DIET FOR THE YOUNG

A very large share of the mortality among young children results from dietetic errors which proper knowledge and care on the part of those who have them in charge might commonly avoid. From infancy to the age of twelve or eighteen months, milk is the natural and proper food. Milk contains all the food elements except starch, which cannot be digested by very young children, owing to the insufficient formation of digestive elements of the salivary secretion during the first few months. If the child is deprived of the milk provided by nature, the best artificial food is cow's milk; it, however, requires very careful selection and intelligent preparation. The animal from which the milk comes, should be perfectly healthy and well cared for. The quality of her food should also receive attention, as there is little doubt that disease is often communicated to infants by milk from cows improperly fed and cared for. An eminent medical authority offers the following important points on this subject:--

"The cow selected for providing the food for an infant should be between the ages of four and ten years, of mild disposition, and one which has been giving milk from four to eight weeks. She should be fed on good, clean grain, and hay free from must. Roots, if any are fed, should be of good quality, and she should have plenty of good clean water from a living spring or well. Her pasture should be timothy grass or native grass free from weeds; clover alone is bad. She should be cleaned and cared for like a carriage horse, and milked twice a day by the same person and at the same time. Some cows are unfit by nature for feeding infants."

Milk from the same animal should be used if possible. Changing from one cow's milk to another, or the use of such milk as is usually supplied by city milkmen, often occasions serious results. The extraction of the heat from the milk immediately after milking and before it is used or carried far, especially in hot weather, is essential. While the milk itself should be clean and pure, it should also be perfectly fresh and without any trace of decomposition. To insure all these requisites, besides great care in its selection, it must be sterilized, and if not intended for immediate use, bottled and kept in a cool place until needed. It is not safe to feed young children upon unsterilized milk that has stood a few hours. Even fresh milk from the cleanest cows, unless drawn into bottles and sealed at once, contains many germs. These little organisms, the cause of fermentation and decomposition, multiply very rapidly in milk, and as they increase, dangers from the use of the milk increase.

There is no doubt that cholera infantum and other digestive disturbances common among young children would be greatly lessened by the use of properly sterilized milk. Directions for sterilizing milk, and additional suggestions respecting points to be considered in its selection, are to be found in the chapter on Milk, etc.

Cow's milk differs from human milk in that it contains nearly three times as much casein, but only two thirds as much fat and three fourths as much sugar. Cow's milk is usually slightly acid, while human milk is alkaline. The casein of cow's milk forms large, hard curds, while that of breast milk forms fine, soft curds. These facts make it important that some modification be made in cow's milk to render it acceptable to the feeble stomach of an infant. Cases are rare where it is safe to feed a child under nine months of age on pure, undiluted cow's milk. A common method of preparing cow's milk so as to make it suitable for infant feeding, is to dilute it with pure water, using at first only one third or one fourth milk, the proportion of milk being gradually increased as the child's stomach becomes accustomed to the food and able to bear it, until at the age of four months the child should be taking equal parts of milk and water. When sterilized milk is to be thus diluted, the water should be first boiled or added before sterilizing. A small amount of fine white sugar, or what is better, milk sugar, should be added to the diluted milk. Barley water, and thin, well-boiled, and carefully strained oatmeal gruel thoroughly blended with the milk are also used for this purpose. A food which approximates more nearly the constituents of mother's milk may be prepared as follows:--

ARTIFICIAL HUMAN MILK NO. 1.--Blend one fourth pint of fresh, sweet cream and three fourths of a pint of warm water. Add one half ounce of milk sugar and from two to ten ounces of milk, according to the age of the infant and its digestive capacity.

ARTIFICIAL HUMAN MILK NO. 2.--Meigs's formula: Take two tablespoonfuls of cream of medium quality, one tablespoonful of milk, two of lime water, and three of water to which sugar of milk has been added in the proportion of seventeen and three fourths drams to the pint. This saccharine solution must be prepared fresh every day or two and kept in a cool place. A child may be allowed from half a pint to three pints of this mixture, according to age.

ARTIFICIAL HUMAN MILK NO. 3.--Prepare a barley water by adding one pint boiling water to a pint of best pearl barley. Allow it to cool, and strain. Mix together one third of a pint of this barley water, two thirds of a pint of fresh, pure milk, and a teaspoonful of milk sugar.--_Medical News._

Peptonized milk, a formula for the preparation of which may be found on page 426, is also valuable as food for infants, especially for those of weak digestion.

