Artificial Feeding.—While it is true that children often thrive for a time on the various baby-foods with which the market is so abundantly supplied, it is, nevertheless, the case that where fed in this way they are very apt to develop rickets or scurvy, and not uncommonly show evidences of bad nutrition in loss of weight and strength, becoming peevish and fretful, and sleeping badly.
Much better than any of the artificial foods is properly modified cow's milk, which, with care, may be prepared in such a manner as to take the place of mother's milk in the vast majority of instances. In order, however, that this be successfully carried out, much care and attention is necessary.
At this point it is well to stress the fact that the mother's milk differs from that of the cow in some quite important particulars, and it is only by intelligently taking these differences into consideration that it is possible for us to prepare an artificial food that will be satisfactory. Principal among these differences are that cow's milk contains three times as much albuminous material as that of the human being, and that it is less rich by about half in milk-sugar; furthermore, the former is acid in reaction, while the latter is neutral, or faintly alkaline. It will be seen, then, that in order to prepare a modified cow's milk that will approximate that of the human being it is necessary to dilute it with water sufficiently to cause the albumin to approach in proportion that of mother's milk, and at the same time some alkali must be added to neutralize the excessive acidity. Modified milk prepared, however, from the whole cow's milk, would contain much less fat than is desirable, so that we must use in making it the upper third of the whole milk after it has been allowed to remain undisturbed for a number of hours; in other words, in making modified cow's milk we use a large proportion of the cream, with a less amount of the other constituents.
The following table for calculating the proper proportion of milk to be used at the various periods of the infant's life may be recommended, as it gives quite as satisfactory results as those that are more elaborate; it also gives the frequency of feeding and the proper amounts that should be used. The table was devised by Dr. C. E. Boynton, of Atlanta, Georgia.
| Fat percentage desired. | Quantity ounces at feeding. | No. of feedings in 24 hours. | Intervals by day. | ||
| Premature | 1.00 | ¼ - ¾ | 12 - 18 | 1 - 1½ | hrs. |
| 1 - 4 day | 1.00 | 1 - 1½ | 6 - 10 | 2 - 4 | " |
| 5 - 7 " | 1.50 | 1 - 2 | 10 | 2 | " |
| 2 - week | 2.00 | 2 - 2½ | 10 | 2 | " |
| 3 - " | 2.50 | 2 - 2½ | 10 | 2 | " |
| 4 - 8 " | 3.00 | 2½ - 4 | 9 | 2½ | " |
| 2 - month | 3.00 | 3 - 5 | 8 | 2½ | " |
| 4 - " | 3.50 | 3 - 5½ | 7 | 3 | " |
| 5 - " | 3.50 | 4 - 6 | 7 | 3 | " |
| 6 - 10 month | 4.00 | 5 - 8 | 6 | 3 | " |
| 11 - month | 4.00 | 6 - 9 | 5 | 4 | " |
| 12 - " | 4.00 | 7 - 9 | 5 | 4 | " |
| 13 - " | 4.00 | 7 - 10 | 5 | 4 | " |
In making calculations from this table it is assumed that the milk from the upper third of the bottle, after it has been allowed to sit for at least four hours, contains 10% of fat, and this is therefore called 10% milk. The calculation is made as follows:—10% milk is to the fat percentage desired, as the amount which we wish to make up is to X. For example, if we wish to prepare twenty ounces of milk for an infant two months old, we will note by referring to the table that 3% is the amount of fat that is desirable for a milk for a child of this age, and the formula will be constructed as follows:—
10:3::20:X. X = 60/10. X = 6.
Six ounces is then the amount of 10% milk that must be used for making twenty ounces of modified milk,—this being mixed with one ounce of lime-water and thirteen ounces of boiled water. It should never be forgotten that while milk modified by the foregoing formula is suitable for most children, it is by no means always satisfactory, and we may, therefore, be compelled to do a considerable amount of experimenting in some cases before arriving at the correct formula.
Suppose the infant is twelve months old, we would get according to the rules just stated the following equation:—