Nursery problems

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Feeding .

Milk . .

Weaning Diet . .

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Will you kindly advise me by what means I can stop my baby's excessive vomiting? Old-time aunties and grandmas tell me that all babies vomit, and that nothing is wrong with Baby, but it seems to me if the food is properly digested it should be retained.

I give uiy baby (nearly three mouths old), every two hours, six tablespoonfuls of barley-water and one teaspoonful of fresh condensed milk. Sometimes she seems satisfied and sometimes she does not, but to increase the quantity of food results in something just short of a deluge. Of the six tablespoonfuls she retains about one-half. Her habits are good, and she seems to thrive, her weight being now twelve pounds. She weighed eight at birth. She goes to sleep every night before eight o'clock, and rarely wakens before 5.30 A. M. She is remarkably vigorous and bright, her skin a healthy color, and is in every respect a model baby aside from the vomiting.

I have tried Mellin's and Carnrick's foods. Both had the effect of loosening the bowels, which have acted perfectly since she was born until the past three weeks, when there has been a slight constipation. I am away from home, and, as I cannot seek the advice of my physician, I turn to you for help.

Brooklyn, X. Y. J. S. 11.

The question presents a child of three months that has gained weight moderately since birth, and seems to be in good health except for excessive regurgitation of food. We are not quite sure if the other foods were likewise vomited. Now, while it is true that all babies may vomit, it is not true that all or even most babies habitually vomit; and when this symptom is persistent, it is usually pretty clear— supposing the child to be in good health — that there is something wrong in the quantity or quality of the food, or that there is some indiscretion, such as want of quiet, with or after the meal. Inasmuch as the total quantity given to your child at a meal does not seem excessive, we have to question whether lengthening the intervals slightly, or change of food would be most likely to correct the tendency. The lengthening of the interval is the simplest; this failing, we should be incliued to try peptonized milk. II.

I come to you for help in the case of my little duughter, aged five months. Let me state first that medical aid has failed thus far to benefit her. Being deprived at two weeks of age of her mother's milk,

FEEDING. 19 the great question was to find some food that she could assimilate. Cow's milk with additions of lime water, Mellin's Food, barley, peptonizing powders, etc, came up in distressingly large curds. Condensed milk was substituted; there was no further trouble from curds, and for several weeks the baby thrived, when suddenly she changed, her stomach seeming to reject every drop of nourishment taken, and her weight decreasing frightfully. My physician then gave her eream and water, not too rich, slightly sweetened with sugar of milk and strengthened with oat-meal water. The little girl is now gaining in strength and length (though there has been no gaining in weight in the past fortnight), weighs 14 pouuds and five ounces, and is the "picture of health ;" she is very contented, and sleeps splendidly. Yet the trouble remains ; she seems to retain almost nothing. Her mother and nurse endeavor to keep her perfecty quiet after each feeding, but without avail ; the regurgitation is constant and excessive for certainly an hour after her meal, which consists of ten tablespoonfuls. Can you offer any advice ?

E. D. H.

This problem, while much like the preceding one, differs from it in some respects. In the first place, medical aid has been already invoked and apparently freely. We may say frankly that where a physician on the spot has missed the mark, one at a distance is not likely to hit it. But. we offer such suggestions as we can. We note, first of all, what is quite common in vomiting of the regurgitative type, that in spite of the seemingly excessive rejection of food a good deal must be retained, for the child gains in "length and strength," and her weight, 14£ pounds, is not bad for her age, live months. A second point is this: The vomiting at first was marked by the presence of very large curds, which were less when condensed milk was used, and it is so with the cream mixture. Now, it is probable that some difficulty in the digestion ofcaseine is at the bottom of the mischief . The food suggestion by your physician leads us to suppose that such was bis opinion. In such a cawe, if we were convinced that the regurgitation was so great that proper nutrition was not obtained, we should make a food free from unchanged caseine for a time, which may be done by diluting and sweetening egg albumen, or we should perhaps make a careful trial of Carnrick 's Food in some quantities. I f it agrees it may be continued for some time. Later — as we have a predilection for milk foods— the change can be made to food prepared with some peptogenic preparation, Fairchild's for instance; but if the child thrives, the change need not be made for months.

Baby's Temptations at the Table.

When is a child old enough to sit at the table with its elders and eat of the same fare (with certain restrictions of course; I don't mean to include condiments), for example, hot muffins, plain cake, soups, fish and vegetables of various kinds ? My little girl seems to be getting tired of all the very few articles of food which she is allowed.

A Learner.

