[Pg 109]
The
Journal-Lancet
The Journal of the Minnesota State Medical Association
and Official Organ of the
North Dakota and South Dakota State Medical Associations
PUBLISHED TWICE A MONTH
VOL. XXXV Minneapolis, March 1, 1915 No. 5
FEEDING OF THE HEALTHY INFANT [1]
By E. J. Huenekens, A. B., M. D.
Instructor in Pediatrics, University of Minnesota
MINNEAPOLIS
[1]Read before the Hennepin County Medical Society,Nov. 2, 1914.
The science of infant-feeding has been revolutionizedin the last twenty years, and, in theprocess, it has advanced too radically in manydirections. Lately, the pendulum has beenswinging backward, so that the most advancedknowledge of today probably represents a middleground between extreme radicalism and extremeconservatism. In no other direction is this moremanifest than in the feeding intervals. Thereligious adherence to the four-hour feedinginterval is giving way to a more rational system.I am one of the firmest adherents of the longerinterval: the food is better digested, the stomachhas a period of rest, and the general well-beingof the infant is better furthered than with morefrequent feedings. But there are certain infantswho do not receive enough nourishment in thisinterval, especially young breast-fed infants inwhom it can be demonstrated by accurate weighing,before and after nursing, that they receiveconsiderably more milk in twenty-four hourswith the three-hour interval. This is the moreimportant in that Rosenstern has demonstratedthat a large proportion of infants up to the ageof six weeks require more than the usual 100calories per kilogram of body-weight. One hundredcalories represents 150 grams of breast-milk,so that a five-kilo, or eleven-pound, baby shouldreceive a minimum of 750 c.c. of breast-milk intwenty-four hours.
By far the best food for the healthy infantin every way—and this cannot be emphasized toostrongly—is mother’s milk. There are certainalimentary disturbances in which it may be advisableto replace breast-milk with certain artificiallyprepared foods, such, for instance, asalbumin milk in alimentary intoxication; but thisis never true of the normally healthy infant.While, as regards growth and freedom fromdigestive disturbances, certain artificially preparedfoods may, when used with exceeding care,produce as good results as breast-milk; nevertheless,this is only one function of breast-milk.The other function which can be imparted to noartificial food is the passive immunization of thechild against infection. Ehrlich (Zeit. f. Hyg.u. Infectionskr., 1892, xii, 183) has proved thatantibodies, antitoxin, and agglutinins are transmitteddirectly through the milk from mother tochild; and it has been shown that the blood ofa breast-fed child is considerably more bactericidalthan the blood of a bottle-fed infant.
The practice of weaning the baby for trivialreasons has increased in the last decade, and canbe laid largely at the door of the medical profession.For all practical purposes the only absoluteindication for weaning the baby is opentuberculosis in the mother. For the last fewyears I have been making a systematic inquiryat the University Dispe