INFANT FEEDING
One of the fundamental problems of to-day, as it was of yesterday and
will be of to-morrow, is the correct feeding of infants and children.
Every civilized country faces the same problem, largely because the
artificial feeding of infants has become so prevalent.
Unfortunately, many women who must labor outside of the home must
resort partially, if not entirely, to artificial feeding of their
infants. Usually on account of the inconvenience of breast feeding and
the strain on the mother, the infant is given artificial food, often
improperly prepared. Although infant mortality is high among the poorer
classes, it is marvelous that so many of these infants survive.
It is an encouraging fact, however, that women among the well-to-do and
educated classes are appreciating the importance of breast feeding and
that the number of these who are not only willing but anxious to nurse
their infants is increasing.
The mother should be firm in her decision to nurse her child and be
encouraged to persevere in efforts to secure the proper development of
the breasts before the birth of the child, that the quantity as well as
the quality of the milk may be adequate.
The fact that nearly one-fourth of the civilized race dies during the
first year of life is astounding. This mortality is due directly or
indirectly to nutritional disturbances that could in a great measure be
prevented if the babies were properly nursed at the breast or if the
artificial feeding was carefully regulated.
Of six hundred and forty-one infants under observation by Dublin, in
Fall River, Mass., five hundred and sixty-five were breast-fed and
seventy-six bottle-fed. After the first week there were one hundred and
six deaths. In seventy-four of these the infants were breast-fed, and
in thirty-two, bottle-fed; nearly one-half of the bottle-fed babies
died and only 10 per cent. of the breast-fed babies. The breast-fed
child, therefore, has five chances to live where the bottle-fed child
has one.
One fundamental principle on which all of the leading specialists in
the study of the baby agree, is that the milk of the healthy mother is
the only ideal baby food. Every mother should be made to realize the
importance of nursing her baby for at least nine or ten months, unless
circumstances beyond control make it impossible or inadvisable.
Proper care of the breasts and of the general health during the
expectant period will usually secure a sufficient flow of milk for the
child’s needs.
The mental attitude of the mother has much to do with the secretion of
milk; therefore she should cultivate the habit of kindly, cheerful,
healthful thoughts. She should keep her circulation and vitality up to
par.
She should take regular exercise and be out in the fresh air daily.
During the first two or three days the child receives little
nourishment from the breast, simply a few ounces daily of a yellowish
substance known as colostrum, which is supposed to have a laxative
effect on its bowels.
It is, however, usual to put the child to the breast at regular
intervals of about four hours after the first day, to stimulate the
milk secretion, which should be quite free on the third day; it,
however, may be slow in coming for a day to two longer.
A teaspoonful or two of warm boiled water, or of a five per cent.
solution of milk-sugar may be given every few hours, in fact it is
considered advisable by some physicians, in order to lessen somewhat
the loss in weight which takes place during the first week.
If the free flow of milk is delayed beyond forty-eight hours, some
nourishment must be given. A little modified cow’s milk is best. The
preparation of this will be taken up under Artificial Feeding.
The mother should not permit herself to become easily discouraged
about her ability to nurse her child, for even though the supply at
first seems very deficient and it is necessary to give the baby other
nourishment, it should be put to the breast at regular intervals, as
the sucking by the child stimulates the secretion of milk. The flow of
milk often increases when the mother becomes more active.
When the milk flows freely, the contents of one breast is sufficient
for one nursing, and the breasts should be used alternately, that is
one breast at one feeding and the other at the next.
Nursing should not last longer than from ten to twenty minutes. Too
rapid nursing is apt to cause vomiting. If it is necessary to check the
flow of milk somewhat, it can be done by pressing the breast slightly
between the fingers.
There is a warmth, a purity, and a vitality to the mother’s milk that
is impossible to secure in any artificial food no matter how carefully
and skilfully prepared. It is also germ-free.
Some women seem unable to nurse their babies for more than two or three
months and it is sometimes thought that it is not worth while for a
woman to nurse her baby unless she can do so for a considerable time.
This, however, is a great mistake, because there is no time in the
baby’s life when it is more important for it to have breast milk than
in the beginning. This is the time when the baby’s digestion is most
easily disturbed and most difficult to correct. Every day or week that
a baby gets breast milk gives it a better start.
It has been thought that it is dangerous to use both breast and
artificial feeding. This idea is erroneous. The artificial food cannot
make the breast milk hard to digest, while the breast feeding seems to
make the artificial food digest more readily. This may be due in part
to the ferments which the breast milk contains, but more probably is
due to the fact that the baby is able to utilize the proteins of human
milk to build tissue when it cannot so readily utilize the proteins of
the artificial food.
* * * * *
[Sidenote: Wet Nursing]
Wet nursing is resorted to less frequently now than in the past on
account of better methods for artificial feeding.
If the mother is unable to nurse the child herself and the conditions
are ideal, that is the wet nurse a healthy, happy woman with a thriving
baby of her own, and very particular in the care of her person, this is
better than artificial feeding.
[Sidenote: Contra-Indications to Nursing]
Total absence of milk, after earnest efforts to stimulate its secretion
necessitates artificial feeding.
If the mother has chorea, epilepsy, or tuberculosis in any form, it is
best to resort to artificial feeding; also if the mother has syphilis
and the baby is free from it. In these conditions the child must often
be taken from the mother to avoid infection.
If the mother has had serious complications in pregnancy or
parturition, the physician must decide on the advisability of natural
or artificial feeding.
In case of nephritis, except perhaps in a very mild form, the milk is
toxic and therefore nursing from the breast should be prohibited.
Sometimes in acute contagious disease it is safer to nurse the baby
than to subject it to the dangers of artificial food. However, when the
mother’s temperature exceeds 101 or 102 degrees, the milk will probably
possess toxic qualities and disagree with the infant.
* * * * *
[Sidenote: Anatomy and Physiology of the Infant]
Every nursing mother should acquaint herself with the process of the
infant’s digestion, as many of the infantile difficulties are caused by
overfeeding or underfeeding, due to ignorance on this subject.
The alimentary tract of the new-born infant differs in many ways from
that of the adult.
As compared with other mammals, the human infant is the most helpless
and undeveloped and therefore the most delicate and easily affected.
It is practically dependent on its mother for nourishment which will
completely supply its needs.
The capacity of the stomach, after careful study, has been placed at
from 1 to 2 ounces at birth, 2 to 3 ounces at the end of the first
month, 6 ounces at the 6th month, and from 9 to 10 ounces at the end
of the first year. This is simply an average guide, as stomachs vary
somewhat in size. Quantities somewhat larger than the foregoing are
sometimes fed, but some of the food has passed beyond the pylorus
before the last of it is taken. Digestion begins as soon as the food
enters the stomach.
The secretion of bile begins within 12 hours after birth, increases
rapidly, and is fully established within a week or ten days.
The pancreatic ferments which digest starches and sugar are present
in the new-born, although scanty; the sucking movements of the child
when nursing exercise the salivary glands so that saliva is secreted;
but starch digestion is not completed in the mouth, hence starch and a
greater proportion of sugar than is in the mother’s milk are difficult
for the infant to digest.
The intestines, when compared with the length of the body, are
relatively long in infants, but the muscular coat is comparatively
weak; digestion is therefore relatively slow and more subject to
derangement by substances that influence peristalsis.
The fact that infants vomit with comparatively little effort, the food
overflowing from an overloaded stomach, is due to the relatively feeble
closure of the cardiac orifice.
The stomach contents are kept germ-free by the secretion of
hydrochloric acid and the upper intestine is nearly free from bacteria
in breast-fed infants, because of the antibacterial nature of the
intestinal secretion. In some digestive disturbances this safeguard
fails and bacteria develop rapidly.
[Sidenote: Intestinal Disturbances]
Intestinal disturbance in the breast-fed infant is most often caused by
overfeeding, the infant often nursing too frequently, thereby emptying
the breasts and securing a high fat ratio. Frequent nursing does not
give the stomach time to empty and thus digestive disturbances are apt
to occur. Therefore, as a means of relieving intestinal trouble in the
infant, nursing at regular intervals and not too frequently, is of much
importance.
