When is circumcision needed? Usually when the foreskin is very long and very tight, so that one must use force to push it back, and always if it produces local irritation.
How should you clean the genitals of a female child? Use good absorbent cotton and warm water, with a solution of boric acid if necessary, about two teaspoonfuls to a pint of warm water. This should be done once a day.
Is the hood of the clitoris ever too tight? Yes, and it needs to be loosened and kept so, or it will produce irritation and sometimes convulsions.
How should you wash the genitals of a male child? In infants and children, this should be attended to daily. The foreskin should be pushed back and the parts washed with absorbent cotton and water. Tight foreskin and unclean parts induce trouble and bad habits.
How should a newly-born baby's eyes be treated? They should be kept clean with a soft cloth and warm water. Do not use the same piece of cloth for both eyes.
Should redness and pus appear in the eye or eyes a few days after birth, what should be done? Use a piece of soft linen or absorbent cotton and wet it in a solution of boric acid or salt (one-half teaspoonful to one pint of water, warm) and wash out the eye or eyes, and if pus appears, use a stronger solution of boric acid (ten grains to eight teaspoonfuls of water.) If the lids stick together grease them with vaselin from a tube and rub in at night. If the sore eyes are severe send for a physician as it may be the beginning of ophthalmia neonatorum.
MOTHERS' REMEDIES.—1. Sore Eyes, Mothers' Milk for.—"There is nothing as good as mother's milk." This is very soothing and healing and seems to work better than medicines in small babies.
2. Sore Eyes. A Nurse from New York sends the following remedy for.—"Take a cup of water that has been boiled and cooled and dissolve in it one teaspoonful boracic acid powder. Bathe the eyes thoroughly and often." A nurse in New York state, gives this recipe, and says she has been a nurse for several years and has never had a case of sore eyes which did not heal with this treatment.
How is washing out the baby's mouth done? Use a swab made by twisting some absorbent cotton upon a toothpick. The folds between the gums and lips and cheeks may be gently and carefully cleaned twice a day unless the mouth is sore.
If a baby cries while nursing, what is the cause? It may have a sore mouth. What is thrush or sprue? Patches looking like little white threads or flakes appear inside the cheeks.
What is the cause of sore mouth? It is usually due to uncleanness and carelessness. It may come in delicate babies without any special reason. Babies who suck a "pacifier" or a rag with sugar in it are very apt to have the disease. Bottle-fed babies get it because of uncleanness of the nipple and bottle.
Should the baby continue to nurse? Yes, but the mother should thoroughly cleanse her nipple with a solution of boric acid after each nursing.
What should be done for it? It should be washed before and after every feeding with a solution of baking soda or boric acid of the strength of one even teaspoonful to twenty-four teaspoonfuls of water, or listerine, one teaspoonful to twenty-four teaspoonfuls of warm water, can be used. (This will be treated more fully later under diseases). A solution of borax (twenty grains to eight teaspoonfuls of water) can be applied every two hours with a camel's hair brush. Borax, sage and honey are good old remedies.
Should the scalp have special care at birth? It should then and afterward be kept clean to keep scurf from accumulating. It should be wet before the body is immersed in the bath. The hair should always be dried carefully; brush first with a soft towel and then with a fine, smooth hair-brush. Never use a comb on an infant's head.
Should any dressing be put on the scalp? No, for if the hair is washed and brushed, the oil from the scalp will keep it soft, glossy and healthful.
Explain more about thrush or sprue? It is an inflammation of the mouth where small particles looking like milk curds appear on the tongue, gums and cheek. This is really a more severe type of sore mouth, and is of a fungus origin.
Causes of sore mouth. Uncleanness, failing to keep the mouth—especially of bottle-fed infants—and the nipples and bottles, clean. Babies who are allowed to suck a "pacifier" or rag with sugar on it. Thrush is parasitic in origin and is always due to uncleanness in bottles, nipples and the mouth, and is commonly associated with the stomach trouble. Diarrhea frequently goes with it.
(See Mothers' Remedies for Sore Mouth, Canker, etc., in general department).
PHYSICIANS' TREATMENT for Thrush. Severe Sore Mouth. 1. Boric acid in a saturated solution (five teaspoonfuls to a pint of distilled water) is a specific for it.
Dr. Tuley, of Louisville, Ky., says:
2. Powdered Borax 8 teaspoonfulsStrained Honey 3 teaspoonfulsMix thoroughly.
3. Glycerin 1 ounceDistilled water 1 ounceBoric Acid 2 drams
4. Golden seal diluted one-half with boiled water makes an excellent mouth wash. Also a weak solution of alum. Use a piece of absorbent cotton or soft linen on your little finger or small round piece of wood and dip in solution and apply. Dr. Douglas, of Detroit, advises the use of a soft brush. This should be boiled after using.
5. In Mild Cases of Sore Mouth.—The medicines need not be as strong as for thrush. One teaspoonful of boric acid or baking soda to a pint of boiled water is usually sufficient; wash after each nursing or four or five times a day.
6. Powdered Borax 1 teaspoonfulPowdered Sugar 4 teaspoonfuls
Put a pinch on the tongue every two or three hours. The child's tongue will work it around. This avoids the pain from washing, etc.
7. Another Mouth' Wash.—
Borax 1/2 teaspoonfulTincture of Myrrh 1/2 teaspoonfulGlycerin 1 teaspoonfulBoiled water enough for one ounce.
Apply gently to the inside of the mouth several times a day in thrush or any form of sore mouth or gums. Use a camel's hair brush.
A diaper should never be used more than once without washing. It should be removed as soon as it is wet and placed in a covered pail in the bathroom, etc., and washed at the first opportunity. Pure white soap only should be used, and the diapers should be thoroughly rinsed and boiled. Dry them in the sun and air and never before the nursery fire. They should be warmed before they are again used. Unclean, soiled diapers frequently cause chafing.
Should a baby cry while passing urine? No; it may be too acid, alkaline, too little of it or too concentrated, or have sand in it. Examine the diapers.
How about bands for the baby? Straight pieces of flannel, twenty-two by five inches or wider. They may be knitted.
How long should they be worn? The snug bands, flannel or knitted should be worn, not tight, three months; then if one is worn it should be loose. It may prevent rupture and bowel trouble.
Do you approve of rubber diapers as an outside covering? No, because they confine the dampness cause more sweating of the parts and may thus cause chafing, etc.
How large should a diaper be? A diaper should be twice as long as wide. They may be different sizes, eighteen by thirty-six inches, twenty-two by forty-four, or twenty-seven by fifty-four.
Chafing is a very common trouble in infants. What causes chafing? A wet diaper left on too long; not drying the folds of the flesh properly; too much and too strong soap in the bath, or in the diapers when they are washed, or failure to wash the child clean.