When we have the choice we think that a child would better not be exposed to the temptations of the parents' table untihit is two and a half or three years of age, and we should prefer that it be four years before it is given a general diet as you describe; for instance, ordinarily a muffin is hard of digestion to anyone. We know of no use for cake for children of any age, and vegetables vary from some of easy digestion to some that tax the adult stomach.

Feeding a Premature Child.

(1) My baby was a little seven-months baby, weighing only four pounds at birth, and now at five months he weighs ten pounds. Has he gained as much as he ought to have done under the circumstances ?

(2) Since the third month he has been artificially fed, taking ten tablespoonfuls or more at a time of Nestle's food every two hours in

FEEDIXG.

the daytime and two or three times at night. Is he fed too much and too often ?

(3) Should he be considered and treated, as regards his food, as a five-months or a three-months-old baby ?

Chicago, HI. An Inexperienced Mother.

(1) The gain seems very satisfactory, his weight being two-and-a-half times what it was at birth.

(2) Probably yon could begin to widen the intervals with advantage.

(3) It is not easy to say for how long and how much allowance should be made for premature birth. We think it safe to make an allowance, gradually diminishing, until the end of a year, and longer if the child is feeble. Your baby at five months, for instance, could be considered a fourmonths baby, at ten months, as nine-and-a-half. This, of course, is only approximative, and the real guide is the condition as to strength, etc., of the particular baby.

"Sucking Wind."

Is it possible for a baby to "suck wind" into its stomach from a nursing-bottle? I had always accepted it as an unquestioned fact until, in a recent number of a periodical, I noticed that the idea was ridiculed. Nurses and mothers might be relieved of considerable anxiety in this matter if it could be shown that "sucking wind" is only an "old woman's whim," as alleged by the writer of that article. North Dig/iton, Mass. Alice.

There is nothing ridiculous in the supposition that a child may "suck wind" from a nursing-bottle improperly managed. Cases of air-swallowing by adults are cited in works on medicine. The celebrated French physiologist Magendie made extended researches on this point. He found thai many persons had the power of swallowing air, and he learned to do it himself, hut gave up the practice owing to the distress it caused him. "Wind-sucking" is a familiar enough vice in horses. There is, therefore, nothing ridiculous in supposing that a baby with good sucking power might swallow air. How far infants actually do so is another matter; the distinction between a colic from swallowing of air and one from gaseous indigestion can only be made after patient watching of the symptoms. The rule should be: Manage the bottle so that the baby cannot get air from it.

Combined Nursing and Bottle Feeding.

Do you think nursing and bottle feeding together at the same meal had for a baby ?

We do not like it, not so much because of the mixing of the two kinds of nourishment, as because, if the breast is not equal to the total feeding, it ought to have the needed rest. Further, the child contracts a bad habit of wanting the breast with artificial food, and weaning becomes difficult. Still further,it is impossible to know just how much a child is taking when this confused method is employed.

MILK,

Pure versus Diluted Milk.

Is it advisable to dilute the milk for a child of two and a half years? It is claimed by my wife that the milk is too rich, and that with a slight admixture of water it agrees better with our boy. 1 think that since milk is his principal nourishment he ought to have it pure, and that if rich it is all the better on that account.

Jeusf.yman.

The answer depends upon the quality of the milk and the digestive powers of the child. A child of ordinary digestive power can take the milk — especially if warmed slightly — of an ordinary cow undiluted. Jersey milk, with an unusual an i on nt of cream, may be too heavy if pure. But it is always safer to err on the side of over-dilution, and to make up the nourishment, if necessary, by increased quantity.

Oatmeal-Water for Dilution of Milk.

Will you kindly tell me how oatmeal-water should be prepared ? Chicago, III. G. F. H.

If you use oatmeal porridge at breakfast you can make oatmeal-water thus : Of the porridge take as much as you can lift with a tablespoon, put it into a quart of cold water and raise to a boil, stirring to prevent burning, and strain.

If you do not have porridge this receipt will do: Add one t.il.lespoonful of line oatmeal (steam-cooked is preferable) to one pint of cold water. Stir well and strain off the

N URS ER Y FROBL EMS.

water. Boil the water thus strained off until it is reduced to about one-half in quantity.

The water is used to dilute milk precisely as plain water would be.

Proper Dilution of Condensed Milk; the Real Use of Lime-Water.