When digestive disturbance has occurred it is best to stop nursing for
twenty-four hours, giving the infant weak barley gruel sweetened with
saccharin. At the end of twenty-four hours let the infant nurse at the
breast for from three to five minutes, this being preceded by a small
drink of water.
As the bowel condition improves, the time at the breast may be
gradually lengthened.
The mother should watch her diet to avoid too much rich food, and foods
that seem difficult to digest, as certain articles of food in the
mother’s diet often causes gastric disturbances in the infant.
She should also carefully watch her thoughts, keeping them well poised
and upon kindness, love, and peace. Worry or unkind thoughts will
affect the mother’s milk and disturb the child’s digestion very quickly.
Fits of temper in the child also disturb its digestion.
* * * * *
[Sidenote: Times of Feeding]
Regular nursing habits should be insisted on, as indigestion, colic,
and diarrhea often result from irregular nursing.
Some authorities discourage night feeding as unnecessary with a normal
baby, but most physicians agree that the child should be aroused
during the day in order not to miss a feeding, as it will fall asleep
again directly after nursing and will soon get into the habit of
awakening at feeding time.
The following table from Holt may be used as a guide in breast-feeding:
——————————————————+———————————+——————————————+——————————————
| Number in | Intervals |Night nursing
Age |twenty-four|during the day|between 9 P.M.
| hours | hours | and 7 A.M.
——————————————————+———————————+——————————————+——————————————
1st day | 4 | 6 | 1
2d day | 6 | 4 | 1
3d to 28th day | 10 | 2 | 2
4th to 13th week | 8 | 2-1/2 | 1
3d to 5th month | 7 | 3 | 1
5th to 12th month | 6 | 3 | 0
——————————————————+———————————+——————————————+——————————————
There may be some slight deviations from this if the child is ill
and small for its age. It is a good general rule to feed the child
according to the age with which its weight corresponds.
There can be no regular rule followed for all. Some authorities hold
that fifteen- to twenty-minute feedings at four-hour intervals during
the day, with one feeding at night, are sufficient, but it depends on
the child. Some babies’ stomachs are smaller than others, and some do
not nurse regularly, but play and are inattentive to the nursing. In
either event the child will not get sufficient nourishment at four-hour
intervals. The intelligent mother can determine what is best.
* * * * *
[Sidenote: Water]
In breast-feeding, as well as in most of the formulæ for
bottle-feeding, there is an allowance for an amount of fluid that,
under ordinary circumstances, satisfies the baby’s requirements.
Additional water is often necessary, especially during the hot weather
when the body heat is regulated through evaporation from the skin.
The most effective means of promoting perspiration is the giving of
water. This, however, should not be done to excess. Eight ounces
for a 10-pound baby, given in divided doses during the day, will be
sufficient.
It is best to give the water when the stomach is nearly or quite empty.
It should be boiled and cooled and should be given by the bottle as the
child will then take at intervals all that its thirst requires, and the
danger of choking as a result of too hasty swallowing is avoided.
* * * * *
[Sidenote: Normal Development in the Breast-Fed]
The growth and general condition of the child will, of course, be
influenced by the quality and quantity of the milk. The birth weight of
7 to 7-1/2 pounds is usually doubled by the end of the fifth month and
trebled by the end of the year. The average gain is from 5 to 8 ounces
a week during the first few months and from 2 to 4 ounces a week the
last few months of the year.
If the mother’s milk is deficient in any way, the child becomes fretful
and loses weight, or the weight remains stationary. In such cases
the physician usually examines the milk to determine its quality and
advises some means of improving it, or in some way adding to the baby’s
food the element in which the mother’s milk is lacking.
The physical condition of the mother often affects the baby’s
nourishment, and besides resorting, temporarily, to means for improving
the quality of the milk, she should build up her general vitality
through regular exercise for the spine and the vital organs, deep
breathing of fresh air, and regular rest.
While a scanty food supply will diminish the flow of milk, overloading
the stomach at meal time and taking quantities of rich food between
meals, as so many nursing mothers, think is necessary, usually does
little to increase the quantity or improve the quality of the milk, but
often results in an accumulation of superfluous flesh and disturbed
digestion, which quickly affects the child.
Sometimes a more restricted diet together with specially directed
exercises to relieve any digestive disturbance and correct
constipation, and relaxing exercises for the nerves, will do more than
anything else to improve the quality of the milk.
Mothers should particularly avoid becoming overtired.
When the milk is good, but the quantity deficient, massage of the
breasts three or four times a day for five or ten minutes will increase
the supply. One effective means of increasing the secretion of the
mammary glands is the mechanical stimulus of suction. If a robust baby
can be put to the breast for a time it may develop an ample flow of
milk for a puny infant whose powers of suction are feeble.
A good malt extract with meals sometimes tends to increase the flow
of milk. When the quality and quantity of the milk are deficient, the
physician usually advises a very nourishing diet and a tonic. This
nourishment does not of necessity require an excessive amount of liquid.
When the quantity is sufficient, but the quality poor, it is usually
necessary to wean the baby, if it is several months old, although
mother’s milk, even if below standard in quality, is better for the
infant than cow’s milk, at least during the first few months.
Nervousness, sleeplessness, worry, and grief have a decided effect on
the milk supply and on the baby. Nervous mothers are apt to have an
abundance of milk one day and little the next day; frequently the milk
will disappear suddenly.
* * * * *
[Sidenote: Weaning]
When it is possible, the baby should be weaned gradually. Although
there is no set time for weaning, it is not advisable to feed the child
exclusively from the breast after the eighth or tenth month. Bunge
holds that human milk contains too little iron at this period and the
babies are apt to become pale and undernourished.
When additional feeding is decided on, the physician should prescribe
the preparation. A bottle a day should be substituted for the breast
feeding at first and, gradually, additional bottle feedings, until,
after about a month the breast is entirely withdrawn.
After the eighth month and until the age of twelve months, as a general
rule, cow’s milk should be diluted and sweetened by mixing eight
ounces of barley water and thirty-two ounces of milk, adding an ounce
of cane-sugar or milk-sugar, and dividing the whole into five 8-ounce
portions.
Additional food may be given to the healthy child after the eighth
or ninth month. Orange juice or other fruit juice one or twice a
day should be given about an hour before feeding. A teaspoonful may
be given at first and the amount gradually increased to about two
tablespoonfuls a day.
Orange juice is a specific in conditions of scurvy resulting from
improper feeding. The child usually improves rapidly after it begins to
take the juice.
Beef juice, meat broths, or strained vegetable soup may be given in
increasing amounts up to 5 or 6 ounces daily.
Zwieback and whole wheat or Graham crackers are permissible in small
amounts after the ninth month. After nine months the healthy baby
should also have a soft-boiled egg occasionally, also baked apple and
well-cooked, mashed spinach or carrots.
Food should be given only at regular intervals and nothing but water
between feedings.
Starch-digesting ferments are present at birth in sufficient amounts
to digest the sugar in milk, but they do not develop sufficiently to
digest starches until about the twelfth month, so white bread, crackers
made from white flour, potatoes, rice, etc., should not be given the
child under a year.
* * * * *
[Sidenote: Artificial Feeding]
When artificial feeding is necessary, the physician must decide
what modification is best for the baby. One can only determine by
experimenting upon the actual percentages of fat, proteins, and sugar
which each baby needs, following, in general, the proportions contained
in mother’s milk, because while many babies thrive on a food of this
composition, some do not. The formulæ given are simply a guide, as the
proportions may need to be changed, or may need to be made weaker in
some cases and stronger in others.
The composition of human milk, however, is a guide to the infant’s
digestive ability. This must be determined by a careful study of the
_individual baby_ as every baby is a problem by itself.
As previously mentioned, no artificial food is the same as human milk,
although it may contain the same proportions of the different elements,
and it is often difficult, especially during the first few months, to
prepare a combination on which the child will thrive.
Cow’s milk, properly prepared, is the nearest available substitute for
human milk. It must be modified, as the digestion of the calf at birth
is equal to that of an infant at eight or nine months.
Farmers have in recent years become more particular about the care of
their cows and cleanliness in milking because the educational campaign
with regard to the danger to human life from tuberculous animals has
caused a greater public demand for good, clean milk.
