Kleinschmidt-Niemann Mixture

Kleinschmidt-Niemann mixture (Kleinschmidt, Niemann) for small children is prepared from buttermilk, butter, flour, and sugar, which are taken in the following amounts: Flour 2–3.5%, butter 4%, sugar 3%. The addition of butter to buttermilk was proposed long before Kleinschmidt and Niemann by various authors. To Kleinschmidt belongs the idea of replacing milk (diluted) in the basic Czerny-Kleinschmidt food with buttermilk in those cases where, after a child has suffered an acute nutritional disorder, reparation occurs (frequent, somewhat liquid stools with an admixture of mucus) and the child needs a complete food, i.e., one containing fat alongside protein and carbohydrates, but cannot yet digest Czerny-Kleinschmidt food. In such cases (we are talking about small children, often underweight and located in institutions), protein milk is usually used. Kleinschmidt's proposal amounts to using the Kleinschmidt-Niemann mixture instead of protein milk in these cases.

Technique of application. For 2 days (after the cessation of the phenomena of the acute nutritional disorder), pure buttermilk is given, to which flour and butter are added: first 2% butter and 3% flour, and then 3.5% flour + 3.5% butter. Finally, sugar is added in an amount of 4–5%. Kleinschmidt proposes giving this type of food in cases where protein milk is usually used, because according to his observations, when it is prescribed, relapses and exacerbations of diarrhea are observed less frequently in the reparation period than with protein milk, and also because this food can be used for a long time, which cannot be said about protein milk. Kleinschmidt recognizes the advantage of this mixture over concentrated protein milk in that with the Kleinschmidt-Niemann mixture, there is no intermediate pathological stage manifesting itself in the formation of fatty-soap stools. The role of fat in this food comes down to increasing the secretion of intestinal juice, which contributes to the occurrence of putrefactive processes, which in turn suppresses fermentation and neutralizes acids. Niemann proposes giving the indicated mixture as a "corrective" food for liquid and frequent stools not caused by an acute or chronic nutritional disorder.

Method of food preparation according to Zhorno. For manufacturing, instead of buttermilk, skimmed (+1% fat in the form of cream) boiled milk is used. A starter culture is introduced into it and the acidity is brought to 5.5° (n/10), it is curdled in a water bath, the settled curd is thrown onto a sieve (or the whey is simply drained), sugar and the separately prepared dough of flour and butter are dissolved in the strongly heated whey, and the whole thing is brought to a boil once. When the mixture cools to 40°, the drained curd is introduced. Preparation of the dough: butter (clarified) is placed in a saucepan on the fire, melted, and brought to a boil; then flour (pre-roasted to a light brown color) is added to it, and the mixture is left on the fire with strong and rapid stirring for 1–2 minutes.

In recent years, the Kleinschmidt-Niemann mixture has often found application for feeding purposes (and not just as a therapeutic food). It is prescribed to children of the earliest age when they require supplementary feeding in addition to breast milk.