CHILDREN'S DIET. At the end of the first year the in fant has passed from an entirely, or almost entirely, liquid diet to one which includes solid food, and yet not to the same degree nor of the same sort as is given to older children. During the second year, and often during part of the third year, an impor tant factor in determining diet is the progress of dentition; foods which require thorough mastication are clearly unsuitable before the molars are present. On the other hand, it is good that the child should be trained to masticate as early as possible, so that even before the molars are present, solids which crumble easily, e.g., rusks, biscuits and stale bread are good. At the end of the first year the child should have reached a regime of three meals daily, with a drink of milk in the middle of the morning.
Up to the age of three years milk continues to be the most important item in the diet : 1 ? pints, exclusive of puddings, should be taken daily. Eggs are also of great value, but must be intro duced cautiously into the menu, as some children show an idio syncracy to eggs, which produce in them various untoward symp toms. Milk and eggs are rich in the bone-forming lime salts; they are also rich in the growth-promoting and antirachitic vitamins. Another food which is of importance and is, fortunately, a favour ite with most children, is potato, which, cooked though it is, supplies very richly the antiscorbutic vitamin ; potatoes should be baked in their skins and given thoroughly mashed.
Bread.—At a year old, bread may also form part of the diet, whether as milksop, or bread with butter. For children from one to three years of age it is better to use white bread ; older children may have brown occasionally; the amount of indigestible residue from brown bread acts as an intestinal irritant, and young children are specially susceptible to the irritation of un digested material in the bowel, very easily contracting therefrom a mild mucous catarrh of the bowel, which interferes with absorp tion. Children are almost always fond of biscuits, and these supply carbohydrate (starch and sugar) in a very easily assimi lable form, especially if the biscuit is of a variety which crumbles easily and finely under pressure. Hard biscuits have been recom mended as encouraging mastication ; the finely crumbling biscuits have been thought harmful, as they cling about the teeth; a tooth-brush, however, can remove this objection.
Sugar.—Sugar is needed by children. The starch which is taken in bread, potatoes, and many other foods has to be converted into sugar in the body, and sugar, given as such, is a ready source of energy; childhood, with its ceaseless activity, needs a large supply of energy. On the other hand, excess of sugar results in unhealthy fermentative processes. Nature has included sugar in milk, so that very little should be added to foods made with milk. There is also natural sugar in ripe fruits, but cooked fruit, which is usually not fully ripe, should have sugar added to it. There is no objection to the addition of a little sugar to bread and-milk, or to porridge, or sprinkled on bread-and-butter. Treacle also, and jam or honey are valuable. The eating of sweets be tween meals is bad : it tends to destroy the appetite for meals. The best time to give them, if at all, is just after a meal, and those made with plain sugar are less upsetting to the digestion than chocolate.
Fruit.—The juice of raw fruit is a pleasant addition to the diet, and is necessary if the child is not having potato ; but for any child who is having an ordinary allowance of potato daily, fruit juice is unnecessary so far as vitamins are concerned. Fruit has, however, other values, in its fruit-sugar and salts, and, more over, is sometimes useful for its laxative effect. The solid part of raw fruit is not suitable until the child begins to masticate well ; fruit such as an apple requires very thorough mastication. Bananas are often given to children at 18 months, or even earlier, but even mashed they are not easy of digestion. Most children are fond of them, and if the digestion will stand it, a mashed ba nana may be allowed occasionally at 18 months. The real value of apples and pears and many other fruits lies in the mineral salts which are combined with citric, tartaric and matic acids and, being converted into alkaline salts in the body, furnish alkali to the blood. Grapes are often given in the second year. They supply sugar and mineral salts and, like oranges, provide antiscorbutic vitamin. The skin and pips should be removed ; even the sub stance of the grape itself sometimes causes trouble and can be seen almost unaltered in the stool.
Meat.—The age when meat may be given depends largely upon the stage reached in dentition ; finely minced meat is often given to children at 15 months, but the finest mincing is not a substitute for chewing, and it is wiser to wait until all the teeth are present. Red gravy from lightly cooked meat, especially beef, will supply all that the child needs from the meat, and two or three tablespoonfuls of red gravy with potato will make a suitable first course for dinner. Steamed fish, such as sole or plaice, which breaks up into shreds with slight pressure, or chicken pounded into a cream, or brains mashed, may be given when the child has at least 12 teeth.
