The Parents' Review

A Monthly Magazine of Home-Training and Culture

Food In Infancy, Childhood and Adolescence.

[Frank William Albion Godfrey, M.B., C.M. Edin., 1860-1925, was originally from Melbourne, Australia and later worked as a surgeon at Scarborough Hospital. He and his wife Mabel had three daughters. His family tree website with many photos of the "Godfrey Family in Scarborough", including this photo of him as a dashing young man.]

A lecture delivered to the Scarborough branch of the Parents' National Educational Union

As to the great importance of the subject which I purpose to speak on this evening, there can hardly be any difference of opinion; and I think, too, that everyone must allow that it is a subject which should form part of every parent's education. It is one which I feel no small responsibility in attempting to deal with popularity in a short lecture; for my duty must be to endeavour to compress a great deal into the time at our disposal, and at the same time to avoid as far as possible all technical terms, which might by their introduction only serve to confuse. To many of you, much that I have to say may sound stale and commonplace, but I trust you will bear with that and that the net result may be some gain, little or great, to all.

Of the four great external conditions on which the proper growth and development of the organism depend, air, food, warmth, and sunlight, food is not the least important; and it is unfortunately a subject on which much ignorance exists, and into which many erroneous old-time notions and prejudices obtrude themselves.

A healthy younger life, with all its bright possibilities before it may be, and I fear often is, blasted or extinguished by a want of knowledge of the food requisite for its growth; and on the other hand, a puny infant may, by judicious feeding, be safely piloted through the shoals that beset it into the smooth waters of vigorous health. More popular knowledge on the subject of children's food would render many a young life healthier and happier, would save parents many an anxious hour, and many a doctor's bill.

Now, we should all clearly realise what food is, and for what purpose food is required. In the human organism, as in all living structures, certain processes are being constantly being carried on, growth development, decay and repair; growth development and repair, are, so to speak, gains from without, and the purpose of food is to supply these gains. In children, not only have the tissues to be kept in repair, but growth and development are also going on apace, in the formation and building up of new tissues and organs; it is on their proper building up of these new tissues and organs that the after-life and health of the child depends, and the material from which these are built is chiefly proper food.

I must ask you to follow me on to some technical ground for a moment while we consider what are the essential elements of food. They are made up of five chief classes: --

(1) --The nitrogenous elements, so-called because their chief constituent is nitrogen, and these are found chiefly in animal foods such as albumen or white of egg, caseine or curd of milk, and the juice of meat.
(2)--The hydrocarbons or fats.
(3)--The carbohydrates,--starch and sugar.
(4)--Mineral matters. Such as salts of lime, iron and potash.
(5)--Water.

And it has been abundantly proved that a perfect food must consist of all these five essential elements. They are required at all ages, in infancy, in youth, in adult life, and in old age; though their relative proportions differ widely with the period of life. The nitrogenous elements are of first importance, for form them are chiefly formed muscle, brain, nerve, and most of the other vital tissues; and without them the organism would assuredly perish.

Next in importance come the hydrocarbons or fats, which take their share in the development of many vital structures. They are largely concerned, and please to note this very carefully, in the formation of the bones and teeth. They also provide the fuel from which bodily heat is generated and maintained, just as coal furnishes the fuel maintenance of what is vital. Indeed, the importance of fat in the young animal organism cannot be over-estimated, and is practically proved by the fact that a young infant requires in the 24 hours no less than half the amount of fat required by a robust man.

The carbohydrates, though of less importance than the preceding elements, aid in the development of the various tissues, and are also consumed as fuel for the generation of heat.

The mineral constituents are, with the fats, specially concerned in the formation and growth of the teeth and bones, as well as in that of nearly all the other tissues.

And lastly,water is required for the liquefying of the blood; for the conveyance of nutriment to the different parts of the body; for the carrying off of waste products from the system, and for the restoration of tissue.

Then these are the essentials of healthy food, for infants as well as adults, and for the former they are all contained in proper proportions in human milk, which must be taken as the type of infant's food.

Its composition is as follows:--

     Nitrogenous elements . . . 3.924
     Hydrocarbons . . . 2.666
     Carbohydrates . . . 4.364
     Mineral Matters . . . 0.138
     Water . . . 88.908
     Total . . . 100.000

The nitrogenous elements are represented by the caseine or curd; the hydrocarbons by the cream; the carbohydrates by the sugar of milk; the mineral matters by salts of lime, potash, and iron; and lastly there is a large amount of water.

A healthy infant requires nothing more than a proper amount of healthy milk from its mother, and on this it will grow, develop, and thrive, and all the vital processes will be properly carried out.