Nature has deprived me of nourishment for my little one, who is five months old. I have given her Borden's Eagle Brand of condensed milk, properly diluted with water that has been boiled, with a tiny pinch of salt and a little lime-water added to it. These are the proportions : 6 ounces boiled water, 2 teaspoonfuls of condensed milk, a pinch of salt, 2 teaspoonfuls of lime-water. She takes about this amount every three hours during the day and about half the amount once during the night. She weighed 7 pounds at birth, and now, at five months, weighs 17 pounds and seems very strong. Her only difficulty is constipation, which I have heard is a usual occurrence with bottle-fed babies.

(1) Would you continue with the condensed milk, when she has gained so much, and seems so well, and I have used nothing else? If not, what do you recommend that is better ?

(2) Am I using the right proportions for her age, and are 42 ounces too much in quantity for twenty-four hours ?

(3) Do you think any harmful results may occur from using lime-water in every bottle? If so, how often would you use it ? She never has sOur stomach, so I do not need it for that purpose, but I have always thought that it aided in "forming teeth."

Yortkers. X. Y. M- v -

(1) When a child is really doing well we do not advise change even if the food is not what it ought to be. Many children, like many adults, have sufficient digestive power to be nourished by imperfect food. In practice— especially in dispensary practice— condensed milk is often the best food that can be obtained, and its deficiency in fat can be made up by using cod-liver oil, and the sugar deficiency,

MILK. 25 which exists if it is properly diluted, made up by adding sugar.

(2) This being the ease, it is not easy to say what are correct proportions as regards a food which is admittedly imperfect. Condensed milk which is preserved and canned is inferior to that made by the same makers and sold in many cities from delivery wagons. This last is only a substitute for good, ordinary milk whenever the latter is not to be easily had. We think that you dilute the condensed milk too much for an adequate food ; its high dilution makes it easily digested but not very nutritious. By increasing the strength of the mixture somewhat, from time to time, you can increase its nutritive power while you watch the digestion. If you wish to try another kind of food altogether, we would suggest that it be done under the advice of a good physician, who has looked the baby over carefully to see what is lacking in her nutrition.

(3) No. Lime-water is added to milk really for this reason : to give to it the alkaline reaction which fresh human milk has. Cow's milk as sold is usually acid to the litmus paper, not "sour" in the popular sense.

Peptonized Milk.

In the directions for using Fairchild's Peptogenic Milk-Powder I find nowhere a recommendation to boil the milk before mixing it with the powder; is this not often desirable, and advisable in any case ?

Two methods are described — that of " humanizing " milk fresh for each feeding, and that of making enough for several feedings in ad vance. Is there no difference between the two ? The saving of time and trouble is certainly on the side of the second.

Is there any harm in the bitter taste which the milk assumes if heated too long or too suddenly ?

Neio York. P.

NURSERY PROBLEMS.

It is better, especially in hot weather, to boil the milk on receipt, as it prevents or retards changes.

We prefer the second method— i.e., that of making enough for several meals at one time — because if the preparation occurs every few hours variations of heat and other circumstances are likely to make variation in degree of peptonization. Besides, six minutes seems a long time when the baby is crying for food, and the time is likely to be cut short in consequence.

In the second method of preparation one manipulation may be saved by putting the mixture into a clean saucepan or pail, which is set into the warm-water pail (115° to 120° P.), and the whole covered with a " cosey " or a blanket, which keeps the heat uniform. The vessel containing the mixture can then be removed at the end of fifteen minutes, and the scalding done in the same vessel, and the food is then put into glass. A preserving-jar with air-tight glass top is a good receptacle for it and easily kept clean.

It is of great assistance to use an immersion thermometer, which can be had for less than a dollar.

With regard to the bitter taste we may say : First, it is likely to disgust the infant after a little if it is not very hungry, and it may refuse a part of the meal. Secondly, the amount of caseine in human milk and in cow's milk differs. There are also differences in the two milks about which chemists are not all agreed ; but it is in general admitted that human milk has in it more peptone than cow's milk, and it is believed that partial peptonizing of cow's milk properly diluted approximates it to the character of human milk. But it would be overdoing the matter to entirely peptonize the cow's milk, and practically in health it is doubtful if it is well to feed the child on pure peptones ; a partially peptonized food is probably better in the long run. In cases of digestive trouble the peptonizing action may be increased.

One Cow's Milk.

My physician claims to be a reader of all the best and latest medical journals and to know all that is going on in the medical •world. He claims that only a few physicians favor herd's milk, and that all the weight of authority is on the other side. Can you give me names of eminent men with which to refute this claim ? It is a matter of some consequence to me, as he lays any disturbance of the digestive organs to the use of mixed milk.

Oberlin. 0. E. R. A.

