The rubber comforter is one of the most fertile causes of infection and illness in babies because of the peculiar adaptability to collecting germs which it possesses.

When the comforter is finally discarded the habit of sucking is so firmly established that the child will suck its thumb for many years after. This results in further disease and deformity to the growing mouth and throat, and also to the thumb.

After a child has used a pacifier or comforter for some time it invariably becomes a mouth breather. A mouth-breathing child is very apt to catch cold and as a consequence of the habit may become catarrhal or tubercular.

WHAT CAN BE DONE TO LESSEN THE EVIL EFFECTS OF THE "COMFORTER"

HABIT?--It is a most difficult habit to cure when once established. The very least that can be done is to keep the comforter scrupulously clean, washing it several times daily. To have not one, but two or three, kept in a saturated solution of boracic acid, ready to put into the baby's mouth should one be required to replace another that has fallen out. We should furnish a large shield to prevent it being swallowed. We can try the method of weaning the baby from the comforter by tying a ribbon to it and to the child's bodice. The system is gradually to shorten the ribbon until it becomes too short for the baby to suck in comfort. It will then gradually grow away from the habit.

FOOD FORMULAS

BEEF JUICE.--Take one pound of round steak and broil it slightly. Press the juice out with a lemon squeezer, or, with a meat-press. Season with salt and serve hot or cold as desired. If it is heated after it has once been cold, it should not be overheated as this will coagulate the alb.u.men which will appear as flakes floating on the surface of the juice.

BEEF JUICE BY THE COLD PROCESS.--Take one pound of finely chopped round steak, six ounces of cold water, a pinch of salt; place in a covered jar and stand on ice, or in a cool place, six hours. This mixture should be shaken from time to time. Strain and squeeze all the juice out by placing the meat in a coa.r.s.e cloth and twisting it very hard. Season and feed as above.

Beef juice made in this way is more nutritious than that made from the steak when broiled; it is not, however, quite so palatable.

Beef juice made in either of the above ways is much more nutritious than the beef extracts sold ready to use.

MUTTON BROTH.--Take one pound of finely chopped lean mutton, including some of the bone, one pint of cold water and a pinch of salt, cook for three hours over a slow fire down to half a pint, adding water to make up this quant.i.ty if necessary; strain through muslin. When it is cold remove the fat and add more salt if required. It may be fed warm or cold in the form of a jelly.

MUTTON BROTH WITH CORNSTARCH OR ARROWROOT.--Add to the above sufficient cornstarch or arrowroot to thicken, cook for ten minutes and then add three ounces of milk, or one ounce of thick cream, to a half pint of broth. This makes a nutritious and extremely palatable broth.

CHICKEN, VEAL, AND BEEF BROTHS.--These may be made and used in the same way as mutton broth.

Sc.r.a.pED BEEF OR MEAT PULP.--Take a rare piece of round or sirloin steak, cut the outer part away, sc.r.a.pe or shred with a blunt knife. Cutting the meat into small pieces is not satisfactory. One teaspoonful to one tablespoonful may be given well salted, to a child a year and a half old. It is best to begin with a small dose and work up to the larger to accustom the digestive apparatus to its use.

JUNKET, OR CURDS AND WHEY.--Take one pint of warm fresh cow's milk, a pinch of salt, a teaspoonful of granulated sugar, to which add two teaspoonfuls of Fairchild's essence of pepsin and allow the mixture to stand until firmly coagulated--this may take about twenty minutes--place in the ice box until thoroughly cold. Nutmeg may be added for older children and adults.

WHEY.--The coagulated milk prepared as above is broken up with a fork and the whey is strained off through cheesecloth. If a stimulant is desired, brandy, in the proportion of one teaspoonful to six tablespoonfuls of the whey may be added.

BARLEY WATER.--One level tablespoonful of Robinson's barley is rubbed up with a little cold water, to this is added one pint of boiled water containing a pinch of salt. The mixture should be stirred while the water is being added. Cook for thirty minutes in a double boiler and strain. Enough boiling water should be added to the mixture to make up the full pint if any has boiled away.

BARLEY GRUEL OR BARLEY JELLY.--Repeat the above process, but instead of using one tablespoonful of the barley powder, use from two to four according to the consistency of the gruel or jelly desired.

Barley water may be made from the grains. A formula for this process will be found in the chapter on artificial feeding.

