Milk

The feeding of infants when the mothers cannot do so with their own milk has been an arduous task for physicians. They have been at their wit's end for substitutes. Wet nurses will not always do, sometimes because they are unavailable, more often because they may suffer from contagious diseases to which their own offspring may be immune. Dr. Brouzet (Sur I'education medecinale des enfants) thought so poorly of human mothers that he wished the state to interfere and keep them from suckling their young lest they communicate immorality and disease. The chemist Van Helmont called milk "brute food" and wanted to substitute for it bread boiled in beer and honey. Substitutes for mother's milk have been made from cow's milk mixed with soft water, lactose ("sugar of milk") and phosphate of lime. This a vigorous newborn child can assimilate. But the frail bambino must have natural human milk.

Last week the Children's Welfare Federation of Manhattan, through Miss Mary Arnold, its Secretary, recounted how it procured 1860 quarts of milk from 98 human mothers in 1925, how it kept 296 babies alive, babies that probably would have died in the 26 hospitals in which they were cared for.

The Federation has three mother's milk depots at three Health Stations. Thither come mothers who are producing more milk than their own babies need. They can sell the balance of the day's production and earn thereby enough money to keep from working. If they went to work while breast feeding, their own children would suffer from irregular nutrition. Besides, the energy the mothers need for creating milk would go into work. They could go around as wet nurses. But there too the effect of irregular hours would tell. The foster baby would also probably suckle more milk than the nurse could spare from her own child's feeding. The latter would suffer.

To the Health Stations the nursing mothers come. They are given a minute physical examination to make certain that no child contracts disease from them. Their diet is inquired into, because certain products (like garlic) in the nurse's food would make the milk unpleasant. If all is well, a certain amount of milk is taken from their breasts, an amount carefully regulated so that the natural child will not be starved. Some mothers yield only 3 to 4 ounces* a day. Others give 15 to 20 ounces. The average output approximates 10 ounces a day. For this milk the nurse is paid 10-c- an ounce for the first five ounces. Over that she earns 15-c- an ounce.

The more milk taken, the greater drain on her vitality. Good milkers get their carfares paid. This milk is set in copiers and later each day is distributed to hospitals and individual mothers. The impoverished can get it free. Other private patients and hospitals pay 15-c- to 25-c- an ounce. Last year the Federation paid out $7,000 for the 1860 quarts of milk produced, or $3.70 a quart** The cost for handling an ounce was 23-c-. There was no profit.

Mamma. The name mammary gland is often given to the breast, or mamma, although the latter is made up of not only the glandular tissue, but also of fibrous and fatty tissues, blood vessels, lymphatics and nerves. In the man the breast is usually flat and insignificant. But traces of the glandular portions exist.***

Milk. At childbirth the mother's breasts yield a yellowish, sticky fluid called colostrum. This is good for the child, although it is only slightly nourishing. Yet it is laxative and prepares the child's stomach for true milk, which arrives shortly after.

Milk production begins in the mother after delivery of the child. It continues as long as needed, although prolonged nursing is harmful to her and not especially good for the child.

When the teeth are on the way, as shown by dribbling, the parotid glands secrete an active saliva capable of digesting breadstuffs. Weaning should be fixed partly by the child's age, partly by the appearance of the teeth. The first come during the sixth or seventh month. From then on the number of sucklings may be reduced--in a month to twice a day. When the second pair of teeth arrive, the mother can wean the child. When the third group (the later incisors and grinders) appeal-about the end of the first year, the baby can chew solid food.

After weaning the mother will find that her milk production powers wane until they stop. Secretion of milk depends on the drainage the suckling child sets up, and continues until that suckling ceases.

In cows and other domestic animals**** whose milk is wanted, milk production is maintained for an inordinately long period by artificial suckling. The milkmaid's fingers imitate on the animal's teats the suckling action of the young one's mouth and tongue muscles. This prolonged lactation may continue until the beast is again heavy with young, when it ceases. The mother needs all her resources for conception.

Composition. Milk is composed of tiny globules of fat suspended as an emulsion with casien and other proteids, lactose ("sugar of milk"), and inorganic salts. A different combination of these develops in different animals. A slighter difference occurs between the milks of two animals of the same species. Therefore a woman's milk is best for her own child, another woman's next best.

The Manhattan Children's Welfare Federation has been doing the next best thing only when the best was prevented for some good reason.

Dried Human Milk. Not always is fresh human milk available. So Dr. P. W. Emerson of Boston (reporting in the American Journal of Diseases of Children) has worked out a method of drying human milk. The process is similar to that used in desiccating cow's milk for canning. This dried human milk has been acceptable to a small number of babies as food, not the most preferable food, yet sustaining to life. In some cases this milk had to be fortified with sugar. Then the infants gained rapidly. Later they were able to go on a diet of cow milk formula. They gained well, probably because of the additional protein present in the fresh fluid.

*There are 16 ounces to a pint.

**Pasteurized cow's milk costs from 10-c- to 15-c- a quart in most U. S. cities.

***Some boys at puberty give out a milky exudation from the nipples. At least one grown man is recorded to have suckled a child. In eunuchs the enlarged breasts are composed mainly of fat. Infants frequently exude a milky liquid.

****Laplanders keep reindeer for milk: roving Tartars mares; Bedouins camels; pastoral tribes sheep; mountain tribes goats; tropical ones buffaloes. Asses' milk is highly esteemed far and wide. Each type of milk has its peculiar flavor, sometimes nauseating to the uninitiated. In the wild state, these animals, and the cow also, cease their milk flow after weaning their young. Farmers know that a calf weaned late is unusually frisky.