Where feeding in this manner is necessary, great care is required in the treatment of the bottles. Avoid any which have a tube, as it is most difficult to ensure perfect cleanliness. The slipper or boat shape, with a rubber nipple at one end, is the best. Wash the bottle and teat in hot water and soda after each feeding. Two bottles are necessary : one in use, and the other to be kept steeping in cold water till required, using them alternately. Twice daily they should be sterilized, by putting them into cold water and bringing it up to boiling-point.
For the first day or two very little food is necessary; some nurses think it advisable to give only a teaspoonful of warm water at intervals.
During the first month a baby should be fed every two hours, giving 3 tablespoonsful at a time, of 1 part milk to 2 parts water, sweetened with a little sugar or "sugar of milk" (obtainable at any chemist's), and adding a teaspoonful of cream.
When it is impossible to procure cream, half a teaspoonful of cod-liver oil may be added, as a proper amount of fat is most essential to keep up the heat of the body, and prevent rickets. If the child is troubled with much sickness, a tablespoonful of lime water may also be included. As the child becomes older more food can be given at a time, and at longer intervals. At the end of nine months saliva will be present, and patent starchy foods can be gradually introduced into the diet. The ptyalin in the saliva will transform the starch into grape-sugar, in which form it can easily be digested.
BARLEY WATER is most useful when the child is crying from thirst and not hunger. It is prepared as follows : Put
2 teaspoonsful of pearl barley in I pint of cold water (after thorough washing), and allow it to simmer until only two-thirds of the water remains, and then strain through muslin. This must be made every day; even twice a day in excessively hot weather.
Sprinkle a little water on a piece of freshly burned chalk or lime about the size of an orange, and, when slaked, put it in a gallon jar, and fill it up with water, corking and shaking it. After it is settled, throw away the liquid. Fill it once again with water, shake, and leave it again to settle for twenty-four hours, when it will be ready for use. This will remain in good condition for quite three weeks.
During the first and second months a child should be fed every two hours, making a total of ten feeds in the twenty-four hours; two of these being given at night between 10 p.m. and 7 a.m. During the third month nine feeds should be given in the twenty-four hours, one only during the night, and the remaining eight at two-and-a-half-hour intervals during the day. From three to five months seven feeds should be given during the same time, one during the night, and the remaining six at three-hour intervals during the day. From five to twelve months six feeds should be given at three-hour intervals during the day, but the night feed should be entirely discontinued.
To each feed should be added from 1/2 to I teaspoonful of cream or virol, according to the need for fat, and from 1/4 to 1/2 a teaspoonful of milk sugar (4 ozs. for 3 1/2d.) This milk should then be sterilized by being placed in a covered jug in a saucepan of cold water, the water coming up to the level of the milk. After being heated very gradually the water should boil for forty minutes, and then the milk should be kept in a cool place until required.
The proper temperature for the food is 98 1/2° Fahr. or " blood warm." Catarrh of the stomach is liable to arise if the food is too hot; and if too cold, digestive disturbances are set up. In cases where milk and water are found difficult of digestion Allenbury's food, humanized milk, or albulactin may be tried (the last sold in 1/3, 2/6, or 5/- bottles).
When a baby reaches the age of seven months a little juice from a freshly cut joint (not flour gravy) may be tried; at eight months a few crumbs may be added to this meat juice, or a very little floury potato. From nine to eighteen months the yolk of a lightly boiled egg, or a little bread dipped in bacon fat, mutton broth, or bread and butter, may be introduced into the dietary.
From one year to eighteen months five meals should be given per day, at 7 and 10 a.m., 1.30, 5 or 5.30 and 10 p.m. Between eighteen months and two years the last meal should be omitted, and at this period a little fish or minced meat may be included in the menu; but no tea, coffee, alcohol, or " made dishes."
To judge whether a baby is thriving or not it should be weighed weekly. It loses weight during the first three days of its life, but at the end of the first week it should equal its birth weight. During the first three months it should gain six ounces a week, but after the end of its first year only one and a half to two ounces a week. If the increase is excessive it may be due to overfeeding which may result in convulsions.