Where are the places where baby is most likely to chafe? The buttocks, in the folds of the neck and in the groins.
How can you prevent chafing? Use very little soap; no strong soap; rinse the body carefully; dry thoroughly after rinsing; use clean diapers; use dusting powder in the folds of the flesh, especially in fat babies.
If the skin is very sensitive, what then? Do not use any soap, but use bran or salt baths.
How can you prepare a bran bath? Place one pint of wheat bran in coarse muslin or cheese-cloth bag and put this in the bath water. It should then be squeezed for five minutes until the water looks like porridge.
How is a salt bath prepared? One teaspoonful of common salt to each two gallons of water.
If the parts are chafed what should we do? Do not use any soap, and give only bran or salt baths or use pure olive oil and no water at all on the chafed parts. Dry the parts carefully with old, soft linen and dust them with a powder made of starch and talcum—equal part—with one-fourth as much boric acid, all carefully mixed together. Or use starch two parts and boric acid one part. Pure stearate of zinc powder is also good. Keep a little piece of soft linen between the folds of the flesh, so they will not be irritated by rubbing together.
[Illustration: Portait of Ardis]
MOTHERS' REMEDY.—1. Chafing in Infants, Mutton Tallow for.—"Five cents' worth of mutton tallow, melted. Apply at night." If there is a tendency to chafe during the day, use talcum powder, putting the mutton tallow on at night when the child will be quiet, giving it an opportunity to heal.
How shall I take care of the buttocks to prevent chafing? This is the most common place for chafing, as it is so frequently wet and soiled; hence all napkins should be renewed as soon as wet and soiled and the parts always kept perfectly clean.
What is prickly heat, and how caused? Fine, red pimples appear, caused by excessive sweating and from irritation of flannel underwear.
How should I treat it? Muslin or linen should be worn next to the skin. The entire body sponged frequently with vinegar and water (equal parts) and plenty of starch and boric acid powder used; starch, two parts; boric acid (one part) should be put on.
(See Mother's Remedies under "Prickly Heat," General Department.)
The chest should be well covered with soft flannel, the limbs protected, but not cramped, the abdomen supported by a band, not too tight. The clothing should be neither too tight nor too loose. No pins should be used, but all bands should be fastened to the body. The petticoats should be supported by shoulder straps.
How should a baby be held during dressing? It should lie on the lap until quite old enough to sit alone. Draw the clothes over the child's feet and do not slip them over the head.
Why use the band, and how long should it be worn? It protects the abdomen, but its main use is to support the abdominal walls in very young infants and thus prevents rupture. The snug flannel band should not be worn more than four months. Then in healthy infants a knitted band may be used and worn up to eighteen months. If the baby is thin and the abdominal organs are not protected by fat, they may be troubled with diarrhea and need protection. In such condition, the band may be worn until the third year.
Four to six dozen diapers (bird's-eye cotton), two to three shirts (wool), four flannel skirts, two white skirts (nainsook), two to four night dresses (outing flannel), six day dresses, two wrappers, six pairs of socks, four to six flannel bands, two flannel sacks, two shawls or afghans. The dresses to be worn after the first four or six weeks. Of course this can be less or more elaborate, according to the conditions and circumstances of the parents, etc.
What changes should be made in the clothing in summer? The thinnest gauze flannel undershirts should be worn, the outside garments to be changed for the changing weather. They should not be kept too hot in the middle of the day, while in the morning and evening extra wraps should be used.
Should older children go with bare legs? There is no objection, if they are strong and well, to doing this in warm weather.
What kind of underwear should be worn in cold weather? Next to the heaviest is thick enough.
Do children require heavy flannels? Not as a rule, as they usually live in the nursery and they sweat readily while playing. When they go out-of-doors, coats and leggings render thick flannels unnecessary.
Are many children too thinly clad in the house? Very few. The usual mistake is excessive clothing and too warm rooms. These cause them to take cold so easily.
At night baby may have a warm sponge bath, a fresh band, shirt and skirt put on. In the winter he should sleep in a flannel nightdress and this can be made with a drawing string or button on the bottom so that he cannot expose his feet. In the summer he can wear a cotton night-dress and after the third month the skirt may be left off in very warm weather. By the time baby has entered his second month he may wear simple little "Bishop" dresses instead of his plain slips. At the end of the third month, the flannel band may be discarded, usually, and a ribbed knitted one used. The band should be of wool in the winter, and of silk and wool in the summer. It should be put over the child's feet when he is being dressed each morning, and be changed for a fresh one at night, if possible. If the baby is healthy he may begin going out in March, if the days are mild and there are no stormy cold winds. Begin by letting him stay out one-half hour during the warmest part of the day, then one hour, etc. When there is much melting snow he should not be taken out. In cold weather the baby's cap and cloak should be lined with flannel or lamb's wool. Woolen mittens should cover his hands. A veil is not necessary.
Cap for Baby's Ears.—If baby's ears stand out from his head a considerable distance, it can be corrected best when he is young. A skeleton cap is made for this purpose. This can be bought or the mother can make one out of thin lawn or pieces of broad tape. It should fit snugly in order to do any good and be worn for some time.
Drooling.—If the baby drools much he is apt to wet any little bib he may wear and take cold by having damp clothing next to his throat and chest. Cut a piece of material now made (Linite, by Johnson & Johnson) in the shape of a bib, and bind with tape. This can be worn underneath the bib.
Short Clothes About the Fifth Month.—Short clothes should be prepared for the baby's wear at the beginning of the fifth month, and may consist of a shirt, knitted band with shoulder straps, flannel skirt made on a cotton waist, in summer or a flannel one for cold weather, and having a row of small flat buttons, on to which the white petticoat may be buttoned; a diaper, and a simple white dress. For summer, white cotton stockings should always be worn, woolen ones in the winter; and they should be long enough so that they may be pinned to the diaper. Moccasins or soft kid shoes should be the first kind worn. At night a baby (in short clothes) should sleep in a shirt, band, diaper and a night-dress of cotton in summer, and flannel in winter. The change to short dresses should not be made in very cold weather; and if the baby is born at such a time as to make it necessary, he may be put into short clothes as early as the end of his third or fourth month, rather than to wait until later and make the change in mid-winter.
Clothing in Summer.—Even in summer, the baby should have clothing which contains some wool. A mixture of silk and wool or cotton and wool may be used for the shirt, band and skirt. The band should never be left off; the shirt may be left off in the hottest weather and the long ribbed band with shoulder-straps may take its place, but the abdomen must be covered by means of the band. The nightdress should now be of cotton and the skirt left off at night, but the band and the thin skirt should be worn. Long, white cotton stockings reaching to the napkin should be worn all summer, and not short socks.
