TO BE CUT OUT AND PASTED IN A SCRAP BOOR FOR FUTURE REFERENCE. FEEDING OF INFANTS.

Otago Witness, Issue 2719, 25 April 1906, Page 70

TO BE CUT OUT AND PASTED IN A SCRAP BOOR FOR FUTURE REFERENCE. FEEDING OF INFANTS.

INFORMATION TO MOTHERS.

Subjoined is a reprint of Dr King's ©riginai instructions to mothers, With simplifications, additions, and modifications suggested*' to- him by various personal inquiries: — N.B. — All tribes, bottles, or vesssls for milk must tx» kept scrupulously clean. This can he effected by washing immediately after use-_srith cold water and then with hot wate* and soda. Hot water should never b^ ueed finst, because is coagulates the alimmen of milk and prevents proper cleansing. Rinse thoroughly with hot boiled water immediately before use, and on no account follow this rinsing by "wipme out with any form of clcth or towel, since, however clean this might be, it-'-would probably contaminate the vessel ■with microbes. • Dieections a?:d Defixitioxs. 1. IvIILK.— No effort^ should" .be spared +o get this as, "soon after milking as possible. Any. milk which has been standing for 12 hours „in summer ■ without having, been rapidly down ana kept belo^r 60deg. j Fahrenheit is want for feeding infante, i Where such is the only milk obtainable it should be- heated at one© to 155deg Eahren- j heit to prevent further growth of fermentative organisms, and should be covered and kept in a cool, clean place. Heating carried above about 155deg Fahrenheit seriously impairs the digestibility and nutritive qualities of the milk. The^milk of a herd of co^73 is more reliable a^ regards equality of composition than the iii^k of a 1 sinjrio cow. The evening milk of a fiven ] herd is distinctly richer thai. the morning i milk ; and in autumn milk Is decidedly richer than in spring. 2. Milk Sugar is the natural sugar of milk, from which it is extracted in the form of a white powder. This substance is easily digested, resists fermentation, and tends to cheek putrefactive Drooesses in the contents of the intestine. The reverse is the case with cane sugar, which readily j ferments itself, tends to set up decomposition, and is a leading ca.use of indigestion and diarrhoea in infants • hence, one evil of condensed milk. Malt s-u^ar and other vegetable sugars and starches are open to similar objections. Milk sugj.r is the principal food constituent of human milk, and is the only form of sugar admissible for th*> fw.ding of infants. 3. Sugar Measube. — A standard measure iB .made to hold goz of milk sugar. Tt ia dipped- into trie sugar and lifted out slightly heaped up. then the portion standing above the level of the rim is removed by pas'jjns; j the "back of a knife across it. Measures can ! by» obtained free from Nurse M'Kinnon, care of- Mrs Murray, (A George street, Diuwdin. (entrance St. Andrew street). As the bulk 1 of a, given weijrht of milk sugar will vary I considerably with the degree of pressure to ! which it* "has- ,besn subjected in the i accuracy *of measuring should be checked I from 'time •to time by seeing whether^ a given weight of milk sugar measures out properly. There should, of course, be 32 ' measurefuls in a pound of sugar. 4. Creams. — '"' Twelve per cent, cream " means a thin, milky cream only three times a* rich in fat as ordinary cow's nv'lk. This can bo obtained by using ~a. " conical dipper " (procurable free from Nurse M'Kinnon) to remove the upper fourth from a jar of fresh milk, which has been kept standing in a cooling-box or cool safe for nine hours. The use of the special dipper is simpler than the use of a svnhon, and is also preferable, because the dipper can le more easily and thoroughly cleaned. In springtime, if morninar milk is procured, dip out only the upper fifth as cream; and in the autumn, especially if usinsr evening milk, a slight allowance can be made the opposite way. " Forty per cent. Cream." — This can be purchased from any reliable milk vendor in cities. 5. ThermomeTEß.— A proper milk thermometer, marked with a red line at temp. 150deg. 6. Coolixg-BOX.— This can bo obtained ready made, or can be made at home at the cost of a few shillings. 7. Glass Measures.— Two graduated glasses to measure up to 4oz and 2Coz respectively. 8. FORMULA. A. 5 per cent. Sugar of Milk.— This is made by dissolving an ounce of sugar of milk in a pint of boiled water. S. Whey. — To make 15 ounces 01 whey pr.t a pint of separated milk, or flum milk, in a quart jug. Place this in a p?ucepan of hot water, and heat until a thermometer stood in the milk regi«tor a lOOJe-p Itemo-cve the jug from the saucepan, and immediately add one of Hansen's Danish rennet tabloids, or half a tcaspooniul of best rennet extract (the tabloids are «>afer and more reliable). ' Sur in well and stand until curd is quite set. Break up thoroughly with a clean fork, snd p'acc the jug again in the saucepan of hot water, anrl heat until the register 155deg. The curd will have sunk in a lump, and the rrnre whsy can now be pcured off. This we have found to be a simpler process end cleaner than straining through muslin, and, as it has been heated to Issdeg, the whey it. ready i for use i C. Humanised Milk. — To make a pint t-od a-half lake !New milk .... 6 oz "40 per cent, cream 2£oz Whey • 15 cz Lame water ... igO/t Sugar of milk 1 oz Boded water 5 oz The sugar of milk should first be dissolved in the boiling water and the whole of the ingredients should then be placed in a Mason's fruit jar or other suitable vessel, perfectly cleansed as before described. The jar should now be put in a saucepan of warm water, and the latter should be heated until a thermometer placed in the jar registers loodeg F. The jr.r should be \ loosely covered with a clean lid or cap to arrest falling particles, but 1

