Accordingly, on the third day, we add milk to the sugar and water. How much milk and how much water? Rather more than a tablespoonful of water to each tcaspoonful of milk, and, with this, just a pinch of sugar. As the days go by and the infant keeps well, we gradually increase the strength of the milk, until by the end of the first week the infant is given a mixture of one part of milk to two parts of water.

All going well and the infant being hungry, and, perhaps, with a tendency to constipation, we add to our mixture during the second week a little cream. How much? To begin with, very little - a teaspoonful in the twenty-four hours and, if this addition proves satisfactory, the amount may be gradually and slowly increased. From this stage onwards - from the stage when the baby first receives a mixture, of milk, water, cream, and sugar - the mixture is slowly and steadily increased in strength.

Thus, while according to the table already given, the mixture consists of two parts water and one part milk at the beginning of the second month, during the second and third months it is gradually strengthened, until at the commencement of the fourth month it consists of equal parts of milk and water, and so on thereafter. In the same manner the amount of cream and sugar is gradually increased.

Should the proportion of the different elements of the mixture be altered separately or simultaneously? Always separately. Here again we guard against unnecessary ignorance in the event of digestive disturbance. If we strengthen the mixture in all or several of its elements simultaneously, and the infant becomes ill, we cannot say with certainty which element is causing the trouble - whether it is the fat, the sugar, or the protein. On the other hand, by increasing each separately, we have a guide to direct us in the event of digestive disturbance. As age advances, then, we gradually strengthen our mixture in all directions, and we increase each element of it separately. But is this all we do? Is this the only possible way of strengthening the nourishment? How about the total amount of food to be given in the course of the day, and the amount at each feed?

Obviously, we can increase the amount of nourishment we are giving, not merely by strengthening the mixture but otherwise, or also by increasing the amount. Just as it is unwise to increase the elements of the mixture simultaneously, so is it unwise to increase the amount and the strength of the mixture at the same time. During the first two days we give the infant an occasional teaspoonful of boiled water, or of a dilute sugar solution, and on the third day commence feeding with 3 tablespoonfuls of the milk-mixture at each feeding period. This amount at each feeding we continue throughout the first fortnight, and then gradually increase, till by the beginning of the second month the infant receives 2 ounces at each feed, and thereafter the amount is gradually increased, as set forth in the table. And the number of feeds in the course of the twenty-four hours? We must always strictly enjoin that a minimum interval of two hours must elapse between two succeeding feeds. Human milk passes readily through the pylorus, cow's milk loss readily, and even in the case of the most dilute solutions of the latter we calculate that the stomach is not empty until about one and a half hours after a feed. To give the stomach necessary rest, then, a minimum interval of two hours must be demanded, this interval gradually lengthening as the amount and strength of the mixture increases.

Thus, during the first month ten feedings are given, eight during the day at intervals of two hours, and two during the night; by the end of the third month the number of feedings is reduced to seven, of which six are given during the day at intervals of two and a half hours, and one at night; during the sixth month, six feedings are given, all during the day at intervals of three hours, and this procedure is continued thereafter.

The Prescribing Of The Diet

So much for the diet of the average healthy infant, but how are we to prescribe it? In the first place we do well to remember that we have to prescribe it. A written prescription somewhat after the following form is essential in every case: -

Six bottles to be given during the day (a feeding period never to exceed fifteen minutes) at intervals of two and a half hours, and one bottle at night. Or else this may be stated otherwise as -

Six bottles to be given during the day (a feeding period never to exceed fifteen minutes) at intervals of two and a half hours, and one bottle at night.