The head should be kept cool, therefore do not use a sunbonnet which shuts out all of the air. Muslin caps and light pique hats provide enough shade, if the baby-carriage has a parasol.
Creeping aprons can be used for babies. They are made of fine gingham and may be put over the dress or worn without one in very warm weather. Make them so as to button all the way down the back, and they sometimes have an elastic or draw-string run into the hem at the bottom of the apron so that the white skirts may be kept clean.
For early fall, two or three little jackets of light flannel or cashmere can be made; and the baby can wear one of these either over or under his white dress in the morning or evening when it is cool. The baby should be in the house by six o'clock unless the weather is exceptionally warm. In the fall, if he has been accustomed to having his nap on the piazza, in his carriage, a screen should-be placed around the carriage to protect him from any possible draught. After the first of October, in chilly days, he should have his nap in the house.
Winter.—A year-old baby in winter should wear a medium weight wool shirt, knit band with shoulder-straps, a flannel skirt on a flannel waist, white skirt buttoned on to the waist of the flannel skirt, woolen stockings pinned to the diaper, laced shoes, a white dress of some cotton material and for very cold days, a little flannel, or cashmere sack. At night should be worn a band, shirt, diaper and flannel night-dress long enough to keep his feet warm. For an outing in the winter he should have on a light, but warmly lined coat; a wadded lamb's wool lining is best, but it is expensive, and flannel may be used. His bonnet should be lined with flannel; and leggings and mittens should be of wool.
First Half of Second Year.—A baby of this age may wear a thin gauze shirt with short sleeves, but he should wear under it the ribbed silk and wool band and also his flannel petticoat during the summer. Summer complaint is often kept off by such clothing.
Second Half of Second Year.—A baby of this age is too young to walk in the streets in the winter, and his feet cannot be protected from the damp and cold sidewalks by the usual roomy shoes. When in the go-cart instead of his carriage, his legs should be well covered, so that dampness and wind will not chill and give him a cold. A large bag having a draw-string at the top is an excellent thing to use for the lower part of baby's body while in the go-cart, and the strings should be drawn up and tied under his arms. This bag may be made of any material (warm) from eiderdown, cloth, flannel to felting; or it may simply be made of an old crib blanket and a small carriage robe placed over it. Baby's ears should be covered at this age on very cold days, when out. The baby girl should wear a lined bonnet, well covering her eyes. Tam O'Shanter caps of angora wool can be made and pulled down over the eyes for both girls and boys alike; or a soft felt hat with rosettes of ribbon lined with flannel sewed onto the elastic can be made for the boy to protect the head and ears.
By the time baby is two years old, diapers should be given up and little drawers used instead. It may be frequently necessary to use diapers at night for several months longer, although if the baby be taken up at ten or eleven o'clock p. m. he will frequently go all night without urinating.
First Half of Third Year.—Children of this age should be put into night-drawers, cotton ones in summer and flannel ones either with or without feet, in winter. Tiny overalls or "rompers" are now used a good deal for both boys and girls while at play.
Second Half of Third Year.—Now he can walk in the street for a little while each day, even in winter, having his legs protected by warm leggings and with small rubbers for his shoes when the walks are at all damp. Woolen leggings should be used.
Children should not be allowed to race about in their night-drawers and bare feet. They should also have little wrappers and bedroom slippers.
What About the Nursery? The furnishings should be very simple. No unnecessary hangings or upholstered furniture. A large room, well ventilated and one in which the sun shines at some part of the day. The shades should be dark, but no extra hangings or curtains. Nothing should be allowed about the baby's crib but what can be washed. The air should be kept pure. There should be no plumbing, no drying of napkins or clothes, no cooking of food, and no gas burning at night. A small wax candle will do for all usual purposes.
What kind of heat is best? An open grate fire is best; next, heat from a Franklin stove. Steam heat is bad in a nursery. Never use a gas stove unless for a few minutes during the morning bath.
What should the temperature be during the day? From 66 to 68 degrees with the thermometer hung three feet above the floor. It should never be allowed above 70 F. At night, not below 65 F. during the first three months. After that it may go to 55 F., and after the first year it may go to 50 and even to 45 F.
Does the fireplace furnish enough ventilation? No, the principal ventilation must be from the windows.
How soon can you leave the windows open at night? Usually after the third month, except when the outside temperature is below the freezing point. How often should the nursery be aired? At least twice a day, after the baby has had his bath in the morning and also before putting him to bed for the night. This ventilation should be done thoroughly and the baby should be moved to another room. In the meantime, any time the child is out of the room it should be aired.
How can you ventilate the room at night? During the winter, while the baby is young, the sleeping room may be ventilated at night by opening a window in an adjoining room; or if the weather is not very severe, a window board may be used, or a frame on which has been tacked heavy muslin; this may be from one to two feet high and put into the window like an ordinary mosquito screen. In summer, a screen around baby's crib will furnish all needed protection from the open windows.
How does a room that is kept too warm affect the baby? He becomes pale, loses his appetite, has some indigestion, gains no weight, perspires very much and takes cold easily.
How early in baby's life may airing indoors be commenced, and how long continued? When the baby is one month old. For fifteen minutes at a time at first and may be lengthened ten to fifteen minutes daily. This airing may be continued in all kinds of weather.
Will the baby take cold? Not if the period is at first short and the baby becomes accustomed to it gradually. It is a cold preventive.
How should such an airing be given? The baby should be dressed with bonnet and tight coat and placed in a crib or carriage which should stand a few feet from the window; all the windows should be thrown open for baby's airing. Doors should be closed to prevent draughts.
How soon can baby be taken out of doors? In summer when one week old, with eyes thoroughly shaded. In spring and fall usually in about one month; in winter, when about three months old, on pleasant days, and kept in the sun and out of the wind.
What time of day is best? A baby may go out almost any time in the early summer and early autumn between 6 A. M. and 7 P. M. In winter and early spring a young child only between ten or eleven and three.
Can this be done in all kinds of weather? When the winds are sharp and the ground covered with melting snow, and when it is very cold, the baby should not go out. If the thermometer is below 32 degrees F., a child under four month's should not go out. If below 20 degrees F., a baby under eight month's should not go out.
What care should be taken? The wind should never blow in the baby's face, its feet and legs should be properly covered and warm and the sun should never be allowed to shine directly upon its eyes either sleeping or waking.
Does this outing do the baby any good? The fresh air renews and purifies the blood, and this is just as necessary for its health and growth as proper food.
How does it show in the baby? The appetite is good, also the digestion.The child sleeps better and all signs of health are seen.