cot to prevent access of air. Af'er the jar has stood in cold water (preferably running water) for 20 minutes, it should be removed to a cooling box or cool safe. After 12 hours the unused remainder should be again heated to 155deg, and be quick'y cooled down as before. D. Simp'e Modified Coiv's Milk. — To make a pint and a half, take: New milk ... 10 cz Forty per cent, cream. . . 2oz Lime water v .. l^oz Sugar of milk l^cz Boiled water 16£oz Treat; as above. E. Oat Jelly. — Put 6cz of oatmeal into one quart of water; boil for 20 minutes, add waler enough to replace what has evaporated, and strain while hot through a thin white cloth. Where " -10 per cent, cream " is cot obtainable, mixture C may be made with ".12 per cent, cream." prepared as above described. The following formula "will then be used : — "12 per cent, cream ' .. . 9joz--WJisy .. . .- •• 15 cz Lime water l^oz Sugar of milk ."* ..» ... Icz Boiled water 4 oz Treat as above. Similarly mixture D may be prepared by using — " 12 per cent, cream" 10 oz Milk - 1 cz Lime water la oz j Sugar of milk ... .: .. l{oz J Boiled water . .. ~. ll^oz ; Treat as above. It is important to grasp the fact that whatever form of artificial fcod is used the mixture must always be heated to 155deg. Fahr. immedialelv it is prepared. TEe jar should be again heated to 155deg. FaV. at the end of 12 hours, because j more or less contamination is inevitablein the course of repeated handling, pour- ■ ing outj etc. | The question is often asked as to whether cream will rise properly after milk has been heated *o 155deg. Fahr. The. heating is found not to appreciably affect the rising of the cream. In specially warm : weather, if there is any doubt as to the freshness of the miJk, it should be heated at once when recerved, and then cooled , as quickly as possible, whether it is to be stood for the rising -of cream or not. General Rules f<3r Feedikg. The day feedings are supposed to begin at 6 a.m. and to end at 10. p.m. n « is 1 " £ ■ s -« . o •~ § *° « 5 " i Ills II 11 85.8 5. & & < First week .... 10 1 1 Second week 10 1 1$ Third week ... 10 1 2 Month to 2 months 9to 8 1 2* to 3J 2to 4 months . . 7 0 3J to 4£ 4to 6 months .. 7to 6 0 5 to 5J 6 to 9 months . 6 0 6 to 7 The above table shows how the intervals of feeding and the amount of food to begiven should correspond to the normal capacity of the stomach at different periods of the first year. Professor Rotch says : — " It is so important to avoid stretching so easily distensible an organ as the stomach that it is wiser to give too little rather than too much in the early days of life, and then gradually to increase the amount if the infant cries from hunger. : The first month is the most critical for the infant's nutrition. organism is then adapting itself to performing the , entirely new and complex task of digesting and assimilating food, and the chances of survival are then lowest. It is -*fiser always to accomplish first the- proper digestion of food, even if there is no gain in weight, and then, when once the infant I is digesting well, to increase the percentages of the different elements. 1 During the first 12 hours of life, and in most cases during the first 24 to 36 hours, owing to the inability of the mother to supply milk to her infant, scarcely any food is as a rule obtained. If during this ' period the infant is restless and evidently hungry, from one to two teaspoonfuls of the 5 per' cent, solution of milk sugar may be given at intervals of two or three hours. If the mother's milk is delayed still longer, something additional must be 1 eiven- Througkout the first week con- j tinue feeding with the sugar solution, but gradually add humanised milk (formula 1 C) in increasing proportions, so that when a week old the baby may receive equal < quantities of sugar mixture and humanised , milk. By the end of the second week j two parts of humanised milk may be ! given to one of sugar mixture, and by | the end of the third we^k three parts of j humanised milk to one of sugar mixture. From the end of the first month the , humanised milk may be given pure, and ' t'ois can be continued throughout the first nine months of life ; or towards the end of the fourth month, if the infant is strong and is digesting its food well, simple modified cow's milk (formula D) may with advantage be blended with the humanised milk in gradually increasing | proportions, until at four months and a-balf the child gets D mixture pure. I There should be no sudden transitions. The growing digestive organs should be carefully trained and gradually habituated to assume each new function. The natural development of" organs is a delicately adjusted process of orderly growth. ' Feeding Aftek Nixe Months. ■Whole milk should now be mixed with j th« modified milk in gradually increasing j proportions, so that when the child is a J year old further use of specially-modified milk is unnecessary. Professor Rotch save : "At about the tenth or eleventh month I usually begin to give at first one and then two meals daily of equal parts of oat ielly with plain cows' milk heated to 155deg Fahr., and add a little salt at the time of ,

