In feeding cow's milk undiluted to infants in this country our prac- 
tice in this direction must be controlled by the following circumstance : 
Abroad, owing to different methods in feeding, and different grades 
of cattle, milk containing over 3.75 per cent of butter fat is rarely 
found, and the average is probably not over 3 to 3.50 per cent in the 
majority of cases. In our country it is a milk poor in butter fat in- 
deed which does not average 4 per cent, while selected milk supplied 
to many of our institutions and hospitals and our “ certified ” grades 
of milk are often nearer 4.50 or 4.75 per cent. Thus Chapin found 
that the average content of fat of the milk used in the Babies’ Ward 
of the Postgraduate Hospital in New York was 4.40 per cent. The 
use of milk of this grade of richness is likely to be followed by diges- 
tive disturbances and symptoms of overfeeding when fed whole to 
infants, both by reason of excessive caloric value and of the formation 
of large fat-containing curds. 
While agreeing with the experience in France of the digestibility 
of undiluted cow’s milk as an infant food, I am not prepared to ad- 
vocate its use in this country unless the fat content is known to be 
below 3.50 per cent. This condition can, however, be secured either 
by using milk from Holstein cattle, which is normally no richer than 
this, or by removing appropriate amounts of the “ top milk ” from 
bottled milk after the cream has risen and then thoroughly mixing 
the remainder. 
GENERAL DIRECTIONS FOR THE ARTIFICIAL FEEDING OF INFANTS. 
For children one month old or over. — First, weigh the child. 
Allow a daily ^quantity of cow’s milk of one-seventh body weight 
for infants up to 3 months of age, one-eighth the body weight from 
3 months to 6 months, and after that from one-ninth to one-tenth. 
Quality of milk to he used . — Use nothing but clean, fresh, bottled 
milk, “ certified ” if possible, . If this can not be had, use bottled 
milk from a high-grade dairy, making sure that the fat content 
does not exceed 3.50 per cent. If it is greater than this it must be 
reduced to this figure by dipping the cream out of the top of the 
bottle in the amounts given in the following table and then mixing 
thoroughly the remainder. 
Note. — A cow’s milk of this percentage of fat — 3.50 — lias a lieat value of 
653.5 calories per kilogram, or about the average caloric value of woman’s 
milk. 
Table showing quantities of top millc that must be removed from top of quart 
bottles of milk in order to reduce the perecentage of fat to 3.50 per cent. 
Original percentage of fat in the milk. 
Quantity of cream to be removed from top 
of quart after cream has risen to reduce 
fat to 3.50 per cent. 
4.00.. 
30 cubic centimeters =1 ounce. 
60 cubic centimeters=2 ounces. 
80 cubic centimeters=2§ ounces. 
4.50 
5.00 
