SHILDREN 182 The Mother who cannot Nurse her Baby If, through ill-health or the exigencies of civilisation, a mother cannot nurse her baby she should consult her doctor. In most cases cow's milk will have to be used, but as cow's milk was meant for the calf, it is obvious that it must be modified before it can approach the human standard. Comparing the two we find : (i) That the proteids in cow's milk are greatly in excess, especially the casein, or curd. This causes a hard curd to form in baby's stomach, differing in this respect very markedly from the light, flocculent curd of mother's milk. (2) That cow's milk contains less lactose, or milk-sugar, than mother's, while the cream, or fat, is about the same. (3) That mother's milk is fresh, alkaline, and sterile — that is, free from disease germs. By the time cow's milk reaches the purchaser it is often stale, acid, dirty, and Ir.den with disease germs. The first requisite is to get a pure milk, that is, reasonably free from bacteria. When the milk is brought direct from the cow to the baby it may be unnecessary to interfere with it. This would be excellent, as fresh milk possesses the fine anti-scorbutic property, which, when wanting, causes scurvy and rickets. But the ordinary milk of commerce is anything but pure ; it has been tumbled about in railway waggons and exposed in dusty places. Under these circumstances the milk must be sterilised ; otherwise it may bring disease and death to baby. Sterilisation can be effected simply by boiling, but to this there are objections. First, such milk is constipating. This, however, can be over- come by adding a small quantity of car- bonate of magnesia to each bottle. Second, boiling destroys the anti-scorbutic property of milk and causes a loss of pro- teid, which rises in a skim to the surface. It is for these reasons milk is not sterilised, or Pasteurised, more often than it is. sterilisation and Pasteurisation The best way to sterilise milk is to take a Sohxlet apparatus or a cruet frame of wire (this the local tinsmith will make), and into this frame to fit five bottles, each con- taining a feed. The bottles should be fitted with indiarubber caps and, when filled, placed in a saucepan with cold water. Then place the lid on the saucepan, bring the water to the boil, and leave it to boil for forty minutes. Next lift out the frame or cruet con- taining the bottles, and cool rapidly by placing in ice-cold water. To Pasteurise, proceed as for sterilisation ; but, as soon as the water reaches a tempera- ture of 160° F., remove from fire, but leave unopened for twenty minutes, then cool down. Modification of Cow's Milk To reduce the proteids it is usual to add thin, freshly made barley-water, in the proportion of one-third milk to two-thirds of barley-water, during' the first month. The proportion should be lessened as baby grows older. To increase the sweetness sugar must be added. This should always be sugar of milk, not cane sugar, which ferments and gives rise to discomfort and pain on th^ part of baby. A little fresh cream, free from any preser-^ vative, should also be added, since fat is so essential in baby's dietary, helping to keep down rickets. This modified cow's milk, warmed to a temperature of 99° F., is now ready for baby. The amount of food to be given varies with the age and capacity of baby, but most mothers make the mistake of giving too much, and this distends the child's stomach, causing pain and flatulence. During ist and 2nd week, i J fluid ounces per feed. During ist month, 2 fluid ounces. During 2nd month, 2^ fluid ounces. During 3rd month 3 fluid ounces. During 4th and 5th months, 4 fluid ounces. And so on, increasing the amount of the feed slowly as the child grows and thrives. Bottles Needless to say, bottles should be without tubes. The long rubber tube of the ordinary feeding-bottle is well named the " baby- killer." Its use has been made illegal in France and in several states of America. The bottle used should be so shaped as to be easily cleansed, should have a teat on one end, and an opening to allow the entrance of air behind or above the milk. When giving the milk the mother must hold the feeding-bottle, and see that the baby is carefully fed, neither choking nor dribbling. It is wise to have two bottles. The one not in use should be cleansed and put into cold water containing a pinch of salt or boric acid. Bottles should be boiled at intervals. Any milk left over from one meal should never he used for the next ; it should be made fresh each time. If this modified milk does not agree with baby after a fair trial, the doctor should be consulted. There are many patent foods for baby on the market, and some of these are good. It is unwise, however, to use any of them until a doctor has been consulted, as the food must be chosen with due regard to the infant's constitution. Weaning Weaning depends on how the baby is thriving, and is usually indicated by the coming of the teeth. It should be done gradually, beginning with one meal a day other than milk. It should not be done dur- ing warm weather or if baby is suffering from infantile diarrhoea. Milk should form the largest item of the diet till the child is two years old. Further articles of advice to tnothers will appear in Every Woman's ENcyci^OP^DiA.
