When it is necessary to bring up a child by hand, the greatest care and accuracy are re quired in the preparation of the food.
There is now in the market a very large number of foods for infants, to which the mother or nurse who thinks more of her own ease than her child's welfare is apt to turn, because their preparation seems so simple. But there are several serious objections to the use of any- such prepared foods. They have a definite composition, which is not always stated, and which, if it is suitable for one age, is not for another. One cannot always have a guarantee that they are quite fresh, and once the package is opened they are apt to undergo changes. They are also comparatively expen sive. On the other hand, cows' milk is nearly always available; it is cheap when one con siders that a halfpenny's worth will supply the daily amount needed by a newly-born infant for the first week or two; it can usually be had fresh twice daily, and when treated in a certain way it can be kept for a time unchanged. During an experience of twenty-five years the writer has abandoned the use of prepared in fants' foods, one after the other, and finds prac tically no difficulty in so preparing cows' milk as to meet the needs of every child without exception.
For successful artificial feeding the following conditions must be fulfilled: 1. The food must resemble mother's milk as nearly as possible.
2. The food must be given at stated intervals with absolute regularity.
3. A similar amount should be given at each feeding.
4. Each supply should have the same com position as every other.
The opposite of these conditions is seen when a mother or nurse follows no rule, feeds the child whenever it cries, is never ready, but mixes in a hurry some milk and water, adds some sugar by rule of thumb, and takes a pull at the bottle herself to see that it is not too hot before thrusting the teat into the child's mouth. It is no wonder that children so fed suffer from colics and diarrhoea.
Mother's Milk itself varies in composition. It contains the same ingredients as cows' milk, but in different proportions. These ingredients are :— 1. Proteid or albuminous (flash-forming) material; 2. Fat in the shape of cream ; 3. Sugar in the form of milk sugar (lactose); 4. Mineral substances—phosphate of lime, &o.; and the proportion in which they are present may be taken as represented by the following percentage figures:— Now cows' milk contains much more proteid and mineral matter, a little more fat and much lees sugar, so far as mere quantities go, but there are also other differences.
One of the chief of these other differences is that cows' milk tends to curdle in mass, while human milk curdles in fine flakes. But this curdling is the first part of the digestive pro-. cess, and one can easily understand what an enormous difference it will make to the child's digestion whether the milk it takes at a meal curdles all at once into large pieces, or only slowly into fine flakes. The curdling process is due to the proteid being in solution in the milk and to its being precipitated by the action of the stomach juice. Now human milk under goes this process more slowly, partly because the proteid is somewhat different in character in human milk, and also partly because human milk is alkaline, while cows' milk is slightly acid. But when cows' milk is largely diluted, and is made also slightly alkaline by the addition of a very little bicarbonate of soda, it is made to coagulate more slowly and in smaller pieces.
Cows' milk, then, can be made to resemble more nearly human milk by dilution with water and by the addition of a little bicar bonate of soda.
But when sufficient water has been added to secure these ends, the mixture contains too little fat and much too little sugar.
This is corrected by the addition to the mix ture of fresh cream and a considerable amount of sugar, cane-sugar, or, still better, milk-sugar.