DIET FOR INFANTS AND CHILDREN

47. From birth until a child has attained full growth, the food requirement is high in proportion to the size of the child. This is due to the fact that energy must be supplied for a great deal of activity, and at the same time new tissue must be manufactured from the food taken. It should be remembered, too, that all body processes during growth are extremely rapid. At birth, the average child weighs about 7 pounds, and for several days after birth there is a normal loss of weight. In a few days, however, if the diet is correct, the child begins to increase in weight and should gain about 1/2 pound a week until it is 3 months old. From this time on, its weekly gain should be slightly less, but it should be constant. If the weight remains the same or there is a decrease for a number of consecutive days or weeks, it is certain that the diet is incorrect, that the quantity of food is insufficient, or that the child is ill. The reason for the loss should be determined at once and the trouble then corrected.

Normal diet for the infant is the mother's milk, but if this cannot be supplied, the next best diet is modified cow's milk, which for the young child must be greatly diluted. If it is found necessary to give proprietary, or manufactured, foods, raw food of some kind should be used in addition, the best way to supply this being with a little orange juice or other fruit juice. At the age of 3 months, this may be given in small quantity if it is diluted, and then the amount may be gradually increased as the child grows older.

48. EFFECT OF WEIGHT ON CHILDREN'S DIET.--The food requirement in the case of children is determined by weight. To decide on the proper amount, it is necessary to know the normal weight at certain ages. At birth, as has been stated, the normal weight is 7 pounds; at 6 months, 15 pounds; at 1 year, 21 pounds; at 2 years, 30 pounds. The food requirement for 24 hours per pound of weight is as follows:

CALORIES PER LB. IN 24 HOURS
Children up to 1 year	45
Children from 1 to 2 years	40
Children from 2 to 5 years	36

From a study of these figures, it will be noted that there is a gradual decrease in the required number of calories per pound as the child grows older. The decrease continues until maturity is reached, and then the scale for adults applies.

49. EFFECT OF AGE ON CHILDREN'S DIET.--A child should not be kept exclusively on milk for more than 6 or 8 months, and then only in case it is fed on the mother's milk. Fruit juice, which has already been mentioned as an additional food, is recommended if the diet requires raw food or if it is necessary to make the child's food more laxative. When the child reaches the age of 6 months, it should be taught to take foods from a spoon or a cup; then when it must be weaned, the task of weaning will be much easier. At the age of 8 or 9 months, depending on the condition of the child, small amounts of well-cooked, strained cereals may be added to the diet, and these may gradually be decreased as the food is increased in variety. Up to 1-1/2 years of age, a child should have 8 ounces of milk three times a day, which amounts to 1-1/2 pints. At this age, half of a soft-cooked egg or a spoonful or two of tender meat chopped very fine, may be given, and for each such addition 4 ounces of milk should be taken out of the day's feeding. But from 1-1/2 years up to 5 years, at least 1 pint of milk a day should be included in the diet.

At a little past 1 year of age, a normal child may begin taking a few well-cooked vegetables, such as a bit of baked potato, a spoonful of spinach, carrot, celery, green peas, or other vegetables that have been forced through a sieve or chopped very fine. At 1-1/2 years, the normal child should be taking each day one vegetable, a cereal, buttered bread or toast softened with milk, eggs, fruit juice, a little jelly, and plain custards. However, each of these foods should be added to the diet with caution and in small amounts, and if it appears to disagree with the child in any way, it should be discontinued until such time as it can be tolerated.

In case a child is being raised on a formula of cow's milk and it is a strong, normal child, it should be taking whole milk at the age of 8 or 10 months. If the child is not strong, the milk may still be diluted with a small amount of sterile water, but this should be gradually decreased until the child is able to tolerate whole milk.

50. FEEDING SCALE FOR INFANTS.--It is, of course, a difficult matter to make definite rules for the feeding of all children, for conditions arise with many children that call for special plans. However, for children that are normal, a feeding scale may be followed quite closely, and so the one given in Table VI is suggested.

TABLE VI

FEEDING SCALE FOR INFANTS

First Three Months	Milk.
Fourth Month	Same as for preceding months and orange juice and cereal waters.
Sixth Month	Same as for preceding months and well-cooked and strained cereal.
Eighth Month	Same as for preceding months and beef juice, beef broth, and yolk of soft-cooked egg.
Tenth Month	Same as for preceding months and unstrained cereal, half of soft-cooked egg, both white and yolk, chopped or strained cooked vegetables, such as spinach and other greens, asparagus, carrots, celery, and squash, stale bread, crackers, toast and butter.
Eleventh Month	Same as for preceding months and well-cooked rice, baked potato, jelly, plain custard, corn-starch custard, and junket.
Twelfth Month	Same as for preceding months and whole egg, a tablespoonful of tender meat, string beans, peas, turnips, onions, chopped or strained applesauce, stewed prunes, and other fruits.
Eighteenth Month	Same as for preceding months and home-made ice cream, plain sponge cake, milk soups, and cereal puddings.

This scale is to be used by adding to the diet for one month the foods suggested for the next month, giving them at the time the child reaches the age for which they are mentioned. For instance, a child of 8 months may have everything included in the first three, four, and six months and, in addition, beef juice, beef broth, and the yolk of a soft-cooked egg, which is the diet suggested for the eighth month. Then at the tenth month it may have all of these things together with those given for this month.

51. When any of these foods is first added to the diet, much care is necessary. Each new food should be given cautiously, a teaspoonful or two at a time being sufficient at first, and its effect should be carefully observed before more is given. If it is found to disagree, it should not be repeated. If at any time a child is subject to an attack of indigestion, its diet should be reduced to simple foods and when it has recovered, new foods should be added slowly again. In the case of any of the ordinary illnesses to which children are subject, such as colds, etc., the diet should be restricted to very simple food, and preferably to liquids, until the illness has passed. The diet of a baby still being fed on milk should be reduced to barley water or a very little skim milk diluted with a large amount of sterile water. When the illness is over, the child may be gradually brought back to its normal diet.