MIXED FEEDING (ALLAITEMENT MIXTE) When the secretion of milk is not ;sufficient for the demands of the infant from the time of birth or later, or when other reasons (for instance, external circumstances) do not permit the baby to have the required amount of mother's milk, it becomes necessary either to give artificial food in addition or to raise the infant on the bottle entirely. In Ger many until a short time ago the latter method was generally adopted, because it offers certain advantages, due to its greater uniformity, and to the fact that many children do not like to nurse after becoming acquainted with the more convenient drinking from the bottle, which fact exercises au unfavorable influence on the secretion of mill:. Fortunately, circumstances have altered since French observers have shown that mixed feeding may be carried out in many cases with good success. It is surprising how' frequently the secretion of milk can he kept up to a satisfactory amount for many months, even when the mothers are not able to nurse the baby during the day-time. It is important to make the drinking from the bottle more difficult by providing a nipple with fine holes (the use of suction tubes, or of a suction apparatus which can be regulated, is not advisable), and to make the baby more eager for the breast by relatively long intervals bet ween bottle- The quantity and the composition of the ;ulditional food is regu lated according to the age, weight, and state of health of the infant (see the chapter on Artificial Feeding), and furthermore depends on the amount of available mother's milk. This has to be determined care
fully. Under certain conditions one bottle-feeding will suffice, while in other eases perhaps only one breast-feeding can be given in 21 hours. The different meals should alternate as far as possible and should be separated by corresponding intervals; if the secretion of milk is very scanty and the infant is strong. the breast and the bottle may be given at the same meal, but under such conditions the amount of mother's milk taken should be determined.
During the first weeks of life the mixed feeding is of the greatest importance. The younger the infant. the more valuable is each drop of human milk. In this period the majority of women are capable of nursing. Not infrequently it is even possible to return completely to the breast-feeding. Czerny and Keller emphasize this advantage. that by this plan the mothers may become convinced of their ability to nurse.