The physiology of digestion considered with relation to the principles of dietetics

by Andrew Combe

Many mothers consider every expression of uneasiness as an indication of appetite, and whenever a child cries they offer it the breast again, although ten minutes may not have elapsed since its preceding repast. Nothing can be more injurious than this custom. It overloads and oppresses the stomach,—excites griping and bowel-complaints, restlessness and fever,—and not unfrequently leads to fatal disease in the brain. It does harm also by withdrawing the mother’s notice from the real source of uneasiness.

It is astonishing, indeed, with what exclusiveness of understanding, eating is regarded even by intelligent parents as the grand solatium or panacea for all the pains and troubles which afflict the young. If a child falls over a stone and bruises its leg, its cries are immediately arrested by a sugar-biscuit stuffed into its open mouth. If its temper is discomposed by the loss of a toy, it is forthwith soothed by an offer of sweetmeats, the ultimate effect of which is to excite colicky pains in its bowels, which are worse than the original evil, and for which, in their turn, it is presented with “nice peppermint drops,” or some other equally pleasant antidote. Because the mouth is open when the child is crying, and the mouth leads to the stomach, parents jump to the conclusion that it is open for the purpose of being filled, and proceed to cram it accordingly; forgetting all the while that the mouth leads also to the windpipe, and may be open for the admission of air to the lungs as well as of food to the stomach,—and that if they stuff it with cake or pudding when it is open only for the reception of air, they run the risk of suffocating the little innocent when their only wish is to soothe him. Every body must have seen fits of convulsive cough induced by fragments of food being drawn into the windpipe in such circumstances.

To confound crying and the expression of pain with the cravings of hunger, is far from being a matter of indifference to the child. If food be given when it wishes only to be relieved from suffering, the offending cause is left in activity, and its effects are aggravated by the additional ill-timed distention of its stomach. But so far is this important truth from being sufficiently impressed on the minds of parents and nurses, that nothing is more common, when the infant refuses to swallow more but still continues to cry, than to toss it in the nurse’s arms, as if on purpose to shake down its food, and then resume the feeding. And in such attempts, it is too true that the perseverance of the nurse often gets the better of the child, and forces it at last to receive the food at which it really loathes.

“Let appetite, then, be the only rule, but allow it to appear, and do not attempt to provoke it. The breast ought not to be offered to the infant; it is for him to seek it. He has little need of sucking who takes it with indifference, or as if he were conferring a favour. He who is hungry acts very differently; all his gestures express clearly the want and the desire; his eye follows his nurse, and tries to interpret her every movement. If he is crying, his cries cease at her approach, and smiles replace his tears. If he is offered the breast, he seizes it with ardour, and the mother yields to a natural want.” But it is far otherwise when real appetite is wanting, and “it then becomes an act of cruel perfidy to tempt the infant by the offer of the breast. How can it be expected to resist the temptation, when the adult whose appetite is already satisfied at the festive board, yields to the solicitations of the host, and gorges himself with aliments which he cannot digest?”[46]

The same intelligent author remarks, that the lower animals instinctively avoid this error, and, instead of offering suck too often, rather allow themselves to be strongly solicited before yielding to the wishes of their young. By this provident arrangement, the latter are protected from the evils of too frequent eating. Many mothers imagine that milk is so bland a fluid that it is impossible for an infant to take too much of it; but the fallacy of the notion is exposed when we recollect that milk is coagulated the moment it reaches the stomach, and that the real subject of digestion is curd—a substance not quite so light as milk has the appearance of being.

The grand rule, then, during the early months of infancy, is to satisfy the clearly indicated and ascertained wants of the child, but neither to confine it to regular hours, nor to offer it food when it is crying solely from pain and not from hunger. When the system has become more developed, and the stomach accustomed to the exercise of its functions, regularity in the distribution of its meals may be gradually and beneficially introduced; because, in the animal economy, there is a natural tendency to periodicity, which greatly facilitates the formation of proper habits.

From the sudden change attending the introduction of the infant into the world, the many new sensations which it begins to feel, and the non-secretion of milk in the mother’s breasts for some hours after delivery, it seems to have been intended by Nature that both parent and child should have some time for repose before a supply of food should be required by the one or furnished by the other. But, through pure ignorance and mistaken kindness, many nurses, imagining themselves wiser than Nature, and conceiving that the newly-born infant must of necessity be starving after what they consider a nine months’ fast, hasten to fill its stomach with gruel, or some other food. Not unfrequently, severe indigestion is thus induced at the very outset, which in a delicate child may be sufficient to lay the foundation of much suffering and bad health.

On the general principle, that no physical want ever exists without the means of supplying it having been provided by Nature, we may safely infer that, in ordinary cases, the secretion of milk will be begun before the infant can possibly require it; and to counteract this arrangement, is to set ourselves up in direct opposition to the Creator, and to give a species of food for which the stomach is not then adapted.

It is true that, in the artificial state of society in which we live, the secretion of milk is sometimes delayed so long as to endanger the welfare of the child. In such cases, it may be necessary to give a few tea-spoonfuls of fresh cow’s milk diluted with water, as a temporary substitute for its natural food; but this ought to be only when the necessity is obvious, and in very small quantity at a time, otherwise the stomach and bowels will to a certainty suffer.

One evil result of the ignorance of the animal economy which prevails in society, is a habitual distrust of, or want of faith in, the efficiency of the laws which God has appointed for the regulation of the animal functions. We cannot rest satisfied with discovering and yielding obedience to His designs, but we also must do something to assist or correct them! At birth, for example, the stomach and bowels, never having been used for the purposes of digestion, contain a quantity of mucous secretion—meconium—which requires to be removed before they can enter upon their functions. To effect this object, Nature has rendered the first portions of the mother’s milk purposely watery and laxative; and, on the part of the infant, nothing farther is required than to allow it to follow its natural instinct and suck it in. Nurses, however, distrusting Nature, often hasten to administer castor oil or some other active purgative in preference, and the result is the excitement of irritation in the stomach and bowels, which is not always easily subdued. If the young of the lower animals were treated after the same unnatural fashion, it can scarcely be doubted that the mortality among them also would be greatly increased.