The same guiding principle is to be observed here, namely, that the child should have an amount of the three chief elements, proteins, fats, and carbo-hydrates, sufficient for the nutrition of the body, the repair of tissues, and the more active movements which are now developing. The digestive organs are now capable of dealing with more concentrated material so that more solid food can be given. The food must be of a nature suited to the young child and must be selected according to the guidance of experience. It is not to be inferred that the strengthening food of a healthy adult is equally strengthening to the young and developing digestive organs of the infant. The teeth are present for a definite purpose, so that a certain amount of the food should be hard, and biting and chewing be rendered necessary. There should be no bottle-feeding after the first year as the infant can now take solids out of a spoon and fluids out of a cup. The meals should not exceed four in number and there should be no night feeding. The foods to be advised are those which are plain, wholesome and nourishing, and which at the same time call for the exercise of all the digestive powers. The foods to be avoided are the patent preparations of predigested or partially digested materials, the tinned and preserved foods of all kinds, whose only recommendation is that they are rapidly prepared, and the meat juices and beef soups which are popularly regarded as very nourishing. All these foods, which may serve a purpose in restoring a temporarily disabled digestion, are only a means of reducing the efficiency of a healthy stomach and preventing its development on normal lines. A considerable amount of variety in the meals is desirable, and is easily obtained within the limits of suitable food.
Milk, porridge, boiled bread and milk, an egg, bread and butter, fat bacon.
Half a pint of milk should be taken at breakfast. It may be given plain (hot or cold) or flavoured with cocoa, or along with porridge or bread. The porridge should at first be made of fine oatmeal or groats, or rolled oats, and should be of semifluid consistency. Later it should be thicker and made of coarser oatmeal. The refined preparations of oatmeal are more rapidly cooked and more easily digested, but they do not possess the same amount of nitrogenous and mineral matters as the coarse. Boiled bread and milk is palatable and nutritious, and can be made thicker, as the child grows. An egg contains a large amount of nutriment, which as a rule is suited to most infants, but in a certain number produces disagreeable results. This can only be determined by experience, but if really fresh eggs could always be obtained, the results would probably be more generally favourable. The yolk of an egg can be given, beaten up in milk. After fifteen months of age the whole egg can be given, lightly boiled, or poached, or scrambled, with bread and butter. At this age also a piece of fat bacon supplies the fatty element in a digestible and palatable form.
Milk, potato, gravy, milk pudding, suet pudding, stewed fruit, biscuit, rusks, bread, raw fruit, pounded chicken or fish.
From 5 to 10 oz. of milk should be taken at dinner. Potatoes are much relished by children, and mixed with milk or gravy or butter they form a useful part of the diet. Potatoes should be boiled until of a floury consistency and then put through a sieve. Beginning with a teaspoonful of this the amount may be gradually increased until two tablespoonfuls are taken. All the milk puddings are useful. At first they should be of a creamy consistency and watery but gradually they are to be made thicker. A milk pudding may be made as follows. One tablespoonful of rice or tapioca, after being thoroughly washed, is put into a pie dish with a pint of milk and allowed to stand for an hour. It is then sweetened, and baked in a slow oven for an hour. Suet puddings supply a large amount of fatty material, and some jam or golden syrup or stewed fruit may be combined with them. An orange or a banana or some grapes form a pleasant finish to the meal. During the latter half of the second year some pounded fish or chicken may be given occasionally at this meal. Plain biscuits or rusks should be eaten as they call into play the masticatory apparatus more than soft bread does. There should not be more than two courses at dinner time.
Milk (half a pint), cocoa and milk, bread and butter, biscuits, rusks, honey, jam, an egg occasionally.
As regards intermediate meals at this age, one will allow at first some milk or boiled biscuit and milk between breakfast and dinner, and some hot milk before going to bed if desired. Dr. Sim Wallace points out that a drink of milk is not the best thing before going to bed as it leaves a suitable nidus about the teeth for micro-organisms to develop in. This may prove a factor in dental caries. He recommends instead some tooth-cleaning food such as a piece of stale bread or dry biscuit, and this should preferably be given as soon as the child has reached the chewing age. This age is reached much sooner if the child is accustomed early to hard foods, which call into play the masticatory powers.
Dr. Eustace Smith recommends the following dietaries:
First meal, 7.30 a.m. A rusk, or a slice of stale bread, well soaked in a breakfast cupful of new milk.
Or the yolk of a lightly boiled egg, a slice of thin bread and butter, and a cupful of new milk.
Second meal, 11 a.m. A drink of milk, with a slice of thin bread and butter or a biscuit.
