PERFECT FOOD FOR INFANTS.—Nature in her wisdom provides ideal food for the infant,—mother's milk. No perfect substitute has been found for it. It is most unfortunate when a child is denied this food.

It has been found [Footnote 117: See "Feeding the Family," by Mary Swartz Rose, Ph.D., p. 98.] that babies fed with mother's milk are much less likely to contract disease and much more apt to grow to maturity. A mother's milk is adapted to the needs of her child. It agrees with the infant and nourishes it well. A practical advantage of a healthy mother's milk is that it is sterile and of the proper temperature.

MODIFIED MILK.—In case it is necessary to give the infant artificial diet, the greatest care should be taken to provide clean, easily digested food. Cow's milk is the basis of the food generally chosen. The way babies digest cow's milk shows the necessity of changing or modifying it to meet the needs of an infant. Cow's milk is modified sometimes by diluting it to make it digest easier and adding other ingredients to it. In order to increase the fuel value of diluted milk, carbohydrate food of some soluble, easily digested kind is added. Sometimes gruel or cereal water is used as one of the constituents of modified milk.

Formulas for modified milk vary with the individual infant. A physician should be consulted regarding the formula for food for a baby.

(a) Utensils for measuring and preparing the ingredients of modified milk should be kept very clean. Before using, all glass and metal utensils used for measuring and holding the milk should be covered with cold water, then the water should be heated and allowed to boil for twenty minutes. Just before using rubber nipples, place them in boiling water for a few minutes. After using, they should be rinsed in cold water and then carefully washed inside and out with soap and water. When not in use, nipples should be kept in a clean covered jar or jelly glass. (The jar and cover should be sterilized daily.) After using the milk bottles (have as many bottles as there are feedings a day), rinse them in cold water, and then fill them with water and add a pinch of baking soda. Before filling the bottle with milk, wash with soap and water—using a bottle brush—and then sterilize in boiling water for twenty minutes (as directed above). Bacteria cannot pass through cotton, hence it is used for stoppering the filled milk bottles. It should be clean, however. Paper caps are also used.

(b) Ingredients.—(1) Milk.—The selection of milk for an infant is an important consideration. Clean milk is most essential. Milk is considered clean when it comes from dairy farms where clean milkers work under sanitary conditions, approved by a medical milk commission (see Care of Milk). Such milk contains few bacteria and is called certified milk. This is by far the safest milk for infant diet, but it is expensive. It usually costs almost twice as much as ordinary milk. Milk is pasteurized commercially by heating it to 150 degrees F., keeping it at that temperature for about thirty minutes, and then quickly cooling it. While pasteurizing kills most of the disease-producing germs, it does not destroy all the spores (see Microorganisms in theSpore Form). The taste of milk is not affected by pasteurizing. Milk is sterilized—all germ life destroyed—by heating at 212 degrees F. from one to one and one half hours.

Since the value of milk as an infant food depends upon its cleanliness, it is difficult to state just how old milk may be before it is unsafe for infant feeding. It is safest to use only fresh milk. Bacteria in milk may develop so rapidly that it is unfit to use a few hours after it has been drawn from the cow. Unless milk is certified, it should not be used in summer after it is twenty-four hours old, and in winter, after it is forty-eight hours old. Bottled milk should be used for infants. According to most plans for modifying milk, whole milk is used.

(2) Sugar.—Several kinds of sugar are used in modified milk. These are:

Milk sugar or lactose.
Malt sugar combined with dextrin or dextrimaltose.
Granulated sugar or cane sugar.

The advice of a physician should be consulted regarding the kind of sugar best suited to the needs of the particular infant. The first two kinds of sugar can be obtained at a drug store. Granulated sugar is too sweet for general use.

(3) Water or Cereal Water.—If plain water is to be used with milk, it should be boiled before adding to the other ingredients.

