Pasteurization does not change the taste nor make the milk constipating, nor does it render the casein less diges tible. -Whether pastenrizing the milk changes it so that scurvy may result is not determined; certainly the danger is so slight that it may be disregarded.
Pasteurization is recommended in all cases during the warm months. Steril ization is advised only for use among the very poor, in cities during very hot weather, in any place where ice is not obtainable, and for transportation on long journeys. In cool weather, with a fresh, clean milk-supply and plenty of ice, neither method is necessary.
Investigation of the milk-supply of New York City shows that both in win ter and summer the ordinary commercial milk upon its arrival in the city is within the incubation-period, this stage lasting 24 hours in winter, 13 to 17 hours on a fairly cool day, and 5 hours on a hot summer day, after reaching the city. This milk is therefore considered fit for infant-feeding, if prepared early in the day. On a warm summer day pasteur ized milk had a fairly stationary acidity for from 10 to 12 hours, the acidity tben rising slowly until at the end of 24 hours the milk was curdled. The growth of the bacterium lactis was thus retarded about 6 hours as compared with unions tetiru,ti milk. On the other hand, stern it at from 90' to 92° C. for 40 min s. hile makitig the milk far from ah. Intely sterile. rendered the bacterium 1.u:its inert for 2 days at least. at a .uninitr temperature. It may therefore be eoncluded that without subsequent rarigeration pasteurization in summer do,a not offer a safe means of preparing milk for Emily Lewi . N. Y. Med. Jour., Feb. 9, *95).
Since using pasteurized milk, the death-rate from diarrhceal diseases in Brooklyn has been lower in 1896 and P497 than it had ever been. George P. West 4San. Record, Nov. 26, '97).
While neither sterilization nor pas teurization renders the milk more di gestible. so many dangers of gastro-in testinal infection are removed by their use that they are to be rezarded as valu able safeguards.
Number of eases of mild milk-infection noted occurring among children fed upon pasteurized milk or milk-mixtures. The
peratnre of at least 194° to 198° or 212° F. for ten minutes. It should be rapidly cooled and kept below 20° C. till ready for use. Koplik (Med. Rec., Feb. 19, '98).
Modification of Milk for Healthy In fants during the First Year.
Not all infants, even those who are healthy, can be fed in the same way. The problem, therefore, is to make a food in which the quantity of each in o-redient—fat, sugar, and proteid—shall be known, and in which, also, these quantities can be separately varied so as to suit the individual child. At present the percentage method has come to be generally used by those who have had the greatest experience in the feeding of infants.
The following table may be taken as a general guide for feeding a healthy in fant of average weight by the percentage method. The schedule shows the per symptoms are sometimes insidious; sometimes marked and troublesome. In some cases there will be first a looseness Qf the bowels; the movernents suddenly increasing to 5 or 7 per day, and are curdy and acid. There may be some fever. In other cases the green acid stools will disappear after a dose of castor-oil. Again, several normal stools may be followed by a semifluid, ex tremely-acid stool and the child be very. weak. or there /nay be simply no gain in weight and rather fluid stools. All these cases improve rapidly under a change from pasteurized to sterilized I milk. Milk should be heated to a tem- I centage of fat, sugar, and proteids, and the daily quantity.
During the first month of life an aver age infant requires about ten feedings of front 1 to 2 ounces daily. During the second and third months from 2 to 4 ounces, and so on. As the amount is increased the number of feedings must be reduced and the interval between each lengthened.
An average formula for a healthy in• fant during the first week of life would be: fat, 2.0; sugar, 6.0; proteid. 0.6. The percentage may then be gradually increased to reach; fat, 3.0; sugar, 6.0: proteid, I.0, by the end of the first month. By the third month a healthy infant thrives well on a mixture such as: fat, 4.0; sugar, 7.0; proteid, 1.5.