Causes

This morbid condition is usually due to one or more of the following causes: overfeeding, too frequent and irregular feeding, feeding with improper and spoiled foods. It is much more frequent among bottle-fed than among breast-fed babies. Occasionally, illness of the mother will cause a simple diarrhea in her suckling. In most cases food other than milk, given before the child is sufficiently mature to digest it, is the cause. Milk that is not clean, or is old and on the verge of spoiling, also frequently provokes the illness. In other cases milk is contaminated by passing through dirty nipples or by being held in dirty bottles or vessels. Nipples are sometimes dried with unclean cloths, or after sterilization handled with fingers that though apparently clean are bacterially contaminated. Sometimes babies infect themselves by sucking their own dirty fingers, or wash-rags or handkerchiefs. Bacteria that grow in the milk or in the contents of the stomach, thereby giving rise to irritating chemical products, are undoubtedly the immediate cause.

Cleanliness of the child, the mother, their surroundings, the nursing-bottle, nipples, and utensils in which the baby's milk is kept and handled is a necessity if this disorder is to be prevented. The greatest care must be exercised to discover all possible sources of infection, although even with the most faithful watchfulness in this respect some slight cause of infection is sometimes overlooked.

Treatment

When diarrhea exists, the best results are obtained by abstinence from food for twelve or twenty-four hours. The stomach and bowel should be cleansed by lavage if possible; if not, by a mild mercurial or castor oil. Sterilized water, and in the mildest cases a little egg-albumen in water or barley-water, may be given to quench thirst. Later, when the stools are less frequent and more natural, beef-juice, or thin mutton and chicken broth may be taken. Milk well diluted should be given after convalescence is established. Lime-water is the best diluent. Milk can often be modified advantageously.

When excessive intestinal fermentation as well as diarrhea exists, a modification of the milk is essential. If the stools have a sour smell and are acid in nature, the percentage of sugar and fat should be lowered. If the odor is putrid, the albumin should be lessened.

All foods ought to be given in small amounts and often until convalescence is well established.