If by " herd's milk " you mean the mixed milk of a herd as compared with that of a single cow, we can only say that we cannot recall any one, at least in America, whom we should call an authority, who now clings to the "one cow's milk " theory. Twenty-five years ago we heard it taught. We have taken up such recent books as are lying at band, but find no one in favor of one cow's milk. We mention two authors, because more widely known than the rest, who express their preference for mixed milk. Jacobi (article "Infant Hygiene," in Ziemssen's Cyclopaedia, XVIII, 107); Rotch (article "Infant Feeding," in Keating's Cyclopedia, I, 338).

Top Milk.

What is "top milk," and how much water should I use with it for a baby three months old '.'

8t. Louis, Mo. W. S. S.

"Toj) milk" is the upper half of milk which lias been allowed l" Stand for a time, say three hours. It should he dipped, nol poured, off from the under milk. For a baby

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of three months at first add as much water as there is milk gradually diminish the proportion of water.

Scum on Boiled Milk.

Will you kindly tell me what part of the milk rises to form the scum on the top when boiled, and whether it should be removed or stirred in before feeding to a child ?

Newtown, Conn. M. E. B.

"We do not remember to have ever seen a chemical analysis of this scum, but suppose that it is chiefly the milk albumen and probably some fat mechanically mixed with it by the boiling. Whether it is to be rejected or not is a question of palate. Personally, we throw it out.

A Warning against Sour Milk.

Can you tell me what I can do when the milk sours with which I have to feed my eight months-old child ? My milkman comes at night, and on one or two occasions the milk has been sour at the two o'clock meal the next day. What can I give my child as a substitute when this occurs ? It troubles me when I try to think of what I should do in case of not having any milk. The milk I get is usually very good, and the man who brings it says the souring is caused by some cows going dry. Ought such milk to be used?

Brookline, Mass. C. G. D.

Under no circumstances should sour milk be given. Duriug hot weather it is better to attend to the preparing of food and sterilizing of milk as soon as the latter is received. In ease of milk souring, if sweet milk cannot be had, we should use condensed milk, or even water gruel, for the day, rather than give any doubtful milk.

MILK.

The Apparatus for Sterilizing.

I -wish to try the method of feeding described by Miss Montrose in the " Mother's Nursery Guide," but have so far failed in my efforts to obtain the " patent corks " — none of the druggists here knowing anything about them.

Will you kindly tell me where I can get all the articles necessary for sterilizing milk, viz., thick bottles which will bear boiling, and "patent corks " of rubber and glass exactly to fit them?

A Learner.

The best sterilizing apparatus that we yet have seen is that called the " Arnold." The best stopper is simply clean cotton, absorbent cotton being preferable. If for the purpose of transportation a cork is necessary, one can be prepared thus: Get fine corks with as few holes as possible; cut a long wedge-shaped piece out of the side of each reaching not quite to the top of the cork. The corks can be made pure by putting them into the chamber with the bottles while the steam is generated. When a bottle is taken out a cork may be crowded into the mouth until the slit is closed by the compression. Rubber corks of the same pattern are sold, and common rubber corks are excellent. They can I »e sterilized, after thorough washing daily.

Bottles for Sterilizers.

Are there no larger bottles made for the sterilizer than those that hold seven or eight ounces? I cannot find any in Boston. As my child grows older he needs more milk, and 1 should think larger bottles ought to be had to meet this requirement.

There are nursing bottles made to hold twelve ounces, but very few Children, if any, under a year should have more than ( ighi ounces at ameal. After that age it is better to teach

the Child to drink from a cup.

NURSER Y PROBLEMS.

If you wish bottles only for sterilizing you can get them of any size at an apothecary's. Very good strong bottles are those used for bottled soda or beer, which, if kept clean, will do very well for sterilization.

Keeping Sterilized Milk in Summer.

Will you kindly tell uie whether you think it necessary to keep sterilized milk on ice during the warm weather? Our summers are quite severe at times, the thermometer registering from 80 to 95 degrees in the house. I have never used the sterilized milk before in the warm season, and so I am ignorant as to what I should do. At present, I keep the bottles in as cool and breezy a window as I can find. The milk is thoroughly sterilized, boiling hard 45 minutes, and has never yet disagreed with my nine-months-old baby, who has taken it almost since birth.

Macon, Ga. L. W.

Milk which is thoroughly sterilized and thoroughly well corked need not be iced. In fact, so far as its sterility goes, it ought to stand anything so long as the bottles are tight. When milk is only partially sterilized or imperfectly corked, or in any way neglected in the preparation, of course this remark will not hold.

Does Sterilized Milk Constipate?

Are there not cases where milk sterilized will produce constipation ?

