In the preceding few pages the diet to be recommended for an average healthy infant has been briefly outlined. But some healthy infants are markedly below the average, and others just as markedly above it: they differ from it as regards nutritional needs, and as regards digestive capabilities. We meet, on the one hand, with the unusually small and weak, or the premature infant. The premature infant is frequently unable to suck satisfactorily, and, when possible, the secretion of the maternal breast should be drawn off and given to the infant by the spoon. If, however, artificial feeding is necessary, the infant should be fed by the spoon every hour or one and a half hours, according to its age and strength. It is usually wise to commence with 1 tablespoonful of sugar and water (1 teaspoonful of white sugar in I pint of boiled water) every hour for a day or two, and afterwards to add 1/2 teaspoonful of peptonised milk to each feeding, and to feed every one and a half hours instead of every hour. The amount of milk is, later on, gradually increased, and the degree of peptonisation gradually decreased. It is frequently advisable to add two or three drops of brandy to each feed. In some cases very dilute condensed milk (1 dram Nestle's milk in 3 ounces of water), given in small quantities (i- ounce) hourly, is also very useful as the initial food.

In the case of an infant which is merely undersized, the food should be that suitable for a younger infant, and, as a rule, it should be adapted more with regard to the weight than the age of the infant.

This, however, does not always result successfully, and when satisfactory gain in weight is not attained, the food must be increased in amount or quality, or some other change must be made. The methods most likely to be successful in such a case are two in number: either a cereal gruel (thick barley water, p. 34, or oatmeal gruel, p. 29C) may be added to the milk-mixture, or the milk-mixture may be replaced by Nestle's milk (one of the best varieties of condensed whole milk sweetened). When the infant is receiving a milk-mixture of a composition suited to its age, and, consequently, somewhat over-strong when consideration is had of its weight, when there are no symptoms of digestive disturbance, and when there is not satisfactory gain in weight, in such a case add a cereal gruel to the food, replace the water with barley-water. When, however, the infant shows in any manner that the digestive powers are being highly taxed, while the addition of a cereal gruel may prove of value, it is usually advisable rather to have recourse at once to Nestle's condensed milk. Give this milk in the proportion of I tea-spoonful of the milk to C tablespoonfuls of water, and, of this, give at each feeding time the amount suited to the age of the child. This mixture should be continued for ten days, a fortnight, or even longer, and then, if all goes well, cow's milk is gradually added to it. Now, in these two changes - the change from a cow's milk-mixture to Nestle's milk, and later the addition to this latter of cow's milk - an important principle in infant feeding is involved, and it is this:

In altering the diet of an infant, when the change to be made is that from a food of higher nutritive value and greater digestive strain to that of a lower value and less strain, the alteration may be made suddenly; but when the alteration is in the reverse direction, it must be undertaken slowly and step by step.

The Big, Strong Baby

In the case of a big, strong infant, the quantities and the strength of the food previously mentioned are insufficient for his needs; the milk-mixture must be more rapidly strengthened, a cereal gruel may be added to it, and to the infant of six months of age and over, a malted food, such as Horlick's malted milk, may be given once or even twice daily.