1. The two lower middle teeth,6 to 8 months.2. The four upper middle teeth,8 to 10 months.3. One on each side of two lower middle teeth,8 to 12 months.4. One on each side, above and below, back of above teeth (four in all),12 to 15 months.5. The next one on each side, above and below, back of those already in (four in all),18 to 24 months.6. The four back teeth on each side, above and below,24 to 30 months.
At 1 year a child should have6 teethAt 1-1-2 years a child should have12 teethAt 2 years a child should have16 teethAt 2-1-2 years a child should have20 teeth
They may not come in the above regular order even in well children. The upper front teeth may come first. If the child is sickly there may be marked irregularity in the order in which they appear. Twenty teeth comprise the first set.
The Permanent Teeth.—This set consists of thirty-two teeth. They begin about the sixth year and they are usually not complete until the twentieth year. They appear in the following order:
First molars6 yearsIncisors7 to 8 yearsBicuspids9 to 10 yearsCanines12 to 14 yearsSecond molars12 to 15 yearsThird molars17 to 25 years
Care of the Teeth.—The teeth should be given attention as soon as they appear. It is an excellent custom to wash the teeth and gums twice daily with a piece of clean absorbent cotton rolled round the finger of the mother and dipped in a saturated solution of boracic acid. This should be done up to the second year. After the second year a soft brush should be used and the teeth thoroughly cleaned morning and night with pure castile soap or a powder. The teeth of every child should be examined by a dentist every six months. All cavities should be filled with a soft filling. The milk teeth should not decay, but should fall out, or be forced out by the second set. A child should be taught to gargle early and a mouth wash should be used morning and night.
Dentition.—As a general rule the process of teething is accompanied by some symptoms. There may be fever, restlessness, and loss of appetite; though in many cases there are absolutely no symptoms. Some children seem to teethe hard, others easily. The same child may have some teeth without pain, and with others it may suffer severely. The condition of the child at the time, its age, and the season of the year undoubtedly have an influence. Children who are sickly and puny may have much difficulty while teething.
The degree of sickness varies quite considerably. There may only be, as stated above, slight fever, restlessness, with loss of appetite; or there may be, in addition to these symptoms, a pronounced fermentative diarrhea, which may lead to serious intestinal diseases; frequently there is a cough. This is more apt to be the case if the child is teething during the hot season.
Treatment.—When dentition affects the child's disposition it is a good plan to reduce the feeding in quantity and quality for the time being. If the child is bottle-fed,two ounces can be taken out of each bottle and one ounce of boiled water added. If the child is breast-fed, he should be given two ounces of warm, boiled water before each feeding, and the actual feeding time at the breast shortened.
Rubbing the gum over the erupting tooth with a clean cloth may aid in helping it through. If the child is very restless and has lost sleep, the cloth may be moistened with brandy and water. Lancing the gum, though it is seldom done now-a-days, is justified in a few cases. Teething is not the cause of actual disease as was once thought, but it must be remembered that a child whose vitality is reduced by fever, restlessness, loss of appetite, loss of sleep, and irregular bowels, is more susceptible to disease than when enjoying robust health.
Sometimes a child will have a fever for one or two weeks during a hard dentition. There is apt to be more or less intestinal indigestion and fermentation at this time and as a consequence actual intestinal disease may develop. To avoid such a possibility it is an excellent plan to give an occasional dose of castor oil to clean thoroughly the whole intestinal canal. This should be done irrespective of the condition of the bowel, because frequently a diarrhea is caused by retained fermenting products.
Mothers must not acquire the habit of attributing all symptoms to the teething process simply because the child is teething. It must be remembered that a child may get a disease, or an ailment, while teething, that has nothing to do with teething. If this is neglected, serious consequences may result. Many children have lost their lives by a mother's carelessness in this way. Be on the safe side, consult your doctor; let him assume the responsibility.
How to Weigh the Baby.—The test of weight is one of the most satisfactory we possess as an indication of physical progress and health. It is not an absolute test, but it may safely be relied upon. The fattest baby is not necessarily the healthiest. A gradual and a uniform increase is a satisfactory growth. At birth a baby weighs, on an average, from seven to eight pounds, though somebabies weighing less are equally healthy. The normal and customary gain is from four to six ounces every week after birth.
The baby should be weighed about the same time of the day each week, and before a meal.
