Dr. Jacob Hvoslof: I would like to ask about the value of lime-water added to the milk. I recently had an experience where I mixed an ounce of lime-water to a pint of milk, as I thought that would improve it. but for some reason or other the baby would not digest his milk. After a while I left the lime-water out, and everything went well. Whether this is a “post” or “propter” I should like to find out.
Dr. O. R. Bryant: In case of an exudative diathesis, where you probably will start solids early, you will also be able to use meat earlier. An infant that does well on solids at six months can probably have meat once a day at fifteen months and show a normal stool.
Dr. S. R. Maxeiner: I would like to ask Dr. Huenekens where he classes eggs and egg albumin.
Dr. C. G. Weston: I have been very much interested in Dr. Hueneken’s paper. I care only for the babies during the three or four weeks after birth; and of late years many of them have passed from me directly into the hands of the pediatrists. I formerly had the babies nursed every three hours, but finding that the baby specialist immediately, on assuming charge, put them on the four-hour schedule, I changed, about a year and a half ago, to that interval; and I thought my troubles would cease, but such has not been the case, and it has been my impression, as well as that of the nurses who have had the care of the infants, that it has made very little difference.
The four-hour schedule is not a new thing in Minneapolis. Many of the older members of this Society may remember that twenty years ago Dr. R. O. Beard always fed his babies in this way.
It seems to me that we should make no hard and fast rules for the feeding of babies, except the one that mother’s milk should be used whenever possible. We should individualize with the babies. If they do well on the four-hour schedule, follow it, as it makes the care of the child easier for the mother; if, however, the child does not get sufficient milk on this interval to properly nourish it, diminish the latter to three hours.
The only way to accurately determine how much milk the nursing infant is getting, is to weigh the baby before and after nursing. One is often surprised at the varying amounts obtained by the same baby at different nursings with no obvious difference in the condition of the breasts. We have had a baby obtain as much as three ounces in the first five minutes of nursing, and at the next feeding take only one or one and a half ounces in twenty minutes.
The green and frequent stools, with evidences of colic, etc., are often found to be due to too much milk, or taking it too rapidly; and the weighing method is the only way to determine this.
I most heartily endorse what Dr. Huenekens said with reference to the importance of encouraging in every way maternal nursing. Many a mother gives up the attempt to nurse her baby on account of some soreness of the nipples or because she has thought she had too little milk to be of any use. Most of these cases may become, by the means recommended by the reader, good milkers, and many a baby’s life may thus be saved.
Dr. E. K. Green: I would like to ask a question in regard to putting babies on cow’s milk. I have adhered very closely to the principle that modified cow’s milk is absolutely the best food for infants, if it is impossible to get mother’s milk, but many times when I have had the opportunity to follow these cases carefully I have had all sorts of stomach and bowel disturbances on cow’s milk until someone would suggest some other food, such as malted milk, or Mellin’s Food, or even condensed milk, which seems to be the farthest from the natural food, and then the babies would get along fairly well. Is this a common experience, or is there something wrong with my method? We have in our own home two children brought up on the bottle, one with malted milk and the other with Mellin’s Food. In both these cases I tried, not only once, but several times to use the modified cow’s milk, but failed absolutely. I would like to know if you consider the fault usually with the modified milk, or does the individual have considerable to do with the case?