REFECTION--THE CHILD'S DIET
In connection with the exercises of practical life, it may be fitting
to consider the matter of refection.
In order to protect the child's development, especially in
neighbourhoods where standards of child hygiene are not yet prevalent in
the home, it would be well if a large part at least of the child's diet
could be entrusted to the school. It is well known to-day that the diet
must be adapted to the physical nature of the child; and as the medicine
of children is not the medicine of adults in reduced doses, so the diet
must not be that of the adult in lesser quantitative proportions. For
this reason I should prefer that even in the "Children's Houses" which
are situated in tenements and from which little ones, being at home, can
go up to eat with the family, school refection should be instituted.
Moreover, even in the case of rich children, school refection would
always be advisable until a scientific course in cooking shall have
introduced into the wealthier families the habit of specialising in
children's food.
The diet of little children must be rich in fats and sugar: the first
for reserve matter and the second for plastic tissue. In fact, sugar is
a stimulant to tissues in the process of formation.
As for the _form_ of preparation, it is well that the alimentary
substances should always be minced, because the child has not yet the
capacity for completely masticating the food, and his stomach is still
incapable of fulfilling the function of mincing food matter.
Consequently, soups, purees, and meat balls, should constitute the
ordinary form of dish for the child's table.
The nitrogenous diet for a child from two or three years of age ought to
be constituted chiefly of milk and eggs, but after the second year
broths are also to be recommended. After three years and a half meat can
be given; or, in the case of poor children, vegetables. Fruits are also
to be recommended for children.
Perhaps a detailed summary on child diet may be useful, especially for
mothers.
_Method of Preparing Broth for Little Children._ (Age three to six;
after that the child may use the common broth of the family.) The
quantity of meat should correspond to 1 gramme for every cubic
centimetre of broth and should be put in cold water. No aromatic herbs
should be used, the only wholesome condiment being salt. The meat should
be left to boil for two hours. Instead of removing the grease from the
broth it is well to add butter to it, or, in the case of the poor, a
spoonful of olive oil; but substitutes for butter, such as margerine,
etc., should never be used. The broth must be prepared _fresh_; it would
be well, therefore, to put the meat on the fire two hours before the
meal, because as soon as broth is cool there begins to take place a
separation of chemical substances, which are injurious to the child and
may easily cause diarrhea.
_Soups._ A very simple soup, and one to be highly recommended for
children, is bread boiled in salt water or in broth and abundantly
seasoned with oil. This is the classic soup of poor children and an
excellent means of nutrition. Very like this, is the soup which
consists of little cubes of bread toasted in butter and allowed to soak
in the broth which is itself fat with butter. Soups of grated bread also
belong in this class.
Pastine,[10] especially the glutinous pastine, which are of the same
nature, are undoubtedly superior to the others for digestibility, but
are accessible only to the privileged social classes.
[10] Those very fine forms of vermicelli used in soups.
The poor should know how much more wholesome is a broth made from
remnants of stale bread, than soups of coarse spaghetti--often dry and
seasoned with meat juice. Such soups are most indigestible for little
children.
Excellent soups are those consisting of purees of vegetables (beans,
peas, lentils). To-day one may find in the shops dried vegetables
especially adapted for this sort of soups. Boiled in salt water, the
vegetables are peeled, put to cool and passed through a sieve (or simply
compressed, if they are already peeled). Butter is then added, and the
paste is stirred slowly into the boiling water, care being taken that it
dissolves and leaves no lumps.
Vegetable soups can also be seasoned with pork. Instead of broth,
sugared milk may be the base of vegetable purees.
I strongly recommend for children a soup of rice boiled in broth or
milk; also cornmeal broth, provided it be seasoned with abundant butter,
but not with cheese. (The porridge form--polenta, really cornmeal mush,
is to be highly recommended on account of the long cooking.)
The poorer classes who have no meat-broth can feed their children
equally well with soups of boiled bread and porridge seasoned with oil.
