Cows' milk, then, can be made to resemble human milk 1. By dilution with water ; 2. By the addition of cream and sugar ; 3. By a small quantity of bicarbonate of soda.
Experience, however, shows that such a mix ture is somewhat constipating to many chil dren. This fault is, in a great majority of cases, corrected by substituting pure golden syrup for cane or milk sugar.
One other point remains. When a child is nursed at the breast the milk of the mother passes straight to the child without exposure to the air, and is, therefore, free of those living organisms which exist in the atmosphere and are sown in myriads into any fluid exposed to the air for even the briefest time. An arti ficially prepared milk, on the, other hand, will contain these organisms in an active condition, unless it be boiled, or brought at least near to the boiling-point, and thereafter kept in per fectly clean and covered vessels. The heating, however, tends to add to the constipating effect.
The rules for preparing cows' milk as a sub stitute for mother's milk will now be clear. Let us summarize them :— 1. A definite quantity of water is added to a definite quantity of cows' milk to reduce the proteid to the proper proportion and to hinder the proteid coagulating too quickly, and in too large pieces, in the child's stomach.
2. A pinch of bicarbonate of soda is added.
3. Definite quantities of fresh cream and golden syrup are added to bring up the fat and sugar to the proper standard.
4. The mixture is brought nearly to the boiling-point.
But it is desirable to give the child the same strength of mixture at each feeding-time. If the supply were made each time the child was fed, the strength would not be so uniform as it would be if the whole day's supply were made at once. Therefore the amount necessary for each day is calculated and made all together in the morning. To secure it from deposit of atmospheric organisms, the day's supply should ;.;e kept in a properly scalded jug, carefully covered, in a cool place. As, however, cream is materially altered by heating, and, besides, it rises to the surface on standing, and so the clay's supply would have to be shaken thor oughly each time the amount necessary was removed for the child's feeding, it is better not to add the cream to the mixture, but to add the necessary proportion direct to the feeding. bottle each time.
If these principles on which artificial food is prepared are thoroughly understood, we shall be met with the two following questions:— I. How much does the infant require daily? 2. What is the amount of each ingredient hi the day's total? We shall proceed to answer these questions, but one very important fact must be noted first. The milk of a nursing mother undergoes some slight changes during the progress of nursing, but on the whole the milk does not grow richer. As the child grows older it grows
also bigger, and needs a larger supply of nour ishment; but this is not met, on the part of the mother, by a milk of stronger and stronger quality; it is met by a simple increase in amount.
If, therefore, one can decide on what should be the standard strength of milk for the infant of one day old, it is not necessary to go on con tinually changing it, it is only necessary to give more as the child grows ; the same mixture will do for the ten-day-old baby, though the latter will take more at each meal. This is a broad statement that is worth remembering, and is not inconsistent with the fact that as a matter of convenience, it is advisable to increase the strength of the mixture from time to time, for reasons that will be stated immediately.
The Quantity of Food required daily by an infant. This is answered by going back to breast nursing. For the first three days or so after birth the infant gets very little from the mother, and in consequence it falls off in weight. The first day it probably gets no more than 1 or 2 ounces, the second about 5 ounces, the third about 8 ounces, the fourth about 10 ounces, the fifth about 11 ounces, the sixth about 124 ounces, and the seventh about 134 ounces, and by the end of the second week about 17 ounces. Thus the total supply for a day will be— Let us take 20 ounces, that is 1 pint, or 2 tumbler or 4 tea-cupfuls, as the amount to calculate by ; the question now is, what proportions of milk, water, &c., are required to make up this 20 ounces? Proportion of Ingredients in Infant's the standard of mother's milk, already stated (p. 563), we should make up a mixture containing about 14 per cent proteid, 3 per cent fat, 6 per cent sugar, and 1. per cent mineral substances. But, as a matter of experience, it is unwise to begin right away with a full-strength mixture, doubtless because there are other differences between mother's milk and cows' milk that cannot be expressed by percentages. Experience shows that what agrees best is a mixture containing about half that proportion of proteid, and every two weeks or so to increase it, till by the end of the third month the child's milk is made half of water, half of cows' milk, with the addition of cream and sugar, and at the end of the sixth month cows' milk diluted with a quarter of water is used. The mixture made for the first week the writer is in the habit of calling the milk mixture. Taking it as the standard, it is easy from time to time to strengthen it, and we shall now proceed to give the details as to quantities.