ARTIFICIAL DIET FOR INFANTS

It should be as like the breast-milk as possible. This is obtained by a mixture of cow's milk, water, and sugar, in the following proportions.

Fresh cow's milk, two thirds; Boiling water, or thin barley water, one third; Loaf sugar, a sufficient quantity to sweeten.

This is the best diet that can be used for the first six months, after which some farinaceous food may be combined.

In early infancy, mothers are too much in the habit of giving thick gruel, panada, biscuit-powder, and such matters, thinking that a diet of a lighter kind will not nourish. This is a mistake; for these preparations are much too solid; they overload the stomach, and cause indigestion, flatulence, and griping. These create a necessity for purgative medicines and carminatives, which again weaken digestion, and, by unnatural irritation, perpetuate the evils which render them necessary. Thus many infants are kept in a continual round of repletion, indigestion, and purging, with the administration of cordials and narcotics, who, if their diet were in quantity and quality suited to their digestive powers, would need no aid from physic or physicians.

In preparing this diet, it is highly important to obtain pure milk, not previously skimmed, or mixed with water; and in warm weather just taken from the cow. It should not be mixed with the water or sugar until wanted, and not more made than will be taken by the child at the time, for it must be prepared fresh at every meal. It is best not to heat the milk over the fire, but let the water be in a boiling state when mixed with it, and thus given to the infant tepid or lukewarm.

As the infant advances in age, the proportion of milk may be gradually increased; this is necessary after the second month, when three parts of milk to one of water may be allowed. But there must be no change in the kind of diet if the health of the child is good, and its appearance perceptibly improving. Nothing is more absurd than the notion, that in early life children require a variety of food; only one kind of food is prepared by nature, and it is impossible to transgress this law without marked injury.

There are two ways by the spoon, and by the nursing-bottle. The first ought never to be employed at this period, inasmuch as the power of digestion in infants is very weak, and their food is designed by nature to be taken very slowly into the stomach, being procured from the breast by the act of sucking, in which act a great quantity of saliva is secreted, and being poured into the mouth, mixes with the milk, and is swallowed with it. This process of nature, then, should be emulated as far as possible; and food (for this purpose) should be imbibed by suction from a nursing-bottle: it is thus obtained slowly, and the suction employed secures the mixture of a due quantity of saliva, which has a highly important influence on digestion. Whatever kind of bottle or teat is used, however, it must never be forgotten that cleanliness is absolutely essential to the success of this plan of rearing children.

Te quantity of food to be given at each meal ust be regulated by the age of the child, and its digestive power. A little experience will soon enable a careful and observing mother to determine this point. As the child grows older the quantity of course must be increased.

The chief error in rearing the young is overfeeding; and a most serious one it is; but which may be easily avoided by the parent pursuing a systematic plan with regard to the hours of feeding, and then only yielding to the indications of appetite, and administering the food slowly, in small quantities at a time. This is the only way effectually to prevent indigestion, and bowel complaints, and the irritable condition of the nervous system, so common in infancy, and secure to the infant healthy nutrition, and consequent strength of constitution. As has been well observed, "Nature never intended the infant's stomach to be converted into a receptacle for laxatives, carminatives, antacids, stimulants, and astringents; and when these become necessary, we may rest assured that there is something faulty in our management, however perfect it may seem to ourselves."

The frequency of giving food must be determined, as a general rule, by allowing such an interval between each meal as will insure the digestion of the previous quantity; and this may be fixed at about every three or four hours. If this rule be departed from, and the child receives a fresh supply of food every hour or so, time will not be given for the digestion of the previous quantity, and as a consequence of this process being interrupted, the food passing on into the bowel undigested, will there ferment and become sour, will inevitably produce cholic and purging, and in no way contribute to the nourishment of the child.

