SOME OBSERVATIONS ON THE FEEDING OF PREMATURE INFANTS BASED ON TWENTY YEARS' EXPERIENCE AT THE NEW HAVEN HOSPITAL

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Abstract
No new concepts of infant nutrition have been presented, but an old one is emphasized. It is that infants' dietaries can be understood intelligently only when analyzed in terms of the unit of metabolism—the calorie. When babies do not thrive on a given food, it should not be changed blindly, but with careful consideration of the clinical conduct of the individual child, of the relative proportions in terms of calories of the essential food elements and of the concentration, i.e. the water content. Qualitative characteristics of food essentials are important but are not discussed in the paper. It is also pointed out that infants, particularly those who are feeble, premature, convalescent, malnourished, can be fed very successfully on a cooked cow's milk mixture lower in fat and higher in protein and carbohydrate content than human milk. Calcium and phosphorus are present in ample amounts, but vitamins must be added to the diet. Liver, or liver extract, is recommended for administration to feeble, sick and premature infants based on the concept that unrecognized deficiencies may thereby be supplied. The evidence is against the ideal food for these infants' being human milk—nature's food, certainly—but for the mature, healthy infant. No one can regard nourishing infants with adulterated or "reinforced" human milk as breast milk feeding.

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