==========================+============+============+============ | _Fat_ |_Milk Sugar_| _Protein_ --------------------------+------------+------------+------------ Whole milk | 4.00 | 4.50 | 3.50 7% cream | 7.00 | 4.45 | 3.40 10% cream | 10.00 | 4.40 | 2.25 16% cream | 16.00 | 4.20 | 3.05 32% cream | 32.00 | 3.40 | 2.50 Skimmed milk | 1.00 | 5.00 | 3.55 Separated milk (fat-free) | 0.25 | 5.00 | 3.65 Whey | 0.25 | 5.00 | 0.90 ==========================+============+============+============
Seven per cent. (7%) cream is obtained from the upper 16 ounces of a quart bottle of milk which has been allowed to stand undisturbed for six hours. The upper third of the bottle contains 10% fat, while the whole fat layer from the quart bottle, regardless of the number of ounces, contains about 16% of fat.
~Methods of Artificial Feeding.~--The use of whole milk, top milk, or skimmed milk, diluted with water, and either milk sugar, malt sugar, or sucrose (cane sugar) added, is the method of feeding most commonly used, and upon it are based the formulas universally advised by infant specialists. There are cases in which simple dilution is not advisable. In premature or very young infants, for example, the whey mixtures have been found to give the best results. In toxic diarrheas, where the putrefactive bacteria make the use of all but the minimum amount of protein inadvisable, the above method is contraindicated, as it is likewise in cases where vomiting of casein curd is a prominent feature.[68]
~The Use of Alkalies.~--There are many cases in which the physician deems it advisable to add an alkali to the milk mixture. The one generally selected is limewater. However, sodium citrate and sodium bicarbonate are also used. The reasons for adding alkalies to the milk mixtures are: (1) to check the coagulation of the casein, (2) to hasten the emptying of the stomach, or (3) to chemically change the formation of the curd. In certain cases it is only necessary to delay the coagulation of the casein in the stomach, in which case a certain amount of limewater is used. Its action is to swell the protein of the milk and in this way effect the precipitation of the casein. In other cases it is found advisable to prevent the formation of curd and hasten its departure from the stomach. Cannon[69] claims that milk before it coagulates leaves the stomach quickly like water in gushes. Hence, if an alkali like limewater, bicarbonate or citrate of soda is added to the milk this coagulation will be checked and the digestion be facilitated.