The posture of the child when fed:- It is important to attend to this. It must not receive its meals lying; the head should be raised on the nurse's arm, the most natural position, and one in which there will be no danger of the food going the wrong way, as it is called. After each meal the little one should be put into its cot, or repose on its mother's knee, for at least half an hour. This is essential for the process of digestion, as exercise is important at other times for the promotion of health.

As soon as the child has got any teeth, and about this period one or two will make their appearance, solid farinaceous matter boiled in water, beaten through a sieve, and mixed with a small quantity of milk, may be employed. Or tops and bottoms, steeped in hot water, with the addition of fresh milk and loaf sugar to sweeten. And the child may now, for the first time, be fed with a spoon.

When one or two of the large grinding teeth have appeared, the same food may be continued, but need not be passed through a sieve. Beef tea and chicken broth may occasionally be added; and, as an introduction to the use of a more completely animal diet, a portion, now and then, of a soft boiled egg; by and by a small bread pudding, made with one egg in it, may be taken as the dinner meal.

Nothing is more common than for parents during this period to give their children animal food. This is a great error. "To feed an infant with animal food before it has teeth proper for masticating it, shows a total disregard to the plain indications of nature, in withholding such teeth till the system requires their assistance to masticate solid food. And the method of grating and pounding meat, as a substitute for chewing, may be well suited to the toothless octogenarian, whose stomach is capable of digesting it; but the stomach of a young child is not adapted to the digestion of such food, and will be disordered by it.

It cannot reasonably be maintained that a child's mouth without teeth, and that of an adult, furnished with the teeth of carnivorous and graminivorous animals, are designed by the Creator for the same sort of food. If the mastication of solid food, whether animal or vegetable, and a due admixture of saliva, be necessary for digestion, then solid food cannot be proper, when there is no power of mastication. If it is swallowed in large masses it cannot be masticated at all, and will have but a small chance of being digested; and in an undigested state it will prove injurious to the stomach and to the other organs concerned in digestion, by forming unnatural compounds. The practice of giving solid food to a toothless child, is not less absurd, than to expect corn to be ground where there is no apparatus for grinding it. That which would be considered as an evidence of idiotism or insanity in the last instance, is defended and practised in the former. If, on the other hand, to obviate this evil, the solid matter, whether animal or vegetable, be previously broken into small masses, the infant will instantly swallow it, but it will be unmixed with saliva. Yet in every day's observation it will be seen, that children are so fed in their most tender age; and it is not wonderful that present evils are by this means produced, and the foundation laid for future disease."

The diet pointed out, then, is to be continued until the second year. Great care, however, is necessary in its management; for this period of infancy is ushered in by the process of teething, which is commonly connected with more or less of disorder of the system. Any error, therefore, in diet or regimen is now to be most carefully avoided. 'Tis true that the infant, who is of a sound and healthy constitution, in whom, therefore, the powers of life are energetic, and who up to this time has been nursed upon the breast of its parent, and now commences an artificial diet for the first time, disorder is scarcely perceptible, unless from the operation of very efficient causes. Not so, however, with the child who from the first hour of its birth has been nourished upon artificial food. Teething under such circumstances is always attended with more or less of disturbance of the frame, and disease of the most dangerous character but too frequently ensues. It is at this age, too, that all infectious and eruptive fevers are most prevalent; worms often begin to form, and diarrhoea, thrush, rickets, cutaneous eruptions, etc. manifest themselves, and the foundation of strumous disease is originated or developed. A judicious management of diet will prevent some of these complaints, and mitigate the violence of others when they occur.

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APPEARANCE OF MILK-TEETH

The first set of teeth, or milk-teeth as they are called, are twenty in number; they usually appear in pairs, and those of the lower jaw generally precede the corresponding ones of the upper. The first of the milk-teeth is generally cut about the sixth or seventh month, and the last of the set at various periods from the twentieth to the thirtieth months. Thus the whole period occupied by the first dentition may be estimated at from a year and a half to two years. The process varies, however, in different individuals, both as to its whole duration, and as to the periods and order in which the teeth make their appearance. It is unnecessary, however, to add more upon this point.

