To complete the composition of cow's milk:

• cow's milk is diluted to reduce the proteins and salts;

• sugar is added, to increase the glucose part and restore the calorific value of the food. Sugar is added to restore the proteins/sugar  proportion to 1:6, as in human milk.

The dilution:

• reduces the proteins concentration;
• reduces the concentration of the buffer substances which neutralise the gastric acidity and determine a hypersecretion of HCI;
• reduces the concentration of calcium ande magnesium, which when in excess form an alkaline-earthy soap with a decrease in fat absorption.

Milk can be diluted with boiling water or water with a low mineral content. Cereal mucilage can also be used (rice, barley, oats), as it has an astringent action and a colloidal-protection action. In that case the precipitation of casein in small flakes (which are more digestible) is an advantage.

The level of dilution differs according to the baby’s age:

• 1/3 (one part milk and two water) in the first days, after some infective diseases or intestinal problems;
• 1/2 (one part milk and one water) up to the fourth month;
• 2/3 (two parts milk and one water) from the fourth month until the feeding with milk only.

The addition of glucide must consider two aspects:

• fermentability;
• digestibility.

Monosaccharides are quickly absorbed and determine jumps in glycaemia. They also have an osmotic activity superior to other glucides which get water from tissues, and produce an exciting effect on the intestinal peristalsis. Monosaccharides are therefore not recommended.

Disaccharides are easily digested because the baby has disaccharase at intestinal level, but it is necessary to consider the fermentability. Saccharose is slightly fermentable. In quantities greater than 5-7%, lactose produces fermentative processes, above all if it is á-lactose from cow’s milk (found in trace), while in human milk we find b-lactose. Maltose has a fermentability average between that of saccharose and lactose.

Polysaccharides (amid and dextrins), as cereal flour or unmodified, rule the fermentative and putrefactive processes. They determine a larger utilisation of food due to the lack of digestive overburdening, and avoid post-prandial glycaemic jumps.

The addition of fats is not carried out, despite dilution, as fats are badly tolerated and chemically there are no deficiency effects.