Fish of the white varieties, boiled, broiled, and fried, are always allowable. Chicken and rabbit may be given twice a week. Beef and mutton boiled and roasted is quite digestible, but it is generally advisable not to start with red meats until towards the end of this period.
Broths and soups should not be made too strong, or thickened with meat puree; but meat stock can be added to good vegetable soup made with carrots, turnips, onions, leeks, potatoes, lentils, peas. This may be thickened with barley, rice, tapioca, groats, sago, macaroni, yolk of egg, cream. A nourishing fish soup can be prepared and thickened by adding a puree of the fish.
Puddings should be taken once daily, the most suitable being custards, plain, baked, or boiled; milk puddings of different grains made with or without eggs; jelly (lemon or orange or other fresh fruit); curds with cream. Suet puddings are less digestible, and should certainly not be given frequently.
Fruits are good for children; the fresh juice contains properties which are good for the blood, and they contain sugar in an easily assimilable form. Some fruit should be taken daily. Of fresh fruits, oranges, apples, grapes, bananas, may be taken, avoiding the skin and stones.
Raspberries, Red And White Currants, Brambles, Etc are best cooked and the juice eaten with a pudding. Strawberries should be given very sparingly, as in many children they disagree.
apples, prunes, rhubarb, apricots, pears - may all be given as an agreeable change to the milk puddings.
The growing child demands sugar, and usually shows a great craving for it. It is best to supply this in the form of sweet pudding or stewed fruit. Honey, syrup, jam, eaten with bread and biscuits, are also good. A little good chocolate or pure plain toffee drop can do no harm in moderation, but the indiscriminate partaking of confectionery is prejudicial to the teeth and to the general nutrition.
It will be convenient at this stage to indicate the special articles of food which may with advantage be withheld from children under seven years of age.
Sausage, pork, salted fish, corned beef, goose, kidney, liver, stewed meats.
Fried vegetables of all varieties, raw or fried onions, raw celery, radishes, lettuce, cucumbers, beetroots.
All newly baked bread, rolls, scones, buns. All rice cakes containing dried fruits and thick icings.
Candies, pies, tarts, pastry of every description.
The following diet sheet is adopted for a child at this period of life. The actual amount of the foodstuffs to be given will vary with the age and size of the patient:
If child awake early (6 to 6.30 A.M.) - Drink of milk, a piece of dry bread, or plain biscuit.
Breakfast: 8 A.M. - Milk to drink, or cocoa made with milk.
Toasted bread and butter (with crusts), a little jam. This should be a sufficient breakfast for children up to seven years, but if more is found necessary it should not be more than an egg boiled, poached, or scrambled, or a little fish. A little fresh fruit may be taken after breakfast or during the forenoon.
Daring the forenoon, about 11 am , a drink of milk and a biscuit is advisable, or fruit may be taken. Dinner - Milk to drink and toast to eat (with crusts); and a two-course dinner as follows. As the child get older, soup and a more liberal supply of vegetables may be added.
I Soup, well thickened, Milk pudding.
Eggs with a vegetable, Junket.
3 Fish, Potatoes, Suet pudding.
4 Chicken or rabbit, Stewed fruit.
5 Roast meat,
Milk, or milk and cocoa; bread and butter, biscuits, plain scone, jam. Supper - Milk and bread and butter, with a cereal (e.g. gruel).
The child should be taught to eat slowly, and to chew the food well. In this connection attention may again be directed to the importance of such articles of diet as crusts of bread, crisp rolls, and the like being given daily, care being taken that the child chews the food and does not merely wash it down with fluid. The importance of this can hardly be overestimated. The quantity of food depends largely on the appetite of the child. The appetite should not be forced.
If the food is not all taken, it is well to wait until the next meal. Loss of appetite is often an indication that the digestive organs require a rest. This rule does not apply to sick children.
In families where there is a marked gouty tendency the diet of the children should be carefully regulated, since it is certain that with care much can be done to eradicate the tendency. The special points to observe are: - (1) The necessity of bringing up the child very largely on a lacto-vegetarian diet; red meats of all kinds should be withheld, or, at most, given very occasionally; and (2) sugar and foodstuffs rich in sugar should be given sparingly. If the child is carefully dieted along these lines during the growing period, he will be much less prone to develop gouty symptoms in later life (see also p. 526).
In families where there is a marked tendency to tuberculous disease the question of diet is a highly important one, since as in the case of gout, much can be done to eradicate the tendency. The special feature about the diet in such cases is the necessity of an increased amount of animal protein food, and more especially meat or raw-meat juice. The beneficial effects of a properly planned dietary in these cases are very remarkable. Needless to say, the appropriate diet must be continued for many months, or even for a year or two, if the best results are to be obtained. The following diet sheet is adopted for a child of five or six years of age with a strong hereditary tendency to tuberculosis: -
This dietary contains a more liberal supply of animal proteins in the form of milk, eggs, meat, and soup than an ordinary diet, the diet including 2 pints of milk, and meat foods at least three times daily. This point should be insisted on and continued during the growing period.
6.30 A.M. - Milk, biscuit and butter. Breakfast - Milk, butter, bread, egg, fish, or bacon. Lunch - Cup of soup (meat stock), or egg flip.
Soup, with raw meat, Curds and cream, Glass of milk.
Pounded meat and vegetable, Stewed fruit cream, Glass of milk.
Chicken, Bread sauce, Vegetable, Blancmange cream, Glass of milk.
Milk, bread and butter.
Good meat soup, thickened with milk; or egg, or meat puree, or lentil puree.
In children, where there is a family history of nervous disorders, including mental derangements, careful regard must be paid to the diet. It must essentially be of a non-stimulating character; meats and meat foods must be withheld, milk, farinaceous foods, fruits, and vegetables forming the dietary. The diet should be of the lacto-vegetarian character described on p. 526.