Many infectious diseases are conveyed by milk, and impure milk is a
large cause of the extraordinarily high mortality of early infancy.
With the improvement of the milk supply, the decline in the infant
death-rate has been wondrously gratifying.
Manufacturers have taken advantage of the fact that the public has
become a little afraid of cow’s milk and have extensively advertised
their prepared foods, claiming them to be the best substitute for
mother’s milk. However, experiments have proven that these statements
for the most part are misleading, the composition of the foods not
being suited to the actual requirements of the infant. Some prominent
physicians think that infant mortality has been increasing since
prepared foods have been used so extensively.
One leading authority states that “clean, fresh cow’s milk, properly
modified, is the best substitute available. It is to be preferred to
any prepared food, no matter how sweeping may be the manufacturers’
claim for it.”
The most striking thing about the prepared foods is their tremendous
excess of carbohydrates, either cane-sugar or sugar derived from starch
by the process of malting. Condensed milk, in particular, contains much
too large a percentage of cane-sugar for the child.
Another authority states:
An excess of sugar is likely to damage the organism by the production
of poisonous substances in the body. This is particularly true in
those infants who are already suffering from indigestion. An excess of
sugar in such a baby is likely to render him severely and dangerously
sick and result in catastrophe.
[Sidenote: Bacteriology]
The study of the bacteriology of the alimentary tract of the new-born
infant reveals a most interesting fact and explains why artificial
feeding is often so difficult and dangerous.
In the intestinal canal at all times many varieties of vegetable
organisms (bacteria) are present. These are called floral organisms.
Some of these aid digestion while some others increase disturbance in
the intestines, particularly if in excess, or if digestive derangements
occur.
The flora which predominate are those peculiar to the infant which is
properly digesting human milk. This accounts for the uniform action of
the bowels in breast-fed infants. As soon as the child gets milk from
the breast, the intestinal flora assume this definite form.
When cow’s milk or any other food is given, the intestinal flora
change. When the change is made too suddenly, these new flora which
live on the digested products of human milk gradually disappear and
the action of the new flora often causes intestinal derangements which
the infant is not strong enough to overcome.
* * * * *
[Sidenote: Composition of Human Milk]
If artificial feeding must be resorted to, the composition should
resemble mother’s milk as nearly as possible. It is impossible to
duplicate it exactly and even though the elements and the proportion
of them are the same, the bacterial flora will be different and
consequently the effect also.
If the breasts are emptied regularly, human milk varies little in
composition after the first few weeks. According to Holt there is an
average in mother’s milk of
Fat 4%
Sugar 7%
Protein 1.5%
Salt 0.2%
Water 87.3%
[Sidenote: Adaptation of Cow’s Milk]
When the baby has been fed at the breast for several months, pure cow’s
milk sometimes agrees very well, if overfeeding is avoided.
The amount of milk taken every twenty-four hours by a healthy infant is
usually about 1-1/4 ounces to the pound of the baby’s weight.
A normal infant of twelve pounds would be taking between twelve and
eighteen ounces of milk in its twenty-four hour mixture.
Budin recommends one-tenth of the body-weight daily of milk and reports
excellent results in infants after the fifth or sixth month, weighing
from thirteen to fifteen pounds.
Most infants under the age of nine months are more or less incapable of
digesting cow’s milk undiluted. If artificial food is resorted to from
the start, practically all physicians agree that the milk should be
diluted or otherwise modified during the first few months at least.
Milk diluted with water is often given, one part of milk to two parts
of water. This reduces the protein to about the amount found in breast
milk.
It is necessary to keep up the proportion of protein, as this alone
contains the important food element, nitrogen. From one-half to
three-fourths of an ounce of milk-sugar is added to the twenty-four
hours’ supply of food to approximate the seven per cent. found in
breast milk.
The proportion of milk and milk-sugar is gradually increased and the
water decreased, so that at the end of the first or second month the
baby gets equal parts of milk and water and about an ounce more of
milk-sugar. This process is continued until, near the end of the first
year, the child is on whole milk. The sugar is lessened as the water is
omitted.
If, after a few months, it is desired to give a baby starch in its
food, cereal waters made of barley, rice, wheat, or oatmeal may be used
in place of plain water.
As cow’s milk leaves the stomach more slowly than mother’s milk, longer
intervals between feeding seem advisable. When the breast-fed infant
receives nourishment every two and one-half to three hours, an infant
given a cow’s-milk preparation would be fed every three and one-half or
four hours.
The most important thing is to prevent both overfeeding and
underfeeding as these are often the greatest factors in producing
infantile disturbances. A too rapid gain in weight, (from 8 to 12
ounces a week), which often occurs in artificially fed infants, is not
a good sign.
Milk prepared according to the formula desired by the physician can now
be secured from milk laboratories in all of our larger cities. However,
the milk is apt to spoil in transit, and to secure its freshness when
one is not in or near a large city, it is best to prepare it at home.
Any intelligent mother or nurse can do this very satisfactorily if the
physician gives definite instructions.
Its careful preparation is quite as important as the correct formula.
Mineral (calcium) and protein are bone and other tissue builders, and
it is a significant fact that cow’s milk contains about twice as much
protein and a little more than twice as much of the mineral as mother’s
milk, indicating that the growth of the human infant is to be slow.
The calf requires about four years for full growth and the human being
twenty-one years. Both human and cow’s milk, however, contain an equal
amount of fat, the heat-producing element, as Nature intended that the
infant should be warm and active.
It seems almost impossible to get milk from the cow as clean and
free from bacteria as it should be and therefore sterilization and
pasteurization are resorted to almost universally. Various substances
such as formaldehyd, boric acid, and salicylic acid are used by dealers
to preserve the milk. These all have a deleterious effect on the child.
Therefore the safety of the child demands that the mother choose a
reliable dairy. The milk may be analyzed occasionally to make sure of
its purity.
[Sidenote: Top-Milk]
A very popular milk preparation and one frequently prescribed by
physicians is the top-milk method as originated by Dr. Holt.
Top-milk is that at the top of milk bottles in which milk has been
allowed to stand for five or six hours.
The cream at the top contains the most fat. For instance, in a quart of
milk that has been permitted to stand, the
Upper 4 ounces contain 20 per cent. of fat.
” 6 ” ” 16 ” ” ” ”
” 8 ” ” 12 ” ” ” ”
” 10 ” ” 11 ” ” ” ”
” 12 ” ” 9 ” ” ” ”
” 14 ” ” 8 ” ” ” ”
” 16 ” ” 7 ” ” ” ”
” 20 ” ” 6 ” ” ” ”
” 24 ” ” 5 ” ” ” ”
To remove the top-milk, the first ounce is taken out with a spoon and
the remainder with a Chapin milk dipper which contains one ounce.
The following formula is considered a good top-milk mixture, although
it is not supposed to meet the needs of all infants and would therefore
have to be modified in some cases and made stronger in others.
TOP-MILK MIXTURE
Top-milk (upper 8 ounces) 2-1/2 ozs.;
Bottom-milk 1 oz.;
Limewater 1/2 oz.;
Milk-sugar 1 measure (1/2 oz.);
Water, sufficient to make 8 ozs.
The sugar is dissolved by boiling it in the quantity of water to be
used for the mixture. If not perfectly clear, it is strained through
cheesecloth.
The one thing to be particularly guarded against is overloading the
stomach with rich food. On account of the high percentage of fat,
digestive disturbances often occur when top-milk is used. Some infants
can dispose of an abundance of fat from the beginning and most of them
can after six or nine months, but many infants have difficulty in
digesting fat. The condition called “fat rickets” may exist, though the
child may seem to thrive and increase in weight. Its flesh, however, is
not hard and firm as it should be in health.
The cream from Guernsey and Jersey cows is usually too rich for infants
and therefore the best milk for the baby is that from Holstein or grade
cows. The mixed milk from various cows is usually best.
The physician can determine from the stools if the fat ratio is too
high, in which case it is best to use top-milk lower in percentage of
fat, and lengthen the feeding intervals to four hours.