Is it better for the baby to be carried by the nurse in this airing? No, for it can be made more comfortable in its carriage and as well protected from exposure.
Is there any objection to a baby sleeping out of doors in the daytime? No, it needs only to be kept warm and out of draughts. A covered inclosed porch is a good place.
What can be done for a child that takes cold easily? The room should be kept cool when it sleeps, the clothing should be light so that he will not perspire so freely. Every morning the chest and back should be sponged with cold water, 50 to 60 degrees F.
How should such a sponge bath be given? The child should stand in a tub containing a little warm water, and a large bath sponge filled with cold water should be squeezed over the body two or three times. Follow this with vigorous rubbing with a towel until the skin shows quite red. This may be given at least at three years old. For infants the temperature should be 65 to 70 degrees F.
Why is it necessary to weigh the baby regularly? To be able to tell how it is doing. This is especially necessary during the first year.
How frequently should this be done? During the first six months every week, and during the last six months at least once in two weeks; once a month during the second year.
How rapidly should the baby' gain weight during the first year? During the first week it loses a few ounces, after this it shows a gain of four to eight ounces a week up to the sixth month, then two to four ounces a week, up to the twelfth month.
Do bottle-fed infants gain so rapidly? Very seldom during the first month, but after that with favorable air and circumstances, the gain is quite regular, and they may gain faster during the latter part of the first year, because the nursing baby loses weight at weaning time.
Why do they not gain so rapidly at first? Because it takes a few weeks for the stomach to become accustomed to cow's milk and until this is accomplished it is necessary that the milk be made very weak or indigestion will result.
What is a baby's average weight at birth? Seven to seven and one-half pounds.
How much should it be at different months at this average birth? At three months it should be twelve to thirteen pounds; at six months fifteen to sixteen pounds; at nine months seventeen to eighteen pounds; at one year twenty to twenty-two pounds. A healthy baby will usually double its weight at five months and at twelve months it will nearly triple its weight.
Should a healthy baby gain steadily in weight during the first year? He usually does, but not regularly in every week during the year. There are periods when most infants do not gain any weight. This is most often seen from the seventh to the tenth month and frequently occurs when the child is teething and sometimes in the very hot weather.
Is gaining regularly in weight a sure sign that the child is thriving normally? Not always, some infants' foods produce weight, but not strength nor development in other respects.
Can the regular gaining in weight guide us as much in the second year? The gain after the first year is not so continuous; interruptions occur during change of seasons, sometimes without any apparent cause.
How soon should a child hold its head up? During the fourth, and sometimes in the third month, as a rule. If the body is supported the head can be held erect.
How early does a baby notice things? During the second month he shows pleasure by smiling and will turn his head in the direction of a sound. They should be kept quiet, or their sleep will be broken.
What will it do at three months? It will recognize its nurse or mother, and will smile and "coo" when she approaches, and now for the first time the tear glands become active and the baby cries with tears. At this age when taken out he should lie out straight in a heavy folded blanket, or hair pillow, having a small thin pillow under his head; a hot water bag should be near his feet; a light woolen blanket or afghan should be put into the carriage and the baby placed upon it, then it should be carefully wrapped around him and the outer carriage robe tucked in. These wraps should be modified according to the weather. Babies should not perspire much for they will take cold readily; so the covering should not be too heavy.
When does the baby laugh aloud? From the third to the fifth month.
When does it first notice toys, etc.? From the fifth to the seventh month. At four months he is able to hold his head without support. He begins to use his hands better. He will often grasp an attractive object; he will throw it on the floor and expect it to be picked up for him. And also frequently shows signs of fear at the end of the fourth month, and strangers will scare him. He can now be played with for a little time every day, but never before bedtime. The best time is after the morning nap. Do not toss him about, but be gentle with him or you will make him nervous and sleepless at night.
What is baby's condition at the fifth month? He is now a bright lively fellow, and may sit in a half upright position in his carriage or in his chair for a short time each day. When in his chair he should be tied in, a soft pad or pillow should be at his back to support him. He now enjoys exercise on a bed or in a large clothes basket, and may even have one toy at a time to play with. Do not shake rattles at him. It tires him. His naps now grow shorter gradually, but he should take two daily; a long one of two or three hours in the morning and about one hour in the afternoon. He should not sleep late in the afternoon, or he will not sleep as well at night. He now "drools." This is a sign of teeth coming, and baby will bite his fingers and put everything he can hold in his mouth. He may form the sucking habit now, and if he does, put a small toy in his hand, or dip his thumb in a solution of quinine or aloes. The habit of thumb sucking is an ugly one. Another way to stop it is to bind a piece of cardboard on the arm and long enough to reach a little above or below the elbow. Then the arm cannot be bent.
Should the baby use an ivory or rubber ring to bite on when teething? A special cracker is now made in the form of a ring; it is quite hard and composed mostly of malt sugar and is intended for teething babies to bite on.
MOTHERS' REMEDIES.-1. Teething, What One Quebec Mother did for.—"Rub paregoric on the gums. This always eased my children."
2. Teething, Novel Canadian Method to Aid in.—"Put a thimble on your finger and when holding the baby rub his gums gently with it, and let him chew on it. This cuts the gums and starts bleeding when the baby doesn't think of it."
How early should a baby be able to sit and stand alone? At seven to eight months he is usually able to sit erect and support his body. He first attempts to bear the weight upon his feet at nine to ten months, and at eleven to twelve months babies can stand without assistance.
When should a child walk without help? At twelve to thirteen months he attempts to walk. At fifteen to sixteen months the average child is able to run alone.
What conditions postpone this? Premature birth, a delicate constitution, or prolonged illness and especially chronic or digestive disturbances. Rickets is a common sign of late sitting, standing or walking.
Should you urge a child to walk? No; his muscles and bones may not be ready. He will walk soon enough if able.
How early does a child begin to talk? Generally a child can say papa and mamma at one year. The end of the second year the average child is able to put words together in short sentences.
If a child does not attempt to talk in two years, what should be suspected? Child may be a deaf-mute or mentally deficient. It is sometimes seen in children who are very backward.
Baby will be sensitive to light, even the first day. Do not allow the sun to shine in his eyes, or gas or electric light if that must be used. The baby's skin may change to yellow for a few days, but this soon passes away and frequently there is scaling. The fine soft hair usually comes out and is replaced later by a second growth. The open spot on the head should not be touched. When the head is out of shape or is swollen, this need not cause worry for it will soon disappear. Mold it a little. Do not allow the baby to lie in one position, as the soft skull may become flattened or all the hair rubbed off in one place. The baby sleeps about nine-tenths of the time, but he should be wakened regularly for his food and kept awake while taking it. This will soon become a regular habit to him, and he will wake of his own accord in a short time. Do not allow the baby to fall asleep nursing at the breast or while taking food in his bottle. He will not get enough nourishment and will want to nurse too often. Also if he is bottle-fed the milk is apt to grow cold and cause colic. He should be taught to nurse slowly and if he tries to nurse too fast the breast or nipple should be taken away for a minute, and then given again. The baby should nurse from fifteen to twenty minutes. A certain amount of crying is necessary for a baby if he is to be strong and healthy. It exercises his lungs. "Soothing syrup" should never be given to quiet him.