_Milk and Eggs._ These are foods which not only contain nitrogenous
substances in an eminently digestible form, but they have the so-called
_enzymes_ which facilitate assimilation into the tissues, and, hence, in
a particular way, favour the growth of the child. And they answer so
much the better this last most important condition if they are _fresh_
and _intact_, keeping in themselves, one may say, the life of the
animals which produced them.
Milk fresh from the cow, and the egg while it is still warm, are
assimilable to the highest degree. Cooking, on the other hand, makes the
milk and eggs lose their special conditions of assimilability and
reduces the nutritive power in them to the simple power of any
nitrogenous substance.
To-day, consequently, there are being founded _special dairies for
children_ where the milk produced is sterile; the rigorous cleanliness
of the surroundings in which the milk-producing animals live, the
sterilisation of the udder before milking, of the hands of the milker,
and of the vessels which are to contain the milk, the hermetic sealing
of these last, and the refrigerating bath immediately after the milking,
if the milk is to be carried far,--otherwise it is well to drink it
warm, procure a milk free from bacteria which, therefore, has no need of
being sterilised by boiling, and which preserves intact its natural
nutritive powers.
As much may be said of eggs; the best way of feeding them to a child is
to take them still warm from the hen and have him eat them just as they
are, and then digest them in the open air. But where this is not
practicable, eggs must be chosen fresh, and barely heated in water,
that is to say, prepared _a la coque_.
All other forms of preparation, milk-soup, omelettes, and so forth, do,
to be sure, make of milk and eggs an excellent food, more to be
recommended than others; but they take away the specific properties of
assimilation which characterise them.
_Meat._ All meats are not adapted to children, and even their
preparation must differ according to the age of the child. Thus, for
example, children from three to five years of age ought to eat only more
or less finely-ground meats, whereas at the age of five children are
capable of grinding meat completely by mastication; at that time it is
well to _teach the child accurately how to masticate_ because he has a
tendency to swallow food quickly, which may produce indigestion and
diarrhea.
This is another reason why school-refection in the "Children's Houses"
would be a very serviceable as well as convenient institution, as the
whole diet of the child could then be rationally cared for in connection
with the educative system of the Houses.
The meats most adapted to children are so-called white meats, that is,
in the first place, chicken, then veal; also the light flesh of fish,
(sole, pike, cod).
After the age of four, filet of beef may also be introduced into the
diet, but never heavy and fat meats like that of the pig, the capon, the
eel, the tunny, etc., which are to be _absolutely excluded_ along with
mollusks and crustaceans, (oysters, lobsters), from the child's diet.
Croquettes made of finely ground meat, grated bread, milk, and beaten
eggs, and fried in butter, are the most wholesome preparation. Another
excellent preparation is to mould into balls the grated meat, with
sweet fruit-preserve, and eggs beaten up with sugar.
At the age of five, the child may be given breast of roast fowl, and
occasionally veal cutlet or filet of beef.
Boiled meat must never be given to the child, because meat is deprived
of many stimulating and even nutritive properties by boiling and
rendered less digestible.
_Nerve Feeding Substances._ Besides meat a child who has reached the age
of four may be given fried brains and sweetbreads, to be combined, for
example, with chicken croquettes.
_Milk Foods._ All cheeses are to be excluded from the child's diet.
The only milk product suitable to children from three to six years of
age is fresh butter.
_Custard._ Custard is also to be recommended provided it be _freshly
prepared_, that is immediately before being eaten, and _with very fresh_
milk and eggs: if such conditions cannot be rigorously fulfilled, it is
preferable to do without custard, which is not a necessity.
_Bread._ From what we have said about soups, it may be inferred that
bread is an _excellent food_ for the child. It should be well selected;
the crumb is not very digestible, but it can be utilised, when it is
dry, to make a bread broth; but if one is to give the child simply a
piece of bread to eat, it is well to offer him the crust, the end of the
loaf. Bread sticks are excellent for those who can afford them.
