The fragility of artificial feeding: A history of systemic risks from colic to botulism

“ For we should always bear in mind, in comparing our poor spiritual achievements with the genial performances of antiquity, the Middle Ages, the Renaissance, and the pre-Victorian era, that the artificial feeding of infants is essentially a modern invention, and that it was unknown to antiquity. ”

“ As late as the fifteenth century the only kind of infant-feeding, other than breast-feeding by the mother, that was known, was that which a foster-mother, or so-called wet-nurse, could provide. Metlinger in 1473 appears to be the first to mention cow’s milk as a substitute, and Rosslin comes next, in 1522, with a theory about egg-yolk and bread-mash. But these men speak of these substitutes as applicable only in case of extreme need, and there is nothing to suggest that the practice of artificial feeding was common. ”

“ Believing that many more mothers than do so should nurse their babies, we have carefully tabulated a number of aids to the milk supply, which we hope will be most earnestly tried before the baby is taken from the breast—for so many, many more bottle-fed babies die during the first year than the breast fed. The dangers of infection, the worry of the food preparation, the uncertainty of results, all call for a most untiring effort on the part of every doctor, nurse, and mother, in their endeavors to secure maternal nursing. ”

“ TO THE CHILD BROUGHT UP BY HAND. Children brought up on an artificial diet are very liable to indigestion and bowel complaints; indeed none more so: and it is from these affections that so many of these infants perish. When, then, it is absolutely necessary from untoward circumstances to have recourse to this mode of nourishing the child, the rules and regulations laid down in the section on "Artificial Feeding" must be most strictly followed out, if the parent would hope to avoid disease and rear her child. ”

“ Frankly, feeding a baby deprived of breast milk often resolves itself into an experiment; but an experiment which must be conducted in an intelligent manner, with the advice of a physician. Do not consult your neighbor, no matter how many babies she has raised successfully. The bottle food which was nourishment to her babies may be poison to yours. There are no hard and fast rules for bottle foods. Each baby is a case unto itself and requires the most delicate attention and unrelenting vigilance. ”

“ And if these affections should at any time unfortunately manifest themselves, the mother ought carefully and diligently to examine whether the plan of feeding pursued is in every particular correct, particularly bearing in mind that the two causes most frequently productive of disorder in the child are overfeeding and the exhibition of unsuitable food—the two grand errors of the nursery. These results, however, have already been sufficiently dwelt upon as likely to take place at weaning, and they may of course occur to a child who is brought up on an artificial diet at any period. ”

“ A judicious management of diet will prevent some of these complaints, and mitigate the violence of others when they occur.
THE KIND OF ARTIFICIAL DIET MOST SUITABLE UNDER THE DIFFERENT COMPLAINTS TO WHICH INFANTS ARE LIABLE. Artificial food, from mismanagement and other causes, will now and then disagree with the infant. The stomach and bowels are thus deranged, and medicine is resorted to, and again and again the same thing occurs. ”

“ The high death rate among bottle-fed infants during the summer months, and the traditional popular dread of the 'second summer' as a critical period in infant development are directly traceable to the use of stale milk. ”

“ Flies carry sputum and its infection to food, to your hands, your face, clothes, the baby's bottle, from which the germs are taken into the mouth, and thus gain access to the stomach or lungs.
Spitting on the sidewalk, on the floor, on the wall, on the grass, in the gutter, or even into a cuspidor containing no disinfectant is a very dangerous practice for a consumptive to indulge. ”

“ Since few bacteria thrive in acids, their destruction is less difficult in fruits than in vegetables (with the exception of tomatoes) .
Botulism is a deadly poison caused by a toxin from the growth of spores (seeds) of the bacteria, Clostridium botulinum. These spores will produce a deadly toxin in low-acid foods in the absence of air (oxygen) inside a sealed jar. Therefore, the spores must be destroyed by processing under pressure at 240° F. The length of time has been determined by scientists for each individual food. ”

“ Botulism is an intoxication—not an infection. The fact that the bacillus can grow in nature only when the free oxygen supply is cut off explains in part at least the relatively rare occurrence of botulism since all the conditions necessary for the production of the botulism toxin do not commonly concur. Next to nothing is known as to how widely B. botulinus is distributed. ”

“ WEANING TOO EARLY.—The substitution of artificial food for the breast- milk of the mother, at a period when the digestive organs of the infant are too delicate for this change, is a frequent source of the affections now under consideration.
The attempt to wean a delicate child, for instance, when only six months old, will inevitably be followed by disorder of the stomach and bowels. Unless, therefore, a mother is obliged to resort to this measure, from becoming pregnant, or any other unavoidable cause, if she consult the welfare of her child, she will not give up nursing at this early period. ”

“ What harm results from over-feeding an infant? The food lies in the stomach or bowels, undigested, ferments, and causes gas and colic, and if the over-feeding is long continued, serious trouble arises. The baby becomes restless, fretful, irritable, sleeps badly, stops gaining weight and may lose weight. ”

