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Page 27
_Why is it that an infant so often vomits some of its food within a
few moments after finishing its bottle?_
Usually because the quantity is too large. Sometimes it is due to the
fact that the food is taken too rapidly, from too large a hole in the
nipple. It may be due to too tight clothing, or to moving the child
about in such a way as to press upon the stomach.
_What are the principal causes of, and the changes in the food
required by habitual vomiting, regurgitation, or spitting up of small
quantities of food between feedings, often repeated many times a day?_
This is always a symptom of gastric indigestion, and a most
troublesome one. In such conditions the fat and often the sugar also
should be reduced and the lime-water increased.
Formulas made from rich top-milk or milk and cream are to be avoided.
Those made from 7-per-cent milk are less likely to be the cause of
trouble than those from 10-per-cent milk; but if the symptoms are at
all severe it is better to use instead of these the formulas of the
Fourth Series derived from plain milk.
Reduction in the sugar may be made by adding only one half ounce of
milk sugar to each twenty ounces of the food; in severe cases the
sugar may be omitted altogether.
It is often advisable to double the amount of lime-water--i.e., use
two ounces to each twenty ounces of food.
The malted foods and all other foods containing much sugar usually
aggravate the symptoms.
The intervals between meals should generally be half an hour longer,
and sometimes an hour longer, than when digestion is normal.
The quantity given at a feeding should generally be less than with a
normal digestion. Usually a smaller quantity of a strong food succeeds
better than a larger quantity of a weak food.
_What are the causes of, and food changes required by a constant and
excessive formation of gas in the stomach, leading to distention and
pain, or eructations (belching) of gas and often of a sour, watery
fluid?_
This is often associated with habitual vomiting, and is due to similar
causes, but particularly to the sugar, which should be greatly reduced
or omitted entirely.
_What changes should be made when there is habitual colic?_
This is generally due to an accumulation of gas in the intestines
which forms there because the proteids (curd) of the milk are not
digested. They should be reduced by using in the early months a weaker
formula--i.e., instead of Formula V of the First or Second Series, IV
might be used, or, for a short time, even III. The proteids may be
reduced in the middle period by using weaker formulas If we desire to
reduce the proteids without reducing the fat, we may change from the
Second to the First Series.
Another means of relieving habitual colic is the use of partially
peptonized milk (page 115); still another the dilution with
barley-water instead of plain water.
_What change should be made if curds appear in the stools regularly or
frequently?_
This is usually associated with habitual colic, and has to be managed
exactly like that condition, by the means just described.
_How should the milk be modified for chronic constipation?_
The constipation of the first weeks of life has been already referred
to (page 82); it usually disappears as the food is gradually
strengthened in all its proportions.
Habitual constipation at a later period is difficult to overcome by
diet alone. It sometimes depends upon the fact that the proteids are
too high, and sometimes that the fat is too low. Hence it is more
frequent when infants are fed upon plain milk variously diluted (page
90), then when 7-per-cent or 10-per-cent milk is used, and diluted to
a greater degree. But it is not desirable to use a top-milk containing
more than ten per cent fat for this purpose, nor is it wise to carry
the fat in the food above 4 per cent (i.e., 8 ounces of 10-per-cent
milk, or 12 ounces of 7-per-cent milk, in a 20-ounce mixture) or other
disturbances of digestion may be produced.
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