It is, I think, an almost national misfortune that from various causes more mothers do not nurse their children. Some, of course, from ill-health or physical incapacity are unable to do so; many poor women in our large manufacturing centres are prevented from doing so, by reason of their being engaged away from home during the day as bread winners in factories and workshops. For them, and for their offspring, we trust a remedy will ere long be provided by legislation; such legislation is under discussion and is much needed. But there are many other mothers who could perfectly well nurse their children if they had the will, but who allow the claims of society, or the attractions of pleasure-seeking, to outweigh their maternal instincts, to the possible detriment and damage to their offspring. A healthy mother should nurse her own child if she is physically able, and if she neglect to do so, then she fails in what is probably her most important duty. If the mother does not nurse her child, the infant becomes dependent on some artificial food for its growth. Of course, if that artificial food be properly selected, the child suffers no harm; but if, as is so very often the case, its composition falls short of the proper standard, if one of the essential elements be deficient in amount or absent, then the child will assuredly suffer, either immediately or later on in life.

Let us take an example. I have said that the development of the teeth depends mainly on fat. Now, what is probably the chief cause of the very common occurrence of decay of the teeth in children and young adults? a question often asked, and one to which all kinds of answers are given. Sweets are commonly made the scapegoat and unjustly. The real cause is most probably the absence of fat and mineral matters, in requisite amount, from the artificial substitutes for the natural food, the teeth which appear late are soft and ill-nourished, and early decay attacks them.

Human milk, then, being a perfect and typical infant's food, its composition must serve as a model for any artificial substitutes which have to be employed, and what ever food is given instead of the natural food should correspond as closely as possible with it in composition.

Before passing on to artificial foods for infants, it would be well to stop for a few minutes to discuss some points on the feeding of infants generally. And firstly let me urge the great importance of regularity of meals. An infant's stomach, like an adult's takes a certain time to digest the food put into it, and we must be careful not to hamper its action by filling it with further food before it has got rid of the preceding meal. A young infant, up to six weeks old, should be fed every two hours from five in the morning till 11 o'clock at night, and it should be trained to sleep in the interval. Children are creatures of habit, and you cannot begin too early in training them to regular habits. Once a mother begins feeding her infant every time it wakes and cries, she is most assuredly sowing the wind to reap the whirlwind, for she is starting it on habits which it will take long enough to correct. Her baby will soon become her master, and an exacting one too.

After six weeks, the period for food can be gradually lengthened out to every 2 ½, 3, and 4 hours up to the eighth month; and the interval for sleep at night can be lengthened also.

Rapidity of swallowing should be carefully guarded against, for a stomach rapidly filled is unable to deal properly with the food, and indigestion is the result. It is surely as injurious for a baby to bolt its food as for an adult; and we know the ordinary result of a hastily swallowed meal.

Another very important point is the quantity of food which should be given, and it is I believe a point on which great ignorance exists. An infant's stomach at birth will contain, when filled, only one ounce, or two tablespoonfuls, of fluid; a very much smaller amount than you would probably imagine. Of course, the stomach grows with the rest of the body, and its capacity increases. During the first month of life from one to two ounces of food, according to the age, is quite sufficient for a meal, and this means a total in the 24 hours of from 12 to 24 ounces of food; and these amounts should be gradually increased until a total of 36 to 40 ounces is arrived at by the sixth month. Of course, children vary in size and in stomach capacity, so that exactitude in quantity is not of great importance; each child is an individual and must be treated as one; its stomach measure being found and provided for just as its feet will be measured for boots later on. So long as the infant is satisfied, and so long as it is thriving, there need be no anxiety as to the amount of food it consumes. If you give more food than the stomach can deal with, you hamper its action, cause indigestion, ill-health, and wasting.

And let me draw your attention to a very common and fatal mistake. An infant with indigestion usually manifests its trouble by signs of hunger, it cries fretfully, mouths about for its food , and takes food ravenously when offered it. "Poor little dear," says the old nurse, "it is being hungered to death," and she forthwith loads the little labouring stomach up with more food, possibly of a very indigestible character, and so increases the evil; and the rapid loss of flesh in the baby only tends to confirm her in her erroneous opinion. This mistake is a common one, which we are constantly being called upon to correct, not unfrequently, I must own, with the result of being thought ignorant and heartless monsters.

