642 
them are dependent many nutritional disturbances of the nursing 
child. 
The most common abnormalities to be recognized are (a) disturb- 
ances in the quantity and (6) disturbances in the quality of the lac- 
teal secretion. 
According to the researches of Haehner, Feer, Huebner, Laure, 
Alilfeld, and others, the average daily quantity of milk drawn by 
infants of different ages is as follows : 
Ounces. 
At end of first week, 300 to 500 grams 10 to 16 
During second week, 400 to 550 grams 13 to 18 
During third week, 430 to 720 grams 14 to 24 
During fourth week, 500 to 800 grams 16 to 26 
From fifth to thirteenth week, 600 to 1,030 grams 20 to 34 
From fourth to sixth month, 720 to 1,150 grams 24 to 38 
From sixth to ninth month, 900 to 1,220 grams 30 to 40 
The average daily amount of milk per kilo of body weight drawn 
by the child was found to be as follows : 
Ounces. 
During first three months, 150 cubic centimeters 5 
During second three months, 140 cubic centimeters 4f 
During third and fourth three months, 120 cubic centimeters 4 
It was also found that the total daily amount drawn corresponds 
very nearly to the following figures in proportion to the body weight 
of the child : 
First three weeks, one-fifth of body weight. 
First month to end of sixth month, one-sixtli to one-seventh of body weight. 
Last half of first year, one-eighth of body weight. 
* 
The daily quantity of the milk drawn from the breast by the child 
is best determined by weighing the child before and immediately after 
each feeding during the entire twenty- four hours for several days. 
An accurate set of scales, sensitive to 15 grams (J ounce) should 
be used. By computing the sum of the weights of the separate feed- 
ings for each day and striking an average for the daily amounts 
during the period of observation, the average amount of the daily 
consumption of milk can then be determined. As children vary in 
age, weight, and nutritive needs, the figures obtained will only be of 
value when compared to the body weight and age of the child that 
received them, as is subsequently to be discussed. 
Reaction . — This may be tested by litmus paper and should be alka- 
line or amphoteric, never acid. 
Specific gravity . — This may be determined with the aid of any 
small hydrometer, such as a urinometer with a scale registering from 
1,010 to 1,040. The specific gravity is lowered by fat, but increased 
by the other solids. 
