FEEDING BOTTLES

We extract from ‘The Sanitary Record’ the following valuable paper on ‘Feeding Bottles,’ by Dr Eustace Smith, a istant-physician to the City of London Hospital for Diseases of the Chest, and Physician to the East London Hospital for Children:—“In the artificial rearing of infants it is of importance that food should be given to them from a feeding-bottle. By this means the natural method of taking nourishment is imitated; the muscles of the mouth and cheeks are brought into play; and the secretion of saliva—a secretion which, very scanty at birth, becomes gradually more copious and takes so active a part in digestion—is encouraged and increased. “Almost all babies will take their food more readily by this method, their instinct teaching them to suck everything that is put into their mouths. Even in cases where a deficiency in the hard palate presents so great an obstacle to sucking, on account of the impo ibility of creating the nece ary vacuum in the mouth, the difficulty can be overcome by a simple mechanical contrivance. Therefore, in every case of hand-feeding, a suitable bottle is the first thing to be desired. “To be satisfactory a feeding-bottle must fulfil three indispensable conditions: it must be simple in construction and easily manageable; it must be capable of being readily cleaned; and in its use the milk must flow easily and without great effort on the part of the infant. The ordinary feeder in use at the present time consists of a flattened gla flask, closed at the mouth by a cap, which fits over the neck. A caoutchouc tube pa es through the cap, and is connected inside the bottle with a straight gla pipe. The other end of the elastic tube is attached to the teat, or mouth-piece, by means of a short hollow cylinder called the ‘union-joint.’ The teat is firmly fixed to this by means of the shield. In the construction of the cap and union-joint, metal, earthenware, or wood, is employed. The metal used by the best makers is tin, and this, if cleanline be properly attended to, is not objectionable. In cheaper bottles, sold in the shops for sixpence, the mouth is closed by a perforated cork, through which the flexible tube pa es. Here there is no cap, but in all e ential points the construction is the same as in the more expensive articles. “In this apparatus it is important that the channel through the tubes should be perfectly free. The point at which the channel is narrowest is the union-joint, which connects the mouth-piece with the flexible tube. In a badly made bottle an impediment may exist at this point from carele ne in the manufacture, and may present a great obstacle to the ready pa age of the fluid. Care also should be taken that the flexible tube pa es completely through the cap, before it becomes connected with the gla pipe. This is very important. In the early feeding-bottles constructed upon this model by O′Connel, the gla pipe pa ed from within the bottle through the cap, and was attached outside this to the caoutchouc tube. It was thus held rigidly in the centre of the bottle, and as a natural consequence, when the apparatus was in use, unle the bottle was held upright during the whole meal, long before its contents were exhausted the milk ceased to flow, as the end of the pipe soon came to be above the surface of the fluid, which nece arily gravitated to the lowest part as the bottle lay on its side. “When, however, the connection between the two tubes is made within instead of outside the bottle, this disadvantage no longer exists, for the gla tube being free to move, its end is able to sink to whichever side of the bottle is undermost, and therefore always remains below the level of the fluid. The best bottles have a small cylindrical stop, i.e. a thick ring of metal or wood placed within the flexible tube, just above its junction with the gla pipe. The object of this is to prevent the latter being drawn through the cap, and thus held rigidly in the centre of the bottle. “The method of connection of the cap with the neck of the bottle is not unimportant. It should not be too tight or air will be prevented from entering the bottle to supply the place of the milk which is withdrawn. A common plan is to line the interior of the cap with cork, but this substance, besides its risk of being broken and detached by carele handling, has the further disadvantage of absorbing milk, which turns sour and may afterwards set up fermentation in fresh milk put into the bottle for a subsequent meal. In the best bottles the cap is constructed to screw on to the neck, as in the ‘Alexandra’ Feeding bottle made by the Me rs Maw; or is united to it by an application of the ‘bayonet catch,’ as in the ‘Improved’ feeding-bottle made by Me rs Lynch and Son. In this very admirable apparatus three grooves in the inside of the cap pa over corresponding projections on the neck of the bottle; the cap is then turned to the right, with a slight screwing motion, and becomes securely fastened. “With badly made bottles infants often have very great difficulty in drawing up the milk, and can only do so by violent efforts, which soon exhaust their strength or their patience. There are two reasons why milk in these cases may not flow easily—either the cap fits too tightly, so that air cannot enter with sufficient facility in proportion as the liquid contents become diminished, as has just been mentioned; or the caoutchouc forming the flexible tube is too thin, so that it collapses when suction is applied. In the first case a small hole should be made through the cap, so as to allow a free admi ion of air, or if the bottle be a simpler one, closed