Cow’s milk has a little more than half as much sugar; it has nearly three times as much proteids and salts; its proteids are different and much more difficult of digestion; its reaction is decidedly acid, that of mother’s milk is faintly acid or neutral.

Are there any other important things to be considered?

Yes; mother’s milk is always fed fresh and is practically sterile.  Cow’s milk is generally kept twenty-four hours and sometimes much longer.  It is always to a greater or less degree contaminated by dirt and germs, the number of which increases rapidly (1) with the age of the milk; (2) in proportion to amount of the dust or dirt which enters it; (3) with any increase in the temperature at which the milk is kept.

It is just as important for success in infant feeding that these conditions receive attention as that the proportions of the different elements of the milk are right.

How is the acidity of cow’s milk overcome?

By the addition of lime-water or bicarbonate of soda.  If lime-water is used, one ounce to twenty ounces of food is generally required; if soda is used, twenty grains to twenty ounces of food.

If there is a tendency to constipation the milk of magnesia (Phillips’s) may be used; from one half to one teaspoonful being added to each twenty ounces of food.

How is the sugar best increased?

By adding milk sugar to the food; one ounce to each twenty ounces of food will give the proper quantity for the first three or four months.  This will make the proportion about the same (between 6 and 7 per cent) as in mother’s milk.

How should the sugar be prepared?

Simply dissolved in boiled water; if the solution is not clear, or if there is a deposit after standing, it should be filtered by pouring through a layer of absorbent cotton, half an inch thick, which is placed in an ordinary funnel.

Will not cane (granulated) sugar answer as well?

Not as a rule; however, there are many infants who get on very well when cane sugar is used.  It has the advantage of being much cheaper.  A good grade of milk sugar is somewhat expensive, costing from twenty-five to sixty cents a pound, and cheap samples are apt to contain impurities.

If cane sugar is used, what amount should be added?

Considerably less than of the milk sugar.  Usually about half the quantity (half an ounce to twenty ounces of food) is as much as most infants can digest If the same quantity is used as of the milk sugar, the food is made unduly sweet, and the sugar is likely to ferment in the stomach and cause colic.

Is not the purpose of the sugar to sweeten the food in order to make it palatable?

Not at all; although it does that, its real use is to furnish one of the essential elements needed for the growth of the body, and the one that is required by young infants in the largest quantity.