715 
nesses or acute sickness of short duration are not indications for 
weaning, though if the attack be severe the infant may be placed 
temporarily on the bottle, and the flow of milk maintained by the 
breast pump. Upon the establishment of convalescence, the infant 
is returned to the breast. 
Mixed feeding . — This is a combination of breast and artificial feed- 
ing. It is useful when the mother’s milk is good but somewhat defi- 
cient in quantity. It may also be adopted when it is evident that the 
strain of maternal nursing is making inroads on the mother’s reserve 
of health. She may then be relieved to the extent of one or two 
nursings a day, and thus considerably prolong the period of her lac- 
tation. Mixed feeding is also useful as an expedient to bridge over 
temporary insufficiency in the mother’s supply of milk. It is not 
expedient, however, to reduce the maternal nursings by three or more 
a day, lest the mother suffer a serious deterioration in the quality of 
her milk. 
ARTIFICIAL FEEDING. 
In considering the artificial feeding of infants, there are several 
general principles which have received universal acceptance : 
First. That as mother’s milk is an ideal food, supplying the infant 
with proteid, fat, and carbohydrate in proportions adapted to its 
needs, the only logical substitute is a food that will do the same. 
Second. The substitute should approximate mother’s milk (a) in 
the energy quotient that it furnishes, (6) in proximate principles, 
and ( c ) in the amounts necessary to maintain nutrition. 
Third. These conditions are secured only by some animal milk. 
While infants have been sucessfully fed on the milk of other do- 
mestic animals, such as the goat, the horse, and the ass, cow’s milk is 
the only substitute commercially and practically available in this 
country as a food for the artificial feeding of infants less than 1 year 
of age. 
Comparison of cow's milk and woman's milk . — In order to proceed 
with intelligence it is necessary to compare the average composition 
of woman’s milk with cow’s milk. The following table shows the 
difference between their average composition: 
Woman’s 
milk. 
Cow’s 
milk. 
Fat 
Per cent.a 
4.00 
Per cent. a 
3.00 
Proteid - 
1. 50 
4. 50 
7.00 
4. 50 
.20 
.75 
87. 30 
87. 25 
Calories per kilo - - - - 
100. 00 
710.50 
100. 00 
700. 00 
“Average. 
