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Infantile Atrophy

milk, child, cows, infant, curd, diet and difference

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atrophy, or the slow which is a familiar symptom in hand-fed babies, is one of the commonest causes of death in early infancy. The child ceases to digest his food—possibly he has never begun to do so ; gradually dwindles away, and after a longer or shorter period, dies with all the symptoms of starvation. This condition, which, under the name of " marasmus," finds a large place in the mortality returns of all countries, is a perfectly curable complaint, and may be arrested at almost any stage by the exercise of judgment and care in the feeding and general manage ment of tliP infant.

Causation.—Infantile atrophy is the consequence of insufficient nourish ment. The child wastes because he is starved. But it is not to actual lack of feecling that the starvation is usually to be ascribed. A baby fed from a breast which secretes milk poor in quality and insufficient for the child's support, will, of course, grow slowly thinner ; but an infant sup plied largely with farinaceous compounds from which his feeble digestive organs fail to derive even a minimum of nourishment, will waste with start ling rapidity. Starvation is then a relative term. The tissues may be starved, although the stomach is regularly filled. In every case, the nutri tion of the infant is dependent upon his power of extracting a sufficiency of nourishment from his so-called "food." It may seem unnecessary to insist upon so self-evident a matter ; but in practice it is common to find a diet persisted with which the infant's stomach rejects, or his tissues fail to assimilate. Many a baby's life is sacrificed through the inability of those about the child to understand that feeding and nourishing are not quite the same thing.

For efficient nourishment, four classes of substance are indispensable, viz., albuminates, hydro-carbonates, fats, and salts. It is further necessary that these should be presented to the child in such a form that they can be digested with ease. The most perfect food for infants—the only one, in fact, which can be relied upon in itself to furnish all these requirements—is milk. Milk contains nitrogenous matter in the curd, fat in the cream, be sides sugar and the salts which are essential to perfect nutrition. In the milk of the mother or of a good nurse the new-born infant finds these ele ments combined in exactly the proportions best adapted to supply all the wants of his system. In the milk of animals, the proportions deviate more

or less widely from the human standard. Cow's milk, especially, contains a larger proportion of curd and cream than is found in human milk, but less sugar ; and although to an exceptionally sturdy infant this difference may be immaterial, for a child of ordinary powers it will be necessary, by suitable preparation, to bring the milk into closer resemblance with the natural diet of which he has been deprived.

The chief obstacle to the digestion of cove's milk by young babies is not, however, the mere difference in the proportion of the several constituents. Were this so, dilution with water and the addition of sugar of milk would be sufficient to perfect the resemblance between the two fluids. A more important difference is the denseness of the clot formed by the curd of cow's milk. Ample dilution with water does not affect this property. Un der the action of the gastric juice, the particles of casein still run together into a solid, compact lump. This is not the case with milk from the breast. Human milk forms a light, loose flocculent clot, which is readily disinte-, grated and digested in the stomach. The difficulty which even the strong est children find in digesting cow's milk, is shown by the masses of hard curd which a child fed exclusively upon this diet passes daily from the bowels. This difference between the two milks is answerable for much of the trouble and disappointment experienced in bringing up infants by hand. But it is not merely new-born infants for whom a diet of cow's milk is inap propriate. Gastric and intestinal disorders often date from the time of weaning ; and this is partly the consequence of an abrupt change from human to cow's milk in cases where little or no care is taken to make the new diet a digestible one. The heavy curd of cow's milk is often difficult of digestion, even by children of ten or twelve months old, if they have been accustomed only to the breast ; and unless measures are adopted to hinder the firm clotting of the casein, serious dangers may arise.

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