Ever since the influence of bacteria upon the fermentation of milk has been established the necessity for observing carefully the most minute details for cleansing all the infant's feeding utensils has been apparent.

The necessity for use of the bottle for feeding is always to be regretted on account of the difficulty of keeping the milk from bacterial infection. Adams says: "One of the greatest nuisances in infantile life is the popular feeding bottle. It probably causes more intestinal diseases in the infant under two years of age than any other article".

The use of nursing bottles with long rubber tubing is to be unhesitatingly condemned, although it saves trouble in holding the bottle. It is impossible to keep the tubing sterile. The bottle should be of pure glass, white, of half-pint capacity, with a wide mouth and a sloping neck, and never with a shoulder, which prevents cleaning every part of the interior with a sterilised cotton swab.

A measure of ounces should be blown in the side, and it should be fitted with a short black rubber nipple, which can be removed and turned inside out for thorough cleansing. This short nipple has the further advantage that the child is less apt to be left by the nurse alone with the bottle. The latter is a slovenly way to feed an infant, and should be discountenanced, for the child gets its milk with periods of delay and irregularity. The bottle may slip out of reach, or after it is empty the child keeps on sucking or draws in air, and obtains the milk at uneven temperatures, or sometimes the child goes to sleep with the nipple in its mouth, and, awaking, it finishes the bottle. "The sucking power of the child is to a great extent produced by the muscles at the posterior portion of the mouth; if this action is carried on to too great an extent it has a tendency to contract the width of the mouth and cause protrusion of the teeth" (Cryer). For these reasons the nurse should always continue holding the bottle in a comfortable position for the child until it has taken its portion. This usually requires a few minutes less time than is occupied in nursing at the breast.

The usual time is not above ten minutes (Dencke). Any residue in the bottle should be at once thrown away, and not warmed over for a second feeding.

For washing the milk bottles a solution of sodium bicarbonate or salicylate, a teaspoonful to the pint, should be first used, after which they must be thoroughly scalded in boiling water. If fitted with a plug of sterilised baked absorbent cotton they will remain sterile until ready for use.

When from six to eight teeth have appeared the bottle can usually be discarded.