The cry of pain is strong, sharp, but not continuous, often accompanied by contractions of the features and drawing up of the legs. The cry of hunger is a continuous, fretful sound, after feeding or sometime before the next feeding. The cry of temper is loud and strong, accompanied by kicking or stiffening of the body, and, this should never be given away to from the first. The cry of a sick child is feeble and whining. Baby should not be rocked to sleep, nor carried about the room.
Baby's First Meal.—He should be placed to the breast as soon as the mother can have him. He will not get much milk for the first few days, but he should be given the breast four or five times daily. He needs what is then secreted and it is also good for the mother to try to nurse as soon as possible. The baby may be given a few teaspoonfuls of boiled water between nursing, but no teas. At the third day the milk is usually established, and the baby should nurse regularly every two hours up to 10 p. m., and twice at night. He should not sleep in his mother's bed, but have his own crib and be taken to her at nursing time. There is danger of baby being smothered sleeping with its mother, and it will not sleep so well. As a rule it is best to wash baby's mouth out before nursing, and the mother's nipple should also be wiped off with a little boric acid solution.
Baby's Bed.—As before stated, baby should sleep in his own crib, an iron or brass crib without rockers is best. A screen or plain white curtain of some wash material may be used to protect him against draughts. If this cannot be had, he may sleep while very young in a large clothes basket placed on two chairs. The crib should have a good woven wire mattress and a pair of heavy airing blankets should be placed on top of the crib, folded so as to fit the mattress; a square of rubber or any waterproof material should come next, then a cotton sheet, a quilted pad, a second sheet, a pair of wool crib blankets and a light counterpane. This should be removed at night and a comfortable afghan be used in its place. The pillow should be of hair, never of feathers or down, about one inch thick. The bed clothes should be aired thoroughly and the heavy airing blanket be washed occasionally and thoroughly dried and aired before it is again used. The blanket can hang on a line out of doors on a bright sunny day for an hour or two; in this way the blanket will be kept cleaner and will last comfortably until baby is three years old. The baby should never be put in a cold bed; warm the sheets before the fire just before putting baby in his bed (or crib) or place a hot water bag between them until they are warm. Now (second month) the baby is old enough to use his chair, not to soil his napkin. Place a small chamber on the mother's lap and hold the child on it, supporting his head and back. Do this exactly the same hours every day, morning and afternoon, directly after a meal. This training should be continued, as the position alone often goes a great way in helping to over-come constipation or any tendency to irregularity of the bowels that may exist. They cannot be taught not to wet the napkin until they are some months older.
The baby needs water as much as any adult person. Boil a fresh supply daily and cool and keep it in a covered dish or bottle. A little,—four to eight teaspoonfuls,—should be offered to the baby between each meal. It can be given from a spoon, a medicine dropper, or taken from a nursing bottle, and either hot or cold. This aids in overcoming constipation and teaches a breast-fed baby to use a nursing bottle, which will be of much benefit should sudden weaning be necessary.
During the second month his meals should be given every two and one-half hours during the day, having eight meals in twenty-four hours of three to four ounces at each meal. At night he should be fed at ten and two.
Meals for the Third Month.—Baby should be regularly nursed or fed every three hours up to ten p. m. Then have one meal at two or three a. m., and nothing more until seven a. m. If bottle fed he should be given three and one-half to four ounces at each feeding.
Fourth Month.—If the mother is nursing her baby, it is a good plan now to teach him how to use the bottle. Some doctors advise one bottle feeding each day from the start, for, should the mother's milk suddenly fail, or should she be obliged to stop nursing for any reason, there will be no struggle, which would be very hard for the baby if it happened in hot weather. Also the gradual accustoming of the digestive organs to the cow's milk before weaning must be commenced and does away in some degree, at least, with the danger from indigestion from the cow's milk given regularly.
Fifth Month.—Night feeding should now be discontinued; he should be taught to sleep from ten p. m. to seven a. m. There may be a few nights of crying and a struggle when the night feeding is first stopped, but he will soon learn to sleep without waking for his meal. He should be fed every three hours until ten p. m., and if bottle fed he should be given five to six and one-half ounces at each meal, making six meals in twenty-four hours.
Sixth Month.—The baby sleeps about two-thirds of the time. He shows signs of increasing intelligence. The baby should now accustom itself to taking either condensed milk or only the best prepared foods once or twice daily. The mother may become ill or unable to nurse for some reason, or wish to take a journey, etc., and baby is then prepared for emergencies.
When the baby is seven months old he will need more exercise than a clothes basket will afford. An exercise pen should be made.
Teeth.—As soon as the teeth come they should be kept clean, otherwise they will decay, milk is likely to remain in the mouth, turn sour and gradually destroy the enamel of the teeth.
With a soft linen cloth or a piece of absorbent cotton dipped in a solution of boric acid wash out the mouth and teeth, twice a day at least, carefully. A soft brush may be used later when baby has eight or ten teeth, and a little finely prepared chalk may be put on the brush, if there are any specks on the teeth. The baby should have three meals in twenty-four hours of six or seven ounces at each meal, if bottle-fed.
Eighth Month.—Baby should be allowed to creep on the floor a little or in his pen. It is good exercise and it will benefit him, but he should not be urged to do it. Many mothers give baby potato, etc., at this period; this is bad, as potato is hard to digest on account of having so much starch. Bread and cakes are also prohibited; convulsions are often caused by such food. Milk gruel and broths are enough for the baby and he will thrive using them. Baby should feed every three hours up to ten p. m., six and one-half to seven and one-half ounces at each meal.
Mosquito Bites.—If baby is bitten by mosquitoes wash the spot off with a little camphor water, soda water, or a wet compress of witch-hazel should be kept on the bite or boracic acid or soda solution. Keep the baby from scratching the part by fixing his hands; scratching will further poison the part.
Flies.—They often carry germs of disease on their legs and wings, and they frequently light on baby's mouth or on the nipple of the nursing bottle. Diseases can be contracted in this way. The windows should be screened. Everything that the fly has touched should be washed with some light antiseptic solution.