* * * * *
[Sidenote: Certified Milk]
If the additional expense of certified milk can be met, it is advisable
to use it in preparing the baby’s food, as it is reasonably constant in
its composition and is prepared under the most hygienic conditions, in
accordance with the requirements of the American Association of Medical
Milk Commissions.
All utensils used in preparing the baby’s milk must be absolutely
clean. Bacteria develop very quickly in milk and, therefore, the
bottles, nipples, etc., should be kept as germ-free as possible by
being boiled daily, and the nipples, when not in use, should be kept in
a solution of boracic acid (one-fourth ounce boracic acid to one-half
pint of water).
The artificially fed baby does not usually thrive as well as the
breast-fed infant. It does not gain in weight as fast and the teeth are
slower in coming. The general condition of the baby, and a steady, even
if slow gain in weight, will indicate whether the food is agreeing.
Every baby, however, is a law unto itself and it sometimes requires
considerable study to determine what is the best food. Even with the
utmost care a cow’s-milk preparation cannot be made identical with
mother’s milk and sometimes an entirely different mixture must be
resorted to.
However, no mother should attempt to experiment on her baby or permit
herself to be misled by the advertisements of so-called Baby Foods. It
is only when these are used in the right proportion and in combination
with other ingredients that they can be suited to the requirements of
the infant.
* * * * *
[Sidenote: Milk Modifications]
Malt used in place of milk-sugar or cane-sugar will greatly assist the
absorption of fat and decrease the tendency to fermentation and colic.
It is being extensively used in milk modifications.
It is best to use the dextrin-maltose preparations that do not contain
sodium chlorid, as it is rarely advisable to add this salt to the
infant’s food.
Some physicians have been securing very satisfactory results with a
preparation containing whey. Whey is a thin, watery fluid, looking very
much like skimmed milk; its caloric value is about 300 per quart, 9 per
ounce, barely one-half that of whole milk. It is therefore adapted only
to temporary feeding, while its low fat content is of great value in
cases of fat dyspepsia.
To secure the whey, 5 grams (1 teaspoonful) of rennet should be used
to each quart of milk. The mixture must be kept at a temperature of
about 100 F. until it separates into a liquid and a solid portion. It
is then strained through cheesecloth. Practically all the casein is
left on the cloth, the fluid being the whey. The curd should be broken
up before straining, in order to obtain, as nearly as possible, the
casein. However, about two-thirds of the milk fats remain in the curd.
The whey, besides the whey proteins, thus contains only about one-third
of the fats, but nearly all of the milk-sugar and salts. The whey still
contains the rennet and, to destroy this, the whey must be heated to at
least 140 F. for thirty minutes.
The average composition of whey according to Wachenheim is as follows:
Proteins 0.8 per cent.
Fats 1.0 ” ”
Milk-sugar 4.5 ” ”
Salts 0.7 ” ”
Water 93.0 ” ”
Sometimes sugar is the primary cause of intestinal fermentation, due to
the concentration of the whey and the relative proportions of casein
and sugar in the mixture.
According to Finkelstein and Meyer, to prepare a food which will combat
intestinal fermentation there must be:
A diminution in the quantity of milk-sugar, a diminution of the
salts through dilution of the whey, and an increase in the casein,
with varying, and, under certain circumstances, not inconsiderable
amounts of fat. After improvement has begun, an easily assimilable and
consequently little fermentable carbohydrate should be added.
They developed a food to meet these requirements to which they gave the
name of “_Eiweissmilch_.” This food is prepared as follows:
* * * * *
Heat one quart of whole milk to 100 F.; add four teaspoonfuls of
essence of pepsin, and stir. Let the mixture stand at 100 F. until the
curd has formed, then strain. Press the mass of curd through a rather
fine sieve two or three times by the means of a wooden mallet or spoon.
Add one pint of water to the curd during this process. The mixture
should now look like milk and the precipitate must be very finely
divided. Add one pint of buttermilk to this mixture.
Finkelstein and Meyer used buttermilk in the preparation of this food:
(1) Because of the small amount of milk-sugar which it contains;
(2) To obtain the good effects of the lactic acid;
(3) Because buttermilk can be kept for a longer time.
The composition of this food is:
Fat 2.5%
Sugar 1.5%
Protein 3.0%
Salts 0.5%
One quart of this milk contains about 360 calories.
They call attention to the low caloric value of this food and to the
necessity of increasing it as soon as possible by the addition of
dextrin-maltose mixtures.
They claim that it is worthy of employment in all the disturbances of
nutrition in infants, which are accompanied by diarrhea, of no matter
what kind. The use of this food has been extended by others to all
sorts of conditions including the feeding of healthy infants and the
newly born, and good results are claimed for it.
To use a food low in sugar and salts and high in protein in the
fermentative conditions caused by sugar, is rational. In these
conditions the substitution of the dextrin-maltose mixtures for lactose
is also good.
Not all disturbances of nutrition accompanied by diarrhea, however,
are due to the same cause and should not be treated in the same way.
No method of feeding can be applicable to both the sick and the well,
nor can all babies be given the same food without regard to their
individual digestive ability.
The main principles of this method of treating intestinal fermentative
conditions may be used and, at the same time, the disadvantages of a
routine food may be avoided, by applying the modification of milk by
the percentage method as given by Moise and Talbot.
* * * * *
[Sidenote: Sterilizing and Pasteurizing]
To sterilize the milk it should be heated to 212 F., that temperature
being maintained for ten minutes or longer.
Many physicians consider pasteurization the better process. In this the
milk is heated to from 150 to 165 F. and kept at that temperature for
from twenty to thirty minutes. Boiling produces chemical changes, such
as converting the milk-sugar into caramel, etc., while pasteurizing
does not.
After pasteurization or sterilization, the milk should be quickly
cooled to a temperature of 40 F. or lower and kept, until used, in
bottles corked with non-absorbent cotton.
Sterilized or pasteurized milk does not keep as well as raw milk
probably on account of the change in the ferments which destroy
bacteria; therefore the baby’s milk should be pasteurized fresh every
day.
Freeman’s pasteurizer is a very satisfactory and simple device. It
consists of a metal pail into which is fitted a rack with a separate
cylinder for each bottle. This holds just enough cold water to surround
the bottle and keep it from cracking through a sudden change of
temperature. The pail, containing a certain amount of water, is placed
on the stove, the water is heated to the boiling point, the pail being
then removed. The rack of bottles containing the milk preparation, with
corks of non-absorbent cotton, is placed in it and the lid applied.
The apparatus is placed away from a direct current of air for about
forty-five minutes.
As the water in the pail cools, the milk in the bottles grows warm
until both are at the same temperature. After forty-five minutes, cold
water is turned into the pail to cool the bottles rapidly. They are
then kept on ice until again warmed ready for use.
This is the simplest and best way to pasteurize milk and the expense is
small.
Improvised apparatus may be used, but it requires much more labor and
is not as satisfactory.
All milk should be sterilized or pasteurized before being used as a
food for infants.
The following table shows an analysis of milks and infant foods helpful
in the selection of a food to supply deficiencies indicated by a
chemical analysis of the infant.
