592 MILK 



Overfeeding. — That overfeeding is responsible for many of 

 the nutritional ills of childhood there exists no shadow of a doubt. 

 A great many infants are overfed either through getting too 

 much food at one feeding or through receiving food at too fre- 

 quent intervals. This may be equally true of both the baby that 

 is breast fed and the one that is artificially fed, although it occurs 

 more frequently in the case of breast-fed babies. It is not always 

 easy to gauge the exact amount of milk received at a breast feeding. 

 A much greater evil, however, lies in the tendency of many moth- 

 ers to allow their babies to nurse at their breasts continuously. 

 When overfeeding is stretched over a long period of time vomit- 

 ing sets in, and if the condition continues the child soon becomes 

 unable to retain even the amount of food required for its age and 

 weight. Later on a diarrhea may set in and persist for a con- 

 siderable length of time. 



The treatment of overfeeding is essentially one of prophylaxis. 

 Mothers should be taught to nurse their babies at regular inter- 

 vals. When vomiting and diarrhea do occur, rest of the stomach 

 should be enforced by withholding food from the child for a 

 period of from twelve to twenty-four hours, depending upon the 

 severity of the case. If vomiting still persists, lavage and small 

 doses of sodium bicarbonate are recommended. 



Underfeeding. — This condition may be present in breast-fed 

 as well as in artificially fed children, although it presents itself 

 more often in the artificially fed, being due in most cases to the 

 prolonged use of a greatly diluted milk. The most frequent 

 symptoms of underfeeding are loss in weight, irritabUity, and 

 vomiting. The weight curve goes down instead of going up; the 

 muscles become flabby, the skin loses its elasticity, and the abdo- 

 men sinks in. The child acts restless and cries most of the time. 

 Many children also vomit. The condition is frequently accom- 

 panied either by constipation or diarrhea. 



The treatment of underfeeding, Hke that of overfeeding, is 

 essentially one of prophylaxis. It consists primarily in giving 

 the child food sufficient in quantity and in caloric value. The 

 determination of underfeeding in breast-fed babies is most easily 

 and most efficiently effected by weighing the child a number of 

 times before and after nursing to see how much or how httle the 

 baby receives at one feeding. Chemical examination of mother's 

 milk is worth very little. If the child gets a sufficient amount 

 of breast milk it is safe to assume that the milk is of good quality. 

 If it is found that the child does not get enough nourishment from 

 the mother, a supplemental feeding should be instituted. The 

 child should be put to the breast for ten to fifteen minutes, and 