Ninth Month.—His long morning nap should be encouraged and he should sleep in the early afternoon. If the baby is heavy his little moccasin or kid shoes will not now support his ankles and he should have a shoe with a piece of stiffening at the side. The shoe should have no heels; laced shoes fit better and should be preferred. The baby (bottle-fed) can take seven to eight ounces of the proper food every three hours until ten p. m.
Tenth Month.—He can now take a little beef juice, beginning with one teaspoonful once a day and soon twice a day; then increase to two teaspoonfuls at a time and keep on until he is taking eight teaspoonfuls daily.
This should be given between his regular meals. Some babies cannot take beef juice; orange juice may then be tried, strained through cheesecloth or fine muslin and be given at first in doses of one teaspoonful and increased until baby gets the juice of one-half an orange.
If the mother is nursing baby and he has been given one bottle of milk daily, as advised for a four-months-old babe, he can now have two bottle feedings daily. Every healthy baby should be weaned when one year old, and it is better to do it gradually in this way. The baby's food should now be given him every three and one-half hours up to ten p. m., thus making five meals in twenty-four hours of seven to eight ounces at each meal.
Eleventh Month.—Baby can now have added to his diet another cereal like farina well cooked,—twice as long as the directions advise and it should be half solid when finished. Begin with one teaspoonful and then try two. This should be given in addition to his beef juice or orange juice. It should come between his regular meals, which should now be given at four-hour intervals. He should take eight or nine ounces to a meal.
Twelfth Month.—Baby should go to bed at six p. m., and take long morning nap. He should have five meals a day of such food as directed later.
What is the best food for an infant? Mothers' milk.
What is the composition of mothers' milk? About thirteen parts solids and eighty-seven parts water.
Name the solids? Fat, sugar, proteids and salts.
What is sugar? Milk sugar or "lactose."
What are the proteids? The curd of the milk, which is very similar to the white of an egg, and is the muscle making element in the milk.
Is it necessary to have all these elements? Yes.
What benefit is the fat? It is needed for the growth of the bones, nerves, fat of the body and also for producing heat.
Give the use of sugar? It is needed to produce heat and make fat in the body.
Use of the proteids? They are needed for the growth of the cells of the body, such as those of the blood, the various organs of the muscles.
What do the salts do? Help in the growth of bone.
What is the use of water? Water keeps the food minutely subdivided or in solution, so that the infant's delicate organs can digest it. It also enables the body to get rid of the waste material.
Should all mothers make an attempt at nursing their babies? Yes, as a rule.
What are the most important conditions that may prevent nursing? Tuberculosis now or in the past or, in fact, any other serious chronic diseases; very delicate health herself. Some acute disease like typhoid fever or cancer.
How soon after labor should the baby be put to the breast? As soon as the mother is able to have it.
What is the food called that it then obtains? Colostrum.
What does this do? It aids in cleaning the baby's system.
Should the mother nurse the baby inclining or lying? Yes.
Does nursing drain the mother? Not if she is reasonably well. It is a natural process.
If the mother cannot nurse immediately after labor, what should you feed baby? The baby will not starve in a few days. Give it warm water regularly every few hours, or a little cream and warm water.
Are there any impediments to nursing? Sometimes the baby is tongue-tied.
Is the baby ever too weak to nurse? Yes.
What should be done in that case? Draw the milk from the breast and feed it through a free flowing nursing bottle. Such babies are generally born prematurely.
Are the mother's nipples ever at fault? Yes, they are; poorly developed, retracted, that the baby's tongue cannot surround it to draw upon it.
What can be done for them? They should be drawn out, and sometimes a breast pump is needed for this.
Should the nipples be treated after nursing? They should be dried and clean clothing put against them. Some recommend washing them with a mild solution of boric acid.
Are they ever so tender that nursing is painful? Yes.
What can be done for this? The nipples should be drawn out before confinement; if neglected use the following: Compound tincture of benzoin one-half ounce. After each nursing wash them clean with warm water or water and a little alcohol and after drying them, put on the tincture of benzoin with a camel's hair brush. It will not hurt the baby.
What can be done with cracked nipples? Apply benzoin as before directed, and use a glass or rubber nipple shield until it gets well.
How can caked breasts be prevented? The breasts should be kept emptied and well protected, both while nursing and during the intervals. Empty with a breast pump if necessary.
If mother's clothes are wet by the excess milk, what can she do? Use a breast-pump and drink and eat less fluid; eat more solid.
Should a baby nurse at both breasts? It is better.
If the breast contains pus, what can be done? Nurse at the other breast, but if both breasts are affected it must stop breast nursing.
Should an infant nurse from a mother who is taking medicine? Not as a rule.
When will the mother be able to nurse again? It is hard to tell. If the child is six months old the child should be weaned if the mother is seriously ill, and children with delicate stomachs should always be weaned, when the mother is sick.
If the mother has not enough nurse, what can be done?—Nurse partly and feed it the rest.
Can the milk secretion be increased? Yes, by regulating the mother's diet. She should drink freely of good cow's milk and have an occasional bowl of gruel, soup, etc.
How long can you wait to see if the mother can have milk? It is well to wait several days, nurse all there is and supply the deficiency by bottle feeding.
How often should the baby nurse at first, and how long? Every four or five hours for the first few days—usually nurses fifteen to twenty minutes; one night nursing.
When is there a full secretion of milk? Usually on the third day.
How often should the baby be nursed afterward? After the third day every two hours and twice at night.
How often during the rest of the year? For two to three months every two to two and one-half hours during the day, two times at night; three to five months about every three hours up to ten p. m.; and one time at night; five to twelve months every three to three and one-half or four hours and not at night.
Is it necessary as a rule to give additional food the first few days? No; give plenty of water.
What important things should be attended to in nursing? First, a regular time night and day. Second, nipples should be kept clean.
What should a nursing mother eat? Her diet should be simple and plentiful, and lots of fluids; she should have three regular meals a day, and gruel, cocoa, or milk at bedtime and sometimes between meals. She can use cereals, most soups, most vegetables; avoid sour tart fruits, salads, pastry, and desserts. She may eat egg, meats once or twice daily, but in most cases but once. Tea and coffee if taken should be very weak, and ordinarily no wine or beer.
Are fruits eaten by the mother likely to injure baby? Sour fruits do in some cases, but sweet fruits and most fruits that are cooked do not, and are useful for the bowels.
Should the mother take special care of herself? Yes, she should lead a simple, natural, happy life, with outdoor exercise, as soon as possible after the confinement. She should make her bowels move daily by food and habit; she should not worry, should sleep plenty and should nap for an hour during the middle of the day.
Will the milk of the mother be affected by nervousness? Yes, more so than by her diet; worry, anxiety, fatigue, loss of sleep, household duties, society functions, have an injurious effect upon the child. Mother's grief, excitement, anger, passion, act upon the child through the milk.
