BOTTLE FEEDING
=Suggestions for demonstrations.= =1.= Show and demonstrate the
care of utensils to be used in modifying milk. =2.= Demonstrate
the process of modifying milk. =3.= Demonstrate the process of
pasteurizing milk.
=Foods.= Condensed milk and proprietary foods should be used only in
emergency or on the advice of a physician. They are of value only
in the rare instances when a baby cannot digest cow’s milk or when
prescribed by a physician.
=Cow’s milk.= If a baby cannot have breast milk, the next best food
is properly modified cow’s milk. Cow’s milk, when used for the baby,
must be fresh. It should be delivered in sealed bottles. Milk sold from
open cans should never be given to a child. Milk should not be left
standing on the doorstep nor in a warm kitchen, but should be placed in
the ice box as soon as received, where it should be kept covered and at
a temperature between 35° and 45° F.
=Choice of milk.= Whenever possible, certified milk should be used.
_Certified milk_ is milk produced under conditions that conform to
certain standards of cleanliness laid down by the state. Uncertified
milk may of course often be used without danger, but if there is any
question about its purity, it should be pasteurized (see page 52 for
directions for pasteurizing).
COMPARISON OF MOTHER’S MILK AND COW’S MILK
+---------------+---------------+---------------+
| | MOTHER’S MILK | COW’S MILK |
+---------------+---------------+---------------+
| Fat | 3.50 per cent | 4.00 per cent |
| Sugar | 7.00 per cent | 4.50 per cent |
| Protein | 1.25 per cent | 3.50 per cent |
| Salts | .20 per cent | .70 per cent |
+---------------+---------------+---------------+
No matter how cow’s milk is modified, it differs from human milk in
certain other ways that we do not understand, and this renders it less
desirable for infant feeding than human milk.
=Modified milk.= The formula for the baby’s food must be given by a
nurse or a physician. The following general directions for feeding a
baby that does not require a special formula have been prepared by a
committee of the American Medical Association:
Beginning on the third day the average baby should be given three
ounces of milk daily, diluted with seven ounces of water. To this
should be added one tablespoon of limewater and two level teaspoons
of sugar. This should be given in seven feedings.
At one week the average child requires five ounces of milk daily,
which should be diluted with ten ounces of water. To this should
be added one and one-half even teaspoons of sugar and one ounce of
limewater. This should be given in seven feedings. The milk should
be increased by one-half ounce about every four days. The water
should be increased by one-half ounce every eight days.
[Illustration: MODIFICATION OF THE MILK]
At three months the average child requires sixteen ounces of milk
daily, which should be diluted with sixteen ounces of water. To
this should be added three tablespoons of sugar and two ounces of
limewater. This should be given in six feedings. The milk should
be increased by one-half ounce every six days. The water should be
reduced by one-half ounce about every two weeks.
At six months the average child requires twenty-four ounces of milk
daily, which should be diluted with twelve ounces of water. To this
should be added two ounces of limewater and three even tablespoons
of sugar. This should be given in five feedings. The amount of milk
should be increased by one-half ounce every week. The milk should be
increased only if the child is hungry and digesting his food well. It
should not be increased unless he is hungry, nor if he is suffering
from indigestion, even though he seems hungry.
At nine months the average child requires thirty ounces of milk
daily, which should be diluted with ten ounces of water. To this
should be added two even tablespoons of sugar and two ounces of
limewater. This should be given in five feedings. The sugar added
may be milk sugar or, if this cannot be obtained, cane (granulated)
sugar or maltose (malt sugar). At first plain water should be used to
dilute the milk.
At three months, sometimes earlier, a weak barley water may be used
in the place of plain water; it is made of one-half level tablespoon
of barley flour to sixteen ounces of water and cooked for twenty
minutes. (See Appendix B.)
Fill the feeding bottles, cork them, and put on the ice. If the milk
is not certified, it should be pasteurized.
=Utensils.= The utensils used for preparing the baby’s food should be
reserved exclusively for that purpose. The best material for these
utensils is enamel or agateware.
LIST OF UTENSILS
1. A big covered kettle or dish pan. This should measure at least
eighteen inches in diameter, so that all other utensils may be boiled
in it at one time.
2. Bottles. There should be as many bottles as there are feedings in
one day.
3. Nipples. It is important to select those that can be turned wrong
side out to be cleaned.
4. A bottle brush.
5. A nipple brush.
6. A sixteen-ounce graduated measuring glass.
7. A tablespoon, teaspoon, and cream dipper.
8. A teapot of enamel or agateware in which sterile water is kept for
use as needed.
9. A wire rack for holding bottles.
10. A roll of nonabsorbent cotton for the stoppers for the feeding
bottles.
=Pasteurizing.= This process consists of heating the milk to 145° F.
and keeping it at this temperature for thirty minutes. The following
method may be used: Fill the bottles with the modified milk and place
in the wire rack. Put the rack in a dish of water, with the water
just above the level of the milk. Suspend a milk thermometer in the
water and heat until the thermometer registers 145° F. Keep at this
temperature for thirty minutes, then take out the rack and cork the
bottles at once. Place carefully in a dish of cool water or put an
inverted basin over the rack containing the bottles and set under the
cold-water faucet. Cool quickly and place on the ice at once.
[Illustration: PASTEURIZING THE BABY’S MILK]
If no pasteurizing outfit is at hand, the bottles of milk may be
heated in a double boiler until the steam arises. Continue heating at
this temperature for fifteen minutes. If the pasteurized milk is used
for a long time, it is well to give the baby orange juice to prevent
rickets and scurvy. This should be given in the morning, regularly,
three quarters of an hour before feeding time. One teaspoonful should
be given at first, and the amount gradually increased up to one
tablespoonful.