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It is now recognised that without an adequate supply of vitamins in the diet of a growing child healthy
growth and development is impossible.
We may now consider whether the usual food of an infant in its first year is satisfactory. The food may be :
(a) Breast milk.
(b) Cows' milk.
(c) Dried milk or patent foods.
(d) Ordinary foodstuffs.
For several reasons it is convenient to take (b) first.
Cows' Milk.—It is agreed that the quality and vitamin content of cows' milk vary very considerably. Milk
produced by cows which are grass fed in the open is likely to contain sufficient vitamins, but when these ideal
conditions do not obtain there is found a serious deficiency in Vitamin D, and also some deficiency in Vitamin A.
This deficiency is apparently quite common ; in the milk of cows fed on oil-cake Vitamin D is completely absent.
In practice children are frequently seen who show varying signs of defective development, where the feeding
has been cows' milk and water, with some orange juice each day. The Committee suggest that as such feeding
is seriously lacking in fat and in Vitamins A and D it cannot be regarded as satisfactory.
After weaning also, the position is unsatisfactory. In many families it has been noted that owing to poverty
an altogether insufficient quantity of milk is being given to the children, so that their chances of getting adequate
supplies of Vitamin D must be small.
Breast Milk.—The Committee are agreed that in suitable cases, where the mother has a natural capacity
for breast feeding and a placid temperament, there is no better method of infant feeding. It seems likely, however,
that the environmental conditions under which many mothers attempt to produce breast milk may be as
likely to lead to bad results as the somewhat similar conditions referred to above which lead to the production
of unsuitable cows' milk. Especially is this so if we add the effect of financial or domestic worries to the effects
of poor feeding, lack of fresh air, and lack of sunlight.
Confirmation of this view may be found in the following quotations from No. 38 of the Medical Research
Council's Reports, published in 1919.
"But it is most important to remember that it has been proved experimentally that the mother
is entirely dependent upon her own food supply to provide her young with these substances, and should her diet
be deficient in this respect, they will suffer, sooner or later, in spite of any sacrifices she may make."
" From a consideration of a number of the dietaries consumed by the poorer classes in the towns of this
country, one is led to suggest that no inconsiderable proportion of the population is existing on a food supply
more or less deficient in the fat soluble factor. If that is so, it must follow that thousands of infants which are
being nursed by the women of this population, are indirectly being deprived of an adequate supply of that substance
during the period of their life when it is vitally important that they should suffer from no dietary deficiency."
It is by no means rare for breast-fed babies to be brought to a doctor showing quite definite signs of rickets.
Frequently the weekly gain in these cases proves to be about 4 ounces. The Committee feel that where an infant's
weekly increase in weight falls to as low a figure as this, not only should the feeding methods in use be looked on
with great suspicion, but the infant should be regarded as an early or commencing case of malnutrition. Prompt
action directed to improving the feeding can only have good results, whether the baby is breast-fed or bottle-fed ;
acceptance of these small gains as satisfactory is likely to be followed by the appearance at some later date of
other signs of avitamosis, malnutrition, and lessened resistance to disease.
The Committee understand that improvement has been noted in some cases where the mother has been supplied
with extra meals. While this must be of use in these cases where the mother's diet has been insufficient,
it should be noted that in many of these cases the quality and not the quantity of food has been at fault. This
suggests that a small addition to the mother's diet of food rich in vitamins might be tried, or the more direct
administration of concentrated vitamin preparations to the infant.
Professor Cowell (loc. cit), states:—
"The ill-effects of a faulty diet, particularly in the young, may persist long after the fault has been remedied.
If, then, the maximum benefit is to be gained from correct feeding, such feeding must be instituted at
the earliest possible moment in the life of the child, and that implies attention to the ante-natal feeding of the
mother."
He makes the following practical suggestions:—
(1) "The diet of the pregnant mother, particularly during the later period of gestation, should include
an abundant supply of milk to provide calcium and good protein ; green vegetables to supply iron and vitamin A,
and butter or vitaminised margarine and eggs to furnish the fat soluble vitamins A and D. It is recommended
that additional supplies of vitamins A and D should be given for some weeks before parturition, in the form of
either cod-liver oil, or of a reliable concentrated preparation."
(2) " During early infancy, milk should be supplemented by some rich source of the fat soluble vitamins—
either cod-liver oil or a concentrated preparation which contains vitamin A as well as vitaimn D. Yolk of egg
may be given after the second month of life ; this supplies iron as well as fat soluble vitamins, and is particularly
valuable to the artificially-fed infant."
Dried Milk and Patent Foods.—A few years ago, and to a lesser extent nowadays, feeding on dried milk or
patent foods frequently produced a large, flabby infant that subsequently " fell away to nothing " (to use an
expression commonly employed by the mothers of such children), usually after a severe attack of bronchitis.
Nowadays most of the manufacturers supply a foodstuff that approximates very closely to the standard of
good breast milk, and contains an adequate amount of the necessary vitamins. Such a food must, in many cases,
be better for the infant than the breast milk or cows' milk it would otherwise receive, and this is borne out by
the excellent late results obtained by this method of artificial feeding.