COMPARATIVE ANALYSIS OF MILKS AND INFANT FOODS (COMPILED)
(Percentage of Composition of the Dry Substance)
———————————————+—————————+—————————+—————————+—————————
| | | |
|Mother’s | Cow’s |Borden’s |Horlick’s
COMPONENTS | Milk | Milk | Malted | Malted
| | | Milk | Milk
| | | |
———————————————+—————————+—————————+—————————+—————————
Protein |14.00 |27.00 |15.10 | 13.83
Fat |31.00 |31.00 | 9.20 | 7.90
Cane-Sugar | None | None | None | None
Other Soluble | | | |
Carbohydrates | | | |
(Lactose, | | | |
Maltose, etc.)|52.00[18]|36.00[18]|69.77[19]| 66.56
Starch | None | None | None | None
Ash (Mineral | | | |
Content) | 2.00 | 5.00 | 3.46 | 3.42
———————————————+—————————+—————————+—————————+—————————
———————————————+—————————+———————————+—————————+—————————
|Borden’s | Nestle’s |Mellin’s | Eskay’s
|Condensed| Food | Food | Food
COMPONENTS | Milk | (Milk | (Milk | (Milk
| (Eagle |Substitute)|Modifier)|Modifier)
| Brand) | | |
———————————————+—————————+———————————+—————————+—————————
Protein | 10.10 | 12.40 | 12.10 | 6.82
Fat | 12.10 | 4.15 | 0.25 | 3.58
Cane-Sugar | 59.1 | 22.10 | None | None
Other Soluble | | | |
Carbohydrates | | | |
(Lactose, | | | |
Maltose, etc.)| 16.0[18]| 35.00[19]|84.00[19]| 56.78[20]
Starch | None | 25.70 | None | 30.42
Ash (Mineral | | | |
Content) | 2.4 | 1.62 | 3.78 | 1.00
———————————————+—————————+———————————+—————————+—————————
The following table from Holt shows at a glance the comparative average
composition of human and cow’s milk:
HUMAN AND COW’S MILK COMPARED
—————————+————————————+———————————
| Human Milk | Cow’s Milk
—————————+————————————+———————————
Fat | 4% | 4%
Sugar | 7% | 4.5%
Proteins | 1.5% | 3.5%
Salts | 0.2% | 0.75%
Water | 87.30% | 87.25%
—————————+————————————+———————————
Total | 100.00% | 100.00%
—————————+————————————+———————————
* * * * *
[Sidenote: Gruels]
Barley, rice, oatmeal, corn meal and soy-bean flour are generally used.
If the grains of the cereals are used, they must be cooked from three
to four hours.
As a rule, cereal gruels are made by cooking the flour and water for
from fifteen to twenty minutes. Two ounces to the quart is about as
strong as plain gruels can be made.
_Dextrinized_ gruels may be made as high as eight ounces to the quart.
Four level tablespoonfuls of the cereal flour weigh one ounce.
As the soy bean contains no starch, it does not thicken when cooking.
About 1 level tablespoonful to 3 ounces of soy-bean flour are used to
the quart. One or 2 tablespoonfuls of barley, oat, or wheat gruel may
be added before cooking to increase the nutritive value. One ounce of
soy-bean flour, or 2 ounces of barley flour, to 1 quart of water makes
a very good standard gruel. It contains 2 per cent. protein, 0.6 per
cent. fat, 5.1 per cent. carbohydrates, giving a food value of ten
calories per ounce, just one-half the value of milk. In certain forms
of intestinal trouble in which cow’s milk is not assimilated, this
gruel is valuable used with condensed milk.
Malted gruels are made by adding 1 teaspoonful of good malt extract
or diastase to a cereal gruel after it has been cooled. It should be
stirred in very thoroughly.
* * * * *
[Sidenote: Vomiting]
In artificial feeding “spitting” is usually an annoying symptom that
does not indicate anything more serious than an overloaded stomach.
This condition is usually relieved by lengthening the feeding intervals
to four hours.
On the other hand, vomiting usually indicates something more serious in
a bottle-fed baby, especially if it is very persistent. It is usually
a sign that cow’s milk, or the preparation of it, is not agreeing with
the infant. It also indicates a digestive disturbance that should be
treated only by the physician, who will probably change the formula.
Occasional vomiting is sometimes due to too rich food and too frequent
feeding. Lengthening the feeding hours and decreasing the amount of fat
in the mixture will usually eliminate the trouble.
* * * * *
[Sidenote: Colic]
This is the most common of all of baby’s troubles. It is often due to
too rapid feeding either from the breast or bottle, and when there is
a tendency to colic, the feeding should be slower. The baby should not
be fed while it is suffering from colic, even though it seems that the
drinking of warm milk relieves it temporarily. Hot water should be
given every half-hour or hour until relieved. If the baby seems cold,
hot water slightly sweetened, and a hot bath, should be given at once.
A hot-water bottle may be placed near it as well.
In colic there is severe pain in the abdomen, which is swollen and
hard. Sudden and violent crying is usually a symptom of colic, which
often ceases very suddenly after the emission of gas from the mouth or
bowels.
If the baby seems exhausted, the physician should be summoned at once,
but these suggestions may be helpful until the physician arrives.
When colic is very frequent in a bottle-fed baby, the food should be
modified.
* * * * *
[Sidenote: The Stools in Infancy]
The character of the stools depends primarily on the composition of the
food. They are varied according to the digestive powers of the infant,
and according to the amount and rapidity of absorption of the products
of digestion. The amount of absorption depends to a considerable extent
on the rapidity with which the contents pass through the intestinal
tract.
* * * * *
The nature of the food, of course, influences the character of the
stools. The examination of the stools is of the greatest aid in
determining whether or not any given food element is properly digested
and assimilated, and, in many diseased conditions, in telling what
element is at fault. This, however, can only be determined by analysis,
but a little information on this subject will be of value to the mother
or nurse.
During the first few weeks or months of life, the breast-fed infant
has three or four stools daily. These are of about the consistency
of thick pea soup and are golden yellow. The number of stools
gradually diminishes to two or three in the twenty-four hours, and the
consistency becomes more salve-like.
It is not uncommon for thriving breast-fed babies to have a large
number of stools of diminished consistency and of a brownish color; in
such instances, the examination of the breast milk will show that the
proteins are high.
It is best not to pay too much attention to the stools if the baby is
gaining in weight and appears well. It is not unusual to find many soft
fine curds and sometimes mucus in the stools of healthy breast-fed
babies.
It is not only unnecessary, but decidedly wrong to wean a baby simply
because the stools are abnormal, if it is doing well in other ways. The
breast-fed infant will often go weeks or months without a normal stool
and yet thrive perfectly. On the other hand, if a baby has such stools
when it is taking cow’s milk it is a decided evidence of malnutrition.
Infants that are thriving on cow’s milk have, as a general rule, fewer
movements in the twenty-four hours than do breast-fed babies and these
movements are firmer in consistency.
* * * * *
[Sidenote: Constipation]
Constipation seems to be the chief difficulty in artificial feeding,
due usually to the poor absorption of fat, or the low percentage
necessary to prevent indigestion. If the constipation is not severe,
the substitution of oatmeal for barley water in the mixture will
usually relieve the trouble.
If the constipation is severe, causing occasional attacks of colic
or straining at stool, it is sometimes advisable to give a little
higher percentage of fat in the mixture, but this should be done very
cautiously and usually on the advice of the physician.
If, however, this does not relieve the trouble, the best plan is to
substitute one of the dextrin-maltose mixtures for milk-sugar or
cane-sugar. The malt itself is not especially laxative but it prevents
the excessive fermentation which usually occurs when the bowels are
very costive.
* * * * *
[Sidenote: Diarrhea]
Two, three, or more green and loose evacuations, even though they
may contain whitish particles of undigested fat, are of no great
significance in the breast-fed infant, but should be regarded as danger
signals in bottle-fed babies.
Even a mild attack of diarrhea is usually a symptom of fat-dyspepsia
which, if taken in time, may usually be promptly checked.
A dose of castor-oil at the beginning of the attack may relieve any
irritation that might have caused the trouble.
It is best to omit all food for at least twenty-four hours. Plain water
should be given very freely and occasionally barley water, if the baby
is hungry. After that it is best to start with a mixture low in fat.
Skimmed milk or boiled milk free from all fat, diluted with cereal
water, may be given at regular intervals.
Should slight diarrheal attacks continue, or should the stools be of a
diarrheal character, the wisest plan is to substitute a dextrin-maltose
mixture for the sugar, as malt decidedly favors fat absorption.
In almost every case of infantile diarrhea it is advisable to consult
the physician, especially if there is considerable restlessness and
rise in temperature.
Diarrhea is more frequent in summer among bottle-fed babies, as the
heat often promotes the growth of germs in the milk. Therefore to
sterilize or pasteurize milk during the heated months is especially
necessary.
A chill, due to insufficient clothing, will sometimes cause diarrhea.
The abdomen, arms, and legs should be kept warm by close-fitting
garments of soft wool.
* * * * *
[Sidenote: Anemia]
In treating anemia in infants, as in adults, the cause should be
removed by correcting any errors in diet and treating any other
physical deficiencies.
