Buttermilk

BUTTERMILK, a liquid of turbid yellow color, which is a byproduct in the churning of butter from cream and contains all the proteins, salts, and most of the sugar of milk. When sour cream is churned, sour buttermilk is obtained. In pediatric practice, buttermilk is understood as food for infants, made mainly from sour buttermilk with the addition of carbohydrates (sugar and flour). For the first time as infant food, buttermilk began to be used in those countries (mainly in Holland), where the population has long been engaged in the production of dairy products as a trade. When boiled, which sour buttermilk undergoes in the preparation of infant food from it, the curdled protein precipitates in the form of very small, soft to the touch clumps, forming an abundant, loose sediment at the bottom of the vessel, above which is a layer of liquid whey. Thanks to reports from Dutch physicians, the use of buttermilk for feeding children spread throughout Europe and America. The infant food from buttermilk was accompanied by the reputation of a product extremely beneficial for children, almost a panacea for all their pathological conditions, but at the same time it was considered food, the preparation of which was associated with almost insurmountable difficulties, which mainly boiled down to the fact that to obtain buttermilk one had to use as raw material cream, a very expensive product which in turn required a great expenditure of time to obtain. In addition (and this was the main obstacle to the spread of this feeding method), in most cases large, coarse clumps formed, which made the buttermilk unfit for consumption, as children poorly digested it, they developed vomiting, etc. The spread of buttermilk was greatly facilitated by the fact that soon after the appearance of reports from Dutch physicians, sour skimmed milk began to be used instead of buttermilk for the preparation of infant food. This replacement is quite rational, since theoretically buttermilk represents fat-free milk, and at the same time it greatly facilitated the entire process of food preparation, making the raw material available. Nevertheless, it did not eliminate the difficulties associated with the formation of clumps. Various methods were proposed, with the help of which it was supposedly possible to achieve good clumps. However, the recommended methods in most cases did not lead to the goal, and the clumps were still quite often unsatisfactory. This circumstance had the consequence that a considerable number of factory-made preparations appeared on the market, among which it is necessary to point out the older products ('Visso', Dutch infant food according to Koerre, in powder form, Dutch food for children for use in the initial stages of disease* in liquid form) and preparations of later origin - Eleidon, Edelweiss (both in powder form). The wider the use of buttermilk spread among small children, the more precisely the indications for its prescription were established, and the narrower the field of its application became. First of all, it was found that buttermilk by no means represents food that can find application in all cases in sick children, and in addition it is a product completely unsuitable for feeding, especially if skimmed (centrifuged) milk is used for its preparation. The very peculiarities of the composition of buttermilk determine the indications for its prescription. This is food that should find application in cases where the child does not gain weight sufficiently. In these cases, the combination of a large amount of protein and salts proves to be a particularly favorable factor. Nevertheless, despite such a successful composition of the product, it cannot be used in the child for a long time due to the insufficient fat content in it. When cases of failure began to be observed in the prescription of buttermilk, its ardent supporters made an attempt to attribute the blame to the fact that physicians used for its preparation not real buttermilk, but skimmed milk. The entire success of this food depended, in the opinion of its supporters, precisely on the fact that it was prepared from buttermilk. This product supposedly possesses some special fermentative properties, which skimmed milk lacks. The very fact of the connection between failures and the use of skimmed milk instead of buttermilk for food preparation was correctly noted, but incorrectly interpreted. Apparently, skimmed milk, obtained by centrifugation, and buttermilk, for the preparation of which a churn is used, are not homogeneous products with respect to their fine physicochemical structure. However, it must be assumed that this kind of difference does not play a significant role in the dietary significance of this food. The most essential difference between buttermilk and skimmed milk comes down to the difference in fat content: buttermilk contains up to 1.5% fat, while in skimmed milk there is (almost) none. Meanwhile, fat in the child's food plays such a significant role that it becomes completely understandable why skimmed milk, when used for a long time, did not give good results, and in some cases caused definitely negative phenomena (a catastrophic drop in weight). This assumption found confirmation in the works of the German pediatrician Langstein, who in some of his works directly points to the importance of fat in buttermilk and requires that its content in the food prepared from buttermilk not fall below 1.5% (but also not exceed this figure). In recent times, buttermilk has again attracted attention, although the area of its application has significantly narrowed compared to what the old physicians proposed, at least as far as the sick child is concerned. Our understanding of the importance of this kind of infant food has also completely changed. At present, physicians almost do not use buttermilk for feeding healthy children; if buttermilk does find application for such a purpose, it is only on the condition that flour and butter are added to it, i.e., in other words, buttermilk is brought closer to the food of Niemann-Klein Schmidt. Thus modified, buttermilk has become a very popular means for feeding small children, especially those with dystrophy. On the other hand, buttermilk has taken a very important place in the system of treatment for diarrhea (dyspepsia and intoxication). A number of authors prefer in this case to begin treatment not with protein milk, but with buttermilk, and only in later stages of the disease to switch to protein milk, based on the fact that in the first period of the disease it is important to limit weight loss, and buttermilk in this respect is a more suitable product than protein milk, since it contains twice as many salts. Subsequently, when the weight curve turns upward and it is necessary to increase the carbohydrate and fat content in the food, the transition is made to protein milk. But it is difficult to say that the difference in results is very significant. The simplest method of preparing buttermilk is as follows. To skimmed milk (centrifuged), whole milk is added. The mixture is boiled (or sterilized) and after cooling to 30°, a starter culture is introduced into it. When the acidity reaches 6° (n/10), the mixture is frozen. For this purpose, the vessel containing the mixture is placed in a water bath and heated until small clumps appear. Then it is heated with vigorous stirring to 70° and cooled. The composition of buttermilk without carbohydrate addition: proteins-3.4%, fats*-1.5%, sugar-4.0%, calories-492.9 per 1,000. To the obtained product, carbohydrates (sugar and flour) are added in the required amount, poured into bottles and sterilized. Preliminary boiling of the original product and bringing the acidity to the specified limits are necessary conditions, the observance of which guarantees the formation of small and soft clumps. The favorable effect of buttermilk in diarrhea is explained by the fact that in buttermilk there is a significant amount of protein and that all those therapeutic moments that are present in protein milk are present: a relatively high protein content, the fineness of casein, and the presence of lactic acid. All this together represents a combination of those factors that have the property of suppressing diarrhea. The essential difference between buttermilk and protein milk comes down to the fact that the former contains little fat and many salts compared to the latter. This difference determines the indications for the use of one or the other remedy.