Third meal, 1.30 p.m. A teacupful of good beef-tea (1 lb. of meat to the pint) or of beef gravy, with rusk. A good table-spoonful of light farinaceous pudding.
Or a mealy potato, well mashed with a spoon, moistened with two tablespoonfuls of good beef gravy. A cupful of new milk.
Fourth meal, 5.30 p.m. Same as the first.
Or a rusk or slice of stale bread, well soaked in a breakfast cupful of milk.
Fifth meal, 11 p.m. (if required). A drink of milk.
First meal, 7.30 a.m. A breakfast cupful of new milk, with a rusk, or half a slice of bread soaked in the liquid fat of hot fried bacon.
Or a breakfast cupful of new milk, with the lightly boiled yolk of one egg, and thin bread and butter.
Second meal, 11 a.m. A cup of milk and a biscuit.
Third meal, 1.30 p.m. Underdone roast mutton (pounded in a warm mortar), a good tablespoonful, with one well mashed potato, moistened with two or three tablespoonfuls of gravy. For drink, filtered water or toast water.
Or a breakfast cupful of beef-tea, containing a few well boiled asparagus heads when in season, or a little thoroughly stewed flower of broccoli. A good tablespoonful of plain custard pudding.
Fourth meal, 5.30 p.m. A breakfast cupful of milk, with thin bread and butter.
First meal, at 6 to 7 a.m. 6 oz. of boiled milk, hot or cold; a slice of stale bread, or a rusk broken up and soaked in the milk, or a slice of thin bread with dripping or butter.
Second meal, at 8 to 9 a.m. One of these daily : A small basin of bread and milk. A little fine oatmeal porridge, with cream or milk. A basin of thick milk gruel. A cup of thin cocoa made with milk, and a little thin bread and butter.
Third meal, at 1p.m. First course : One of the following : - Mashed baked old potato moistened with milk, chicken or mutton broth, the red gravy of undercooked meat, or meat juice (1-3 oz.). Lightly boiled or poached yolk of egg mixed up with stale bread crumbs, or mashed potato and gravy. Stale bread crumbs soaked in gravy or meat juice.
Second course : One of the following : - A large tablespoonful of custard, tapioca, cornflour, ground rice, or semolina pudding, blancmange, or junket.
Cold boiled water or milk and water to drink.
Fourth meal, at 5 p.m. The same as the first, or thin cocoa with bread and butter.
Fifth meal, at 9 p.m. A large cupful of milk gruel, made with rice, sago, tapioca, or hominy. Or, a rusk or sponge finger soaked in milk.
Experience has shown that certain dangers are present in connexion with the feeding at this age. It is very common to find that the young child is supplied with too much carbo-hydrate and too little fatty food. The excess of carbo-hydrate is often supplied in the form of bread and butter or sweet pudding. It may be from pressing on the part of the parent or from the palatability of the food that too much is taken, but a limit must be placed on the consumption of these popular articles. A child with a healthy appetite will not as a rule eat too much plain food, but sweetened up articles of diet may prove too attractive from their sweetness. When a sufficient amount has been taken it is better to offer a dry biscuit or a piece of dry bread, which will satisfy any remaining appetite without disturbing the digestion. Many children do not get a sufficient amount of fat. By some young people fat is avoided in certain forms from a natural distaste which, however, passes off as a rule in the course of time. Children should not be compelled to eat the forms of fat they dislike, for a positive repugnance may thus be established. As a rule, amongst the various forms of food in which fat is present, such as cream, butter, bacon, oil (cod-liver or salad), dripping, suet, and yolk of egg, it is possible to find some palatable variety. The most marked dislike is to beef and mutton fat. As fat is most important for the growth of the body, and carbo-hydrates fail to meet this demand, a sufficiency of animal fat must be administered. The tendency to like certain articles of food and to dislike others must be checked, as it simply means that the more palatable are preferred. This evil is often started by giving infants milk which has been too much sweetened and a distaste follows for less highly flavoured foods. Some young children will take very readily to beef and mutton, but these must be given in strictly limited amounts. Coaxing to take more food at meals should never be indulged in. Healthy children do not require coaxing, and loss of appetite is often nature's method of securing a curative fast for some temporary disturbance. If coaxing to eat is employed when the stomach and liver are upset by too much food the result will simply be an aggravation of the disturbance. It is a bad plan to bring young children to the family table. They are much better placed in the nursery where they can eat without distraction. At the family table there are many things which they should not eat, which they promptly demand, and which they too often get. As the meals become more solid, young children should be encouraged to drink water freely between meals. Effervescing waters are not palatable at this age, but fresh water should always be at hand. Tea, coffee, and all forms of alcoholic fluids are to be strictly forbidden.