Feeding rules for healthy infants

Front matter

ing Rules ealthy Infants

Book H 13.

Copyright If

Preface

Many valuable books have been written during the past ten years on the nutrition and proper feeding of infants. From these books, the writer has received valuable assistance in pursuing this branch of pediatrical work.

In doing practical infantile feeding, without the assistance of a Walker-Gordon milk laboratory, the author found it necessary to devise a chart which would be a perfect record of the foods and amounts used daily and one which would also show the exact effects they produced. Use and necessity gradually added important features. These were mainly evolved by the demands of memory when treating many cases, and by the necessity to teach mothers and nurses to concentrate their thoughts and attention on all those features necessary for successful work.

Daily filling of these charts by mothers or nurses made them acutely and intelligently interested in doing careful and exact work. Their thoughts were concentrated on the essentials, and daily filling of each item reminded them of everything needed, thus preventing errors of omission.

This work demanded that the food must be prepared in the way most familiar to them, and, consequently, the old way of raising the cream and then removing it from the skim-milk was adopted. Mothers very easily learned to mix these together in the proportions necessary to suit their infants; to dilute them with water and then sweeten the whole mixture.

8 PREFACE

This is the method followed in the Walker-Gordon laboratories, when physicians write prescriptions ordering the required proportions of fat (cream), proteids (skim-milk) and sugar for any infant.

As only a very few rich people can ever feed their infants from laboratories, it was necessary to adopt a plan which could be used by all mothers and one which could educate them to change the food themselves when necessary.

On account of its simplicity and suitability to mothers, all foods are designated by ounces, tablespoons and teaspoons, and no effort is made to express them by percentages of fat, proteids or sugar.

Over fifteen thousand daily records of foods given, and their results were obtained in this manner, and from this material as well as from very many unwritten records also, most of the results in the following pages have been obtained. The milk was all kinds that were reasonably pure and clean.

In the following pages appear some things differing from what is generally understood on some points, and also a few things that are entirely new. These differences and everything that is new are the combined product of these charts filled by many mothers unacquainted with each other, and working with different milks in their own homes, on all kinds of infants and at all ages under two years. Their work shows a striking unanimity in results and unmistakably defines many facts which could not be proven in any other way. These charts have been a welcome experience and education to the writer.

Chas. Douglas. 959 Jefferson Avenue, Detroit, Mich.

THE LENDING AND BORROWING OF BOOKS

Contagious diseases are the most frequent cause of sickness in childhood. Aside from digestive disturbances, children are most amenable to contagion in its many forms. Such diseases as dyphtheria, scarlet fever, measles, whooping-cough, mumps, chicken-pox, etc., are mostly confined to this period of life. These contagions are conveyed by all objects and persons exposed to them, and many thousands of children are sickened and die in this way every year. Thorough disinfections will destroy these contagions in clothes and all utensils, but no means have ever been found by which books can be disinfected and the contagious poison eliminated from the leaves w T here it will live for many months, and some claim even longer.

All books on infantile subjects thus become saturated with contagions and are a great source of danger afterwards.

The mother who lends such books is often the innocent means of sickening her friend's children.

The mother who borrows them runs a great risk of also borrowing some serious contagion. These books are safe only in the house where they are owned.

Chapter I Page

Introductory 13

1, Children of Habit ; 6, Perfect Nutrition ; 20, A Mother's Responsibility ; 24, The Worried and Abused Mother.

CHAPTER II Varieties of Human Milk 25

31, Human Milk; 35, Injurious Human Milk; 41, Irritating but Good Human Milk; 44, Nursing Mothers ; 48, Insufficient Human Milk; 49, Poor Human Milk; 50, Food of the Mother; 55, Drinking Milk to Make Milk; 57, Mothers Taking Medicine while Nursing.

CHAPTER III Condition of the Nursing Mother 37

C3, Nursing Sore Breasts ; 65, Sore Nipples ; 70, Treating Sore Nipples ; 77, The Nipple Shield ; 78, The Breast-pump.

CHAPTER IV Nursing Infants 43

79, Nursing Infants ; 83, Regularity in Nursing ; 84, Length of Time for Nursing; 86, Overfeeding Nursing Infants; 87, Nursing Infants Requiring Additional Food ; 89, Imperfect Nursing which Demands Hand-feeding ; 106, Sudden Weaning.