Their development is a natural process. It is too frequently, however, rendered a painful and difficult one, by errors in the management of the regimen and health of the infant, previously to the coming of the teeth, and during the process itself.

Thus, chiefly in consequence of injudicious management, it is made the most critical period of childhood. Not that I believe the extent of mortality fairly traceable to it, is by any means so great as has been stated; for it is rated as high as one sixth of all the children who undergo it. Still, no one doubts that first dentition is frequently a period of great danger to the infant. It therefore becomes a very important question to an anxious and affectionate mother, how the dangers and difficulties of teething can in any degree be diminished, or, if possible, altogether prevented. A few hints upon this subject, then, may be useful. I shall consider, first, the management of the infant, when teething is accomplished without difficulty; and, secondly, the management of the infant when it is attended with difficulty.

Management of the infant when teething is without difficulty.
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In the child of a healthy constitution, which has been properly, that is, naturally, fed, upon the milk of its mother alone, the symptoms attending teething will be of the mildest kind, and the management of the infant most simple and easy.

Symptoms:
- The symptoms of natural dentition (which this may be fairly called) are, an increased flow of saliva, with swelling and heat of the gums, and occasionally flushing of the cheeks. The child frequently thrusts its fingers, or any thing within its grasp, into its mouth. Its thirst is increased, and it takes the breast more frequently, though, from the tender state of the gums, for shorter periods than usual. It is fretful and restless; and sudden fits of crying and occasional starting from sleep, with a slight tendency to vomiting, and even looseness of the bowels, are not uncommon. Many of these symptoms often precede the appearance of the tooth by several weeks, and indicate that what is called "breeding the teeth" is going on. In such cases, the symptoms disappear in a few days, to recur again when the tooth approaches the surface of the gum.

Treatment:
- The management of the infant in this case is very simple, and seldom calls for the interference of the medical attendant. The child ought to be much in the open air, and well exercised: the bowels should be kept freely open with castor oil; and be always gently relaxed at this time. Cold sponging employed daily, and the surface of the body rubbed dry with as rough a flannel as the delicate skin of the child will bear; friction being very useful. The breast should be given often, but not for long at a time; the thirst will thus be allayed, the gums kept moist and relaxed, and their irritation soothed, without the stomach being overloaded. The mother must also carefully attend, at this time, to her own health and diet, and avoid all stimulant food or drinks.

From the moment dentition begins, pressure on the gums will be found to be agreeable to the child, by numbing the sensibility and dulling the pain. For this purpose coral is usually employed, or a piece of orris-root, or scraped liquorice root; a flat ivory ring, however, is far safer and better, for there is no danger of its being thrust into the eyes or nose.

Gentle friction of the gums, also, by the finger of the nurse, is pleasing to the infant; and, as it seems to have some effect in allaying irritation, may be frequently resorted to. In France, it is very much the practice to dip the liquorice-root, and other substances, into honey, or powdered sugar-candy; and in Germany, a small bag, containing a mixture of sugar and spices, is given to the infant to suck, whenever it is fretful and uneasy during teething. The constant use, however, of sweet and stimulating ingredients must do injury to the stomach, and renders their employment very objectionable.

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TEACHING A CHILD TO WALK

Exercise is essentially important to the health of the infant. Its first exercise, of course, will be in the nurse's arms. After a month or two, when it begins to sleep less during the day, it will delight to roll and kick about on the sofa: it will thus use its limbs freely; and this, with carrying out into the open air, is all the exercise it requires at this period.

By and by, however, the child will make its first attempts to walk. Now it is important that none of the many plans which have been devised to teach a child to walk, should be adopted the go-cart, leading-strings, etc.; their tendency is mischievous; and flatness of the chest, confined lungs, distorted spine, and deformed legs, are so many evils which often originate in such practices. This is explained by the fact of the bones in infancy being comparatively soft and pliable, and if prematurely subjected by these contrivances to carry the weight of the body, they yield just like an elastic stick bending under a weight, and as a natural consequence become curved and distorted.