Again, an all important point in bottle-fed children is cleanliness of the vessels used in preparing and giving of the food. You cannot be too careful. One little bit of carelessness, a bottle left unwashed, or a pan uncleansed, and you may start an illness in a perfectly healthy child which may run on to fatal results. Just as a small portion of yeast rapidly sets up fermentation throughout a basin of dough, so will a mouthful of tainted milk set up fermentation in a baby's stomach, which may spread through the whole of the alimentary tract, a fermentation producing grave results, and often proving difficult to arrest. Bottles, mouth-pieces, and all vessels in which the food is kept prepared and given should be thoroughly scoured in hot water immediately after use, and bottles and mouth-pieces should be kept immersed in pure water, to which some borax may be added, until required again. And, speaking of bottles, let me sound a note of warning against the bottle which is so commonly used, and which I show you here--it is called the "Alexandra bottle"--I am convinced that is it the cause of much infant illness. It is extremely difficult to keep this long soft tube sweet, in spite of all one's care. The brush does not sweep it out as it would a rigid glass tube; portions are, as it were, jumped over, and the places so missed retain small particles of milk, which ferment and sour, and taint the subsequent food passing along the tube. Two other objections may be urged against this bottle; one is that when, as is so commonly the case, it is placed on the bed or perambulator beside the infant, the food syphons along the tube, filling the baby's mouth and stomach far too quickly; and the other, a lesser evil, that when the bottle is empty, the child, unless watched, goes on sucking, and fills its stomach up with wind. The best form of bottle is this, the so-called "Tropical bottle," a modification of the old "Slipper-shaped" bottle [perhaps the "hygeinic feeder", sometimes called a banana bottle?], or perhaps even better still, because the flow of the milk can be so easily regulated, this feeding-cup with mouth-piece attached.

["Alexandra bottle" - a bottle with a long soft rubber straw "with appealing names such as 'Mummies Darling' or 'The Empire'"; a modern (easier to clean) version is the Podee bottle.]

The feeding bottle should always be held in the nurse's hand. Never laid beside the child in bed. Surely the extra trouble so entailed is well repaid by the greater certainty that the food will not disagree. The question of cleanliness, more than any of the other points to which I have alluded, is of prime importance, though to you possibly it is unnecessary to enlarge upon it. But you have all acquaintances amongst the poor, you have all some cottage or some cottages where you visit, and where your advice would be listened to and followed. I would beg of you to lose no chance of explaining this and other vital points on infant feeding to your poorer sisters. It is amongst these children particularly that the results of improper feeding are so appallingly frequent and disastrous, and it is for them that you may do so much. A little simple instruction, I do not for an instant mean amateur doctoring, which would take up but little of your time, might, and would, save much illness, aye, and possible valuable lives.

And not to pass on to artificial substitutes for the natural food. I will not attempt to go deeply into them, I will only draw your attention to the most important points which every mother should know.

Whatever food is chosen it should as nearly as possible approach in composition to human milk. Now the one most commonly given is diluted cow's milk--cow's milk diluted with water, one part to two.

Cow's milk diluted with two parts water:--
     Nitrogenous matters . . . 1.801
     Fats . . . 1.435
     Carbohydrates . . . 1.345
     Salts . . . 0.182
     Water . . . 95.237

This diluted cow's milk differs from human milk, as you can see from this table, in containing less nitrogenous matter, or curd, less fat and less sugar, and further in that its curd is much more dense and hard.

This density of the curd of cow's milk is the great objection to its use, and measures should always be taken to counteract it. This may be done firstly by boiling the milk, which causes the curd to be formed in lighter masses, and secondly by mixing with the milk some substance such as lime water, barley jelly, gelatine, or malted food, which has the effect of separating the curd into smaller particles. Milk used in the nursery should always be boiled directly it enters the house, and for three very good reasons: firstly, boiling renders the curd lighter; secondly, it prevents or rather delays a fermentation and souring, which sets in very rapidly, specially in hot or thundery weather; and thirdly, by boiling, any infectious germs which may have gained access to the milk are destroyed and rendered inert. The objection commonly raised that boiled milk is constipating does not hold good in actual practice; and if children have never tasted unboiled milk they will not object to the taste of boiled. Cow's milk, then, if given to infants must be boiled and diluted in order to lighten and lessen the amount of the curd, and cream and sugar must be added to make up for the deficiency in these constituents after dilution. I would lay especial stress upon the addition of cream, for it is very commonly omitted, and we have seen that fat is a very vital constituent of infants'and children's food. Its omission for the food is a grievous mistake, for without fat the bodily heat is not maintained, the bones and teeth do not develop properly, and the result is wasting, rickets and dental caries. Some years ago a series of experiments were conducted in the London Zoological Gardens on the feeding of young carnivorous animals, the result of which was to prove that those from whose food fat was excluded rapidly developed rickets.

If boiled cow's milk, diluted with two parts of water be given, at least two teaspoonfuls of cream should be added to each meal. The deficiency in the nitrogenous elements is not of such great importance in early infancy, and is made up for when a less dilute mixture can be digested, or by adding unboiled white egg or raw meat juice to the food. White sugar, or better, sugar of milk, must also be added, half to one teaspoonful, to make up for the deficiency in carbohydrate.

(To be continued.)

Proofread by LNL, Apr. 2021