3. Humanised Milk

Humanised milk is really Pasteurised milk but with a permanent alkaline reaction and partial predigestion.

Leeds claims the credit for the origin of the idea of this form of milk, and his formula is:

Milk............................................ pint.

Water........................................... "

Cream........................................... 4 tablespoonfuls.

Peptogenic milk powder........................... 1 large measure.

Heat to 1600 to 170° F. for ten to twenty minutes.

Instead of cream, some other form of fat may be added for invalids, such as olive or cod-liver oil or cacao butter.

The name "humanised milk" is applied somewhat indefinitely to various preparations of cow's milk in which the attempt is made to approach more nearly the composition of human milk by lessening the casein and increasing the sugar and fat. These preparations are partially predigested, but the pancreatinisation is stopped before it has proceeded far, so that the infant stomach shall still have some work to do.

Another good mixture designed to resemble human milk is that of Meigs:

Cream........................................... 2 tablespoonfuls.

Milk............................................ 1 tablespoonful.

Lime water...................................... 2 tablespoonfuls.

Water........................................... 3 "

Milk sugar...................................... teaspoonful.

4. Modified Milk. Milk Laboratories

The establishment of milk laboratories having in view the object of modifying cow's milk for infant and invalid feeding has demonstrated the practical value of this work. Such milk is now called "modified milk." The first laboratory founded in Boston during 1892-'93, upon the suggestions of Dr. Rotch, completely fed about twelve hundred infants and was patronised by more than one hundred and fifty physicians in its first year. Many similar laboratories have subsequently been established. The milk is derived from carefully selected animals kept at farms where their food, stabling, drinking water, and pasture are under the scientific supervision of a veterinary surgeon.

It is now generally acceded that infants thrive better in the long run upon mixed milk derived from several cows than by the exclusive use of milk from a single animal, which is more likely to vary with the condition of the cow at different times; but it is possible to avoid all variation in milk and keep it at a standard which can be graded to correspond with the increasing age of the infant, by the employment of proper means in the milk laboratories, where milk can be prepared with its ingredients mixed with the accuracy of a medicinal prescription, while its freshness and purity are absolutely insured. If desired also, the milk may be predigested in the laboratory, and sweet whey and other materials derived from fresh milk may be obtained there.

Physicians are furnished with blank forms upon which they can definitely prescribe the composition of the milk which they wish to order for any individual case. A sample prescription form from the Briarcliff Laboratory is herewith appended:

Per cent.

Remarks.

Fat

Number of feedings ?

Milk sugar

Proteids

Amount at each feeding?

Mineral matter

Total solids

Water

Infant's age ?

100.00

Infant's weight ?

Alkalinity.

Raw. Pasteurised ------° F.

Sterilised ------° F.

Ordered for------

Date. Signature.

M. D.

"If the physician does not care to mention the especial percentage, he can ask for percentages which will correspond to the analysis of human milk, and he can then vary any or all of these percentages later, according to the need of the especial infant prescribed for " (Rotch).

In order to prepare modified milk by Rotch's method it is necessary to have: I. Pure cream containing the fat. 2. Pure milk containing the albuminoids and no fat. 3. Distilled water. 4. A 20-per-cent solution of milk sugar made fresh daily with distilled water. 5. Lime water.

The milk and cream are separated completely by an apparatus made to revolve 6,800 times per minute, so that they may be recom-bined in any desired proportion. The resulting cream has an average of 35 per cent of fat, but the percentage may vary between 45 and 18, hence analysis should be made whenever accuracy is essential. After separation of the cream the milk is modified according to the formula prescribed for each case, and Pasteurised.

Rotch gives the following sample prescriptions for modified milk to be sent by the physician to the laboratory:

B (1) A Girl 6 Years Old: Duodenal Jaundice

Fat........................................................0.50

Milk sugar................................................. 6.00

Albuminoids................................................ 4.00

Give 4 ounces every two hours. Send 12 tubes, each 4 ounces; lime water, 1/10. Note. - This patient made a rapid recovery. No medicines were given.

B (2) A Boy 6 Weeks Old: Healthy

Fat........................................................ 3.00

Milk sugar................................................. 7.00

Albuminoids................................................ 1.50

Send 12 tubes, each 2 ounces.

Lime water, 1/20.

Pasteurise at 1670 F.

B (3) A Boy 6 Months Old: Healthy

Fat........................................................ 4.00

Milk sugar ................................................ 7.00

Albuminoids................................................ 2.00

Send 8 tubes, each 6 ounces.

Lime water, 1/20.

Pasteurise at 1670.

B (4) A Girl 4 Months Old: Albuminoid Digestion Weak

Fat........................................................ 4.00

Milk sugar................................................. 7.00

Albuminoids................................................ 0.75

Send 8 tubes, each 4 ounces.

Lime water, 1/10.

Pasteurise at 1670.

B (5) A Boy 6 Months Old: Sugar Digestion Weak

Fat........................................................3.00

Milk sugar................................................. 4.00 albuminoids..............................................2.00

Send 8 tubes, each 6 ounces.

Lime water, 1/20.

Pasteurise at 1670.

B (6) A Girl 4 Months Old: Summer Diarrhoea. Food Has To Be Sent Out Of Town By Express

Fat....................................................... 2.00

Milk sugar................................................. 5.00

Albuminoids................................................1.00

Send 20 tubes, each I ounce and I drachm. At time of each feeding add lime water, 3 drachms. Sterilise at 2120. Note. - In this case the diarrhoea had not been sufficiently studied to determine whether it was putrefactive or fermentative, so that a safe general prescription was sent to begin with. The lime water had to be introduced at each feeding on account of the 212° sterilisation necessitated by the hot weather and the distance to be sent.

An ingenious measuring glass is recommended by L. Emmet Holt for the home modifying of milk. The glass, which is sold under the name of the "Materna" (Estraus), holds sixteen ounces and has seven panelled sides. On one side is graduated the quantity of separate ingredients of normal milk and on each of the other panels is graduated the ratio of ingredients of milk modified to suit a certain age of infancy. Milk sugar is placed in the bottom of the glass, water is added to a marked level, then, in turn, lime water, cream, and milk. The formulas given are the following (Holt):

Formula

I

2

3

4

5

6

Fat

3%

2%

3%

3%

4%

For this Formula

6 see special instructions below.

3%

Sugar

6%

6%

6%

7%

7%

3%

Proteids

0,6%

0,8%

1%

1%

3%

2%

3d day to 14th day.

2d wk. to 6th wk.

6th wk. to nth wk.

nth wk. to 5th mo.

5th mo. to 9th month

9th mo. to

12th mo.

Milk parts

I

I5/8

2

4

6

Milk parts

9

Cream "

1

I5/8

2

2

2

Cream

1

Lime water "

I

I

Barley gruel"

5

Water

12

11

11

8

7

Gran, sugar "

Milk sugar "

I

I

I

I

1