The cause of infantile anemia is an insufficient absorption of iron
from the food.
The amount of iron in both human milk and cow’s milk is small and is
insufficient for the needs of the growing infant. However, Nature has
deposited enough iron in the liver of the new-born infant to last until
it can digest foods which contain iron in sufficient amounts. The iron
in human milk is apparently more easily retained than that in the milk
of animals.
The iron content of human milk is dependent on the general condition
of the mother. It is higher in healthy individuals and lower in those
under par.
Anemia in infants is apt to become severe and often take on a
pernicious form. A prolonged intestinal disturbance often brings on
anemia, and not infrequently anemia is due to a deficiency of protein
in the food.
The treatment consists largely of additions or changes in the diet,
depending on the age of the infant. Purées of vegetables that contain
much iron, such as spinach and carrots, and also fruit juices, are
valuable and in proper proportions can be added to the diet after
the age of six months. It is best that the physician decide on the
advisability of this as it will depend on the general condition of the
infant.
* * * * *
[Sidenote: Rickets]
Rickets, a chronic impairment of nutrition, affects not only the bones,
but all of the tissues of the body, particularly the nervous system.
Artificial feeding is the chief cause of rickets on account of the poor
absorption of fats, and often because of protein starvation.
Prepared foods, on account of their large percentage of starch and
their lack of protein and butter-fat are frequently the cause of
rickets.
In addition to its fuel value, milk-fat contains the elements which
promote growth.
As previously stated, the infant requires a certain percentage of
protein, fat, and mineral for the blood and tissue building and the
growth of the bones. In artificial feeding, the preparations given are
often deficient in these important elements.
Climate and poor hygienic surroundings sometimes cause rickets in
breast-fed babies, probably on account of the lowered vitality of the
mother and the child and consequently poor digestion and assimilation,
but it is most frequently found in babies improperly fed.
Dr. Winfield S. Hall says:
Fresh milk, appropriately modified and in proper amount, together
with such other food as is indicated for the age and weight, is the
important point in the treatment of rickets. Fresh air, day and night,
sunshine and outdoor life, are only next in happiness. Cod-liver
oil, especially with the addition of phosphorus, is a very valuable
addition to the treatment.
* * * * *
[Sidenote: Scurvy]
Rickets is a chronic condition, while scurvy is an acute disease.
This difficulty is considered as entirely due to improper feeding and
therefore must be overcome by a change of diet. Recovery is usually
very rapid when the child is properly fed.
Pains and tenderness about the joints, particularly of the legs, are
the usual symptoms, causing the baby to cry when it is lifted or moved
about. The gums sometimes become swollen and bleed. In almost every
case it is found that infants suffering from scurvy have been on a
continuous diet of prepared foods like malted milk, condensed milk, or
boiled milk which Dr. Hall terms “dead food,” presumably on account of
a lack of the life-giving proteins and butter-fat.
When boiled milk has been used, the change should be made to
pasteurized milk or raw milk if it can be secured clean and fresh. If
prepared foods have been given, the amount should be greatly decreased
and replaced by a cow’s-milk preparation in which a small percentage of
the prepared food may be included, or, better still, omitted entirely,
if a cow’s-milk preparation including a good substantial gruel will
agree.
In scurvy, orange juice or other fruit juices should be given, from 1
to 4 ounces a day, according to the age. Orange juice is particularly
valuable, 2 or 3 teaspoonfuls being given before each feeding.
A lack of fresh air often aids in producing scurvy.
* * * * *
[Sidenote: Feeding during the Second Year]
After the baby has reached the age of one year, we often feel that it
is not necessary to be so careful of its diet. However, the number of
deaths due to digestive disturbances caused by improper feeding during
the second year is significant.
After the child is a year old it should be given solid food _very
gradually_ to develop its digestive functions as well as its teeth. A
soft-boiled egg or a little beef juice may be added to the diet. Until
the appearance of the anterior molar teeth, however, the child’s diet
should be confined largely to milk. A thin slice of buttered bread or
a little plain rice or rice pudding, a soda cracker or bread crumbs in
milk may be given. The year-old child may also begin to drink cow’s
milk. One or two glasses a day may be given, until the child is at
least 13 or 14 years old.
Good judgment should be used in feeding children, as habits and tastes
are being formed, and whether they are normal or abnormal will depend
on the kind of food given and when.
Four meals a day, at regular intervals, and nothing but water between
these intervals, is considered the best plan.
Dry toast, zwieback, and crackers may be gradually added to the diet,
also well-cooked cereals, like cream of wheat, rice, and oatmeal. The
oatmeal should be strained the first few months it is given. Very
little sugar should be added to the cereals, as children very quickly
cultivate a desire for sweets, rejecting other more nourishing foods,
and too much sugar is apt to disturb the digestion. It is best during
the first few months that no sugar be added to cereals.
The amount of whole milk, or milk diluted with barley or oatmeal
gruel, should be limited to one quart when the other foods are given.
Beef juice (from one to two ounces), mutton broth, chicken broth, and
cereal broths may be given after the age of one year; not more than two
ounces at first, gradually increasing in a few months’ time to four
ounces. This is best given at the beginning of the noon feeding. These
broths have little nutritive value, but usually stimulate the appetite
for other foods.
The child must build muscle, bone, and sinew, and more protein is
required as soon as he begins to walk. Milk, eggs, and cereals will
furnish this. The heavier protein diet is best given at eighteen months
to two years, in eggs, cooked soft. An egg may be given every other
day, soft boiled for about two minutes, or coddled for four minutes. At
the age of two years an egg may be given every day. These soft-cooked
eggs are best when mixed with broken dry toast or broken whole wheat or
Graham crackers, because if dry food is served with them they will be
better masticated, hence more saliva be mixed with them.
The habit of thorough mastication should be cultivated at this period.
Oatmeal, thoroughly cooked, and shredded wheat, with cream and sugar,
ripe fruit, bread and butter, milk, soft-cooked eggs (poached or
boiled), constitute a rational diet at this age.
Bread is better broken in milk because the chewing movements mix the
saliva with the milk and smaller curds are formed as the milk enters
the stomach.
Custard may after two years be added to the diet, also baked or mashed
potato, plain boiled macaroni, also a little butter on the potato,
toast, or bread.
Also after the age of eighteen months, a small quantity of very lean
meat, like scraped or chopped beef or lamb, or finely minced chicken,
may be given once a day.
Also well-cooked and mashed vegetables like peas, spinach, carrots, and
asparagus tips. For the first few months these should be strained.
Some fruit should also be given each day, orange juice, apple sauce, or
the pulp of stewed prunes; the latter especially is valuable when the
bowels are inclined to be constipated.
Tea, coffee, and cocoa are absolutely objectionable, and before the age
of two years no kind of candy should be given.
One of the most important things to teach the child, when it is taking
foods other than milk, is thorough mastication, not only to assist the
proper growth of the teeth, but to prevent the digestive disturbances
that invariably occur from the bolting of food, and children are
especially liable to do this.
Dry toast and zwieback compel mastication and strengthen the gums.
These should be given in the hand, a piece at mealtime and occasionally
between meals, if the child seems hungry. The child will then gradually
get into the habit of chewing other solid foods when they are given.
If the child is hungry between meals, he should be fed at a regular
period, midway between breakfast and luncheon and between luncheon and
the evening meal. The food should be dry (toast or a dry cracker) to
induce thorough and slow mastication.
Many object to “piecing” between meals, but if this piecing be done
at hours as regular as his meal hour, and the food be dry and well
masticated, it will readily digest and will not interfere with his
meals. The growing child needs more frequent meals than the adult.
His stomach is not so large, he is active in outdoor exercise, and
eliminates waste freely. He also requires much heat and energy. The
active child at outdoor play uses almost as much energy as the laboring
man.
Many mothers are in doubt as to whether the baby’s food should be
salted. It is necessary to add a very little salt to the food for the
baby; broths should be seasoned slightly and a pinch of salt added to
potatoes and eggs. Cereals and vegetables are cooked in water to which
a little salt has been added.
Experienced observers of children and their ailments and diseases have
said that more babies are killed by overfeeding than by underfeeding.
