weeks	8	9	2		11	1	3	7	3			309
2 months	10	11	2		12½	1	3½	7	3			351
3 months	12	15	2	½	15	1	4½	7	3			447
4 months	13	18	2½	1	13½	1½	5½	6	3			553
5 months	14	21	2½	1½	13½	1½	6	6	3½			628
6 months	15	23	2½	1½	10½	1½	7	5	4	one teaspoon	one teaspoon	680
7 months	16	25	2	1½	8½	1½	7	5	4	two teaspoon	¼ cup	732
8 months	17	27	1½	2	8	1½	7¼	5	4	onehalf orange	¼ cup	767
9 months	18	29	1	2	8	2	7¾	5	4	one orange	½ cup	854
10 months	19	30	¾	2	8	2	8	5	4½	one orange	¾ cup	875
11 months	20	31	½	2	8	2	9	5	5	one orange	1 cup	906
12 months	21	32			7	2	9	5	5	one orange	1 cup arrowroot cracker	950
18 months	24	36					12	3	6	toast, gravies, baked potato and apple, etc.

Note	1 ounce of whole milk equals	21 calories	1 level tablespoon of flour equals	25 calories
	1 level tablespoon of cane sugar equals	60 calories	The juice of 1 average orange equals	75 calories
	1 level tablespoon of milk sugar equals	45 calories	1 cup of average bouillon equals about	100 calories

(This table is calculated on the basis of about 45 calories for each pound of baby weight)

TOP-MILK FORMULA

Top milk is the upper layer of milk which has been removed after standing a certain number of hours in a milk bottle or any other tall vessel with straight sides. It contains most of the cream and varying amounts of milk. It may be removed by a small cream dipper which holds one ounce, or it may be taken off with a siphon, but it should never be poured off. To obtain seven per cent top milk which is the one most ordinarily used in the preparation of top milk formulas, we take off varying amounts—according to the quality of the milk—which Doctor Holt describes as follows:

From a rather poor milk, by removing the upper eleven ounces from a quart, or about one-third the bottle.

From a good average milk, by removing the upper sixteen ounces, or one-half the bottle.

From a rich Jersey milk, by removing the upper twenty-two ounces, or about two-thirds the bottle.

Cream is often spoken of as if it were the fat in milk. It is really the part of the milk which contains most of the fat and is obtained by skimming, after the milk has stood usually for twenty-four hours; this is known as "gravity cream." It is also obtained by an apparatus called a separator; this is known as "centrifugal cream," most of the cream now sold in cities being of this kind. The richness of any cream is indicated by the amount of fat it contains.

The usual gravity cream sold has from sixteen to twenty per cent fat. The cream removed from the upper part (one-fifth) of a bottle of milk has about sixteen per cent fat. The usual centrifugal cream has eighteen to twenty per cent fat. The heavy centrifugal cream has thirty-five to forty per cent fat.

The digestibility of cream depends much upon circumstances. Many serious disturbances of digestion are caused by cream.

It is convenient in calculation to make up twenty ounces of food at a time. The first step is to obtain the seven per cent milk, then to take the number of ounces that are called for in the formula desired.

One should not make the mistake of taking from the top of the bottle only the number of ounces needed in the formula, as this may be quite a different per cent of cream and give quite a different result.

There will be required in addition, one ounce of milk sugar and one ounce of lime water in each twenty ounces. The rest of the food will be made up of boiled water.

These formulas written out would be as follows:

	I	II	III	IV	V	VI	VII	VIII	IX
	Oz.	Oz.	Oz.	Oz.	Oz.	Oz.	Oz.	Oz.	Oz.
7 per cent milk	2	3	4	5	6	7	8	9	10
Milk sugar	1	1	1	1	1	¾	¾	¾	¾
Lime water	1	1	1	1	1	1	1	1	1
Boiled water	17	16	15	14	13	12	11	10	9
	—	—	—	—	—	—	—	—	—
	20	20	20	20	20	20	20	20	20

The approximate composition of these formulas expressed in percentages are as follows:

Formula	Fat	Sugar	Proteins
I	0.70	5.00	0.35
II	1.00	6.00	0.50
III	1.40	6.00	0.70
IV	1.75	6.00	0.87
V	2.00	6.00	1.00
VI	2.40	6.00	1.20
VII	2.80	6.00	1.40
VIII	3.10	6.00	1.55
IX	3.50	6.00	1.75

It is necessary to make the food weak at first because the infant's stomach is intended to digest breast milk, not cow's milk; but if we begin with a very weak cow's milk the stomach can be gradually trained to digest it. If we began with a strong milk the digestion might be seriously upset.

Usually we begin with number one on the second day; number two on the fourth day; number three at seven to ten days; but after that make the increase more slowly. A large infant with a strong digestion will bear a rather rapid increase and may be able to take number five by the time it is three or four weeks old. A child with a feeble digestion must go much slower and may not reach number five before it is three or four months old.

It is important with all children that the increase in the food be made very gradually. It may be best with many infants to increase the milk by only half an ounce in twenty ounces of food, instead of one ounce at a time, as indicated in the tables. Thus, from three ounces the increase would be to three and one-half ounces; from four ounces to four and one-half ounces, etc. At least two or three days should be allowed between each increase in the strength of the food.