feeding, according to th-s infant's taste. In the twelfth month accustom the infant to taking a little bread one day old with its milk, and to be fed from a spoon, so that by the time it is a year old it is taking bread and milk for its breakfast and supper, and cat jelly and milk for the three middle j meak." ' By whatever means an infant is fed, it ought to be weighed regularly at least every month to ascertain whether proper growth is taking place. No absolutely fixed standard can be arbitrarily laid down which will be suitable to all infanta and under all circumstances. "We can only give the average requirement, ]eav..ng it to the mother to make such slight modifications as may appear necessary or desirable from the appetite, condition, and weight of the child. If it is not thriving properly, obviously a doctor should be consulted. From its birth until five months old a baby should gain on the average from two-rhirds of - an ounce to one ounce per diem, .and from five months to a year okt one-third to two-thirds of an ounce per diem. The mother . 'should not worry 'about slight irregularities in the -rate of ' growth, because infants tend to put on weight more or less by fits and starts. Outline of Ordinary Course of Artifi- | cial Feeding from , Birth to Twelve j Months, Described in Detail Above. 1 1. For 24 hours — Five per cent, sugar of milk. 2. For one month — /Five per cent, sugar of milk. 1 t. Humanised milk. 1 3. For second to fourth month — I Humanised milk. ( 4. For a few weeks — j Humanised milk. I Simple modified cows' milk. 5. Fourth or fifth to ninth month — Simple modified cows' milk. 6. Tenth month — ( Simple modified cows' milk. \ Cows' milk. 7. Eleventh to twelfth month — Cows' milk etc. i "Vomiting and Diarrhoea. In any case where a b3by is suffering from illness a doctor should bs consulted, but if such aid be not available the general gohem© shown below will suffice _ for simple digestive disturbances. Habitual vomiting after feeding is usually due to the infant being given too - much food and being allowed to suck tro rapidly and greedily without interruption. The remedy is obvious. Attention should, of course, be .paid also to the habits of the mother, as affecting the quality of her*, milk ; or to the proper preparing of artificial fcod. Where there is diarrhoea it is best to ensur& cleansing of the bowels" by means of a dose of castor oil— "say. from ane to two drachms, according to the age o? the infant. The average requirement is an ordinary teaspoonful. Regimen for Babies Suffering from Indigestion'or from Ordinary Diarrbcei and Vomiting, Resulting from Improper Feeding. 1. For 12 hours — Water (boiled). 2. For 12 hoursFive per cent, sugar of milk solution. 3. For 12 hours— TFive per cent, sugar of 'nilk < solution. ( Whey.* 4. For 24 hours or more — Whey.* If continued beyond a, day make the whey of new milk, and add half an ounce of eugar of milk per pint. Further, the quantity for prolonged use should be one and a-half tinK 1 * as much as shown in the table " General Rules for Feeding." 5. For 48 hours or more—- ] Whey.* ( Humanised milk. * The whey in these three instances should be made from whole milk or from milk and cream. If made from skim milk the child would receive too little fat. 1 6. For 48 hours or more — j Humanised milk. Practical explanation and advice as to 1 the use of the eeyeral schemes outlined above can be obtained by application to Nurse M'Kinnon, care of Mrs Murray, 6t George street (entrance St. Andrew street) : telephone No. 724-. Diarrhoea is by far the most frequent cause of death in young children, and where it does not kill it often maims for life. As a chill is often the exciting agent, special attention should be paid to having infants sufficiently clad at all times, but not unduly muffled up. They are made very susceptible to cold by being kept too muck indoors, by living in stuffy, unventilated. overwarm rooms, and by wearing too heavy clothing, especially when in the hou£9. The question as to whether ordinarily strong children should have the legs and feet habitually clad after they can walk and have become fairly active is one upon which there is room for difference of opinion but there is no question that all delicate infants beyond the stage of long clothes should have suitable stockings. Undu« or untimely and careless exposure will not harden an infant, but will render it delicate and prone to catch cold. Quickness in bathing and in getting an infant dre«aed afterwards ia of great importance. Many chills are due to dawdling at the bath. Plenty of freah air anfl sunlight, Droper food" regular feeding, and regular habits are the true means by which to ensure strength and hardiness. Cleanliness and Prevention of Feementation. These are the first and last requirements for successful artificial feeding. The feeding bottle needs as serious consideration and attention as the milk itself. It is the main source of contamination, and should be capable of easy sterilisation. There must be no tube. The use of ordinary tube feeding bottles ie actually contrary to law in France and some other enlightened countries. Boat-shaped feeding bottles, open at both ends, and therefore most readily cl«aneed, are the best feeders obtainable. Whatever form ie used, it must be clearly understood that a child should be nursed while feeding, just as if it were suckled, to Ersve.ns und^e. h§stg t sucking-in of ftir, fto.