If phumion or sanatogen be used, it is not necessary to boil it separately. It is only necessary to add one or two or more tea-spoon fuls to the milk mixture and boil all together. These two are milk products; they represent the proteid of milk in fine powder, and their addition to the milk mixture increases the nutritive value of the mixture without adding to its bulk.
But such additions should be made to the milk only if it becomes quite clear that the milk mixture is insufficient for the infant's nourishment. It is here the intelligence of the mother or nurse can be usefully employed.
For every infant varies in the amount and nutritive value of the food it can usefully con sume. The quantities that have been stated should be sufficient, and indeed slightly more than sufficient, for 99 out of every 100 infants. But the odd case does arise when it becomes apparent that a richer food is called for. The ways mentioned are the simplest in which it may be supplied.
Exceptions in Infants' Diet are every now and again met with. That of the child, who takes little and that very dilute, and who, therefore, requires to be fed oftener, has been already noted. But there are children with whom it is difficult to make cows' milk agree, because of the rapid curdling of the milk in large pieces. The child may be a perfectly healthy vigorous child, to whom it is difficult to give as ranch as it wishes because of this peculiarity. If the directions given are care fully followed, the number of such children will be found to be very few, far fewer than most people think. Before deciding, therefore, that cows' milk, prepared as directed, does not agree, let the mother or nurse carefully investi gate the preparation of the milk to make sure no mistake is being made.
In such a child the little masses of curd will be found in the stools, and the child will suffer from wind and colic and have violent fits of crying. If such a child has been getting the strengthened " milk mixture" when these symptoms appear, it will be better to go back at once to the most dilute mixture, and to give smaller quantities at shorter intervals. In fact an attempt should be made to find how small a quantity is necessary to avoid the symptoms.
The smaller it is the more often it must be given. When the small quantity is begun, also, a tea-spoonful of castor-oil should be given to clear the bowel of the curdy masses. If a quantity is found which agrees, it should be very gradually increased, and the intervals between feeding proportionately lengthened, till the child's capacity to deal with the full quantity at the regulation 3-hour intervals is restored.
If this manoeuvre does not succeed, the addi tion to " the milk mixture" of something which hinders the curd forming in large pieces may get over the difficulty. Arrow-root and all such starchy substances are entirely unsuited for infant feeding, but for this special purpose, and for this purpose only, a little may be used. First mix the ingredients of "the milk mix ture", but do not heat it. Then boil a small tea-spoonful of arrow-root in the smallest quan tity of water that will answer, two or three table-spoonfuls will do. When it is cooked, add slowly with constant stirring "the milk mixture" till the whole is just at the boiling point. The fine particles of cooked starch pre vent the curd forming in large pieces.
The same result may be obtained by using fine oat-flour instead of arrow-root, but it must be boiled for ten minutes before "the milk mixture" is added. Biscuit-powder might be used for the same purpose, or a tea-spoonful of the powder made by rolling a tea-biscuit of good quality into fine powder with a rolling pin. If the difficulty still persists, "the milk mixture" may be partly digested by the use of what are called peptonizing powders. These are described in Vol. II., p. 137. It is necessary here to note only that the ingredients of "the milk mixture" would be mixed as directed, with this single exception, that one of the tea cups of water should be boiling. Into the mix ture thus made it would be sufficient to stir quarter of a peptouizing powder ; the mixture would then be set where it would remain at the heat imparted to it by the cupful of boiling water. After ten minutes it should then be boiled for one minute.