of the
trouble can usually be traced to an excess of starch. When the
percentage of milk sugar is greater than can be handled by the
digestive apparatus of the baby, it is manifested by frequent attacks
of colic, with the passage of watery green stools, highly irritating,
in character on account of their acidity. In acute cases the loss of
weight is often marked, and symptoms of intoxication may develop. The
outlook is grave in the very severe cases, but if the baby can survive
forty-eight hours after the acute symptoms develop, he is apt to pull
through the attack.

~Adjusting the Sugars.~--The treatment in these conditions consists of
eliminating the milk sugar from the formula; in less severe cases
dextri-maltose may be substituted. As a rule, coincident with
indigestion caused by sugar there will be found to be an intolerance
for much fat, so that this must be adjusted as well as the milk sugar.
Skimmed milk mixtures, containing a certain amount of barley or
oatmeal water, are generally found to be suitable in these cases.
Dextri-maltose may be added after a few days in order to maintain the
fuel needs of the body. Eiweissmilch is at times used, but whey
mixtures are contraindicated on account of their high sugar content.

Dextri-maltose also disagrees at times. The baby has colic and
flatulence, the stools are usually loose or watery and dark brown in
color. The dietetic treatment consists of an immediate withdrawal of
the dextri-maltose preparation and a substitution of milk sugar after
a few days.

~Evidences of Excess Starch in Formula.~--The disturbances arising
from an excess of starch in the diet are, as has already been stated,
more apt to be of a chronic than an acute character. Vomiting is not a
common symptom under these conditions, although colic is frequent. The
stools are at times loose and brown, at other times dry and small. The
baby at times suffers from diarrhea and at others from constipation.
When the disturbance is acute the starch must be entirely eliminated
from the formula. If proprietary foods are being used containing
starch, whether it is dextrinized or unchanged, they must be at once
abandoned, and a formula made up of protein with sugar and fat.

MODIFIED MILK FORMULAS SUGGESTED BY MORSE AND TALBOT FOR THESE
CONDITIONS

Fat 1.00% Fat 2.00%
Milk sugar 4.00% or Milk sugar 5.00%
Protein 0.75% Protein 1.25%