An immense number of proprietary infant foods are now on the market, and their composition varies widely. Some are intended as substitutes for cow's milk, and some as additions to it. For the infant under nine months of age the latter are not only unnecessary but harmful; for an older child, however, most of them form a useful and readily digested addition to the diet.

Those forms intended to be used as substitutes for milk are more suitable than the others for young infants, but even with their employment there are associated many drawbacks. All lack the antiscorbutic property, and none are so suitable in composition as carefully modified cow's milk. When the employment of one of these foods is preferred to other methods of feeding the infant, Allenbury No. I is probably the best food for an infant during the first two or three months of life.

For older children, i.e. over three months of age, the most suitable foods are Allenbury No. 2 and Horlick's malted milk.

These three foods - Allenbury, Nos. 1 and 2, and Horlick's malted milk - are intended as substitutes for cow's milk; they consist of desiccated milk with a small amount of cereal - the starch of which is largely converted into malt sugar, and for use they are mixed with water.

Many foods, however, contain no milk in their composition, and are intended as additions to cow's milk. All such foods are composed of cereals, i.e. powdered grain, and are consequently rich in starch. In the case of Mellin's food the starch is completely converted into malt sugar, as is also the case in Hovis No. 1; in Savory & Moore's food, Benger's food, and Allenbury No. 3 it is partially converted; while in most of the other foods the starch remains almost entirely unconverted. (See also Chapter IX (Patent, Proprietary, And Predigested Foods)., p. 154).

The Practice Of Artificial Feeding

Cow's milk, boiled (scalded) and suitably modified, is, however, the best artificial food obtainable for the infant.

This modification as a matter of routine consists of dilution with water, and the addition of cream and sugar; further modification is necessary in special circumstances, and may consist of the addition of sodium bicarbonate sodium citrate, gruel, etc.

Infant Feeding

Before going into any details of diet, I give the following table, which shows succinctly the diet likely to prove satisfactory for the average healthy infant: -

In the foregoing table the amount of food to be given at each feeding for babies of different ages has been placed in the first column. The figures are only valuable as a general guide, but as such - as an approximate indication of the capacity of the infant stomach - they are certainly of practical use.

In the second column there are placed the number of meals which are to be given in the twenty-four hours - for the first two months the infant is fed twice at night, and afterwards till the sixth month once at night.

In the third column it has to be understood that the food of the infant gradually passes from one strength to the next as age advances.

In the final column it Is noted that the amount of cream and sugar ad ministered - which to begin with should be very small (p. 246) - should for a baby under nine months of age never exceed the quantities therein mentioned. The sugar is preferably milk sugar, but cane sugar is also quite satisfactory.

The infant at birth whose future destiny largely depends upon the contents of its feeding-bottle, requires most careful supervision. Breast-nursing is the ideal condition for the child, but in the vast majority of cases, artificial feeding can be conducted to a satisfactory issue without any serious difficulties. The digestive capabilities of the infant are broad and elastic, and capable of suiting themselves, within limits, to the nourishment presented to them. And this very power is too often its own undoing. Infant feeding is a simple branch of medicine compared with many others; simple, that is to say, in its successful practice, though not, perhaps, in its science. But the subject demands intelligent attention, a little thought, and some clinical experience, and without the two former the latter is totally inefficient. The accoucheur is, as a rule, professedly blissfully ignorant of everything in connection with the subject. The baby introduced by him to the troubles of this world is relegated to some female guardian, "to be fed on Allenbury No. I," "Horlick's malted milk," " boiled milk and water," or its nourishment may depend on the particular fad of that particular female. A little later the general practitioner, or it may be the pediatric physician, is called in when trouble has commenced, and such an infant starts with a heavy handicap.

Or it may be the general practitioner is acting accoucheur, or he sees the infant at, or shortly after, birth, in which case its chances are much more hopeful. Prevention is always better than cure; but with regard to the digestive functions of the young infant, the alternative - cure - is not infrequently only a possibility. Catastrophes are apt to occur suddenly and with violence, and the issue is taken out of our hands ere ever we are able to influence it. When entrusted with the charge of an infant's diet, we must know what we want to do, how we ought to do it, and see, so far as we can, that our method is carried into practice. To achieve these objects we have, first of all, to decide on the form or forms of nourishment which we consider most suitable, and in making this decision it is absolutely insufficient to be guided by hearsay, fashion, or chance. Definite knowledge of the peculiarities and various reactions of different foods or milks, or on the other hand, wide clinical experience - one or other, but preferably both - must be the driving force controlling the decision. No back-door rush to a proprietary food is justifiable, when used as an avenue of escape from ignorance.