It is highly necessary that the young and experienced mother should recollect this fact, for the early efforts of the little one to walk are naturally viewed by her with so much delight, that she will be apt to encourage and prolong its attempts, without any thought of the mischief which they may occasion; thus many a parent has had to mourn over the deformity which she has herself created.

It may be as well here to remark, that if such distortion is timely noticed, it is capable of correction, even after evident curvature has taken place. It is to be remedied by using those means that shall invigorate the frame, and promote the child's general health (a daily plunge into the cold bath, or sponging with cold salt water, will be found signally efficacious), and by avoiding the original cause of the distortion never allowing the child to get upon his feet. The only way to accomplish the latter intention, is to put both the legs into a large stocking; this will effectually answer this purpose, while, at the same time, it does not prevent the free and full exercise of the muscles of the legs. After some months pursuing this plan, the limbs will be found no longer deformed, the bones to have acquired firmness and the muscles strength; and the child may be permitted to get upon his feet again without any hazard of perpetuating or renewing the evil.

The best mode of teaching a child to walk, is to let it teach itself, and this it will do readily enough. It will first crawl about: this exercises every muscle in the body, does not fatigue the child, throws no weight upon the bones, but imparts vigor and strength, and is thus highly useful. After a while, having the power, it will wish to do more: it will endeavor to lift itself upon its feet by the aid of a chair, and though it fail again and again in its attempts, it will still persevere until it accomplish it. By this it learns, first, to raise itself from the floor; and secondly, to stand, but not without keeping hold of the object on which it has seized. Next it will balance itself without holding, and will proudly and laughingly show that it can stand alone. Fearful, however, as yet of moving its limbs without support, it will seize a chair or anything else near it, when it will dare to advance as far as the limits of its support will permit. This little adventure will be repeated day after day with increased exultation; when, after numerous trials, he will feel confident of his power to balance himself, and he will run alone. Now time is required for this gradual self-teaching, during which the muscles and bones become strengthened; and when at last called upon to sustain the weight of the body, are fully capable of doing so.

Exercise during childhood.

When the child has acquired sufficient strength to take active exercise, he can scarcely be too much in the open air; the more he is habituated to this, the more capable will he be of bearing the vicissitudes of the climate. Children, too, should always be allowed to amuse themselves at pleasure, for they will generally take that kind and degree of exercise which is best calculated to promote the growth and development of the body. In the unrestrained indulgence of their youthful sports, every muscle of the body comes in for its share of active exercise; and free growth, vigor, and health are the result.

If, however, a child is delicate and strumous, and too feeble to take sufficient exercise on foot, and to such a constitution the respiration of a pure air and exercise are indispensable for the improvement of health, and without them all other efforts will fail, riding on a donkey or pony forms the best substitute. This kind of exercise will always be found of infinite service to delicate children; it amuses the mind, and exercises the muscles of the whole body, and yet in so gentle a manner as to induce little fatigue.

The exercises of horseback, however, are most particularly useful where there is a tendency in the constitution to pulmonary consumption, either from hereditary or accidental causes. It is here beneficial, as well through its influence on the general health, as more directly on the lungs themselves. There can be no doubt that the lungs, like the muscles of the body, acquire power and health of function by exercise.

Now during a ride this is obtained, and without much fatigue to the body. The free and equable expansion of the lungs by full inspiration, necessarily takes place; this maintains their healthy structure, by keeping all the air-passages open and previous; it prevents congestion in the pulmonary circulation, and at the same time provides more completely for the necessary chemical action on the blood, by changing, at each act of respiration, a sufficient proportion of the whole air contained in the lungs, all objects of great importance, and all capable of being promoted, more or less, by the means in question.

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