The average weight of a male child at different ages is as follows:
Birth7-1/2 lbs.3 weeks8 lbs.1 month8-1/2 lbs.3 months12 lbs.4 months13-1/2 lbs.5 months15 lbs.6 months15-1/2 lbs.7 months17 lbs.9 months19 lbs.1 year21 lbs.1-1/2 years23 lbs.2 years26-1/2 lbs.3 years31-1/2 lbs.4 years35-1/2 lbs.5 years40 lbs.6 years45 lbs.7 years49 lbs.8 years54 lbs.9 years59 lbs.10 years65-1/2 lbs.
A female child weighs about one-fifteenth less than a male child, as a rule.
Table showing the average height of a male child, at different ages:
At birth20-1/2 in.6 months26 in.1 year29 in.2 years32-1/2 in.3 years35 in.4 years38 in.5 years41-1/2 in.6 years44 in.7 years46 in.8 years48 in.9 years50 in.10 years52 in.
The Rate of Growth of a Child.—A child grows most rapidly during its first year—six to seven inches; from fourth to sixteenth, about two inches annually; thence to twentieth, one inch. Commonly, a child at two and a half years has attained half of its ultimate adult stature. The diseases of youth always accelerate growth.
Pulse Rate in Children and Adults.—Normal Pulse,—of new born, 130 to 140, per minute; first year, 105 to 115; second year, 106 to 115; third year, 95 to 105; fifthto twelfth year, 80 to 90; thirteenth to twenty-first year, 75 to 80; twenty-first to sixtieth year, 70 to 75; in old age, 75 to 85.
Infant Records.—A record should be kept by the mother of every child which would embrace exact data as to weight, diet, size, development of mental power, teeth, ailments, sickness, pains, etc., with dates and any information which would aid in recalling exact conditions. Such records are of the utmost value in a number of ways. They help in giving suggestions as to diet, general health, and mental qualities of the child in question, and they aid in furnishing what physicians call "past history," which past history has a very valuable significance in estimating the character and importance of sickness during later years.
Such a record is also of importance in comparing a child's development with what is regarded as standard development, and also with the growth and development of other children in or out of the family.
If a child should thus be found to fall seriously below the standard and yet not appear actually sick, a very thorough and routine investigation should be instituted to discover if possible the cause. Some error might thus be detected which might seriously affect the child's future growth and well-being.
The date of the closing of the soft spot on the baby's head should be noted, and if it is still open, when it should be closed, it might mean that the child has a serious brain condition. The soft spot should close between the eighteenth and twenty-fourth months. The family physician should be notified if the soft spot is open later than the second year, as he may want to investigate the cause.
Should the child be unusually backward in walking, and when it does so should limp and feel pain in the knees, it should be examined for any symptom of hip joint disease, of which these are the earliest signs.
If the child complains of so-called "growing pains," keep in mind that these are rheumatic and may need attention. There are no such pains as actual "growing pains," that is, pains caused by the child growing.
Overfeeding Baby—Intervals of Feeding—How Long Should a Baby Stay at the Breast—Vomiting Between Feedings—Regularity of Feeding—Why is Regularity of Feeding Important—"A Baby Never Vomits"—What is the Significance of So-called Vomiting After Feedings—Mothers Milk That is Unfit for Baby—Fresh Air for Baby—Air Baths for Baby.
Overfeeding Baby—Intervals of Feeding—How Long Should a Baby Stay at the Breast—Vomiting Between Feedings—Regularity of Feeding—Why is Regularity of Feeding Important—"A Baby Never Vomits"—What is the Significance of So-called Vomiting After Feedings—Mothers Milk That is Unfit for Baby—Fresh Air for Baby—Air Baths for Baby.
Overfeeding Baby.—Every nursing mother should have printed and hung up, so she may read it every time she nurses her child, the following motto: "DON'T OVERFEED BABY." Few, if any, babies die of willful starvation: many die as a result of overfeeding. Mistaken kindness and lack of judgment are responsible for one-half of all the troubles of infancy. Babies require much less than is constantly given them. The stomach of a baby at birth will not hold more than one ounce, which is two tablespoonfuls; and at two months it will not hold more than three tablespoonfuls; and at six months, six or seven tablespoonfuls. Read these quantities once again carefully and try to realize the significance of the smallness of them. A baby is just like a little pig; it will go on feeding as long as it is allowed. The baby does not reason; it has no judgment; it depends upon its mother's judgment. If the mother is false to the trust the baby overloads its stomach. A swollen, distended, overloaded stomach causes indigestion. A baby with indigestion is a colicky, fretty, sick baby. Overfeeding, therefore, is the beginning of lots of trouble to the mother, and needless pain and suffering and sickness to the baby. A simple matter, but it is one of the most difficult lessons nursing mothers have to learn.
