and abnormal gains in weight point to excessive overfeeding, and re- 
quire a reduction of the nourishment in amount. 
After the initial loss following birth has been regained, the average 
healthy child increases during the first three months from 120 to 150 
grams (4 to 5 ounces) every week and from the third to the sixth 
month from 100 to 120 grams (3^ to 4 ounces). The effect of these in- 
creases is to double the initial weight at six months, and to treble 
it at the close of the first year. Large children gain absolutely but 
not relatively greater weekly amounts than the small. This rate 
of gain may be considerably increased within physiological limits, 
the main indication of abnormality being a wide departure from a 
rate of gain previously observed. To this end infants should be 
regularly weighed on sets of scales sensitive to 15 grams (J ounce). 
A careful record of the weight should be kept. 
Signs of inadequate nursing. — The early detection and diagnosis 
of abnormalities in the quality and quantity of the milk furnished 
by the mother is imperative : for, unless corrected, they are fraught 
with danger to the child. While nothing can take the place of good 
natural nursing, and while poor artificial feeding is the very worst 
method of infant nutrition we have, poor maternal nursing is an 
inferior alternative to good artificial feeding. We should, there- 
fore, endeavor to discover the difficulty as soon as possible in order 
that hasty weaning of the child should not take place when the 
symptoms are unconnected with the food, or the indigestion from 
which it is suffering is due to causes temporary or remediable. On 
the other hand it is obvious that, if from every symptom maternal 
nursing is going to fail, it should not be allowed to continue because 
the mother desires it from mistaken notions of her duty to the child. 
Inadequate nursing , insufficiency . — During the first few days of 
life the temperature of the child furnishes a very important indica- 
tion, not so much of the nourishment as of the amount of fluid it is 
receiving. Very few children who are receiving a sufficient quantity 
of fluid from the breast during the first few days of life present ab- 
normalities in the temperature. 
Fever of inanition. — Many of those who get little or nothing dur- 
ing this time have an elevation of temperature of 38.4° to 39.1° C. 
(101° to 102° F.), while in exceptional cases the temperature rises to 
40° or even 41° C. If no other obvious symptoms of disease are 
present, such a temperature observed on the second to the fourth day 
may be considered evidence of insufficient ingestion of fluid or even 
of starvation. Supplying the needs of the infant in this respect 
rapidly causes a disappearance of the fever. 
If the milk of the mother’s breast be insufficient to. supply a greater 
energy quotient than TO, the child ceases to gain in weight; if below 
this, a loss ensues. The child is fretful and seems always hungry, as 
