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The Care of Babies: Enough
Milk Mixtures.—(From Birth to Three or Four Months of Age.) 9. Milk sugar, 3/4 oz Enough hot * water to make 20 ounces. of upper third milk (10% fat).
After the milk-sugar is dissolved add two ounces This is a suitable modified milk for the infant immediately after birth. 2. Milk sugar, lime water and water same as for No. 1, with the addition of 3 ounces of upper water same as for No. 1, with the addition of 3 ounces of upper third milk. 3. Milk sugar, lime water and water as in No. 1, with the addition of 4 ounces of upper third milk. 4. Milk sugar, lime water and water as in No. 1, with the addition of 5 ounces of upper third 5. Milk sugar, lime water and water as in No. 1, with the addition of 6 ounces of upper third milk. milk. 6. Milk sugar, lime water and water as in No. 1, with the addition of 7 ounces of upper third milk. (From the Third or Fourth Month to the end of the Ninth or Tenth Month.) 1. Milk sugar, 1 oz. (3 level tablespoonfuls.) Lime water, 1 oz.
Enough hot * water to make 20 ounces. After the milk sugar is dissolved add 3 ounces of upper half milk. 2. Milk sugar, lime water and water as in No. 1, with the addition of 4 ounces of upper half milk. of upper half milk. 3. Milk sugar, lime water and water as in No. 1, with the addition of 5 ounces of upper half milk. 4. Milk sugar, lime water and water as in No. 1, with the addition of 6 ounces of upper half milk. and water as in No. 1, with the addition of 6 ounces of upper half milk. 5. Milk sugar, lime water and water as in No. 1, with the addition of 7 ounces of upper half milk. water as in No. 1, with the addition of 7 ounces of upper half milk . 6. Milk sugar, lime water and water as in No. 1, with the addition of 8 ounces of upper half milk. water as in No. 1, with the addition of 8 ounces of upper half milk. 7. Milk sugar, lime water and water as in No. 1, with the addition of 9 ounces of upper half milk. and water as in No. 1, with the addition of 9 ounces of upper half milk. 8. Milk sugar, lime water and water as in No. 1, with the addition of 10 ounces of upper half and water as in No. 1, with the addition of 10 ounces of upper half milk. 9. Milk sugar, oz.
Lime water, 1 oz.
Enough water to make 20 ounces. To this add 12 ounces of upper half milk. Of the above formulas, it is seldom necessary for the healthy infant to use a mixture of less strength than No. 5. Nos. 1, 2, 3 and 4 are of value, however, during temporary disturbances of digestion when it is desired to relieve the digestive organs of as much work as possible. The infant which can take Mixture No. 9 of the above formulas without difficulty is usually able to begin on No. 5 of the following formulas, in which whole milk (4%) is used. * Not boiled.
Milk Mixtures.-(For the latter part of the First Year.) 1. Milk sugar, 1 oz.
Lime water, 1 oz.
Enough hot * water to make 20 ounces. of whole milk.
After the milk sugar is dissolved add 5 ounces 2. Milk sugar, lime water and water as in No. 1, with the addition of 6 ounces of whole milk. 3. Milk sugar, lime water and water as in No. 1, with the addition of 8 ounces of whole milk. 4. Milk sugar, lime water and water as in No. 1, with the addition of 10 ounces of whole milk. 5. Milk sugar, oz.
Lime water, 1 oz.
Enough water to make 20 ounces. To this add 12 ounces of whole milk. 6. Milk sugar, lime water and water as in No. 5, with the addition of 14 ounces of whole milk. 7. Milk sugar, lime water and water as in No. 5, with the addition of 16 ounces of whole milk. * Not boiled.
Other Mixtures. -For mothers who cannot get milk in bottles and who have difficulty in using the mixtures given in the above tables, the following are recommended by the Illinois State Board of Health. They are easily prepared and prove satisfactory for most healthy infants. For a new-born baby, or one a month or two old, take one ounce of fresh milk; three ounces of water; one ounce of fresh cream, and two level teaspoonfuls of milk sugar.
