Modified Milk. — (a) TJie Selection of Milk for an infant is an important consideration. Clean milk is most essential. Milk is considered clean when it comes from dairy farms where clean milkers work under sanitary conditions, ap- proved by a medical milk commission. (See Care of Milk, p. 99.) Such milk contains few bacteria and is called certified milk. This is by far the safest milk for infant diet, but it is expensive. It usually costs almost twice as much as ordinary milk. Milk that is heated to 145° F., kept at that temperature for about thirty minutes, and then quickly cooled, is pasteurized milk. While pasteurizing kills most of the disease-producing germs, it does not destroy all the spores. (See Microorganisms in the /Spore Form, p. 308.) DIET FOR CHILDREN AND INFANTS 389 The taste of milk is not affected by pasteurizing. Milk is sterilized — all germ life destroyed — by heating at 212° F. from one to one and one half hours. If certified milk cannot be used for infant diet, there is some question whether milk should be pasteurized or steri- lized. Most authorities consider that it is made less digest- ible and more constipating by sterilizing. Since the value of milk as an infant food depends upon its cleanliness, it is difficult to state just how old milk may be before it is unsafe for infant feeding. It is safest to use only fresh milk. Bacteria in milk may develop so rapidly that it is unfit to use a few hours after it has been drawn from the cow. Unless milk is certified, it should not be used in summer after it is twenty-four hours old, and in winter, after it is forty-eight hours old. Bottled milk should be used for infants. (b) Measuring and Mixing Ingredients. — Utensils for measuring and preparing the ingredients, of modified milk should be kept absolutely clean. Before using, all glass and metal utensils used for measuring and holding the milk should be covered with cold water, then the water should be heated and allowed to boil for twenty minutes. Just before using rubber nipples, place them in boiling water for a few minutes. After using, they should be rinsed in cold water and then carefully washed inside and out with soap and water. When not in use, nipples should be kept in a covered jar containing a solution of boric acid Q- teaspoonful of boric acid to 1 pint of water). After using the milk bottles (have as many bottles as there are feedings a day), rinse them in cold water, and then fill them with water and add a pinch of baking soda. Before filling the bottle with milk, wash with soap and water — using a bottle brush — and then sterilize in boiling water for twenty minutes. Bacteria can- not pass through cotton, hence it is used for stoppering the filled milk bottles. The cotton should be sterilized by THE PLANNING AND SERVING OP MEALS baking in a moderate oven for one hour. (It should be a very light brown when baked.) To make cow's milk conform with human milk in com- position, it is necessary to decrease the protein and ash con- tent. This may be accomplished by diluting the milk. But when this is done, the fat content is too small. In order to decrease the protein and fat content and at the same time retain the proper quantity of fat, dilute top milk, i.e. milk con- taining more than the average percentage (4%) of fat. Milk containing ten per cent of fat or that containing seven per cent of fat is commonly used for young infants. Whole milk (4 % fat) is often used for older infants.

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Modified Milk. — (a) TJie Selection of Milk for an infant is an important consideration. Clean milk is most essential. Milk is considered clean when it comes from dairy farms where clean milkers work under sanitary conditions, approved by a medical milk commission. (See Care of Milk, p. 99.) Such milk contains few bacteria and is called certified milk. This is by far the safest milk for infant diet, but it is expensive. It usually costs almost twice as much as ordinary milk. Milk that is heated to 145° F., kept at that temperature for about thirty minutes, and then quickly cooled, is pasteurized milk. While pasteurizing kills most of the disease-producing germs, it does not destroy all the spores. (See Microorganisms in the Spore Form, p. 308.) The taste of milk is not affected by pasteurizing. Milk is sterilized — all germ life destroyed — by heating at 212° F. from one to one and one half hours. If certified milk cannot be used for infant diet, there is some question whether milk should be pasteurized or sterilized. Most authorities consider that it is made less digestible and more constipating by sterilizing. Since the value of milk as an infant food depends upon its cleanliness, it is difficult to state just how old milk may be before it is unsafe for infant feeding. It is safest to use only fresh milk. Bacteria in milk may develop so rapidly that it is unfit to use a few hours after it has been drawn from the cow. Unless milk is certified, it should not be used in summer after it is twenty-four hours old, and in winter, after it is forty-eight hours old. Bottled milk should be used for infants. (b) Measuring and Mixing Ingredients. — Utensils for measuring and preparing the ingredients, of modified milk should be kept absolutely clean. Before using, all glass and metal utensils used for measuring and holding the milk should be covered with cold water, then the water should be heated and allowed to boil for twenty minutes. Just before using rubber nipples, place them in boiling water for a few minutes. After using, they should be rinsed in cold water and then carefully washed inside and out with soap and water. When not in use, nipples should be kept in a covered jar containing a solution of boric acid Q- teaspoonful of boric acid to 1 pint of water). After using the milk bottles (have as many bottles as there are feedings a day), rinse them in cold water, and then fill them with water and add a pinch of baking soda. Before filling the bottle with milk, wash with soap and water — using a bottle brush — and then sterilize in boiling water for twenty minutes. Bacteria cannot pass through cotton, hence it is used for stoppering the filled milk bottles. The cotton should be sterilized by baking in a moderate oven for one hour. (It should be a very light brown when baked.) To make cow's milk conform with human milk in composition, it is necessary to decrease the protein and ash content. This may be accomplished by diluting the milk. But when this is done, the fat content is too small. In order to decrease the protein and fat content and at the same time retain the proper quantity of fat, dilute top milk, i.e. milk containing more than the average percentage (4%) of fat. Milk containing ten per cent of fat or that containing seven per cent of fat is commonly used for young infants. Whole milk (4 % fat) is often used for older infants.

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