How does the return of the menstruation affect the milk? The quantity is lessened, the infant is not satisfied. Sometimes the quality is affected and the child may suffer from restlessness, colic, and acute indigestion.
Should regular menstruation prohibit nursing? Not always; as a rule both functions do not go together. If the child thrives, it can keep on nursing, although it might be well to feed the infant, at least partly, during the period.
How can you determine that the baby is well nourished? Good color, sleep for two hours after nursing, is quiet, good-natured and comfortable when awake; has normal bowel movements, three stools daily and gains gradually in weight.
How can you tell when a baby is poorly nourished? It neither gains nor loses weight; it is listless, tired, indifferent, cross, fretful, irritable and sleeps poorly. It looks pale, anemic, and it becomes soft and flabby. If the milk is scanty, it nurses long; at other times it tries the breast and turns away seemingly disgusted.
What should be done? This depends upon the conditions; should the child gain nothing for three or four weeks or lose weight, immediate weaning may be necessary; at least other food must be given in addition to the breast food. Feeding may be alternated with the breast nursing.
How do the symptoms show when the mother's milk disagrees? The child, is in constant discomfort; it sleeps little, is restless, cries much, gulps up gas, passes it by the bowels, or it accumulates in the bowels causing colic. There may be vomiting, but more often bowel trouble. The bowels may be constipated but usually there is diarrhea—frequent, loose, green, with mucus and gas.
What should you do in such a case? If the child does not gain or loses weight and there is little chance of improvement in the mother's milk, the child should be weaned immediately. If the child gains in weight, try a little longer to improve the mother's milk.
Why do some babies nurse so often? The milk does not satisfy.
When the baby has thrush, should the mother take special care of the breasts? Yes, they should be cleaned after every nursing.
How much does the baby's stomach hold at birth? Six to seven teaspoonfuls.
Is vomiting a healthy sign in infants? Frequent vomiting is not natural; see if his bands are too tight; find out if he has been danced or handled after nursing.
When is it harmful? When it is frequent. If it comes up directly after a meal looking just as it was when taken, the child may be over-fed.
What can be done? Reduce the quantity, or do not let it nurse so long or so often. If vomiting takes place a half hour after feeding, in sour swelling masses, it may be getting food too rich in cream, and then the time between nursings should be lengthened; or dilute the breast milk by giving one to two teaspoonfuls of plain boiled water, barley water, five or ten minutes before nursing; the mother should eat less hearty food, especially of meat.
If baby has frequent colic, what is the cause? The milk has too much proteids.
What should be done? Eat less meat, keep quiet, and happy, do not worry, etc.
How many stools does a healthy baby have daily? About two.
What color? Yellow color and pasty consistence.
If a nursing baby has too many stools, what change should be made in the mother's diet? She should eat food that would cause costive bowels in her.
They are caused by the mother eating improper food. If the stools are very yellow, foul, greasy or ropy the mother is eating food that produces too much fat (cream) in her milk. If curds appear there is not enough fat, and too much of the proteids (skim milk). When the stools are very green with much mucus in them, the food should be reduced.
If a nursing baby is constipated, what can be done? More boiled water should be given between nursing. The mother should take exercise at least two hours each day out of doors; her bowels should move every day, even if she must take a laxative. She should take plenty of pure, rich milk, cocoa, oatmeal and cornmeal gruels, and some kind of tonic if she is weak. Tea and coffee should not be used. Ripe fruit (not tart), some green vegetables and a little meat can be eaten. Starchy foods should be avoided. Sometimes baby does not get enough nurse. Then she should be fed and given plenty of pure water between meals.
If a nursing baby has frequent colic attacks, what should be done? The food is probably too strong. The mother should eat food that will produce less fat (cream) in her milk. The baby can be nursed at longer periods for a time; or give an ounce of hot water just before nursing. The mother should take plenty of exercise, enough sleep and have a free movement of her bowels, so as to keep well and free from nervousness.
When and how should this be done? This may usually be begun at nine or ten months by substituting one feeding a day for one nursing. Later two feedings, etc., until weaning is gradually accomplished. Some advise one bottle feeding regularly each day much earlier, as before stated.
Give reasons for weaning earlier? Some serious illness of the mother, pregnancy, but the main reasons usually are that the child is not thriving.
When should the weaning be completed? Generally at one year, It may be advisable to wait longer in warm, damp weather.
Is there any danger in nursing longer? Yes, as the milk is scanty; the child may get rickets or anemia.
Is gradual weaning the best method? Yes.
Should a wet nurse be preferred to bottle feeding? Yes, if you are sure you can get a good and perfectly healthy wet nurse. Her habits, etc., must be unobjectionable—she should be chosen by a physician.
When should a "weaned" child use the bottle, and when the cup? If the weaning is done at the eighth or ninth month the bottle should be used; if weaning is done from the tenth to the eleventh month, the baby should be taught to drink or be fed with a spoon.
How can you overcome some of the difficulties of weaning? As before recommended, by feeding every nursing infant once a day or by giving water regularly from out a feeding bottle, as this accustoms the baby to the bottle. This is very good, for the mother is sometimes away at nursing time, for a few hours and the baby can be fed, and when weaning comes, it is much easier.
How soon should a child stop nursing from a bottle? If the child is well this should be begun at the end of the first year, and after it is fourteen months old, it should not have the bottle except at the night feeding.
What is the objection to longer bottle nursing? They become attached to the bottle and refuse solid food when it is proper to give it. They get the bottle habit; also, it is troublesome and unnecessary. Then they will not take milk in the future, when the bottle is finally taken from them; an exclusive milk diet for children of two to three years old often results in poor nutrition and anemia.
Give the process of training a child to give up the bottle? There is little trouble if it is begun at the right time; pour the milk in a small cup or glass and the child will drink little by little. Give only a small portion of the food in this way, at first, and the balance from the bottle. The child will in a few weeks time learn to drink out of the cup without difficulty. If the child is two or three years old, take the bottle away entirely and let the child get hungry, and give it only milk in the cup and nothing else. Some children may go for a day without food, but hunger will master them finally. As soon as he has learned to drink milk from his cup, cereals and other solid foods are gradually added to his dietary and the child has not only been taught to give up his bottle, but he has also a training which is often necessary.
Can you give a baby just weaned as strong cows' milk as one of the same age who has been fed upon cows' milk from birth? Not generally; it would be almost certain to cause indigestion. You must remember that the change in food is a great one, and the feeding should be begun with a weak milk and increased gradually in strength as the baby becomes accustomed to the cows' milk.
What are the proper proportions for an infant weaned at four or five months? About the same as that given to a healthy bottle-fed baby of two months, except the quantity should be larger. The food can be gradually increased, in most cases, so that by the end of two or three weeks the usual strength can be given.