This makes about five ounces. For twenty ounces use four times as much of each ingredient. This closely remother's milk.
For older babies, take two ounces of fresh milk; two ounces of water; one ounce of fresh cream; two level teaspoonfuls of milk sugar and a teaspoonful of lime water.
Larger quantities may be made by increasing the amounts of each ingredient in proper proportion. More milk and less water will be used as the infant increases in age.
If cream disagrees with the infant its use should be stopped temporarily. The following is a good substitute for mother's milk suitable for an infant of three months or less:
Pure milk, cupful; water, two cupfuls; sugar of milk, one heaping tablespoonful; lime water, one tablespoonful. The following table contains the milk mixtures recommended by the Providence (R. I.) Health Department:
For Babies Under One Month.- Milk, 5 ounces; lime water, 1 ounce; boiled water, 15 ounces; milk sugar, 11 tablespoons.
These are early twentieth-century "percentage feeding" formulas for hand-fed infants, built by diluting cow's milk and adding lactose and lime water. They are of historical interest only; every element of the method has been superseded, and several parts are dangerous.
- Unboiled water is specified deliberatelyThe footnote "* Not boiled" appears twice, attached to the water used to dissolve the milk sugar. No reason is given on the page. Water for an infant's bottle was a common vehicle for typhoid and other enteric infection in this period, and the instruction is the opposite of current practice; note that the Providence table further down the same page does call for boiled water.
- The milk is raw"fresh milk" and "milk in bottles" in this period meant unpasteurized market milk. Raw milk carries Salmonella, Campylobacter, Listeria, Shiga toxin-producing E. coli and Cryptosporidium, and infants under a year are among the groups most likely to be hospitalized or killed by them. Cow's milk of any kind is also not recommended as a drink before twelve months.
- Lime water is calcium hydroxideA saturated solution of slaked lime, kept as an antacid and used here to buffer the casein curd. It is an alkaline non-food chemical with no place in a modern infant's diet; being saturated its strength was roughly self-limiting, but it was never assayed.
- "Upper third" and "upper half" milkBefore homogenization, cream rose in the bottle; the top third or top half was drawn off to raise the fat percentage. Homogenized milk will not separate, so the formulas cannot be followed literally with supermarket milk, though the fat levels could be approximated by blending milk and cream.
- Milk sugar is lactoseCalled "sugar of milk" in the text. The recipe's own conversion, one ounce to three level tablespoonfuls, gives a sense of how coarse the household measuring was; note also the garbled "11 tablespoons" in the Providence table, evidently a mis-set figure, though which one cannot be determined.
- The nutrition is incompleteDiluted cow's milk with added lactose supplies no supplemental iron, vitamin D, vitamin C or the fatty acid profile infants need. Iron-deficiency anemia and rickets were both common outcomes of this era's bottle feeding, and scurvy appeared in hand-fed babies.
- Over-dilution is its own hazardThe weakest mixtures in the first table run from about one part milk to nine parts water up to one part in four, offered as a way to "relieve the digestive organs." Feeding an infant that much free water risks hyponatremia and seizures, quite apart from the caloric deficit.
- What to use insteadFollow current pediatric guidance and a commercially prepared infant formula, prepared exactly as its label directs. No adaptation of the figures above should be attempted.
The tables here are a household digest of "percentage feeding," the system worked out in Boston in the 1890s by the pediatrician Thomas Morgan Rotch, who taught that cow's milk could be made to imitate human milk by adjusting fat, sugar and protein to numbered percentages and stepping the infant up through progressively stronger mixtures. It was the most scientific-seeming answer available to a genuine crisis: urban infant mortality was appalling, wet nurses were scarce and expensive, and the alternatives on the shelf were sweetened condensed milk and proprietary "infant foods" made largely of starch. The appearance of formulas from the Illinois State Board of Health and the Providence health department shows the other half of the story, the municipal milk-station and pure-milk campaigns that did far more to save babies than any arithmetic of percentages. Rotch's system was abandoned within a generation as physicians recognized that its precision was illusory.