Especially in summer, when the child’s condition reflects that of
the mother, too much food will cause indigestion, irritation of the
stomach, and diarrhea.
Often the child is fretful because it is too warm or is thirsty. It
will often be benefited by giving it less food and more water. This
fretful mind affects the child’s digestion just as it affects the
digestion of the mother.
If a healthy child refuses good, wholesome food because it wishes some
other than what is offered it, it is not hungry and doesn’t need the
food.
The growing child craves sweets, but a child should not be given
candy whenever it wants it during the day. Candy or sugar is quickly
converted into heat and is best eaten immediately following a meal.
Sugar may be spread on bread for the four o’clock lunch or a little
candy may be eaten at this time. Two or three pieces of candy an inch
square are sufficient.
FOOTNOTES:
[18] All lactose (milk-sugar).
[19] Mostly maltose (a hard, crystalline sugar formed by the action of
malt on starch).
[20] Mostly lactose.
APPENDIX
MEASURES AND WEIGHTS
A few tables of measures may be helpful here because accurate
measurements are necessary to insure success in the preparation of any
article of food.
All dry ingredients, such as flour, meal, powdered sugar, etc., should
be sifted before measuring.
The standard measuring cup contains one-half pint and is divided into
fourths and thirds.
To measure a cupful or spoonful of dry ingredients, fill the cup or
spoon and then level off with the back of a case-knife.
In measures of weight the gram is the unit.
A “heaping cupful” is a level cup with two tablespoonfuls added.
A “scant cupful” is a level cup with two tablespoonfuls taken out.
A “saltspoon” is one-fourth of a level teaspoon.
To measure butter, lard, and other solid foods, pack solidly in spoon
or cup and level with a knife.
TABLE OF MEASURES AND WEIGHTS[21]
4 saltspoons = 1 teaspoon, tsp.
3 teaspoons = 1 tablespoon, tbsp.
4 tablespoons = 1/4 cup or 1/2 gill.
16 tablespoons (dry ingredients) = 1 cup, c.
12 tablespoons (liquid) = 1 cup.
2 gills = 1 cup.
2 cups = 1 pint.
2 pints = 1 quart.
4 quarts = 1 gallon.
2 tablespoons butter = 1 ounce.
1 tablespoon melted butter = 1 ounce.
4 tablespoons flour = 1 ounce.
2 tablespoons granulated sugar = 1 ounce.
2 tablespoons liquid = 1 ounce.
2 tablespoons powdered lime = 1 ounce.
1 cup of stale bread crumbs = 2 ounces.
1 square Baker’s unsweetened chocolate = 1 ounce.
Juice of one lemon = (about) 3 tbsp.
5 tablespoons liquid = 1 wineglassful.
4 cups of sifted flour = 1 pound.
2 cups of butter (packed solidly) = 1 pound.
2 cups of finely chopped meat (packed solidly) = 1 pound.
2 cups of granulated sugar = 1 pound.
2-2/5 cups of powdered sugar = 1 pound.
2-2/3 cups brown sugar = 1 pound.
2-2/3 cups oatmeal = 1 pound.
4-3/4 cups rolled oats = 1 pound.
9 or 10 eggs = 1 pound.
1 cup of rice = 1/2 pound.
APOTHECARIES’ WEIGHTS[22]
20 grains = 1 scruple, ℈
3 scruples = 1 drachm, ʒ
8 drachms (or 480 grains) = 1 ounce, ℥
12 ounces = 1 pound, lb.
APOTHECARIES’ MEASURES[22]
60 minims (M) = 1 fluid drachm, fʒ
8 fluid drachms = 1 fluid ounce, f℥
16 fluid ounces = 1 pint, o or pt.
2 pints = 1 quart, qt.
4 quarts = 1 gallon, gal.
APPROXIMATE MEASURES[23]
One teaspoonful equals about 1 fluid drachm.
One dessertspoonful equals about 2 fluid drachms.
One tablespoonful equals about 4 fluid drachms.
One wineglassful equals about 2 ounces.
One cup (one-half pint) equals about 8 ounces.
METRIC MEASURES OF WEIGHT[23]
In measures of weight the gram is the unit.
1 gram 1.0 gm.
1 decigram 0.1 gm.
1 centigram 0.01 gm.
1 milligram 0.001 gm.
FOOTNOTES:
[21] _Practical Dietetics_, Alida Frances Pattee.
[22] _Practical Dietetics_, Alida Frances Pattee.
[23] _Practical Dietetics_, Alida Frances Pattee.
INDEX
Absorption of food, 145
Achlorhydria, 258
Acne, 295
Adulteration of foods, 118
Age, 165
Diet in, 230
Affecting digestion, 165
Albumin, 10
Albumin water, 309
Albuminoids, 12, 56
Alcohol, 184
Alkalies, 45
Almond oil, 25
Anemia, 37, 245-250
Appetite, affecting digestion, 160, 161, 163, 164
Apples, 47, 49, 51
Apricots, 47
Arrowroot, 20
Asparagus, 43, 44
Asthma, 282
Athlete, diet for, 228
Baking soda, 136
Balanced diets, 232
Bananas, 48, 49-50
Barley, 74
Barley water, 310
Beans, 43, 82, 85-86
Beef, 53, 54
Beets, 39, 41
Beverages, 103-109
Bile, 144
Biliousness, 267
Biscuits, 68
Blackberries, 48
Blood, affecting digestion, 157
Bouillons, 57
Boy or girl, diet for, 226-228
Bread, 66
Bread and crackers, 61, 62
Graham bread
Rye bread
Wheat bread
Graham crackers
Oatmeal ”
Oyster ”
Soda ”
Breakfast foods, 72-80
Breathing, 3
Blight’s disease, 272
Brussels sprouts, 43
Business man, diet for, 224
Butter, 89
Buttermilk, 89, 101
Cabbage, 44
Caffein, 106
Calcium, 4, 6, 34, 36, 59
Calories, 127-129
Candy, 15-16
Carbohydrates, 13
Carbon, 4, 122
Carbon dioxid, 20
Carbonaceous foods, 4, 9, 10, 38-53
Carbonaceous foodstuffs, 13-25
Carbo-nitrogenous foods, 9, 61-102
Carrots, 39, 41
Casein, 90
Cassava, 20
Catarrh of intestines, 264
Catarrh of stomach, 253
Celery, 43, 44
Cells, formation of, 1, 2
Cellulose, 45
Cereal coffees, 80-81
Cereals, 61-80
Cheese, 89, 100
Cherries, 47
Chicken, 57
Chlorin, 4
Chocolate, 108
Chorea, 291
Circulation affecting digestion, 181
Citrates, 45
Citric acid, 45
Citrus fruits, 216
Clams, 55
Classification of foods, 38-102
Carbonaceous, 38-53
Fruits, 45
Green vegetables, 42
Roots and tubers, 38
Carbo-nitrogenous foods, 61-102
Cereals, 61
Legumes, 82
Milk, 89
Nitrogenous foods, 53-59
Eggs, 58
Meat, 53
Cocoa, 108
Cod-liver oil, 24
Coffee, 106-107
Condiments, 109-111
Capers
Catsup
Cinnamon
Ginger
Horseradish
Mustard
Pepper
Salt
Spices
Tabasco sauce
Worcestershire sauce
Constipation, 96, 97, 262
Convalescent, feeding the, 302
Cooking, 185-199
Corn, 71
Cornstarch, 10
Cotton-seed oil, 24
Crabs, 55
Cranberries, 48
Cream, 89
Cucumbers, 43
Currants, 48, 52
Custards, 314, 315
Dates, 48
Diabetes, 279
Diet, in abnormal conditions, 242-304