What strength is given to a bottle-fed baby of two months? From the top of a quart bottle of pure milk, that has stood from three to six hours, skim carefully off the top six ounces and then pour off three ounces of milk and mix them with the top milk (first skimmed off) making nine ounces in all; add to this nine ounces twenty-four ounces of boiled water in which you should have dissolved four teaspoonfuls of granulated sugar, or six or seven teaspoonfuls of milk sugar; add a pinch of salt and a pinch of bicarbonate of soda, or else two ounces of lime water.
Give the proper proportion for a baby who is weaned at nine or ten months? About the same as for a bottle-fed baby of four or five months. The increase to be as above given.
What is the formula for a bottle-fed baby of four months? For a healthy baby, six ounces of top milk skimmed from the top of a quart bottle of milk, six ounces of milk, then poured off, twenty-four ounces of barley or oatmeal gruel, six teaspoonfuls of milk sugar or three of granulated sugar, a pinch of salt and a pinch of bicarbonate of soda or if lime-water is used instead take one ounce of lime-water to each twenty of the milk or gruel. He should have four ounces of this mixture every three hours up to ten p. m., and then one meal at about two a. m.; none until six or seven a. m.
Will a child lose weight when placed upon this diet? It will often do so for a week or more, but he will soon gain gradually and regularly.
Formula of food.—For the first month: skim off carefully the top six ounces from a quart bottle of pure milk, add to this twenty-four ounces of boiled water, in which water three teaspoonfuls of granulated or six teaspoonfuls of milk sugar have been dissolved, and then add a pinch of soda, or else one and one-half ounces of lime-water. Mix all these ingredients thoroughly, and then pour the correct quantity into each of ten clean nursing bottles. Tightly cork these bottles with clean cotton, and they can all be pasteurized or heated to a temperature of 155 degrees F. (Some say higher).
What strength is given to a bottle-fed baby of two months? From the top of a quart bottle of pure milk that has stood from three to six to eight hours, skim carefully off the top six ounces and then pour off three ounces of milk and mix them with the top milk (first skimmed off) making nine ounces in all; add to the nine ounces, twenty-four ounces of boiled water in which you should have dissolved four teaspoonfuls of granulated sugar, or six or seven teaspoonfuls of milk sugar; add a pinch of salt and a pinch of bicarbonate of soda, or two ounces of lime-water.
Formula for the third month.—(This is often used), Carefully skim off the top six ounces from a quart bottle of pure milk, then pour off six ounces of milk, twelve ounces in all, and now add twelve ounces of boiled water in which three teaspoonfuls of granulated or six of milk sugar have been dissolved, with a pinch of soda or else two ounces of lime-water; add then twelve ounces of barley or oatmeal gruel, divide into eight bottles, pasteurize, etc.; cool quickly and place where the temperature is 50 degrees F., until meal time, when one of the bottles should be warmed by placing it in warm water. Pour a little out in a spoon to test the warmth, etc.; when the milk is lukewarm remove the cotton cork and attach the rubber nipple. He should be fed regularly and equally every three hours up to ten p. m., then have one at two or three a. m., and nothing until seven a. m. He should get three and one-half to four ounces at each meal, so that much should be put in each bottle.
What is the formula for a bottle-fed baby of four months? For a healthy baby, six ounces of top milk skimmed from the top of a quart bottle of milk, six ounces of milk then poured off, twenty-four ounces of barley or oatmeal gruel, six teaspoonfuls of milk sugar or three of granulated sugar, a pinch of salt and a pinch of bicarbonate of soda; or if lime-water is used instead, take one ounce of lime-water to each twenty of the milk and gruel. He should have four or five ounces of this mixture every three hours up to 10 p. m., then one meal at about 2 a. m. None until 6 or 7 a. m.
Will a child lose weight when placed upon this diet? It will often do so for a week or more, but he will soon gain gradually and regularly.
Formula for the fifth month.—Skim off the top six ounces as before, then pour off nine ounces of milk and mix it with the top-milk, add twenty-four ounces of barley or oatmeal gruel, a pinch of salt, four teaspoonfuls of granulated or seven of milk sugar, a pinch of bicarbonate of soda and proceed as before. He should be fed every three hours during the day until 10 p. m. Give five to six and one-half ounces at each meal, making six meals in the whole twenty-four hours.
Formula for sixth month.—Six ounces of the top-milk skimmed off from a quart of pure milk, ten ounces of milk then poured off. Twenty-four ounces of barley or oatmeal gruel, in which has been thoroughly dissolved four teaspoonfuls of granulated or seven of milk sugar, a pinch of bicarbonate of soda, and a pinch of salt. Pasteurized as before, etc. Give baby from four to six ounces at each meal every three hours up to 9 or 10 p. m. If the day is exceedingly warm, pour out one or even two ounces from each bottle of the regular mixture and substitute boiled water for it. If the baby is inclined to vomit, it will be better during the hot weather to use less of the top milk, four, or five ounces instead of six or eight, and add so much more gruel. Barley gruel is better than oatmeal gruel unless baby is constipated. Again if the baby has delicate digestive organs, one meal each day during the very hot weather, can be made of mutton broth prepared as follows: Cut up one pound of neck of mutton, one pint of cold water and a pinch of salt; this is cooked very slowly for three hours until half a pint is left, adding a little water from time to time as it boils away; strain through muslin and allow to cool, and when cool take off all of the fat. Add this to an equal quantity of barley water and feed lukewarm to the baby from the nursing bottle. These measures may ward off summer complaint and assist in teething.
Formula for the seventh month.—From a quart of pure milk carefully skim off the top six ounces, pour off fifteen ounces of the milk and add twenty-one ounces of barley or oatmeal gruel to which has been added dissolved four teaspoonfuls of granulated or seven of milk sugar, a pinch of bicarbonate of soda. Give six or seven ounces at each meal and six meals in twenty-four hours.
Formula for the eighth month.—Skim six ounces of top-milk as before directed, pour off seventeen ounces of milk, add twenty-one ounces of barley or oatmeal gruel, four of granulated or seven teaspoonfuls of milk sugar, a pinch of salt and bicarbonate of soda. Give six and one-half to seven ounces every three hours up to 10 p. m.
Formula for the ninth month.—Use six ounces of top-milk skimmed off as before, twenty ounces of milk poured off, twenty-two ounces of either barley or oatmeal gruel, a pinch of bicarbonate of soda and salt added to the gruel, and five teaspoonfuls of granulated or eight of milk sugar dissolved in boiled water and put in the gruel. Give seven or eight ounces of this every three hours up to 10 p. m.