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

child, milk, pm, mixture, bottle, mother and am

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In the case of such substantial meals, a longer interval should' elapse between one meal and the next.

The diet of a child of between ten and twelve months, not yet weaned, comes therefore to be something like the following Between 4 and 5 a.m.: A drink from the mother.

8 a.m.: Oat-flour porridge, with 4 ounces "milk mixture" of a strength suitable for a six-months' infant.

12 noon : The child may be nursed, or may get a bottle of "milk mixture," strength ened or not, as seems necessary, by oat flour or plasmon.

3 p.m.: A bottle similar to what may be given at 12.

6 p.m.: A bottle as at 3 p.m.

9 p.m.: Oat-flour porridge as at 8 a.m.; or rusk and milk mixture.

This child will probably sleep till 3, 4, or 5 iu the morning, and when it wakes will be nursed. If the child has been well trained, and the food is -given late at night, the mother's rest should not be disturbed more than once; and the above arrangement also frees her at mid-day for other duties. If she still produces so much milk that her own comfort demands more frequent nursing, then suckling at 6 p.m. may take the place of bottle.

Weaning should be effected when the child is ten or twelve months old, the exact time being dependent upon the health of mother and child. It will be begun earlier if the mother is suffering from nursing, and delayed till later if the child is weakly and the mother able to bear prolonged nursing and having good milk. The period named is generally chosen because the child usually has about that time an interval of rest between cutting the front teeth and the first of those at the back. It is often a process involving some trouble to the mother and discomfort to the child, but, if the above directions as to feeding have been observed, the child will really have been in preparation for it since the sixth mouth, and much of the difficulty will be overcome. Weaning should not be allowed to take place if the child is suffering from the irritation of late teething, from any cold, or feverish attack, or trifling illness, but the mother should wait till that has passed off. The process should be performed gradually ; as the breast-milk is withdrawn its place should be supplied by other appropriate nourishment, such as has been already sufficiently indicated.

Artificial Feeding, after six months, should occasion no difficulty 'whatever, if the directions given up to that month have been carefully followed.

"The milk mixture" suitable for a six. months-old child is gradually strengthened by the use of oat flour or plasmon or sanatogen just as indicated on p. 566 Soon this becomes too thick to pass through a bottle, and then the child is accustomed to the spoon and the oat-flour porridge, or rusk-and-milk mixture, as noted on p. 575, varied with less thickened "milk mixture" given by bottle or cup.

When thicker spoon-food is given only once daily, it is best at the bedtime of the mother or nurse, for then the child is likely to sleep all night, or, at the most, to require only a sip of the "milk mixture" from a cup.

For an artificially-reared child, between ten and twelve months old, a diet, suitable to the child and convenient to mother or nurse, would be— 6 a.m.: "The milk mixture", of the strength suitable for a six-months-old child, thickened or not, as seemed necessary, by plasmon or oat flour, and given through bottle or by cup. (This would have been prepared the previous night.) 9 a.m.: The same as at 6 a.m., but freshly prepared.

12 noon : Oat-flour porridge and "milk mix ture." 4 p.m.: A bottle of "the milk mixture" pre pared in the morning.

7 p.m.: The same as at 4 p.m.

10 p.m.: Oat-flour porridge or rusk and milk (as noted on p. 575).

The fuller meal, given the last at night, is likely to secure an all-night's sleep, but there can be no objection to giving it at 7 instead, just after the child has been bathed for the night, and then delaying the final meal—taken out of bottle or cup—till the child wakes spon taneously about 10'30.

But there is no magic in the hours or the order named above. One arrangement will suit one child better than another, and dif ferent arrangements may suit the child and be more convenient for the household in general.

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