RICE, WHEAT, OR OAT WATER.--These are made from the rice, wheat, or oat flour in the same way as barley water described above. They may be made from the grains also, using the same proportions as in the making of barley water.

IMPERIAL GRANUM.--This is prepared in the same way as the barley flour above described.

ALb.u.mEN WATER.--Take half a pint of cold water, the white of one fresh egg, a pinch of salt, and a teaspoonful of brandy, shake and feed from a spoon or from a bottle. This is frequently used in cases of vomiting, or in irritable stomachs. It is often retained when all other food is rejected.

DRIED BREAD.--Cut either stale or fresh bread into thin slices and place in the open oven. When it is dried and crisp but not browned it may be given to children in preference to crackers.

CODDLED EGG.--A fresh egg with the sh.e.l.l intact is placed in boiling water which is immediately removed from the fire. The egg is allowed to remain in the water for eight minutes when it is ready for use. The white only should be used if the digestion is poor.

ARTIFICIAL FEEDING

CHAPTER XIX

ARTIFICIAL FEEDING

Elementary Principles of Milk Modification--The Secret of the Efficiency of Mother's Milk--Two Important Factors in Successful Artificial Feeding--Every Child is a Problem in Itself--Proprietary Foods of Little Value as Infant Foods--Their Value is in the Milk Added to Them--The Credit Belongs to the Cow--Difference Between Human and Cow's Milk--What "Top-milk Feeding" Means--Utensils Necessary for Home Modification of Milk--Artificial Feeding from Birth to the Twelfth Month--How to Measure Top-milk--Easy Bottle-feeding Method--Condensed Milk Feeding--Objections to Condensed Milk Feeding.

ELEMENTARY PRINCIPLES OF MILK MODIFICATION.--Mothers who have to raise their children on artificial food should understand the elementary principles of milk modification. They should know, for example, that the one object of milk modification is to render it as nearly an exact subst.i.tute for mother's milk, according to the age of the child, as is possible. If we could do this with scientific exactness, artificial feeding would be a simple process. We cannot, however; nor has there ever been devised a method by which we may hope successfully to duplicate mother's milk. It is a comparatively simple matter for the efficient chemist to a.n.a.lyze the breast milk of any nursing mother; and it is quite possible to duplicate the milk according to the a.n.a.lysis, with chemical exactness, but the two fluids will not be the same. There is present in the mother's milk something which synthetic chemistry cannot discover. This something is nature's secret,--it is akin to the life-giving principle which is contained in the germinal fluid, and in the hen's egg. We cannot therefore hope to build up an artificial food that contains this mysterious life-giving principle which is the secret of the efficiency of maternal milk,--we can only hope to approximate it. It is possible that we might be successful so far as its nursing efficiency is concerned, if all children were alike, if all children were of a uniform standard of health. As a matter of fact, no two babies are exactly alike. And while the mother of each child undoubtedly secretes a milk suitable to the degree of healthfulness of her own child, the same milk might not be equally suitable to another child. The milk, therefore, that is manufactured to agree with an average mother's milk is dependent for its success upon the vitality of the child to which it is fed. If that child is not a well child, according to an accepted standard, the milk will not agree with it, even though it is the best possible subst.i.tute for an average breast milk.

We have consequently two factors to consider in successful or efficient artificial feeding:

1. Our inability to duplicate exactly mother's milk.

2. The lack of a uniform health standard in children.

It is the lack of a uniform health standard in children that gives to artificial feeding all its difficulties. It renders the successful artificial feeding of children a personal or individual problem. Some children,--those who approximate a standard of health for their age; in other words, "well" children,--thrive on a milk modification that experience has taught us is suitable for well children of their age.

Others, and they are in the majority, have to be fed on a modification which actual test proves to agree with their digestive capabilities.

Every artificially fed child therefore must be studied from its own individual standpoint. A certain modification of milk may not agree with a child fed every two and one-half hours, which will be found to agree if fed in the same quant.i.ty, to the same child, every three hours. The slightest change, a change which would seem to be so insignificant in itself as not to justify serious consideration, may mean the difference between normal healthfulness and constant ill health. A food that is too strong for a child's digestive ability, and which causes vomiting, colic, and diarrhea, may be rendered exactly right by the slightest modification one of its const.i.tuents. To effect such a change quickly and successfully, one must be trained to interpret the symptoms correctly and to know how to make the change in the modification of the milk. Mothers cannot be expected to possess this degree of skill: they should therefore refrain from experimenting, because an experiment on a baby is not only dangerous, but ethically it is criminal. Call the family physician; put the burden on his shoulder.

