The Care and Feeding of Children Part 15

_Why is this precaution necessary?_

Cooling in the air or in an ice box requires from two to four hours, and during that time a great many of the undeveloped germs may mature and greatly injure the keeping properties of the milk. In the cold water, milk can be cooled in from ten to twenty minutes if the water is frequently changed, or if ice is added to the water.

MODIFIED MILK OF THE MILK LABORATORIES

_What is "modified milk" of the milk laboratories?_

It is milk containing definite proportions of the fat, sugar, proteids, etc., put up usually according to the prescription of a physician, who indicates how much of the different elements he desires. The most reliable are the laboratories of the Walker-Gordon Company, which has branches in many of the large cities of the United States.

This is an excellent method of having milk prepared since it can be done with greater care and cleanliness than are possible in most homes. It is besides a great convenience if circ.u.mstances make it impossible to prepare the milk properly at home.

The laboratory should be used for infant feeding only by one who is somewhat familiar with this method of ordering milk.

PEPTONIZED MILK

_What is peptonized milk?_

Milk in which the proteids (curd) have been partially digested.

_How is this accomplished?_

By the action of a peptonizing powder which is composed of a digestive agent known as the extractum pancreatis and bicarbonate of soda, which is added to the plain or diluted milk. This is sold in tubes or in tablets, and it is the active ingredient of the peptogenic milk powder.

_Describe the process._

The plain or modified milk is placed in a clean gla.s.s jar or bottle, and the peptonizing powder, which is first rubbed up with a tablespoonful of the milk, is added and the bottle shaken. The bottle is then placed in a large pitcher or basin containing water kept at the temperature of about 110 F., or as warm as the hand can bear comfortably, and left for ten to twenty minutes if the milk is to be partially peptonized; for two hours if it is to be completely peptonized.

_What taste has partially peptonized milk?_

None, if peptonizing is continued for only ten minutes, but at the end of twenty minutes it begins to be bitter, when the process of digestion has gone further.

_How is the bitter taste avoided in partially peptonized milk?_

At the end of ten or fifteen minutes the milk may be placed in a saucepan and quickly raised to boiling point; this kills the ferment, so that the milk will not become bitter when warmed a second time. Or, the milk may be rapidly cooled by placing the bottles first in cool and then in ice water; in this way the ferment is not destroyed, and the milk may become bitter when warmed for feeding.

_Should the whole day's supply be peptonized at once, or each bottle separately just before the feeding?_

Either plan may be followed. If the former, it is better to raise the milk to boiling point after peptonizing; if the latter, it should not be peptonized more than ten minutes, for it will continue to peptonize while it is being taken by the child.

_Is not the bitter taste of completely peptonized milk a great obstacle to its use?_

Not in the case of young infants; one under four or five months old will usually take it without any objection after two or three feedings; but it cannot often be used for those who are much older.

_How much of the peptonizing powder should be used?_

There are required for one pint of plain milk, five grains of the extractum pancreatis and fifteen grains of bicarbonate of soda. This quant.i.ty is usually put up in a single tube or tablet. In the formulas previously given, less than this will be required; for the weaker formulas, one half or one third of the powder mentioned will be sufficient for one pint of food. For a single feeding of four ounces, one may use one eighth of a tube with a weak formula, or one sixth of a tube with a stronger formula.

_What are the advantages of peptonized milk?_

Partially peptonized milk is useful for young infants who have great difficulty in digesting the curd of milk, sometimes even when diluted as already described; completely peptonized milk, during acute attacks of indigestion.

_For how long a period may the use of peptonized milk be continued?_

Completely peptonized milk may be used for a few days, or at most a few weeks; partially peptonized milk may be used for two or three months, but not indefinitely; it should be left off gradually by shortening the time of peptonizing, and lessening the amount of the powder used.

FEEDING DURING THE SECOND YEAR

_How many meals are required during the second year?_

It is usually better to continue five meals throughout the second year. Some children will sleep from 6 P.M. to 6 A.M. without waking, but unless there is a feeding at 10 P.M. children are apt to wake very early in the morning.

_Should each feeding be prepared at the time it is given, or all feedings at one time, as during the first year?_

During the second and third years it is better to prepare the milk for the entire day at one time. If it is to be modified by adding cream, water, etc., it is done as during the first year.

Later, when only plain milk is used, the quant.i.ties needed for the different feedings should be put into one or into two bottles, which then may be pasteurized or not as may be necessary. In this way the different feedings are kept separate, and the day's supply of milk is not disturbed every time the child is fed, as otherwise is unavoidable. The food should be prepared as soon as possible after the daily milk supply is delivered in the morning.

_Give a proper diet for an average healthy child of twelve months._

6.30 A.M. Milk, six to seven ounces; diluted with barley or oat gruel, two to three ounces; after the thirteenth month, taken from a cup.

9 A.M. Orange juice, one to two ounces.

10 A.M. Milk, two parts; oatmeal or barley gruel, one part; from ten to twelve ounces in all may be allowed; it should be given from a cup.

2 P.M. Beef juice, one to two ounces; or, the white of one egg, slightly cooked; later, the entire egg; or, mutton or chicken broth, four to six ounces.

Milk and gruel in proportions above given, four to six ounces.

6 P.M. Same as at 10 A.M.

10 P.M. Same as at 6.30 A.M., except that the milk may be given from the bottle.

_How long may this schedule be followed?_

Usually until the fourteenth or fifteenth month. After this time the cereals may be given much thicker and fed from a spoon.

_May any other fruit juices be given at this period?_

Orange juice is the best; next to this the juice of fresh ripe peaches, red raspberries or strawberries. All these should be strained very carefully through muslin to make sure that the child gets none of the pulp or seeds, either of which may cause serious disturbance. Of the orange or peach juice, from one to four tablespoonfuls may be allowed at one time; of the others about half the quant.i.ty. The fruit juice is best given one hour before the second feeding.

_When should a child be weaned from its bottle?_

Most children can and should be taught to take their food from the cup or spoon by the time they are thirteen months old; but it is convenient to give the 10 P.M. feeding from the bottle during the greater part of the second year (see page 52).

_Give a proper diet for an average child from the fourteenth to the eighteenth month._