ARTIFICIAL FEEDING OF INFANTS Artificial feeding, in distinction from natural and mixed feeding. means that an infant does not receive any mother's milk during a part or all of the period in which it should he nursed. The artificial feeding may be instituted immediately after birth, or after an infant has received the breast exclusively or partly for a longer or shorter time. While it is relatively easy to rear artificially a healthy infant five to six months of age, after it has been gradually weaned, experience has taught us that exclusive artificial feeding from the time of birth can rarely be accom plished without more or less severe disturbances. even when the great est care is exercised. Fortunately this feat has only rarely to be accom plished, since the majority of infants receive the breast during at least the first days and weeks.
Naturally, the feeding at the breast serves as a prototype for the arti ficial feeding. The increasing knowledge of breast-feeding has made it possible --as has been pointed out previously—to replace rough experi menting by more rational methods. As a result, the feeding has become more successful. The investigations of recent years have clearly demon strated that mother's milk cannot be replaced, and the opinion which was still heard a few years ago, that it might finally he possible to ob tain just as good results with artificial feeding. has been shown to he erroneous. It must be stated, however. that generally the results of artificial feeding, at least in infants who received the breast during the first weeks or months, have been very good, provided the artificial feed ing was conducted carefully by competent persons. Faulty methods are more often responsible for bad results than is the artificial feeding itself. Ebert showed that the artificial feeding was faulty in 9.5 per cent. of the cases which were admitted to the dispensary of Ileuhner. It would be entirely erroneous to assume that all the difficulties could be over come by slavishly imitating the breast-feeding, and that every new discovery in the field of natural feeding must be applied immediately to artificial feeding. Such errors have been made, and led, for instance,
to the production of Dr. Rose's artificial milk. The correctness of the method to be used can be measured only by determining whether the results approach as nearly as possible those obtained by the natural feeding. The growth of the infant forms one of the most important and most striking indications of its nutrition. Regular determinations of the body weight and of the length are of the utmost importance in the con trol of artificial feeding, particularly during the first weeks of life and in delicate infants. Certainly the weighing must be done in a manner free from objections, and it is best to weigh at definite times, in the morn ing before feeding. without clothes or with always the saute light clothing. Tt must be remembered that gain in weight is not always a sign of thriving.
uniform method, which must be adopted in every ease of artifi cial feeding, does not exist. This fact is frequently cited at present to prove our lack of sufficient knowledge, but it simply shows that an infant may be reared by different methods.
In presenting a metabolism balance of the breast-fed infant, the conditions necessary for a successful feeding were explained. Artificial feeding twist so far approach breast-feeding that the digestive organs can dispose of the food without too great an excess of work, or at least that they are not injured by the food. It is necessary also that a suffi cient amount be absorbed of those substances that are needed for the sustenance and growth of the body, and, moreover, the requirement of energy has to be met. Only the breast-milk fulfils all these conditions in an ideal manner, hat different methods of artificial feeding may re spond to the demands more or less. The choice of method must be based on a careful consideration of the individual case.