Overfeeding is most apt to occur at night. Many mothers put the child to the nipple for its regular feeding and fall asleep; the child keeps on nursing at intervalsuntil twice the proper quantity is taken; or she gives it the nipple or the bottle if it cries, without regard to whether it is the proper feeding time or not. The habit of overfeeding is very common in infants who are suffering from indigestion. They cry frequently, and are irritable most of the time; nothing seems to satisfy them but the nipple. Taking the warm milk into the stomach seems to allay the distress for the time being, so mothers get into the habit of quieting them in this way. The cry of the drinking man, whom we try to sober up, is: "Just one more drink and I'll quit." You give the drink and in a little while the demand is repeated. If the mother understood the seriousness of this practice of giving the child the nipple or bottle at irregular times, she would not do it.
Overfeeding an infant may lay the foundation for a lifelong ailment. The excess of food remains in the stomach or bowels undigested. If you remember that this mass of undigested matter is confined in a small space which is both warm and damp, it will be easily understood that putrefaction is the inevitable outcome. As a result of this putrefaction there are produced certain ptomaines and leucomaines. These poisons are carried through the body, causing "auto-intoxication" which upsets and irritates the child's nervous system and may cause very serious consequences, as it frequently produces sudden death from apoplexy and "heart failure" in the adult. These children are always restless, fretful, continually uncomfortable, sleepless and colicky. They lose weight, the stomach becomes distended and a gastritis or inflammation of the stomach results.
Frequently a mother with such a fretful baby, seeing her child getting thinner and thinner, will think that it is not getting enough to eat, and will proceed to add to the trouble by giving the child more to eat.
Mothers must therefore learn not to overfeed their infants; not to imagine that a failure to gain weight means the need of more food (if the quality of the food being given is wrong, will increasing the quantity of bad food do any good?); not to feed irregularly, no matter how insistent the child may be.
Intervals of Feeding.—The physician will give instructions regarding the feeding of the newly born baby for the first few days. After the first few days and up to the beginning of the third month, it should be fed every two hours from 7a. m.until 9p. m., and twice during the night between 9p. m.and 7a. m., when the regular two-hours' interval again begins for the following day. The two night feedings should be about 1 and 4:30a. m.
After the third month, and up to the sixth month, feed every three hours and once during the night. From the sixth month until weaned, every three and one-half or four hours, and not at all during the night.
While it has been pointed out that regularity of feeding is absolutely essential, the above schedule is not to be regarded as an absolute guide. It is a general guide,—approximately it will be found correct in a large majority of cases. Each baby is a rule unto itself. The quantity of the mother's milk will dictate the interval after the first month and for each month as the baby grows. If a mother with no milk to spare, is nursing a big, strong, husky baby, the three-hour interval during the day may have to be shortened to two and one-half hours. As a rule, however, these exceptions are better regulated by attention to the time the baby is given at each nursing to fill its stomach.
How Long Should a Baby Stay at the Breast?—Babies differ as to their method of feeding; some of them seem to like to nurse a moment or two and then look around; others seem to regard nursing as a serious business, and resent any effort to take the nipple away until they have finished. A baby should be taught to nurse methodically; it should not be allowed to play the nipple. Let it fill its stomach and put it down as quickly as possible. A mother will very soon know just how long it takes the baby to fill its little stomach, and when she finds this out she should time it by the clock. When the supply of milk is sufficient, and the child is strong, and nurses freely, eight to twelve minutes are sufficient. After it is taken away from the breast it must be left quiet till the next feeding.
Other babies, according to the ability they evince tonurse, even when the milk runs freely, require a longer time,—from twelve to fifteen minutes. The rule, however, is never to allow them to nurse so long that when they are taken away the milk runs out of the mouth. If this occurs, cut down the length of time they are at the breast, and always time the length of feeding by the clock,—don't guess at it.
Children Who "Vomit" Between Feedings.—When a child habitually brings up food between feedings it is usually a symptom of gastric indigestion. In these cases it is advisable to add lime-water to each feeding, and to remove some of the fat in each feeding. If improvement does not follow remove more of the fat by removing some of the cream from the top of the bottle before shaking it.
