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154
a test feed. This indicates whether the breast is yielding sufficient
milk. If the breast is found to be insufficient it is supplemented, and
if weaning has already taken place, Miss FitzGerald advises the
Manageress of the Milk Depot what "modification" of milk the child
requires. There are three different modifications of quality and seven
of quantity for children of different ages. Any doubtful cases are
referred to the Medical Officer of Health, and for children who
cannot take the ordinary modification special adaptations of the milk
have to be prepared. The Depot and apparatus were fully described
in a previous report.
The Process of Modification. The quantities of milk, cream, and
sugar for each modification have to be daily calculated for so many
infants from given formulse. These calculations are made at the
close of the day's work when the number requiring milk next day is
known. The quantity of fresh milk required is then estimated and
the order for milk telephoned to the farm. The milk is received at
7 in the morning and strained through a Ulax filter. A certain part
is taken and separated in order to supply the additional cream. Each
of the three modifications is then separately prepared by measuring,
weighing, and mixing so much milk, cream, sugar and water.
The mixture must then be passed into an automatic bottle-filling
apparatus, by means of which four bottles can be filled at once.
When the bottles have been stoppered, they are placed in a cradle,
transferred to a trolley, and wheeled into the sterilizer. The door
of this is shut, steam turned on, and the temperature raised to 170
degrees. The temperature is maintained for 15 minutes. In hot
weather the temperature is raised to 212 degrees for 20 minutes.
On taking the bottles out they are put into a tank filled with hot
water which is gradually cooled to about 53 degrees by running in
cold water. The bottles are then ready for delivery.
The Milk and the Farm. For modified milk to be satisfactory,
it is necessary that it be produced from healthy cows who are kept
under good sanitary conditions. A farm was found within the
Borough which complied satisfactorily with these requirements
It is situated on high ground, has been recently re-drained, the
cows go daily to the fields, the sheds are large and well lit and
ventilated, the cows are kept clean, and the milkers wash their hands