MUCILAGINOUS FOOD EXCELLENT IN GASTRO-ENTERITIS.--Wheat, one tablespoonful; oatmeal, one half tablespoonful; barley, one half tablespoonful; water, one quart. Boil to one pint, strain, and sweeten.--_Dietetic Gazette._

PREPARED FOODS FOR INFANTS.--Of prepared infant foods we can recommend that manufactured by the Sanitarium Food Co., Battle Creek, Mich., as thoroughly reliable. There are hundreds of prepared infant foods in the market, but most of them are practically worthless in point of food value, being often largely composed of starch, a substance which the immature digestive organs of a young child are incapable of digesting. Hundreds of infants are yearly starved to death upon such foods.

All artificial foods require longer time for digestion than the food supplied by nature; and when making use of such, great care should be taken to avoid too frequent feeding. It is absolutely essential for the perfect health of an infant as well as of grown people, that the digestive organs shall enjoy a due interval of rest between the digestion of one meal and the taking of another. As a rule, a new-born infant may be safely fed, when using human milk, not oftener than once in every three or four hours. When fed upon artificial food, once in five or six hours is often enough for feeding. The intervals between meals in either case should be gradually prolonged as the child grows older.

QUANTITY OF FOOD FOR INFANTS.--Dr. J.H. Kellogg gives the following rules and suggestions for the feeding of infants:--

"During the first week of a child's life, the weight of the food given should be 1/100 of the weight of the infant at birth. The daily additional amount of food required for a child amounts to about one fourth of a dram, or about one ounce at the end of each month. A child gains in weight from two thirds of an ounce to one ounce per day during the first five months of its life, and an average of one half as much daily during the balance of the first year.

"From a series of tables which have been prepared, as the result of experiments carefully conducted in large lying-in establishments, we have devised this rule:--

"To find the amount of food required by a child at each feeding during the first year of life, divide the weight of the child at birth by 100 and add to this amount 3/100 of the gain which the child has made since birth. Take, for example, a child which weighs 7-1/2 lbs--at birth, or 120 ounces. Dividing by 100 we have 1.2 oz. Estimating the weight according to the rule above given, the child at the end of nine months will have gained 210 oz. Dividing this by 100 and multiplying by 3, we have 6.3 oz. Adding to this our previous result, 1.3, we have 7.5 oz, as the amount of food required at each feeding at the end of nine months by a child which weighed 7-1/2 lbs. at birth. To save mothers the trouble of making these calculations, we have prepared the following table, which will be found to hold good for the average child weighing 7-1/2 lbs. at birth. This is rather more than the ordinary child weighs, but we have purposely chosen a large child for illustration, as it is better that the child should have a slight excess of food than too little.

AGE OF CHILD. |1w.| 1m. |2m.|3m.|4m.|6m.|9m.|12m Amount of each feeding in ounces...| 1| 1½-2| 3 | 4 | 5 | 6 |7½ | 9 Number of feedings.................| 10| 8 | 6 | 6 | 6 | 6 | 5 | 5 Amount of food daily, in ounces....| 10|12-16|18 |24 |30 |36 |37½|45 Interval between feedings, in hours| 2| 2½ | 3 | 3 | 3 | 3 |3½ |3½

"In the above table the first column represents quantities for the first week, the second for the end of the second month, the third for the end of the third month, etc. It need not be mentioned that the change in quantity should be even more gradual than represented in the table.

"Attention should also be called to the fact that the time mentioned as the interval for feeding at different ages, does not apply to the whole twenty-four hours. Even during the first week, the child is expected to skip two feedings during the night, making the interval four hours instead of two. By the end of the second month, the interval between the feedings at night becomes six hours, and at the end of the ninth month, six and one half hours.

"From personal observation we judge that in many cases children will do equally well if allowed a longer interval between feedings at night. The plan of feeding five times daily instead of six, may be begun at as early an age as six months in many instances."

MANNER OF FEEDING ARTIFICIAL FOODS.--All artificial foods are best fed with a teaspoon, as by this method liability to over-feeding and danger from unclean utensils are likely to be avoided. If a nursing-bottle is used, it should be of clear flint glass so that the slightest foulness may be easily detected, and one simple in construction, which can be completely taken apart for cleaning. Those furnished with conical black rubber caps are the best. Each time after using, such a bottle should have the cap removed, and both bottle and cap should be thoroughly cleansed, first with cold water, and then with warm water in which soda has been dissolved in the proportion of a teaspoonful to a pint of water. They should then be kept immersed in weak soda solution until again needed, when both bottle and cap should be thoroughly rinsed in clean boiled water before they are used. Neglect to observe these precautions is one of the frequent causes of stomach disturbances in young children. It is well to keep two bottles for feeding, using them alternately.