Remove from the bottle four ounces of cream and shake before preparing the food from what is left. If the child improves after a few days remove only three ounces, then in a few days remove two ounces and later one ounce. After a time, sufficiently long to permit the stomach to become accustomed to the graded amounts of fat, the former diet of whole milk can be again resumed.
Never decrease the interval of feeding of a baby who is bringing up parts of its meal between feedings; it is frequently advisable to increase the interval. If a child is colicky and is bringing up lots of gas in addition to some food, one-half grain of benzoate of soda may be added to each ounce of food given and continued for a number of weeks if necessary. When the gas is located in the intestines and is not brought up, it must be made to pass downward. Attention to the bowels is of great importance in these cases and it may be necessary to peptonize the milk for some time. A reduction of the sugar and starch in the feeding frequently cures this condition. (See "Colic.")
There are children who continue to have symptoms of indigestion and who do not thrive despite various changes in the quantity and quality of the feedings. It may be necessary to obtain a wet nurse for them, as it is with "the delicate child." If a wet nurse cannot be obtained,or if the age will permit, a substitute may be tried. Borden's Eagle brand of condensed milk, canned, is probably the best substitute under these circumstances. Condensed milk should never be used as a continuous food; as a substitute, however, for a few weeks it is often invaluable. With an infant of three or four months it should be used at the beginning in the proportion of one ounce of the milk to sixteen ounces of plain boiled water or barley water. The proper quantity, whatever the child is taking (four or six ounces according to the age) at the time, can be taken from the sixteen ounces and fed to the child. As the symptoms improve the milk should be diluted less and less, 1 to 14, 1 to 10, and so on until the proper strength is reached. After the child has been on the condensed milk for a month it should be changed back to cow's milk, using of course a diluted formula until the child becomes accustomed to the change. Condensed milk, if used as a permanent food, will fatten babies, but their vitality is very deficient, the muscles flabby, and the resistance to disease exceedingly poor. They are apt to develop rickets and sometimes scurvy.
Regularity of Feeding.—One of the very first, and one of the most important factors in contributing to the good health and the comfort of a baby is absolute regularity in feeding. A regular interval of feeding is particularly essential during the first month of a baby's life.
Despite the explicit way in which young mothers are instructed in this respect, it is one of the disappointing incidents of the practice of medicine to observe how many of these mothers fail to heed the advice. We have personally tried to find an explanation for this astonishing carelessness, and have come to the conclusion that it is not due to intentional forgetfulness, but rather to an inexplicable failure to appreciate that the physician means exactly what he says.
If, for example, specific instructions are given to feed, or nurse, the child every two hours (and by "specific instructions" it is meant, that the physician takes time to explain in detail the instructions he gives—that theinstructions are not incidental to the call, but part of the call;—that the advice is given not as a choice of what is desirable, but as an absolute rule to follow; and carefully explains why it is imperative to do as he says; and is satisfied the mother understands what he means) it would seem that there could be no possible reason why the directions should not be faithfully carried out. Yet such is not the case in many instances, and the excuses given by mothers for failure are so trivial and annoying that they show a failure to appreciate that they are dealing with a serious problem—a problem affecting human life. They fail to understand that fatal consequences may follow their negligence. They treat the baby problem exactly as they would a household incident, and as they do not consider it important whether the breakfast dishes are washed at 9a. m.or at twelve noon, neither do they consider it important whether the baby is fed at 9a. m.or an hour later. When mothers learn that the attention they must give their babies is essentially different from the attention they give ordinary household duties, the problem of raising children with success and comfort will be greatly simplified.
If the instructions are to feed the baby at certain intervals, do so at all hazards. To offer the foolish excuse that the baby was asleep when feeding time came, is no excuse at all; as a matter of fact the baby should be asleep at each feeding time, if it is healthy. Wake it and feed it, for, as will be shown later, it is the constant regularity that counts. It will be more difficult to institute regular feeding intervals during the first month, because a healthy baby is very difficult to wake up, even to be fed, during the first few weeks of life. It is absolutely essential, however, that it should be wakened: otherwise the tendency to overfill the stomach at the next feeding will lead to indigestion and colic.