“ Worry, trouble, sorrow, anger, overwork, and errors of diet in the mother often cause this trouble or the child may nurse too fast, too long, too much, or too often, or the milk may be too rich. If so, give baby an ounce of hot water before nursing. Hand-fed children are too often over-fed, and this produces indigestion.
What are the symptoms of colic? The child screams sharply; the cry comes suddenly and returns every few minutes; he draws up his legs and feet; the muscles of his face contract and he has other signs of pain. The belly is usually hard and tense. ”

“ Neglect of acute indigestion may mean convulsions, intestinal inflammation or other ailment which will quickly prove fatal. Slight but chronic indigestion should be corrected because it disturbs and weakens the entire system, fills it with poison and makes the child liable to disease. The child who “takes cold easily” or “teethes hard” is generally the child whose digestion is out of order. ”

“ Following on the trail of indigestion and intestinal trouble come anemia and malnutrition. The anemic child, suffering with malnutrition, as the result of improper feeding, loses weight steadily, has vomiting and diarrhea, sleeps badly, is listless and pallid. ”

“ Nursing babies who have a healthy mother are not troubled with this disease unless she nurses too long into the second year. Starchy foods, too little milk or other animal food, taking the infant to the family table and allowing it to eat whatever it wants, these are the most common errors in baby feeding which very often result in rickets. Babies who are brought up on condensed milk, or other foods that contain little fat are likely to have rickets. ”

“ Some of the bones become enlarged; the chest is barrel-shaped; and when the baby begins to walk he is bow-legged because the bones are so soft.
If the child survives the illness it is often so deformed that it is marked for life. If the disease is discovered and treated promptly the child becomes strong and outgrows most of the defects.
Rickets is generally caused by improper feeding, by proprietary foods without the needed amount of fresh milk, or by fresh milk and foods that do not contain enough fat or cream. The prolonged use of boiled or sterilized milk, also, will cause rickets. ”

“ Formulas for artificial food should follow the proportions found in mother’s milk by expert analysis. Plain cow’s milk unmodified is too rich in solids to be given to an infant. On the other hand, the nursing baby, or the baby fed on properly modified milk, does not require much plain [Pg 68] water, as it receives an ample supply of water in its feedings to quench thirst and keep the body in good condition.
For the baby which is to be artificially fed at one month or less, plain cow’s milk, boiled water, and malt sugar form the best possible combination. ”

“ If the food is already too rich for the child, this is shown by indigestion, vomiting, diarrhea, or constipation. The increase in the strength of the formulas should be at the rate of half an ounce or less in three days or more for about a month after artificial feeding begins ”

“ The increase in quantity should be at the rate of a quarter of an ounce at each feeding, made at intervals of four to seven days, according to the growth and appetite of the child. It will be noticed that there is a more rapid increase during the first month of the child’s life than at any other time. This is because exquisite care must be taken to start the child on the most delicate form of artificial food. ”

“ One teaspoonful two or three times daily is needed in sour gassy stomach, with constipation or foul smelling stools. Fortunately such medicine is not often needed if the mother is careful, or baby is carefully bottle-fed. When there is vomiting with the colic and the stools contain curds the food is too strong. The nursing baby should be given one ounce of warm water before nursing, and the food for the bottle-fed baby should be made weaker by going back one formula. Sometimes peptonizing the food for a short time will do. ”

“ If after another week is past, there are no signs of indigestion, give him four ounces of the four-month formula, and if he enjoys this very much wait for a day or two and then increase the amount to four and one-half ounces of the same formula, and then to five ounces; as he grows older give him of the same formula as the bottle-fed infant of the same age, and the same amount at the one feeding; if he vomits or has curds in his stools or colic keep him on a weak formula longer than formerly advised. ”

“ Remove all the top-milk of any given strength in making a formula, and not only the number of ounces needed for the formula. By using rich Jersey milk as if it were more common milk. The formulas given are based upon about four per cent fat. Food is very often increased too rapidly, particularly after stomach and bowel indigestion. The food in an infant of three or four months old attacked by acute indigestion should seldom be given in full strength for two weeks afterwards, only half steps should be taken like two to two and one-half, etc. ”

“ Should I be worried if the gain in weight for the first few weeks of artificial feeding is slight, or even no gain? Not as a rule; if the infant loses no weight, sleeps well, is comfortable, does not suffer from vomiting, nausea, colic, you can feel sure the baby is doing well and is becoming used to his new food. As his appetite improves and his digestion is stronger the food may be increased every few days. ”

“ Neglect, or dirty surroundings, are fatal to these little delicate atoms, which really call for the same attention we should give a baby; monotony—being kept shut up in one small room for hours or days—and lack of fresh air, carry off many; while sour milk, meals left about in odds and ends, irregular feeding, and lying to sleep in draughts, are all elements of danger. ”

“ An unclean mouth is not only very unpleasant and often painful to the patient, but is a source of infection. The accumulation of food and mucus is a fertile field for the lodgement of bacteria. If this infected material is allowed to remain, it can easily spread to the middle ear and the mastoid cells, and cause abscesses or be carried by the food to the already overburdened alimentary tract to add to its infection. When the accumulation of sordes is profuse and persistent the patient’s mouth ought to be cleansed after every feeding. ”

