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The Management of Children Between the Sixth Month and Third Year of Age

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THE MANAGEMENT OF CHILDREN BETWEEN THE SIXTH MONTH AND THIRD YEAR OF AGE.

Breast-Feeding.----Up to the sixth month the child has either been nourished entirely by the breast milk, or by milk food given through a bottle, or by the breast milk supplemented by the bottle food.

By this time it may become necessary to make considerable additions to the diet, though there are plenty of cases where the mother is quite able to nourish the child from the breast exclusively up to the ninth or even twelfth month. If the mother requires only a little assistance to continue suckling the infant satis- i factorily, that assistance may be given in the form of bottle food once or twice daily. The time or times when the bottle is given may be arranged to suit the mother's convenience and duties. But whatever hours are arranged should be rigidly adhered to.

The bottle food should consist of "the milk mixture" of the strength and amount stated for a child of six months. But if, up to this date, the child has been wholly nourished from the breast, this strength and quantity should not be given right away ; a considerably weaker strength should be given for the first day or two, till the child's stomach becomes used to the change. Begin, let us say, with the strength and quantity suited for a child of three months; after two days' experience of its suitability give the strength and quantity suited for a child of four months. If this agrees, after another couple of days give the next strength, and so on.

If experience shows the strength and amount of "the milk mixture" suitable for a six months' infant to be barely sufficient, then add the oat flour, or plasmon, suggested on p. 566, and, be ginning with one tea-spoonful, find how much seems to satisfy the child best.

On the whole the addition of oat flour is best, because as the child grows older, and needs a more nourishing diet, the oat flour can gradu ally be increased, till the child gets so accus tomed to it that one may give it no longer through a bottle, but with a spoon in the form of oat-flour porridge.

The breast-fed child is thus gradually pre pared for weaning. Beginning with one bottle a day, let us say, it comes to have two, three, or four, according as the capacity of the mother to continue nursing gradually diminishes. So that by the time the child is nine or ten months old, nursing may be restricted to only a portion of the twenty-four hours, night only perhaps, while the child gets artificial food as indicated during the day.

If the mother objects to a feeding-bottle at all, it is, of course, quite easy to accustom the child to be fed with a spoon. But "the milk mixture" should be used, as before, strengthened or not with plasmon or oat flour. Indeed, if a child has been suckled up to six months, it is a pity to begin with a bottle, for at that age an infant can with little difficulty be taught even to drink out of a cup.

The infant will thus arrive at the age of ten or twelve months, being partly nourished from the mother's breast, partly by "the milk mix ture," strengthened, more or less, with plasmon or oat flour, given through a bottle, or by a spoon, or out of a cup. By this time, probably the child has one or two meals a day made of oat-flour porridge, such a meal being given by a spoon along with "the milk mixture" suitable for a six-months-old child. A sufficient meal at such an age would be a small saucer of well boiled oat-flour porridge (boiled with water) and barely a tea-cupful of "milk mixture". But a child who has been properly reared will itself give the best indication of when it has had a sufficient meal, and its appetite, if never forced, may be safely taken as a guide.

The regularity, already insisted on, as to times of feeding, quantities, character of food, &c., must be scrupulously maintained.

Further, if the child has become accustomed to the thicker spoon-food, rusk may be used as a substitute for the oat flour. If so, the heated milk mixture is poured on the rusk, and the whole beaten to a pulp.

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