Bread contains many nitrogenous substances and is very rich in starches,
but is lacking in fats; and as the fundamental substances of diet are,
as is well known, three in number, namely, proteids, (nitrogenous
substances), starches, and fats, bread is not a complete food; it is
necessary therefore to offer the child buttered bread, which constitutes
a complete food and may be considered as a sufficient and complete
breakfast.
_Green Vegetables._ Children must never eat raw vegetables, such as
salads and greens, but only cooked ones; indeed they are not to be
highly recommended either cooked or raw, with the exception of spinach
which may enter with moderation into the diet of children.
Potatoes prepared in a puree with much butter form, however, an
excellent complement of nutrition for children.
_Fruits._ Among fruits there are excellent foods for children. They too,
like milk and eggs, if freshly gathered, retain a _living_ quality which
aids assimilation.
As this condition, however, is not easily attainable in cities, it is
necessary to consider also the diet of fruits which are not perfectly
fresh and which, therefore, should be prepared and cooked in various
ways. All fruits are not to be advised for children; the chief
properties to be considered are the degree of _ripeness_, the
_tenderness_ and _sweetness_ of the pulp, and its _acidity_. Peaches,
apricots, grapes, currants, oranges, and mandarins, in their natural
state, can be given to little children with great advantage. Other
fruits, such as pears, apples, plums, should be cooked or prepared in
syrup.
Figs, pineapples, dates, melons, cherries, walnuts, almonds, hazelnuts,
and chestnuts, are excluded for various reasons from the diet of early
childhood.
The preparation of fruit must consist in removing from it all
indigestible parts, such as the peel, and also such parts as the child
inadvertently may absorb to his detriment, as, for example, the seed.
Children of four or five should be taught early how carefully the seeds
must be thrown away and how the fruits are peeled. Afterwards, the child
so educated may be promoted to the honour of receiving a fine fruit
intact, and he will know how to eat it properly.
The culinary preparation of fruits consists essentially in two
processes: cooking, and seasoning with sugar.
Besides simple cooking, fruits may be prepared as marmalades and
jellies, which are excellent but are naturally within the reach of the
wealthier classes only. While jellies and marmalades may be allowed,
candied fruits,--on the other hand,--_marrons glaces_, and the like, are
absolutely excluded from the child's diet.
_Seasonings._ An important phase of the hygiene of child diet concerns
seasonings--with a view to their rigorous limitation. As I have already
indicated, sugar and some fat substances along with kitchen salt (sodium
chloride) should constitute the principal part of the seasonings.
To these may be added _organic acids_ (acetic acid, citric acid) that
is, vinegar and lemon juice; this latter can be advantageously used on
fish, on croquettes, on spinach, etc.
Other condiments suitable to little children are some aromatic
vegetables like garlic and rue which disinfect the intestines and the
lungs, and also have a direct anthelminthic action.
Spices, on the other hand, such as pepper, nutmeg, cinnamon, clove, and
especially mustard, are to be absolutely abolished.
_Drinks._ The growing organism of the child is very rich in water, and,
hence, needs a constant supply of moisture. Among the beverages, the
best, and indeed the only one, to be unreservedly advised is pure fresh
spring water. To rich children might be allowed the so-called table
waters which are slightly alkaline, such as those of San Gemini, Acqua
Claudia, etc., mixed with syrups, as, for example, syrup of black
cherry.
It is now a matter of general knowledge that all fermented beverages,
and those exciting to the nervous system, are injurious to children;
hence, all alcoholic and caffeic beverages are absolutely eliminated
from child diet. Not only liquors, but wine and beer, ought to be
unknown to the child's taste, and coffee and tea should be inaccessible
to childhood.
The deleterious action of alcohol on the child organism needs no
illustration, but in a matter of such vital importance insistent
repetition is never superfluous. Alcohol is a poison especially fatal to
organisms in the process of formation. Not only does it arrest their
total development (whence infantilism, idiocy), but also predisposes the
child to nervous maladies (epilepsy, meningitis), and to maladies of the
digestive organs, and metabolism (cirrhosis of the liver, dyspepsia,
anaemia).