In age, 230, 231
For athlete, 228
For boy or girl, 226-228
For business man, 224
For laboring man, 229-230
In sedentary occupation, 222-224
In traveling, 213
Mixed, _versus_ vegetable, 210
Diets, 216-231
Digestion, 133-150
Intestinal, 143
Salivary, 135
Stomach, 140
Dilatation of the stomach, 259
Diuretic foods, 126
Dysentery, 265
Dyspepsia, 250
Economy in food, 148
Eczema, 294
Effervescing waters, 109
Eggnog, 60, 308
Egg preparations, 308
Eggs, 58
Elimination, 2, 130-133
Energy, 2, 13, 120-129
Enteritis, 264
Epithelium, 136
Exercise, 2
Exercise and breathing affecting digestion, 171-174
Fatigue, 174
Fats, 13, 21-25, 58, 59
Almond oil
Butter
Cod-liver oil
Cotton-seed oil
Cream
Meat fat
Nut oils
Olive oils
Figs, 48
Fish, 54, 55, 58
Flaxseed tea, 276
Flour and meals, 62-65, 73, 74
Bran
Corn
Gluten
Graham
Nutri meal
Oatmeal
Wheat
Whole wheat
Food elements, 3, 8, 9
Foodstuffs, 8-10
Frequency of meals affecting digestion, 169
Fruits, 45-53
Bland, 47
Dates
Figs
Prunes
Raisins
Sweet, 47
Apples
Bananas
Blackberries
Blueberries
Grapes
Peaches
Pears
Plums
Raspberries
Fruit juices, 305
Fruit sugar (levulose), 14, 15
Gallstones, 269
Gastritis, 253
Gelatinoids, 12, 56
Glucose, 10, 15, 16, 40
Gluten, 5, 10
Glycerin, 22
Glycogen, 16, 21, 151
Gooseberries, 47
Gout, 277
Grapefruit, 46
Grape juice, 307
Grapes, 48, 50
Greens, 43
Gruels, 314, 317
Gum-chewing, 139
Ham, 54
Heat and energy, 3, 120-129
Hives, 293
Honey, 10, 15
Hydrochloric acid, 34, 35, 46, 140
Hydrogen, 4
Hyperchlorhydria, 257
Hypochlorhydria, 257
Ice-cream, 115
Improperly balanced diet, 221
Indigestion, 250
Mental effect on, 135
Nervous, 252
Infant feeding, 320-356
Influence of mind, 177-178
Insufficient diet, effect of, vii
Intestinal disorders, 262
Intestinal indigestion, 143
Intestines, work of, 141-148
Invalids, foods for, 305
Iron, 4, 37, 59
Itching, 295
Jellies, 313, 314
Junket, 102, 314
Kidneys, derangements of, 271
Affecting digestion, 155, 160
Kumyss, 98
Laboring man, diet for, 229-230
Lactose, 15
Leanness, 298
Legumes, 63, 82-87
Beans
Lentils
Peanuts
Peas
Lemonade, 60, 108, 306
Lemons, 46, 48
Lentils, 82
Lettuce, 43
Levulose, 15
Lime, 7
Lime water, 96
Limes, 46
Liquid foods, 307
Liver, derangements of, 266
Affecting digestion, 151-152, 159
Work of, 151-152
Lobster, 55, 58
Lungs, 153, 154, 155, 160
Macaroni, 62, 69, 203
Magnesium, 4, 34, 45, 46, 59
Malates, 45
Malic acid, 45
Maltose, 15, 143
Maple sugar, 15
Meat broths, 312
Meat juices, 311
Metabolism, 1, 130-133
Milk, 308
Albuminized, 309
And milk products, 89-102
Malted, 92-93
Mind, influence of, 177
Mineral salts, 6, 34-37
Waters, 30
Mollusks, 55
Mould, 68
Mouth, 138
Mulberries, 48
Muscles, work of, 152, 160
Mussels, 58
Mustard, 110
Mutton, 54
Nasal passages, 138
Nephritis, 272
Nerves, work of, 153, 154, 160
Neuralgia, 289
Neurasthenia, 287
Nitrogen, 4, 5, 6, 10, 11
Nitrogenous foods, 9, 10, 53-60
Foodstuffs, 10-13
Nut oil, 24
Nuts, 87-88
Oats, 61
Obesity, 299
Olive oil, 24, 25
Onions, 39, 40
Orangeade, 60, 306
Oranges, 45, 46, 48
Organs and conditions affecting digestion, 151-184
Age, 165
Appetite, 160
Blood, 157
Circulation, 181
Exercise and breathing, 171
Fatigue, 174
Frequency of meals, 169
Influence of mind, 177
Intestines, 156
Kidneys, 155
Liver, 151
Lungs, 153
Muscles, 152
Nerves, 153, 154
Regularity of eating, 168
Season and climate, 164
Skin, 155
Sleep, 177
Tobacco and alcohol, 184
Ventilation, 174
Overeating, effect of, vi
Oxidation, 124, 125
Oxygen, 4
Oysters, 55, 58
Pancreatic juices, 20, 34
Pancreatin, 99, 223
Parsnips, 38, 39, 41
Pastry, 194
Peaches, 47
Peanuts, 83
Pears, 48
Peas, 43, 82, 85, 86
Pectin, 45
Pepsin, 140
Peristalsis, 142
Phosphates, 11
Phosphorus, 4, 36, 59
Pineapples, 48, 52
Plums, 47
Poisoning from food, 113-118
Potassium, 4, 34, 36, 46, 51, 59
Potatoes, 39-40
Poultry, 54
Predigested foods, 78
Preservation of foods, 111-113
Prolapsus of stomach, 259
Protein, 4, 6, 9, 10, 11, 53-60
Prunes, 48
Pruritus, 295
Ptyalin, 136
Purposes of food, 1-3
Produce heat and energy
Rebuild tissue
Pylorus, 142
Pyorrhea, 138
Quinces, 52
Raisins, 48
Raspberries, 48
Recipes for invalids and semi-invalids, 305
Regularity of eating affecting digestion, 168
Rennin or rennet, 90, 140, 141
Repair of waste, 130-133
Rheumatism, 297
Rhubarb, 43, 44
Rice, 61, 69
Rye, 61
Saccharin, 15
Sago, 10, 20
Soup, 311
Saliva, 20
Affecting digestion, 158
Salivary digestion, 135
Salts, 6, 34-37
Calcium (lime), 34, 36
Iron, 34
Magnesium, 34
Potassium, 36
Sodium, 34, 35, 36
Sausage, 54
Season and climate, 164
Sedentary occupation, diet in, 223-224
Shrimps, 55
Skin, work of, 155, 156
Skin diseases, 292
Sleep, 177
Soap, 22
Sodium carbonate (baking soda), 136
Sodium chlorid (salt), 4, 34, 35, 36, 46, 136
Souffles, 318
Soups, 313
Spaghetti, 69
Spinach, 43
Starch, 20-21, 136
Steapsin, 144
Stomach, 158
Strawberries, 48
Sucrose, 14, 15
Sugar, 10, 14, 19
Cane sugar (sucrose), 14, 15
Fruit sugar (levulose), 14, 15
Sugar of grapes or corn (glucose), 15, 16
Sugar of malt (maltose), 15
Sugar of milk (lactose), 15, 16
Sulphates, 11
Sulphur, 4, 11, 36, 59
Syrups, 10
Sweat-baths, 2
Sweetbreads, 54
Tables of use in making up balanced diets, 232
Tannin, 49, 104
Tapioca, 10, 20
Tartaric acid, 45
Tartrates, 45
Tea, 104
Terrapin, 55
Theobromin, 108
Tired, meaning of, 131
Toasts, 318
Tobacco, 184
Tomatoes, 43, 44
Traveling, diet in, 213
Trypsin, 141
Tuberculosis, 283
Turnips, 39, 41
Ulcer of the stomach, 260
Uremia, 275
Uric acid, 46
Excess of, 276
Urticaria, 293
Veal, 54
Vegetable marrow, 43
Vegetables, green, 43-45
Ventilation, 174
Villi, 146
Vitamins, 70
Volatile oil, 40, 41
Water, 25-34
Watercress, 43
Watermelons, 48
Wheat, 61, 63
Whey, 101
Wheys, 307
Whortleberries, 48
Yeast, 67
Transcriber’s Notes
pg 12 Changed: the tissues themselves wll be consumed
to: the tissues themselves will be consumed
pg 262 Changed: the condidition brings a result similar
to: the condition brings a result similar
pg 321 Changed: and in thirty-two, bottled-fed
to: and in thirty-two, bottle-fed