“ When a child must subsist upon boiled milk for a long period, he should be given the juice of an orange each day. Children are not usually strong and normal when fed upon milk of this character for indefinite periods. All living bacteria (except the spores or eggs) may be destroyed by boiling milk for one or two minutes.
PASTEURIZATION
When baby is to use the milk within twenty-four hours, "pasteurization" is better than boiling as a method of destroying microbes. ”

“ The diarrhœal diseases, comprising infantile diarrhœa, cholera infantum, inflammation of the bowels, dysentery, and some others. These are the cause of at least one fourth of the entire infant mortality the world over; while in America cholera infantum alone is responsible for nearly or quite one fifth. ”

“ Neglect to regulate the bowels is one of the most common causes of death among bottle-fed babies. The entire system is poisoned, for the waste matter is not carried off through the bowels. The inexperienced mother will be wise to have her physician watch the stools until the child’s health seems fairly well established. Hundreds of bottle-fed babies, who do not outlive the first month, might be saved if this rule were observed. When a physician is not at hand, the mother must watch the stools with a critical eye. ”

“ Constipation must be corrected during infancy, for there is no other evil of the human system that can bring upon men and women a greater number of ailments which make life one long story of aches and pains.
Diarrhea is a symptom of acute illness, and frequently ends in death. It is the most dangerous of all symptoms that babies develop. With all the agencies at work for infant welfare in large cities, during hot weather, more babies die of diarrhea than of all the contagious diseases, like measles, whooping-cough, diphtheria, scarlet and typhoid fever, put together. ”

“ Botulism—Food-borne illness caused from eating canned foods containing the toxin produced by Clostridium botulinum, an anaerobic bacterium. This organism can grow and produce toxin in sealed jars of canned foods that are improperly processed.
Canning—Preserving food in airtight rigid containers. Micro-organisms are destroyed by heat-processing containers of food at the temperature and time specified for each food. It is essential to follow reliable canning instructions exactly to insure a safe canned product that is free from botulism-causing bacteria and spoilage organisms. ”

“ Acidity helps protect against the growth of botulinum bacteria, which can produce a fatal toxin in canned foods. Specific recipes, times, and temperatures determined scientifically for vegetable mixtures need to be used for their safe canning.
Why is headspace important in canning?
Headspace—the distance between the surface of food and the underside of the lid—allows for expansion of solids or bubbling up of liquid during processing. If headspace is not adequate, some food in the container will be forced out, leaving food particles or sirup on the sealing surface and preventing a seal. ”

“ To assure botulism-free home-canned foods, it is absolutely essential that low-acid foods be canned in a pressure canner at temperatures above 212° F. The poison produced by this bacteria is one of the most potent poisons known to humans. ”

“ Bacteria, yeasts and molds should have been destroyed if the food was properly processed.
When you open the container, look for such danger signs as spurting, cloudy or frothy liquid, an “off” odor, deterioration, or slimy texture. A foamy or murky appearance and patches of mold are visible signs of 319 spoilage. That ordinary looking mold on home-canned food may indicate the presence of a much more deadly problem: botulism.
ALWAYS label home-canned foods.
Destroy food if any of these signs are obvious; discard out of reach of humans and animals. ”

“ Using liquid remaining after reconstitution in recipes
361 Storage of Home-Preserved Foods
by Ralph W. Johnston [17]
Proper storage of home-preserved foods, especially of home-canned products, and close scrutiny before serving are essential. If proper storage requirements are not met, home-preserved foods may lose their quality or spoil.
Homemakers should observe some simple techniques for checking home-canned foods before serving them. This will help prevent consumption of food that could cause the rare but extremely dangerous food poisoning called botulism. ”

“ Although doctors and commercial corporations repeatedly protest that breast-feeding is best, they are quite ready in the same breath to admit that artificial feeding can be made “as good as mother’s milk”; and no one is in the least perturbed when he hears that his own child or that millions of other babies are being hand-fed. We have even read the work of one English doctor who smugly proclaims that we shall improve on Nature in this matter!
Thus, once again, while flagrant abnormalities are becoming the rule amongst us, science hastens to set our minds at rest by a shower of artificial aids ”

“ THE NURSING BABY—WHY THREE HUNDRED THOUSAND BABIES ARE SACRIFICED EVERY YEAR TO IGNORANCE—INFLUENCE OF THE MOTHER’S DIET ON THE BABY’S HEALTH—WHEN THE NEW-BORN BABY MUST BE BOTTLE-FED—A WELL-BALANCED DIET FOR THE NURSING MOTHER—CARE OF THE BREASTS AND NIPPLES—IMPORTANCE OF REGULARITY IN NURSING
Correct feeding is the foundation on which the baby’s good health rests. ”

“ The chief error in rearing the young is overfeeding; and a most serious one it is; but which may be easily avoided by the parent pursuing a systematic plan with regard to the hours of feeding, and then only yielding to the indications of appetite, and administering the food slowly, in small quantities at a time. This is the only way effectually to prevent indigestion, and bowel complaints, and the irritable condition of the nervous system, so common in infancy, and secure to the infant healthy nutrition, and consequent strength of constitution. ”