Before jumping to the conclusion that some other food must be tried for an infant it is extremely important to make sure that the food employed is the element at fault. In the vast majority of cases it will be found that pure milk simply modified will suit the infant perfectly well. A change of diet should not be adopted until the following points have been thoroughly inquired into and corrections made if necessary.

(1) The Purity And Freshness Of The Milk At Each Feeding

If the milk is swarming with organisms, or sour, one cannot expect satisfactory results.

(2) The Strength Of The Milk As Regards Solid Elements

The tendency is to give as rich a milk as possible, to add cream, or some starchy food, in accordance with the popular belief that the stronger the food the stronger the infant. This usually leads to disastrous results as regards digestion and nutrition. The opposite mistake, namely the giving too weak a food, is but rarely met with, but may be the explanation in certain cases where the weight is not being maintained.

(3) The Quantity At Each Meal

Both the feeding up tendency of the mother and the appetite of the infant may require regulating. Overfeeding causes more digestive troubles in early life than all the other causes together. Every cry of an infant is interpreted as being due to hunger, and food is poured in. If the bottle is not finished readily, much time is devoted to coaxing the infant to swallow more. If vomiting occurs, the next meal is hurried on to make up for the previous fluid and curd lost. Then the physician is solemnly assured that the infant cannot digest cows' milk!

(4) The Regularity Of The Meals

It is essential even in the earliest months of life that a proper interval for digesting a meal should be allowed. The minimum length in health should be two hours. Water can be given between meals to allay thirst.

(5) The Presence Of Local Or Constitutional Disease In The Infant

In the case of congenital pyloric stenosis one usually finds that a great variety of foods have been tried but that the disease has not been recognized. In the case of congenital syphilis wasting may have led to a trial of various foods in the belief that the suitable food had not been hit upon. If is of the first importance to make a careful physical examination in every case of supposed food disorder so as to determine the presence or absence of any disease in the infant which may have an influence on the disturbances present.

Were these questions always carefully considered it is our belief that the number of children who are supposed to require specially modified milk would be greatly reduced, and that the infantile stomach would be found to be an organ capable of accommodating itself to the digestion of cows' milk.