In some cases, gruel or cereal water is added. Usually rolled oats or barley flour is the grain used. To prepare either of these use:

4 tablespoonfuls rolled oats or 3 tablespoonfuls barley flour 1 quart cold water

Mix and boil gently until the mixture is reduced to a pint. Then strain through a fine wire strainer or muslin.

[Illustration: Figure 87.—Graduated Measure and Dipper for Measuring the
Ingredients of Modified Milk.]

(c) Method of Mixing.—Measure the sugar. This ingredient is usually measured in ounces, tablespoonfuls, or teaspoonfuls. (1 1/2 dipperfuls (Figure 87) of milk sugar weigh 1 ounce.) In the graduated measure (Figure 87), measure the water or cereal water for diluting the milk and dissolve the sugar in it. Stir the mixture until the sugar is completely dissolved. Then pour it into the mixing pitcher. Measure the milk (and other ingredients if required) and pour into pitcher. Mix thoroughly. While stirring, turn the proper quantity of food into as many sterilized bottles as are required for a day's feeding. Stopper with cotton or cap. If the milk used is certified, place in a clean refrigerator until used for feeding. If the milk is not certified, it may be pasteurized.

PASTEURIZING MILK AT HOME.—Place the bottles of milk in a wire basket. Then place the basket in a kettle. Pour water in the kettle so that the water is a little higher outside of the bottles than the surface of the milk inside. Heat the water and let it boil for 5 minutes. (Do not begin to count the time until the water reaches the boiling point.) At once cool the milk by allowing a stream of cold water to displace the hot water. Do not allow the cold water to run directly on the hot bottles. When the milk is cooled, place the bottles immediately in a clean refrigerator.

PREPARATION OF MILK BEFORE FEEDING.—At feeding time, milk should be heated to about 98 degrees F. Place the bottle in a pan of warm water. Test the milk for proper temperature. Use the method described in Junket "Custard", for testing the temperature of the milk. Shake the bottle before feeding.

OTHER FOODS GIVEN TO INFANTS.—In addition to modified milk, boiled water should be given to infants. A few other foods—egg yolk or vegetable juices and orange juice—may often be given during the first year. The egg yolk should be soft-cooked. This food supplies iron and increases the Calorific value of the diet. Orange juice (strained through muslin) may be usually given at five or six months of age. It is especially necessary to give orange juice to infants whose milk is pasteurized or sterilized. Its use prevents constipation and scurvy.

ENERGY REQUIREMENT OF AN INFANT.—The energy requirement of an infant is greater than one would suppose. Growth and development are going on at a rapid rate. Like the adult, a baby asleep needs energy to carry on the involuntary activities of its body. When awake such muscular activities as crying, kicking, and throwing of arms require energy. An infant's energy requirement is usually based upon its body weight. According to generally accepted standards [Footnote 118: See "Feeding the Family," by Mary Swartz Rose, Ph.D., p. 103.] an infant's average energy requirement is:

1st to 3d months 50 Calories per pound per day 4th to 6th months 45 Calories per pound per day 7th to 9th months 40 Calories per pound per day 10th to 12th months 35 Calories per pound per day

QUANTITY OF FOOD.—When a baby must be given artificial food entirely or as a supplement to natural food, it is safest and most satisfactory to follow the advice of a physician. It is said, however, that an infant requires an average of 1 1/2 ounces of milk per day for every pound of body weight. After the eighth month, this quantity of milk is usually decreased first to 1 1/3 and then to 1 1/4 ounces for every pound of body weight per day.

The amount of artificial food found satisfactory for the infant during the first few months of its life is usually not sufficient to yield as many Calories as given in the table above. But while the baby is adjusting itself to artificial feeding, it is especially necessary that the stomach be not overtaxed. As the infant develops, the quantity of food can be increased and the deficiency made up later.

QUESTIONS

Define certified, pasteurized, sterilized, modified, and top milk.

Give reasons for sterilizing utensils used for measuring and holding milk.

In preparing modified milk why is milk diluted? Why is sugar added?

What is the price per quart of certified milk?