The Mother And Her Child Part 25

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.

PEPTONIZED MILK

Another modification which at times may be ordered by your physician is peptonized milk. Since it is infrequent for the proteins of milk to be the cause of indigestion, peptonized milk has only a limited use, chiefly in cases of acute illness. The milk is peptonized in the following manner:

Place the peptonizing powder (it is procurable in tubes or tablets from the drug store) in a small amount of milk, and after being well dissolved, put into the bottle or pitcher with the plain or modified milk, after which the whole is shaken up together. The bottle is then put into a large pitcher containing water heated to about 110 F. or as warm as would bear the hand comfortably, and left for ten or twenty minutes (if the milk is to be partially peptonized). To completely peptonize the milk, two hours are required. Either of these formulas is only used on the advice of a physician.

b.u.t.tERMILK

In many cases of chronic intestinal indigestion, b.u.t.termilk is used in place of the milk. It is prepared as follows: After the cream has been taken from the milk and it has been allowed to come to a boil, it is cooled to just blood heat. A b.u.t.termilk tablet, having first been dissolved in a teaspoonful of sterile water, is now stirred into the quart of warmed, skimmed milk and allowed to stand at room temperature for twenty-four hours at which time it should look like a smooth custard. With a sterile whip this is now beaten and is ready for the sugar and the boiled water which is added according to the written prescription from the doctor.

CONDENSED MILK

Under no circ.u.mstances should condensed milk be used as the sole food of the baby for more than one month. Children often gain upon it, but as a rule they have little resistance, and they are very p.r.o.ne to develop rickets and oftentimes scurvy; and, as noted elsewhere, orange juice should always be administered at least once during the twenty-four hours as long as condensed milk is used.

Of all the brands of condensed milk, those only should be selected which contain little or no cane sugar. Perhaps the "Peerless Brand" of evaporated milk is the most reliable and in the preparation of food from this evaporated milk the same amount of sugar, etc., should be added as we do in the preparation of "whole milk" or "top milk."

We do not in any way advise the use of condensed milk. Fresh milk should always be used where it is obtainable, but in traveling it sometimes has to be used. Holt says, "It should be diluted twelve times for an infant under one month and six to ten times for those who are older."

Malted milk is a preparation suitable in some cases where fresh cow's milk is not obtainable. Even better than condensed milk, this food will be found serviceable in traveling, or in instances where only very bad cow's milk is within reach.

SPECIAL FOODS

Most patent foods are made up of starches and various kinds of sugars, and some of them have dried milk or dried egg alb.u.min added. Many flours under fanciful names are sold on the market today. For instance, one flour with a very fanciful name is simply the old fas.h.i.+oned "flour ball" that our great, great grandmothers made; and, by the way, perhaps there is no flour for which we are more grateful in the preparation of infant food than the flour ball which is prepared as follows: A pound of flour is tied tightly in a cheesecloth and is put into a kettle of boiling water which continues to boil for five or six hours, at the end of which time the cheesecloth is removed and the hard ball, possibly the size of an orange, is placed on a pie pan and allowed slowly to dry out in a low temperatured oven.

At the end of two or three hours, the ball, having sufficiently dried, has formed itself into a thick outer peel which is removed, while the heart which is very hard and thoroughly dry, is now grated on a clean grater, and this flour has perhaps helped more specialists to serve more sick babies than any other form of starch known. It is used just as any other flour is used--wet up into a paste, made into a gruel, which is boiled for twenty minutes before it is added to the milk.

Whey is sometimes used in the preparation of sick babies' food and is prepared as follows:

To a pint of fresh lukewarm cow's milk are added two teaspoons of essence of pepsin, liquid rennet or a junket tablet. It is stirred for a moment, then allowed to stand until firmly coagulated, which is then broken up and the whey strained off through a muslin.

The heavy proteins remain in the curd, and the protein that goes through with the whey is chiefly the lactalb.u.min.

CHAPTER XIX

THE FEEDING PROBLEM

A friend of ours who presides over a court of domestic relations in a large city, recently told us that he believed much trouble was caused in families--many divorces, occasioned, and many desertions provoked--because improperly fed babies were cross and irritable and so completely occupied the time of the mother, who, herself, knew nothing about mothercraft or the art of infant feeding. Consequently, the home was neglected and unhappy, quarreling abounded and failure, utter failure, resulted. The children were constantly cross, and so much of the mother's time was consumed in caring for these irritable, half-fed babies, that the home was disheveled, the meals never ready, the husband's home-coming was a dreaded occurrence, and he, endeavoring to seek rest and relaxation, usually sought for it in the poolroom or the saloon, with the usual climax which never fails to bring the time-honored results of debauch--despair and desertion.

In the beginning of this book we paid our respects to the present-day educational system which does not provide an adequate compulsory course in which all women could be given at least a working knowledge of home making and the care and feeding of the babies; so that statement need not be repeated in this chapter. But we wish to add, in pa.s.sing, that ignorance is the basis and the foundation of more unhappy homes, broken promises, panicky divorces, and shattered hopes, as well as of more deaths during the first year of infancy, than any other cause. And in speaking of its relations.h.i.+p to babycraft, we believe that ignorance concerning normal stools, how many times a day the bowels should move; how much a baby's stomach holds; how often he should be fed, etc.--I say it is ignorance of these essential details that lies at the bottom of many problems which come up during the first year, particularly the "feeding problem."