at the mouth by a perforated cork, this may be slightly eased at the neck of the bottle, so as to fit le closely. In the second case, stouter caoutchouc should be used in the construction of the tube. In weakly infants, or those much reduced in strength by acute disease, special attention should be paid to these points, as such children will often refuse to take the bottle, if they find any difficulty in drawing up the milk. “Infants born with a cleft palate cannot suck from an ordinary bottle, as the deficiency in the hard palate prevents the nece ary vacuum being formed in the mouth. Such children are, therefore, usually brought up with a spoon, and often waste and die through insufficient nourishment. An ingenious contrivance first suggested by Mr Oakley Coles will, however, entirely remove the difficulty, and enable them to suck with as much ease as if they suffered from no such congenital difficulty. The plan is a very simple one, and consists in attaching to the nipple of any ordinary feeding-bottle a flap of sheet elastic, cut to fit the roof of the mouth. This flap must be of the shape and about the size of the bowl of a teaspoon, and is to be sewn to the upper part of the stalk of the teat, where this projects from the shield. In the mouth of the child the flap forms an artificial palate, which if the sheet elastic chosen be sufficiently stout, offers firm resistance to the tongue pre ing against in sucking, and prevents fluid from pa ing into the nose in the act of swallowing. “The closest attention must be paid to the cleaning of feeding-bottles. Each time after being used the whole apparatus should be well washed out with water containing a little soda in solution. “The inside of the cap must be carefully cleaned, and the brush should be carried several times through the whole length of the tubing. Afterwards the bottle and tubes should be laid in cold water until again wanted. An objection to the common brush usually supplied with each feeder is, that after a few days’ use the softened bristles are apt to get detached and be caught in the joints of the tubing, whence they may afterwards be washed by the stream of fluid and be swallowed by the child. Accordingly, a new cleaner has been manufactured by Me rs Maw and Sons, in which bristles are entirely dispensed with. They are replaced by a thin strip of caoutchouc, which is wound round in a spiral form, at the end of the ordinary wire handle. This instrument answers all the purposes of a brush, without the disadvantages alluded to, and is besides far more durable. “Excellent feeding-bottles are now made by many different manufacturers, and are sold at prices which place them within the reach of the poorest. These cannot all be mentioned, but some of the bottles more commonly met with, may be shortly referred to. The six-penny feeder made by Me rs Maw, Son, and Thompson, can be recommended for its simplicity of construction, and at the same time for its perfect efficiency. In this instrument there is no cap, instead the mouth of the bottle is closed by a cork, which is perforated for the pa age of the flexible tube. In all other respects the construction of this apparatus is the same as in the more expensive instruments. The ‘Alexandra’ feeding-bottle, price half-a-crown, by the same makers, is an admirable bottle. The cap screws on to the neck, and is furnished with a small hole for the admi ion of air. A ‘stop’ in the lower part of the flexible tube prevents the gla pipe being drawn into the cap, and the instrument is supplied with all the latest improvements. The bottles made by Me rs Maw are all furnished with the new patent cleaner just described. The improved feeding-bottle made by Me rs Lynch and Son, at one shilling and eighteen pence, has been before referred to. The material used for the cap is boxwood. It is a capital bottle, and will give the fullest satisfaction to the purchaser. Mr Lang’s ‘Alma Mater’ feeding-bottle can also be recommended. In this instrument the cap is made of earthenware and is lined with cork. A good bottle is made by Mr Elam, of Oxford Street, price two shillings; the cap is formed of britannia metal, and screws on to the neck. A cheaper bottle, but one which for elegance of design and accuracy of detail cannot be surpa ed, is Mr Mather’s ‘Prince ’ feeding-bottle. A tin cup screws on the neck, and is pierced by a small hole for the admi ion of air. The opening is fitted with a ‘cone valve’ of simple and ingenious construction, which allows air to enter freely when suction is applied to the tube, but closes firmly against any escape through the air-hole of the fluid contents of the bottle. The bottle itself has a double curve towards the neck to provide against too sudden bending of the flexible tube against the tap. This is apt to happen when the curve is single, if the bottle lie with the convexity downwards, and partial obstruction of the tube may be the result. The ‘Prince ’ feeding-bottle is sold in the shops for eighteen pence. “All bottles bear their name in raised letters upon the gla , but a report which has obtained currency that these letters are hollow in the interior, and difficult to cleanse is without any foundation in fact. Any one may test this for himself by placing a finger within the bottle underneath the letters, when the internal surface will be found perfectly plain and uniform. In all cases where cork enters into the construction of a feeding-bottle, especial care should be taken in cleansing the apparatus, and the cork should be well soaked in soda and water in order that any sour milk it may contain may be neutralised at once.”