Soups or broths are often given in the second year as part of the midday meal. For occasional use this is not objectionable, but the nutritive value of any soup or beef-tea is extremely small; if potatoes, peas or barley are included, the value of the broth is chiefly the value of these. Some have advised that in the prepa ration of broths, broken up bones should be added, perhaps with a small amount of vinegar to help in dissolving out the lime salts. These salts, however, are much better supplied in milk and eggs, and in general, broths or soups give very little nutrition in proportion to their bulk, which distends the stomach and often prevents the taking of more valuable food.
Vegetables.—Green vegetables are valuable chiefly as supply ing mineral salts, especially of potash; they also tend to prevent constipation. Much of their value is lost by the ordinary method of boiling; steaming is preferable, as less of the salts are lost thereby. Spinach has the further value that it contains some iron, which may be of use in blood-making. Carrot is highly in digestible, and has no special virtue apart from being rich in sugar, and is best avoided. Turnips are much less indigestible if well mashed, but of very little nutritive value. Watercress and raw lettuce have very small value as food, and as purveyors of vitamin they are superfluous in any ordinary diet.
All the farinaceous milk puddings, junket and custard, are valuable at any age from a year onwards. For children of two years and more, light suet or bread-and-butter puddings are excellent.
From Three to Five Years.—Much of what has been already said applies equally to children of three to five years. From the completion of dentition to the age of five, the dietary may in clude, in addition, bacon—fried or cold boiled—bread fried in bacon fat, any fish except salmon and mackerel.
For breakfast, dry cereal preparations, already cooked, are now much in use ; they require an amount of mastication which few children will give, and should not be allowed to replace the much more valuable egg, bacon or fish ; porridge or bread-and milk are much better than these dried cereals. Meat and chicken can be given without mincing or pounding: indeed, the child should learn to masticate them. There is no objection to cakes, if not too rich—sultanas are better than currants, and a plain madeira or a ginger cake is best. Milk is the best drink, and the total amount daily should be 1-14 pints, exclusive of any used in making puddings, etc. At dinner, water should be given, and the child should be allowed water between meals. Cocoa, ovaltine, or very weak China tea may also be allowed.
The diet of a child should be as varied as possible, and this for two reasons : First, that a proper balance of the essential con stituents of food may be maintained, and secondly, to prevent monotony, which is bad both for appetite and digestion. A diet well-balanced in the proportions of the various constituents is essential to good health. (G. F. S.) BIBLIOGRAPHY.—United States Children's Bureau, "Nutrition work for pre-school children," Bureau Publication No. 138. (1924) ; L. E. Hogan, How to Feed Children (11th ed., 1926) ; L. E. Holt, Care and Feeding of Children (8th ed., 1916), and Food, Health and Growth (19a 2) ; United States Department of Agriculture, "Food for Young Children," Farmers' Bulletin No. 717 (1920) ; L. H. Peters, Diet for Children (1024) ; E. Pritchard, The Physiological Feeding of Infants (1919) ; F. H. Maccarthy, The Healthy Child from Two to Seven (192 a) ; D. N. Paton, Poverty, Nutrition and Growth: studies of child life in cities and rural districts of Scotland (1926) ; L. H. Gillett, Adapt ing Nutrition Work to a Community (1924), "Diet for the School Child," Iowa University Extension Bulletin No. S7 (1919), and "A sur vey of evidence regarding food allowances for healthy children," New York Assoc. for Improving the Condition of the Poor, Pub. No. 115 (1917) ; H. R. Baldwin, Nutrition and Health (1924) ; B. W. The Mother's Cook Book (1926) ; T. Clark, Indices of Nutrition (1923) , a reprint from the U.S. Public Health Service Reports, Vol. 38, No. 23 ; K. McHale, Comparative Psychology and Hygiene of the overweight Child (Teachers College, Columbia University, Contribu tions to Education, No. 221, 1926) ; L. J. Roberts, Nutrition Work with Children (5927).