It is this element of uncertainty in our ability to effect a standard modification of milk that has afforded manufacturers the rich opportunity of putting on the market various baby foods for which much is claimed. These foods are really subst.i.tutes for the inefficiency of the average mother. There is no real justification for their use. If all mothers were clean, faithful, and efficient, there is no reason why each one could not be taught to modify cow's milk to suit her child, just as satisfactorily, or more so, than a manufacturer who never saw her child.

The manufacturers, however, do the work, and the naturally ignorant or lazy and inefficient mother, is willing to pay for the extra cost of labor, to save herself the trouble on the one hand, and to subject her child to a series of experiments in order to discover the manufactured food that is particularly adapted to her particular baby on the other hand. We believe that most mothers have never considered the question from this standpoint; that most mothers adopt this method of artificial feeding at the direct suggestion of their family physician, and are not, therefore, responsible. These foods do not contain the nutritional elements necessary to healthy growth; or as they exist in normal breast milk; or as they can be approximated in ordinary milk modification at home. Proprietary foods are of decidedly poor value in infant nutrition, and should not be used. They have a value, however, in certain diseased conditions, but within a very small range. As a food for a healthy growing infant, they should not be used, and when the average physician appreciates this fact, and so instructs the mothers of the country, it will be to the distinct advantage of the race in every respect.

Proprietary foods to which fresh cow's milk is added, are not foods at all,--they depend upon the milk so far as any nutritional value is concerned; and it would be far safer to modify at home a good milk than to buy a proprietary food, the a.n.a.lysis of which cannot be depended upon. The credit for the fat, healthy babies we see advertised does not belong to the manufacturers, but to the cow whose milk you add to the manufacturer's sugar.

The proprietary beef foods are also valueless as infant foods. In certain illnesses, when we want a mild stimulant, a teaspoonful or two in hot water may have a certain value, but that is all. The beef juice of home manufacture is much more valuable.

DIFFERENCE BETWEEN HUMAN AND COW'S MILK.--The composition of cow's milk is as follows:

Fat (represented by cream) 4% Sugar 4% Proteids (represented by curd) 4%

The composition of an average human breast milk is as follows:

Fat 4% Sugar 7% Proteids 1-1/2%

It will be observed from a comparison of the above tables that cow's milk is much richer in proteids (the substances which form with water the curd of sour milk) than is human milk. If one remembers that cow's milk is manufactured by nature primarily for the feeding of calves, not for babies, and that the stomach of a calf is intended to exist exclusively on vegetable products, and that nature is preparing it for this purpose, and feeds it a food when young that will enable it to grow so as to be adapted for that purpose, one can understand that the problem of the modification of cow's milk to suit the stomach of a baby is not by any means a simple matter. Since the proteids are so much in excess in cow's milk, we must dilute cow's milk with twice its bulk or more of water to render it fit food for a new born baby. If we dilute cow's milk to this extent to get the proteid percentage right, we immediately disarrange the percentage of the cream or fat. We overcome this difficulty by taking the cream from the top of the bottle and diluting it because it is richer in fat and does not need so much dilution. This is the explanation of the so-called "top-milk feeding."

The percentage of sugar represents another problem. The percentage of sugar in cow's milk compared with the sugar in human milk is deficient, so we add milk-sugar to the cow's milk to make up the deficient percentage.

There is yet another feature which we must rectify; cow's milk is acid, while human milk is alkaline. To overcome this difference we add lime-water. We must also take into consideration that cow's milk is ordinarily full of germs, while human milk is free from them; to overcome this danger we resort to heating the milk to a degree which experience has taught us will kill all germs. Cooked milk is not as wholesome as uncooked milk, and it has a tendency to cause constipation.

We have to a certain extent overcome the need for cooking all milk for babies, as will be noted later, but in summer time, unless the milk is known to be pure and free from germs, it is advisable to sterilize it.

UTENSILS NECESSARY FOR HOME MODIFICATION OF MILK

One dozen round, eight-ounce nursing bottles.

One dozen black rubber nipples.

One eight-ounce measuring gla.s.s or graduate.