CHAPTER V Cow's Milk Foods 55

107, Selecting Milk for the Baby; 113, Cow's Milk; 118, How to Separate Cream from Milk; 127, Whole Milk vs. Skim-milk; 130, Varying Amounts of Cream in Milk ; 132, Variations in the Strength of Milk; 140, Milk as a Drink; 144, Souring of Milk ; 145, Pasteurization of Milk ; 148, Sterilization of Milk ; 150, Peptonization of Milk; 157, Condensed Milk; 161, Evaporated Cream.

12 CONTENTS

CHAPTER VI Substitute Foods and Feeding 76

164, Artificial or Hand-feeding ; 168, Women Suitable to do Hand-feeding; 174, Ignorance and Inexperience; 177, The Importance of Proper Diet during the First Year; 186 ; Dangers of Imperfect Hand-feeding ; 189, Foods and their Sources ; 198, Human Milk as an Assistant to Hand-feeding ; 202, Preparation of the Infant's Food ; 210, Food Effects and their Substitutes ; 219, The Hungry Child ; 224, Frequency of Meals ; 231, Increases of Foods ; 247, General Principles Governing Necessary Changes in Food; 255, When and How to Change the Baby's Food; 268, Feeding the Damaged Infant; 276, Feeding in Hot Weather; 281, Care of the Food in the Summer-time; 284, Amount of Food and Size of Baby ; 290, Foods Required in the Infant's Meals ; 297, Top-milk ; 302, Starch ; 303, When to Commence and How to Feed Starch ; 306, Starch in its Relation to Sugar ; 307, Feeding Starches and Effects Therefrom ; 312, Salt in Gruel or Milk Foods ; 313, Potato as an Infantile Food ; 315, Gluten ; 319, Proprietary Foods; 324, Selecting Starch for the Infant; 329, Table of Starohes and How to Cook Them; 333, Sour Stomach ; 336, Giving Water to the Baby; 339, Giving Laxatives to Infants ; 340, Teething ; 343, Hiccup or Hiccough ; 344, Cries of Infants ; 356, Washing the Baby's Mouth ; 359, Nipples ; 363, Bottles.

Chapter I Introductory

1. We are all children of habit in this world and a great many of our habits, thoughts, customs and even our politics we inherit from our ancestors. If we critically examine ourselves on these different points, we will, in most instances, find that we are saying, doing and thinking so because we learned to do this while we were yet young and inexperienced and because our parents did or said the same thing. In this way, the errors of our ancestors were obtained from their ancestors, and again by these from their ancestors for ages back and finally have been handed down to us in this twentieth century.

2. There is only a very limited portion of humanity who have critically analyzed the habits and thoughts of their ancestors save where they have been compelled to do so during their educational courses in schools, colleges and universities.

3. In these institutions, again, our thoughts are shaped by those older than ourselves, and, in most cases, we accept their doctrines and teachings without giving that crucial analysis which only the matured and experienced mind of the adult enables one to do.

4. It is much easier to learn a new subject aright than to unlearn an old established one, even though it be wrong. Very few of us have the ability, training, strength of mind, independence of thought and particularly the facilities to unlearn the old errors which have become a part of our nature and which we have practised or followed, as absolutely correct, for many years. It is not that educated humanity does not desire to make these corrections, but because they have not the opportunities and facilities necessary to accomplish such a result.

5. In this way, we continue to feed and clothe our infants, in most instances, according to those ancestral rules followed for ages back, without analyzing them carefully to ascertain whether they are right or wrong.

PERFECT NUTRITION

6. The perfect nutrition of our infants and children, as well as that of all humanity, is entirely dependent upon a knowledge of the proper foods for each individual to consume, the proper amounts of each food to be consumed and those evidences which show that digestion is perfectly performed.

7. There is no department of our educational system which gives to either infants or adults an opportunity to learn this vital and all-important subject; nor is there an educational system in any other government in the world, so far as the writer knows, which affords more opportunities to learn this than does our American system. Just as Americans have made advances in many other lines — scientific, economical and financial — beyond that point reached by many nations, so does it behoove us' to continue in our efforts of advancement in all lines where it is apparent that improvement is very necessary.

8. It is needless to dwell upon the great difficulties under which the delicate, weak or crippled labor in this life. We have too many illustrations of this continually before our eyes in all communities and in all parts of our country. If our parents were so educated that they could trace appar-

PERFECT NUTRITION 15

ent weaknesses back to their origin as clearly and distinctly as can the intelligent physician, there would be such an awakening of the public on these matters as would compel all our educational systems to thoroughly implant and teach the perfect nutrition of humanity as the first and most important subject necessary for successful advances in all branches pf education, whether they be in the preparatory work of our youths or in the whole life work of our citizens at large. To all thoughtful, progressive, scientific and experienced physicians, there is no subject of so grave and great importance as this perfect nutrition of the human being (179).

