Each ounce of a 10-per-cent. cream in a 20-ounce mixture means that the result ing mixture will contain 0.5 per cent. of fat, 0.2 per cent. of proteids, and 0.2 per cent. of sugar, and each tablespoon ful of sugar of milk added to this will raise the sugar 2 per cent. If it is de sired to increase the proteids this is done by adding milk from which the cream has been removed, thus giving no more fats, but an added amount of pro tcids. By using the upper half of top milk one obtains a mixture which con tains but a little more than 7 per cent. of fat, and this can be used to make mixtures containing relatively high per centage of proteids. Townsend (Boston Med. and Surg. Jour., Mar. 23, '99).
It is of great importance to increase the percentage of proteids in the milk as rapidly as the infant can digest it, but also to avoid commencing with too high a percentage. One should begin with only 0.25 or 0.5 per cent. of proteids, and increase it rapidly, so that, in many instances, the food ill contain 1.5 per cent. of proteids at the end of the first six weeks. This is the key-note to suc cess in the artificial feeding of infants. L. Emmett Holt (Phila. Med. Jour., Mar. 24, 1900).
Bottles and Nipples.—Graduated cylindrical bottles, with wide mouths, are generally preferred, being easily cleansed. The best nipples are those of plain black rubber which slip over the neck of the bottle. On no account should a nipple with a long rubber tube be used. The hole in the nipple should not be large enough to let the milk run in a stream when the bottle is inverted. Bottles should be boiled before the food is put into them; and both bottles and nipples thoroughly washed after use. Nipples should be kept in a borax or boric-acid solution.
The feeding question is at the root of the great mortality of infants; but of almost equal importance to the health of the child is the receptacle from which it takes its nourishment, viz.: the nursing bottle. A bottle furnished with a long
rubber tube has been justly condemned, as it is an impossibility to keep the tube clean; and, therefore, the child draws impurities into the mouth, which, on ac count of its warmth and moisture, is one of the most*prolific parts of the hu man anatomy for the propagation of every species of microbe. Henri de Rothschild (Med. Times, July, '98).
lit Iculty experienced in feeding I ? eau, of a spoon children Wit 11 cleft a aft in the hospitals led to personal .t ito of a nipple \\ W 011id obviate tl is. The modification in the nipple ton-ists in the attachment of a "wing" of she( t lubber. which tills the cleft dur ing the act of suckling. \Vit.') the ordi nary rubber nipple this device does 110t NS Ork well. because of the collapse of the nipple. By putting the attachment on the "non-collapsible nipple" the desired ubject is accomplished. S. Lloyd (Pediat rics, Mar. 1, 1901).
Rules for Artificial Feeding.
The rules as to frequency and regu larity of feedings are more important with bottle-fed than with nursing babies. The table given below will serve as a guide. Just before feeding the food is heated to body-temperature by placing the bottle in a vessel of bot water; a bottle should not be warmed over for a second feeding. Twenty minutes is lung enough for a feeding; no child should be allowed to sleep with the nipple in its mouth.
is the milk enters the child's mouth from the breast of the mother, its tem perature is always below 98° F. It usually varies from 96.5° to 97° F. It is evident that milk given to children should not be heated above these tem peratures. 8mester (Maladies de l'En lance, No. 15, '97).
54ehedule for feeding healthy infants during. the first year:— The Use of Other Substances than Milk during the First Year.
Besides the ingredients of modified milk, the only other foods to be given during the first year are beef-juice and the fruit-juices.