675 
PRECAUTIONS TO BE OBSERVED IN THE ARTIFICIAL FEEDING OF INFANTS. 
Every utensil used in the preparation of infant food should be 
clean. This does not mean a mere macroscopical cleanliness, but sur- 
gical cleanliness as well. Vessels used to hold the infant’s food dur- 
ing its preparation should be scalded with boiling water after previ- 
ous thorough cleansing. Feeding bottles are to be cleaned after use, 
first with cold water, and then with warm water and some alkaline 
soap powder. Adhering particles of milk are to be removed with a 
bottle brush. The bottles are to be sterilized by boiling them in 
water, and storing them in an inverted position, when empty, to pre- 
vent the access of dust to their interior. When new nursing bottles 
are bought, in order to prevent them from cracking from the ex- 
tremes of cold and heat to which they are subject, they should be 
annealed. This is accomplished by placing them in cold water, bring- 
ing the water to a boil, and allowing the bottles to remain in the water 
until it is cold. 
Only rubber nipples fitting on the necks of the bottles should be 
used. One should be able to turn them inside out for cleansing pur- 
poses. The hole in the top should be just large enough to allow the 
milk to drop rather rapidly when the bottle is inverted. If it issues 
in a stream the hole is too large. Nipples before use should be boiled, 
and may be kept in a saturated solution of boric acid. In feeding the 
child care should be taken to hold it in such a position that it can 
easily take its food. A child should not be coaxed to take more food 
than it desires at the time, and its wishes in this matter should be 
treated with respect. Any portion of food left after a feeding should 
be thrown away, and on no account should it be used again. 
While, as a rule, it may be postulated that no infant is born with 
a digestion congenitally weak, still, as the result of inadequate feed- 
ing, both maternal and artificial, we do encounter infants whose 
digestive processes are a law unto themselves. The efficient nutri- 
tion of such infants often presents a problem which must be attacked 
upon individual lines. The investigations of Teixeira de Mattos,® 
Salge , * * 6 and others have shown that fat-free buttermilk, or equal parts 
of buttermilk and malted cereal broths, are in many instances di- 
gestible with apparent satisfaction by such infants. As skimmed 
milk, also, is closely related to buttermilk in its composition, its use as 
an article of diet (sterilized) under these circumstances is warmly rec- 
ommended. As soon as tolerance for cow’s milk in this form is 
established, it must, however, be supplanted by a gradual return to 
® Teixeirai de Mattos. Die Buttermilcli als Sauglingsnahrung, Jahrbnck f. 
Kinderheilk., 1902, pp. 1-61. 
& B. Salge Buttermilch as Saiiglingsnalirung, Jalirb. f. Kinder beilkunde, 
3902, 157-164. 