9. The time will come, as it must, when humanity will fully realize that the only sure and safe foundation, upon which rests the future success of both children and adults, is the perfect nutrition of all parts of their bodies. We all know that sick men or women, confined to their beds, are unable to make any physical or mental efforts except in a very limited degree. Between this degree of weakness and that of the perfectly healthy condition, every evidence of inability to perform a full proportion of labor is recognized when due to physical inability; but when it comes to that mental strength necessary for the performance of regular duties, humanity does not recognize or see that there must be the same incapacity in this that they see in the physical condition, and the consequence is that distressing results and failures are continually presented by people whose nutrition is not such as is and should be demanded for every person doing heavy mental labor.

10. The American habit of demanding extraordinary business, professional, scientific, and other forms of mental labor, while we notoriously neglect our meals and the quality of the food which we consume, is very common. We are continually filling all the different walks of life with failures which could have been and will be avoided when proper nutrition of the body and mind are thoroughly understood and this subject given the first consideration as the foundation of future success.

11. The day will come, in America, and in other countries also, when the principles of human nutrition are taught to the rising generation just as are now taught in our agricultural colleges the different kinds of soils and fertilizers suitable for growing and nourishing grain, flowers, shrubs, and trees, and also the various kinds of food needed for growing and nourishing different animals to the highest state of perfection, whether they are required for the purpose of labor or for the meat-market. Does it not seem an awful reflection upon Americans, as a progressive nation, that all subjects concerning animals and articles which we convert into money, we thoroughly understand and teach, but at the same time, neglect to give our rising population the advantages of knowing and understanding themselves as well as they do all animals and products of the soil ?

12. It would seem as if we could not, or would not, look farther into this subject than that distance which has a visible gold or silver lining; in other words, we have paid close attention to all things needed for accumulating the money required in procuring those things necessary for our sustenance and support and fail entirely to reach that point which demands a perfect knowledge of how to use this accumulation to accomplish our own proper support and nourishment and also that of our children.

13. Would it not seem a natural sequence that, having learned how to produce properly and successfully all things needed for the nourishment of humanity, we would most

PERFECT NUTRITION 17

certainly learn to use them to our greatest advantage, both mentally and physically? Yet, such is the unfortunate position which we intelligent, civilized citizens of this twentieth century occupy. Statistics from all over the country show that we contentedly look on and are satisfied to see thousands upon thousands of our children sicken, fade away and die simply because they are improperly fed, and very many more thousands barely escape death itself, through long and continued sickness, to grow up permanently maimed, crippled or debilitated through damages produced directly upon the digestive organs, or indirectly on other parts of the body which are dependent upon the healthy condition of the digestive tract.

14. We see mental and physical wrecks at all stages and in all walks of life, but we are not well enough educated as a people to analyze these results and trace them back to their origin.

15. We see a thin, pale girl suffering from headache, nervousness and loss of sleep, but we do not recognize that these symptoms are merely the result of her imperfect dietary, her too great confinement to the house and the lack of fresh air while she is trying to study her school lessons.

We see the badly shaped boy with head too large and altogether out of shape, but we do not recognize that, had he been fed properly when an infant, his head would not be of this uncouth form and size.

We see that other boy with bow legs, an object of fun for his class-mates, but we fail to recognize that errors in his food, while he was yet a child a year old, gave his legs this ungainly shape.

We see that other boy or man whose knees are continually in collision with each other as he walks about the streets and whose efforts in running have always been the cause of laughter for those who saw him, but we do not know that his legs were born straight and merely became crooked because his mother did not know how to feed him correctly. That mother has always wished that he were a girl, so that his skirts would hide his deformity.

In like manner, we can travel through imperfect teeth, badly shaped mouth, muddy complexion, frequent convulsions, diarrhea, dysentery and many other disturbances which an intelligent physician knows are found nearly always in children who are improperly fed and whose nutrition is consequently poor, thus making them susceptible to these disturbances.

16. Does not all this seem a sad commentary upon our boasted intelligence and our vanity? But we are no worse than the rest of the world. Is it not time that we awake as a nation to the realization of our ignorance and weakness on this vital point and make a proper effort to infuse that intelligence and knowledge into ourselves, and especially into our children, which will enable them in days to come to escape either from the grave, from debility, or from that weakened condition of both mind and body from which so many of us suffer at the present day?

17. This will be accomplished gradually just as soon as our young mothers, who have been taught everything else necessary in this life for their benefit and success, realize that they have the opportunity and must learn this also, for the benefit and advantage of their children.