DIET FOR OLDER CHILDREN.--No solid food or table-feeding of any kind should be given to a child until it has the larger share of its first, or milk teeth. Even then it must not be supposed that because a child has acquired its teeth, it may partake of all kinds of food with impunity. It is quite customary for mothers to permit their little ones to sit at the family table and be treated to bits of everything upon the bill of fare, apparently looking upon them as miniature grown people, with digestive ability equal to persons of mature growth, but simply lacking in, stomach capacity to dispose of as much as older members of the family. The digestive apparatus of a child differs so greatly from that of an adult in its anatomical structure and in the character and amount of the digestive fluids, that it is by no means proper to allow a child to eat all kinds of wholesome foods which a healthy adult stomach can consume with impunity, to say nothing of the rich, highly seasoned viands, sweetmeats, and epicurean dishes which seldom fail to form some part of the bill of fare. It is true that many children are endowed with so much constitutional vigor that they do live and seemingly thrive, notwithstanding dietetic errors; but the integrity of the digestive organs is liable to be so greatly impaired by continued ill-treatment that sooner or later in life disease results. Till the age of three years, sterilized milk, whole-wheat bread in its various forms, such of the grains as contain a large share of gluten, prepared in a variety of palatable ways, milk and fruit toasts, and the easily digested fruits, both raw and cooked, form the best dietary. Strained vegetable soups may be occasionally added for variety. For from three to six years the same simple regimen, with easily digested and simply prepared vegetables, macaroni, and legumes prepared without skins, will be all-sufficient. If desserts are desirable, let them be simple in character and easily digestible. Tea, coffee,

It is especially important that a dietary for children should contain an abundance of nitrogenous material. It is needed not only for repairs, but must be on deposit for the purpose of food. Milk, whole-wheat bread, oatmeal, barley, and preparations of wheat, contain this element in abundance, and should for this reason be given great prominence in the children's dietary.

Flesh foods are in no way necessary for children, since the food elements of which they are composed can be supplied from other and better sources, and many prominent medical authorities unite in the opinion that such foods are decidedly deleterious, and should not be used at all by children under eight or ten years of age. Experiments made by Dr. Camman, of New York, upon the dietary of nearly two hundred young children in an orphan's home, offer conclusive evidence that the death rate among children from gastro-intestinal troubles is greatly lessened by the exclusion of meat from their dietary. Dr. Clouston, of Edinburgh, an eminent medical authority, states that in his experience, those children who show the greatest tendencies to instability of the brain, insanity, and immoral habits are, as a rule, those who use animal food in excess; and that he has seen a change of diet to milk and farinaceous food produce a marked change in their nervous irritability.

Scores of other authorities corroborate. Dr. Clouston's observation, and assert that children fed largely on flesh foods have capricious appetites, suffer more commonly from indigestion in its various forms, possess an unstable nervous system, and have less resisting power in general.

Candy and similar sweets generally given to children as a matter of course, may be excluded from their dietary with positive benefit in every way. It is true, as is often stated in favor of the use of these articles, that sugar is a food element needed by children; but the amount required for the purpose of growth and repair is comparatively small, and is supplied in great abundance in bread, grains, fruits, and other common articles of food. If an additional quantity is taken, it is not utilized by the system, and serves only to derange digestion, impair appetite, and indirectly undermine the health.

Children are not likely to crave candy and other sweets unless a taste for such articles has been developed by indulgence in them; and their use, since they are seldom taken at mealtime, helps greatly to foster that most pernicious habit of childhood--eating between meals. No food, except at their regular mealtimes, should be the universal rule for children from babyhood up; and although during their earliest years they require food at somewhat shorter intervals than adults, their meal hours should be arranged for the same time each day, and no piecing permitted. Parents who follow the too common practice of giving their little ones a cracker or fruit between meals are simply placing them under training for dyspepsia, sooner or later. Uninterrupted digestion proceeds smoothly and harmoniously in a healthy stomach; but interruptions in the shape of food sent down at all times and when the stomach is already at work, are justly resented, and such disturbances, if long continued, are punished by suffering.

The appetite of a child is quite as susceptible of education, in both a right and wrong direction, as are its mental or moral faculties; and parents in whose hands this education mainly rests should give the subject careful consideration, since upon it the future health and usefulness of their children not a little devolve. We should all be rulers of our appetites instead of subject to them; but whether this be so or not, depends greatly upon early dietetic training. Many a loving mother, by thoughtless indulgence of her child, in season and out of season, in dainties and tidbits that simply serve to gratify the palate, is fostering a "love of appetite" which may ruin her child in years to come. There are inherited appetites and tendencies, it is true; but even these may be largely overcome by careful early training in right ways of eating and drinking. It is possible to teach very young children to use such food as is best for them, and to refrain from the eating of things harmful; and it should be one of the first concerns of every mother to start her children on the road to manhood and womanhood, well trained in correct dietetic habits.