INFANT WELFARE

In the city of Chicago at the time of this writing, the Infant Welfare a.s.sociation maintains over twenty separate stations where meetings are held for mothers, where lectures are delivered on the care and feeding of babies. Babies are brought to these stations week in and week out; they are weighed and measured and, if bottle-fed, nurses are sent to the homes to teach the mother how properly to modify the milk in accordance with the physician's orders. The health authorities of our city also maintain several such stations where mothers and babies may have this efficient help. A corps of nurses are employed to carry out the instructions and to follow up the mothers and the babies in their homes, and thus the death rate has been greatly reduced, not only in our city but in all such cities where baby stations have been inst.i.tuted. In a certain ward in Philadelphia the death rate was reduced forty-four per cent in one year after the baby stations were established.

CHOOSING A FORMULA

There are three cla.s.ses of infants who require weak-milk mixtures to begin with: namely, the baby who has been previously nursed and whose mother's milk has utterly failed; the baby just weaned; and the infant whose power to digest is low. If these children were six months old, and the formula best suited to them is unknown, we must begin with a formula suited to a two- or three-month-old child and quickly work up to the six-month formula, which may often be accomplished within two or three days.

THE BOTTLE-FED BABY

When a baby is getting on well with his food, he should show the following characteristics: He should have a good appet.i.te; should have no vomiting or gas; he should cry but little; and he should sleep quietly and restfully. His bowels should move once or twice in twenty-four hours. His stool should be a pasty h.o.m.ogeneous ma.s.s. He should possess a clear skin and good color. He should show some gain each week--from four to eight ounces--and he should also show mental development.

As long as a baby appears happy and gains from four to eight ounces a week and seems comfortable and well satisfied, the feeding mixture should not be changed or increased.

MAKE CHANGES GRADUALLY

In our experience with the artificial feeding of infants, we have come to look upon the practice of gradually changing the food formula as the most important element in successful baby feeding.

We recall one mother in the suburbs who came to us with her baby who had been feeding on a certain proprietary food. She declared that it "just couldn't take cow's milk." She admitted "it was not doing well,"

and so she would like to have help. The baby was old enough, had it been normal, to have been taking whole milk for some time. We recall our having the mother prepare the proprietary food just as she had been used to preparing it, and each day we had her throw away one-half ounce and put in one-half ounce of whole milk, this mixture she fed the baby for two days.

The next time, we had her take out one ounce of the mixture and put in one ounce of whole milk, which we fed the baby for three successive days; and then one and one-half ounces were subst.i.tuted which was fed to the baby for four days; and thus we carefully, slowly, and gradually withdrew the proprietary food and subst.i.tuted fresh, certified cow's milk. It took us a month to complete the change, but we are glad to add that it was done without in the least disturbing the child.

Now, had the change been made abruptly--in a day or two, or three days--the baby would probably have been completely upset, while both the mother and the doctor would have been greatly discouraged. Many mothers and even some physicians have jumped from one baby food to another baby food; they have tried this and they have tried that, until the poor child, having been the victim of a number of such dietetic experiments, finally succ.u.mbed.

We cannot urge too strongly the fact that, as a rule, whenever a change is made from one food to another, it should be done gradually, unless it be the change of a single element such as that of a very high per cent of cream found in top milk mixtures, when it seems to be a troublesome element in the milk. No bad effects will follow the quick change to skimmed milk with added sugar, starches, etc; but in changing from a proprietary food to a milk mixture, the change should always be made gradually, the quant.i.ty of the new food being increased gradually. Milk should be increased by quarter (1/4) ounce additions, and it should not be increased more than one ounce in one week; while the mixture should not be increased as long as the baby is gaining satisfactorily. A wise mother and an experienced physician can usually see at a glance when a child is doing well--by the color and consistency of the stools, the child's appet.i.te, his sleep, and his general disposition.

COMMON MISTAKES IN FORMULAS

First and foremost, we believe a great mistake is often made in using too heavy cream mixtures; babies as a rule do not stand the use of too high a percentage of cream. Formulas that call for whole milk should contain four per cent fat or cream; and while babies often gain rapidly on the higher percentage of cream found in a rich Jersey milk, nevertheless, sooner or later serious disturbances of digestion usually occur. Herd milk is, therefore, better for the babies because in the "whole milk" of the herd of Holsteins we have only about four per cent fat.

Another common mistake is too heavy feeding at the time of an attack of indigestion; even the usual feeding may be too heavy during this time of indisposition. It is not at all uncommon for us to dilute baby's food to one-third its strength at the time of an acute illness.

Still another trouble maker is dirt--dirt on the dish-towel, dirt on the nipple, dirt in the milk, dirt on the mother's hands. Dirt is an ever present evil and an endless trouble maker, as evidenced by stool disturbances, indigestion, fretful days, and sleepless nights. A dirty refrigerator is another factor which has been responsible for much illness and distress.

Indigestion is often brought on because a nurse, caretaker, or possibly the mother, not wis.h.i.+ng to go down to the refrigerator in the middle of the night, brings up the food early in the evening and allows it to become warm--to remain in a thermos bottle--and we are sure that had they been able to see the enormous multiplication of germs because of this warm temperature, they would never have given occasion for such an increase in bacteria just to save themselves a trifle of inconvenience.

Still another common mistake is to use one formula too long; a feeding mixture which was good for four or possibly six weeks, must be changed as the child grows older and his requirements become greater. Let the weight, stools, general disposition and sleep of the child be your guides, and with these in mind errors in feeding can be quickly detected and minor mistakes speedily rectified.