18. The following pages will be devoted to showing what are the different foods necessary for perfect nutrition at different ages and a simple and reliable method of recognizing their correct as well as injurious effects upon the

A MOTHER'S RESPONSIBILITY 19

human body. By this means, they can regulate the dietary of infants and children so as to secure that perfect nutrition at all times which guarantees perfect growth and development, both mentally and physically in children of all ages.

19. These principles which make successful growth and good health in the infant and youth, if always followed, cannot miss in retaining also that good nutrition and health in the adult which always makes success possible to him.

A MOTHER'S RESPONSIBILITY

20. On this subject, the proper nutrition of infants and children, our mothers are perhaps farther behind the advances of civilization, education, science and progress than on any other subject with which our educational and progressive nation is acquainted. Where is the young mother whose mind is not concentrated most intently, night and day, upon the proper care, growth and development of her infant from the very hour it was born? Just look at the position in which she is too often placed — a graduate from our public schools, high schools, and possibly from colleges or universities — and yet when her first child is born and she is unable to nurse it, she has, forsooth, to ask some old friend, her mother or possibly, even a stranger, "What shall I feed my baby?" Just think of the trouble she has in getting the right answer as against the many wrong answers which she is sure to get just in proportion with the number of times and the number of persons of whom she asks that question. Out of a dozen answers, possibly no two will be precisely the same and very likely not one will be exactly right. Such is the problem which a very young mother encounters. Why should it be so ? Ignorance ! Ignorance ! That is the only answer to give to that question in this en^ lightened day, no matter where it is asked, in city or town, in country or village, anywhere from Maine to California.

21. What a commentary upon our civilization! Yet, there are no members of our community who are keener or more anxious to advance in the right direction and be in the van of progress than our American women; and of these, there are none so keen and anxious on this subject as our American mothers, in their desire and determination to do all and everything they possibly can to secure that good health, strength and development necessary for their children. They fully realize that only good health and perfect development can procure future healthy matured men or women and enable them to compete successfully in the great battle of life before them.

22. It is not the fault of the young mother that she does not have this important information. It is the fault of our educational systems, for they have neglected to teach it. It will continue to be so until the nutrition of the human family is taught to our children as perfectly and as regularly as they are taught to read and write, and if. there is any one use to which our educational system could be turned with advantage to themselves, it would certainly be to enable them to study this subject. When this is the case and all our children thoroughly understand what perfect nutrition is, and can regulate the diet according to the evidences thereof at any time, our young mothers will not require to ask, "What shall I feed my baby?" but will immediately give proper directions and also see that they are successfully carried out. Their responsibility will be great, but the duty will be a pleasant one and one in which they will rejoice and take up with a happy heart, always cognizant of a successful result, feeling competent in their ability to do

THE WORRIED AND ABUSED MOTHER 21

that which is right and always recognizing promptly when an error has been committed by themselves or any one entrusted to do the work.

23. What a strong contrast will then be our position to that of the present day, where ignorance reigns and this whole work is a mere guessing and trying ; guessing and trying by mothers, hoping to find something that will suit the infant's digestive power and give their weary heads and aching limbs a temporary rest and also secure for them quiet sleep. Any mother who has gone through the broken sleep, the tiresome rocking, the back-breaking walking and the incessant weariness that always accompany and follow a cross baby suffering from distressing indigestion, realizes that this is the result of efforts to digest food, the proportions of which are entirely unsuited to its age and tender digestive organs. Her present misery, her future gloomy thoughts and possible acquaintance with the undertaker, are all the result of her ignorance and consequent inability to extricate herself or her child from the painful and distressing position into which she has, like thousands of other mothers in the same position, innocently fallen.

THE WORRIED AND ABUSED MOTHER

24. The mother who has an infant that is very difficult to feed and whose growth has been very slow is continually in a very anxious and worried frame of mind. If she has been unfortunate enough to lose an infant previously, this intensifies her situation and she is usually so worried about the little one that she is inclined to talk a great deal regarding it among her friends. This is a mistake on her part, but she does not know it. The fact that she obtains advice from every woman with whom she converses and that scarcely any two of these women agree on this question, should be proof enough to her that it is a mistake to talk so much about the little one. Usually, the mother with a delicate baby has many callers, all asking about the little one, all giving advice ; the sum total of which, when counted up, amounts to six or eight formulas each day. Six or eight advices in a day are not a high estimate of the number the mother frequently receives. This repeated, continually, shows the anxiety and mental abuse to which the young mother is subjected.