Yes, practically. That is to say, the milk, having been rendered unirritating by sterilization, no longer stimulates the bowels to the degree that raw milk does, and is constipating in the same sense that white bread is constipating as compared with coarse bread. To speak more accurately, we

MILK. 31

should say that sterilized milk was not laxative as compared with uncooked milk ; and so some infants become, temporarily, at least, more constipated than before.

A Case where Sterilizing is Unnecessary.

My boy of eighteen months, who weighs over 26 pounds (without clothing), is still taking sterilized milk with his Mellin's Food, supplemented by a little strained oatmeal and bread and butter. How much longer is it desirable to sterilize the milk ? He has twelve teeth and seems very well.

Aurora, X. Y. G.

If the milk you have is of good quality, we see no reason for sterilizing it any longer.

WEANING.

Age for Weaning ; First Food ; Learning to Drink Milk.

My baby boy is eigbt months old. He seems perfectly, healthy, with the exception of being constipated, though that trouble appears to be disappearing gradually. I have nursed him entirely, and thought of doing so until he was a year old.

(1) Would it be better to wean him at nine or at twelve months ?

(2) With what would it be best to feed him ? I thought of using sterilized milk, but do not know how much to give him nor how much to dilute it, nor whether to put in lime-water.

(3) Would it be better to teach him to use a bottle or drink from a cup ? He drinks water from a cup very well now.

(4) How soon before weaning him entirely would it be best to give him cow's milk to get him accustomed to it.

Augusta, Me. A Grateful Mother.

(1) If you have plenty of milk of good quality you may nurse him until twelve months. If not, you may wean at nine months, or at any time thereafter.

(2) At twelve months he will probably do well on diluted milk, beginning with half water or, still better, barley-water and strengthening the mixture very soon if it agrees with him. The lime-water would be useful but is not necessarily called for.

(3) To drink from a cup.

(4) A month probably will give him sufficient preliminary trainiug.

WEANING.

A Question of Weaning before Summer.

When should my baby be weaned ? His two older brothers were fall babies, and nursed ten and eleven months ; but this one came in May, is a plump, health}', nine-months-old boy without a tooth to be seen, though there are signs of their speedy coming.

My supply of milk seems plentiful and nourishing. He eats six times in the twenty-four hours — once in four hours — regularly night and day (is that too often ?) ; and if it is best while he is teething, I can probably keep tolerably strong and nurse him through September, though it is usually quite a tax upon my strength. We shall be in the country during July and August, where good milk from one cow could be obtained.

Have I explained to you clearly enough, so that you can advise which is safer for my baby ?

Elyria, 0. M. D. M.

It is probable from what you say that Baby already needs more than you can give him. At nine months six nursings in twenty-four hours is rather more frequent than is necessary, but is not excessively so. You cannot, in all probability, carry him on the breast alone until the end of September, and you would better begin to give him some artificial food very soon ; it is quite probable that before June he will have weaned himself.

Time for Weaning; First Food.

My baby is nine and a half months old, has two teeth, just through, has always been well, except an attack of tonsilitis which he nursed from me, and has never been fed except from the breast. He is strong, weighs 23 pounds, and will walk beside the chairs or push one across the room. He has been fed on time and not been given patent medicines of any kind. He nurses now only once in four or five hours.

(1) Do you advise weaning him before warm weather?

(2) Shall I feed him some milk, diluted with water, one part to three? If so, how many times a day and at what hours? He nurses now at 8 or 9, about 1, 5 and 9, and once or twice through the night, I am sorry to say.

Springfield Mass. C. B.

(2) One part of water to three of milk will probably agree at the age of eleven months, in the case of your child. Give at as regular hours as possible, say at 7 and 10 a.m. and 1, 4 and 7 p.m., and a night bottle if necessary. Give food blood-warm, of course.

Dropping the Night Meal.

At what age and how can a baby best be weaned nights? If he wakes up and wants the bottle should he be allowed to cry ?

Providence, R.I. A. E. R.

At six months usually, by eight months pretty certainly, a child can go from, say, 10 p.m. till early morning, and would better do so. There is only one way to accomplish this. Arrange the day's meals so that the last comes at or about 10 p.m. Then if food is cried for give drink and get the child to sleep without feeding. If it will not go to sleep wait till considerably after its usual time before feeding, and each night make the hour later until your set time is reached. Usually two or three nights at most win the battle. Most of the difficulty comes from the vicious habit of feeding a child whenever it cries, until it comes to feel that it cannot become quiet without the breast or bottle, when over-feeding may be the real cause of the restlessno-.