﻿INFANT FEEDING. 381 



Having determined the necessary amounts of the different substances 

 to be used in the finished product, a prescription should be written 

 showing .these amounts and the percentages of each ingredient. The 

 mixture is best made in the following manner : 



Place the necessary amount of distilled or boiled water in the graduate, add 

 the milk sugar and stir with a clean glass rod until solution is complete, next 

 add the requisite amounts of milk and cream and stir again. Finally, add the 

 limewater, sodium citrate or other modifier, stir and pour the product directly into 

 the necessary number of clean nursing bottles, stopper with clean cotton and place 

 in the ice chest until ready for use. 



When using sodium citrate in the food it is best to prescribe a 3 

 or 5 per cent solution to which a few drops of chloroform have been added 

 to prevent bacterial decomposition. 



With little care, any reasonable percentage food may be made according 

 to the above method and we need not at this day emphasize the confidence 

 with which such known percentages are fed, nor the excellent control 

 which' a knowledge of just what the infant is being fed gives us over 

 many of the more frequent disturbances which food often causes in 

 infants. 



Both the manner of percentage feeding, and its results may be further 

 shown by a few illustrative cases. 



' Case 1. — Four months old, weight 9i pounds, aniemic, toasted, diarrhcea with 

 excoriations about anus, mucous membranes of mouth red and inflamed, abdomen 

 prominent, vomiting of food, fretful and crying much of the time. Percentage 

 feeding instituted with rapid gain in weight and complete recovery. 



This baby was a normal child at birth, weighing 8 pounds. The mother's milk 

 was reported to be deficient in quantity from the beginning but no examinations 

 were made. At 2 weeks of age alternate feedings of breast milk and a certain 

 condensed milk were instituted, the milk being prepared according to the direc- 

 tions of the manufacturer. No improvement followed and at 5 weeks of age 

 another milk was tried. Still the baby failed to improve and during the next 

 ten weeks the giving of still another brand of artificial food was instituted. 

 When the baby came under our observation a dose of castor oil was given and all 

 food withheld for twenty hours, after which a prescription was given of sterilized 

 milk, pure 27 per cent cream, milk sugar and sodium citrate in such proportions 

 as to give a little less than the normal percentage of fat, sugar and proteid. The 

 child enjoyed the food, did not vomit and improvement was rapid from the date 

 the feeding was instituted. By altering the amounts of "milk" and "cream" which 

 were used, the percentages of the fat, sugar and proteid were changed so that at 

 5* months of age the child was taking normal amounts and was in .excellent 

 health ; he passed from observation at 8 months of age. A study of the mother's 

 statements about the amount and kind of food previously given in connection with 

 the analysis given in Table No. 15 shows that this baby had been receiving too 

 much proteid (3* per cent) and sugar (8 per cent) and not enough fat (1.8 per 

 cent), and in addition 10 per cent limewater was being used. 



Case 2. — Four months of age, weight 12 pounds, fretful and crying, fontanelles 

 sunken, muscles icasted, constipation, head perspiring, tender joints and back, 

 57712 4 