25. Where there is such great diversity of advice and suggestions, it is quite evident that there is no golden rule which all know alike and which she can adopt as her guide. If she would realize this fact and think the subject over carefully when alone, she would see that she cannot follow every advice ; therefore, she must select one particular course, adopt that one and follow it out intelligently. Trying to work in this way, will naturally drive her to select that course which is backed up by the most reason and intelligence, and such a one as she feels she can herself follow intelligently for her child's success and happiness.

26. Now, who is there who can intelligently advise the young mother on this subject? Is it the mother who has had half a dozen children, now partially grown up, and who has nursed them all until nearly a year old? What experience has she had about hand-feeding infants except during the second year ? Does she tell the young mother about the diarrhea, dysentery, fevers, convulsions and other disturbances from which her children suffered during the second summer, while they were strong and vigorous after the successful first year's nursing? She does not know that her irregular feeding and uncertain dietary were the cause

THE WORRIED AND ABUSED MOTHER 23

of her own infant's sickness and perhaps death during the second year. Just because she happened to have had half a dozen children whom she nursed during the first year and who were healthy while she nursed them and were sick more or less after she stopped nursing and hand-fed them, she and her friends think that, of course, she must know how to feed a young infant from three to six months old — that which she never did. She often thinks she knows enough to give advice about something which she is sure to spoil if she attempts to do it.

27. Take all the other mothers, perhaps even some also who have never been mothers, yet who, because of their age think they know something about this matter. They, also, presume to advise on this vital subject about which they have had little, and some of them no experience whatever. One of them, perhaps, may have heard of a certain kind of food that did some person's baby good at a critical time. They think it took so and so, and was fed so and so, and, without any reason, they immediately proceed to give indistinct details and great certainties for which they vouch most unhesitatingly.

28. Is there anything so simple in infant feeding that many women presume to know something about it which they think is good enough to try on another woman's delicate little infant? Would these same women presume to suggest to this mother how she should run her house, how to do her cooking or how to conduct herself in company? If they did, they would probably receive a sharp rebuke for their impudence; and yet, on this subject of feeding her infant, which is of far more vital importance to the mother and a subject requiring ten times more intelligence, they unhesitatingly say things and suggest changes for which they are not at all responsible and about which the great bulk of them invariably know a great deal less than the mother herself.

29. The poor mother who is subjected to this abuse is the victim of their kindly intended pertinacity and their foolish, though well-meant, disposition to recommend something that may, perhaps, be good for the infant, but they do not know whether it will or not. This mother is very much to be pitied for her sufferings and great mental torture through these kindly but cruel and untimely advices, and she continues to suffer from this mental abuse until, through her own study and the education from her physician, she reaches the point where she does not talk about her baby at all, or else she receives the officious advices of her friends in silence and inwardly pities them for their ignorance. The writer sees this result, frequently and constantly, in young mothers with their first infants.

30. In days to come, this mother is competent to give advice to some other mother in like distress. Does she do it? Perhaps she does; but if so, she does it very sparingly. Realizing what an important subject this is, she usually advises the mother to seek instructions from the proper source ; that is, from a physician thoroughly competent to advise and direct her. She has learned enough from her own experience in a like condition not to presume to give advice on such a responsible subject and in a matter of such vital importance.

Chapter II Varieties Of Human Milk

31. There is no food so suitable for a young infant as healthy human milk; and when a mother supplies enough of this to satisfy a healthy infant, its growth and success are assured. While the proper amount of milk of the right quality is the ideal food for an infant, there are only a limited number of mothers who secrete that quality and quantity which insures success. The infant who suffers continually from colic, looseness of the bowels and various kinds of digestive disturbances is certainly not getting a food which guarantees successful growth. It is possible that such an infant would, be better off if entirely weaned, providing the weaning was done with a food suited to the child's digestive secretions.

32. In order to thoroughly understand the proper nutriment for the young infant, it is necessary to look at the composition of human milk. Mothers should never consider milk as a single substance. The intelligent physician always looks upon it as a food composed of fat, sugar, proteid and salts, very largely diluted with water.

33. In one hundred parts of human milk, there are eighty-seven and one-half parts of water and only twelve and one-half parts of food. In these twelve and one-half parts of food, there are four of fat, seven of sugar and one and one-half of proteids. This composition shows that nature's plan in feeding is to use a very dilute mixed food, and she has so arranged the digestive glands in the infant that they secrete different fluids suitable for the digestion of these various amounts of fat, sugar and proteids, each fluid being able to dispose of only that particular food suited thereto. From this, it is plain that each food and the digestive fluid suited to it, must be correctly proportioned to each other for comfortable digestion and consequent successful growth and development.