How can this be remedied?  By increasing the fat in the milk before it is diluted.

How is this done?  By adding top milk or milk and cream.

What is the top-milk?  It is the upper layer of milk, one-third or one-half of milk removed after it has stood a certain number of hours,—­six to eight hours.

How is the strength of the top-milk measured?  By the fat it contains.  A ten per cent milk contains a ten per cent of fat; a seven per cent milk contains a seven per cent of fat.

Are these strengths used for infant feeding?  Yes, they are most used.

What increases the percentage of fat in the top-milk? 1.  The longer time it stands. 2.  Manner of its removal. 3.  Number of ounces removed. 4.  Thickness of the milk used.

When is top-milk removed?  If milk is fresh from the cow or before the cream has risen, is bottled and rapidly cooled, it may be removed in four hours.  It does not make much difference in bottled milk, and it may stand much longer.

How should top-milk be removed?  Skim carefully off with a spoon, or cream-dipper (specially prepared) holding one ounce.  It may be taken off with a glass or rubber syphon, never pour it off.

How can ten per cent top-milk be obtained from the different kinds of cow’s milk?  From rather poor milk (three to three and one half per cent fat) remove the upper eight ounces from a quart.

How can it be obtained from good average milk (four per cent fat?) Remove the upper eleven ounces or one-third.

From rich Jersey milk (five and five one-half per cent fat)?  By removing sixteen ounces or upper one-half from the quart.

How is seven per cent top-milk obtained? 1.  By removing the upper eleven ounces or one-third of a quart from poor milk. 2.  By removing the upper half from average milk. 3.  By removing two-thirds or about twenty-two ounces from rich Jersey milk.  As stated before the seven per cent and ten per cent are the two kinds generally used.

If top-milk is treated in this way, is it like the human milk?  The proportion of the fluids and solids are about the same, but the elements are different.  The curd (albuminous element) is still different in structure and action from the same element in human milk.  The curd of human milk when it is met by the gastric juice in the stomach coagulates in minute particles, and the pepsin acts upon this very readily, but the curd of cows’ milk being much coarser and firmer coagulates under these conditions, into large hard clots or masses, and these are quite indigestible if the child’s stomach is sour from an under amount of acid being present.

[580 Mothers’ remedies]

How can we prevent this?  By adding some bland and nonirritating substance to the milk which will mingle with the particles of curd and separate them until the gastric juice can act upon each separate particle and digest it.