If the "Children's Houses" were to succeed in enlightening the people on
such truths, they would be accomplishing a very lofty hygienic work for
the new generations.
Instead of coffee, children may be given roasted and boiled barley,
malt, and especially chocolate which is an excellent child food,
particularly when mixed with milk.
DISTRIBUTION OF THE MEALS
Another chapter of child diet concerns the distribution of the meals.
Here, one principle must dominate, and must be diffused, among mothers,
namely, that the children shall be kept to rigorous meal hours in order
that they may enjoy good health and have excellent digestion. It is
true that there prevails among the people (and it is one of the forms of
maternal ignorance most fatal to children) the prejudice that children
in order to grow well must be eating almost continuously, without
regularity, nibbling almost habitually a crust of bread. On the
contrary, the child, in view of the special delicacy of his digestive
system, has more need of regular meals than the adult has. It seems to
me that the "Children's Houses" with very prolonged programmes are, for
this reason, suitable places for child culture, as they can direct the
child's diet. _Outside of their regular meal hours, children should not
eat._
In a "Children's House" with a long programme there ought to be two
meals, a hearty one about noon, and a light one about four in the
afternoon.
At the hearty meal, there should be soup, a meat dish, and bread, and,
in the case of rich children, also fruits or custard, and butter on the
bread.
At the four o'clock meal there should be prepared a light lunch, which
from a simple piece of bread can range to buttered bread, and to bread
accompanied by a fruit marmalade, chocolate, honey, custard, etc. Crisp
crackers, biscuits, and cooked fruits, etc., might also be usefully
employed. Very suitably the lunch might consist of bread soaked in milk
or an egg _a la coque_ with bread sticks, or else of a simple cup of
milk in which is dissolved a spoonful of Mellin's Food. I recommend
Mellin's Food very highly, not only in infancy, but also much later on
account of its properties of digestibility and nutrition, and on account
of its flavour, which is so pleasing to children.
Mellin's Food is a powder prepared from barley and wheat, and containing
in a concentrated and pure state the nutritive substances proper to
those cereals; the powder is slowly dissolved in hot water in the bottom
of the same cup which is to be used for drinking the mixture, and very
fresh milk is then poured on top.
The child would take the other two meals in his own home, that is, the
morning breakfast and the supper, which latter must be _very light_ for
children so that shortly after they may be ready to go to bed. On these
meals it would be well to give advice to mothers, urging them to help
complete the hygienic work of the "Children's Houses," to the profit of
their children.
The morning breakfast for the rich might be milk and chocolate, or milk
and extract of malt, with crackers, or, better, with toasted bread
spread with butter or honey; for the poor, a cup of fresh milk, with
bread.
For the evening meal, a soup is to be advised (children should eat soups
twice a day), and an egg _a la coque_ or a cup of milk; or rice soup
with a base of milk, and buttered bread, with cooked fruits, etc.
As for the alimentary rations to be calculated, I refer the reader to
the special treatises on hygiene: although practically such calculations
are of no great utility.
In the "Children's Houses," especially in the case of the poor, I should
make extensive use of the vegetable soups and I should have cultivated
in the garden plots vegetables which can be used in the diet, in order
to have them plucked in their freshness, cooked, and enjoyed. I should
try, possibly, to do the same for the fruits, and, by the raising of
animals, to have fresh eggs and pure milk. The milking of the goats
could be done directly by the larger children, after they had
scrupulously washed their hands. Another important educative
application which school-refection in the "Children's Houses" has to
offer, and which concerns "practical life," consists in the preparing of
the table, arranging the table linen, learning its nomenclature, etc.
Later, I shall show how this exercise can gradually increase in
difficulty and constitute a most important didactic instrument.
It is sufficient to intimate here that it is very important to teach the
children to eat with cleanliness, both with respect to themselves and
with respect to their surroundings (not to soil the napkins, etc.), and
to use the table implements (which, at least, for the little ones, are
limited to the spoon, and for the larger children extended to the fork
and knife).