Why is Regularity of Feeding Important?—Because a baby's stomach holds a very small quantity, and experience has taught us that a baby will thrive better on small quantities given frequently, rather than large quantities at longer intervals. The smaller the baby, the smaller the quantity to begin with. Some babies weigh fromfive to seven pounds at birth, while others weigh from nine to twelve pounds. It would be unreasonable to expect a very small baby to be able to hold and digest as much as a very large baby. Considerable common sense and the exercise of some judgment is therefore necessary on the part of the uninstructed mother, as to just the right quantity to give. Fortunately, a little experience will enable the observant mother quickly to solve this important problem. Nature promptly furnishes the symptoms which will correctly guide her. Before considering the significance of these symptoms let us appreciate certain facts common to all babies, and we will more easily interpret the meaning of the special symptoms the baby will furnish.
First of all the baby never vomits. The ejection of food, therefore, is dependent upon a condition, not a disease. If milk runs out of its mouth immediately, or within a few moments, after a feeding, the explanation is that it was fed too much; it does not vomit, the stomach simply overflows. It is exactly like trying to put more milk into a cup after it is full,—it will not hold more, it overflows.
The significance of this symptom, therefore, is that the quantity of the feeding is wrong (it is not the baby's stomach that is at fault,—it is the mother's judgment). Reduce the quantity of each feeding and you will quickly cure it. If the milk does not overflow soon after a feeding, the baby will appear satisfied and will go to sleep, and will sleep until it is time for the next feeding. It may not do this, however. In half an hour, or a little longer, after the feeding, it wakes, it begins to fret and cry, and very soon it suddenly belches gas and ejects a mouthful of milk, after which it will rest quietly for a few moments, when it will begin fretting all over again. It may keep up this performance for an hour, or until the next feeding, and if so it is exhausted and unfit to carry on the digestive process. It is in these cases where most mothers make serious mistakes. This is the beginning of real trouble, and the family physician is the only one qualified to give advice under such circumstances. Remember the warning given regarding heeding the adviceof every busybody just at this time. Your baby's health is at stake; maybe its life depends upon what you choose to do.
What is the Significance of "Vomiting" After Feedings in Babies?—Let us examine the difference between the milk which overflowed immediately after the feeding and the milk which the baby ejects one-half hour or so later, and which is now being considered.
The first milk looks like ordinary milk (breast milk), or if the baby is being fed from the bottle, it looks just like the mixture in the bottle. It not only looks like what it took, but it smells just like it. Now examine the other; we find it looks like curdled milk, it is lumpy, and we immediately can tell that it is sour, because it smells sour and looks sour.
The explanation of the first overflow (immediately after the feeding) was the too great quantity; the explanation of the second overflow (one-half hour or so after the feeding), is the wrong quality of milk. The quantity was right because none overflowed right after the feeding, but the quality was wrong. Again, it is not the baby's stomach that is at fault,—it is the quality of the milk.
How do we know this? Because of what takes place in the baby's stomach during the one-half hour between the feeding and the time of the overflow of the sour milk. The quantity being right, why should the baby have any trouble if the quality is correct? It should not. Therefore by changing the quality (not the quantity as in the former case) we cure the trouble, thus proving the quality of the milk to be at fault.
What took place in the baby's stomach in the intervening half hour? The quality being wrong, the little stomach could not digest the mixture quick enough. Fermentation set in, gas was evolved, and as the stomach was full before the gas was manufactured (and as more and more gas is manufactured when food ferments), the stomach overflowed and out of the baby's mouth comes gas, and sour, fermenting, curdled milk. This process goes on until fermentation stops, or until the little stomach has just enough left to fill it and no more. But think what this is,—a sour mass of rotting, indigestible,curdled milk,—and that is what this baby is expected to live and thrive on.
Some babies seem to have trouble from the very first day of life. Either they will not retain the food, or the food fails to agree with them. If the baby is put upon artificial food at once, these troubles are, of course, not unexpected (because the right artificial food may not be first chosen for the particular baby), but it is not always the artificially fed baby that gives us trouble, and it is sometimes difficult to find the cause for such trouble in a baby who has had nothing but its mother's milk since it was born.
The cause of stomach trouble in a baby a few days old, fed exclusively on mother's milk, is invariably to be found in the quality of the milk.
The quality of the mother's milk may be affected in a number of ways which will render it unfit for the baby. For example, if the mother for any reason becomes sick, and has a high fever shortly after confinement, it will affect her milk and render it unfit temporarily.
If the mother worries or becomes highly nervous during the first few days of her baby's life, she will so affect her milk as to render it unfit for baby. If a baby is fed for a number of days after its birth by its mother, and it should prove afterward that she has not enough milk to continue feeding it, and has finally to put it on artificial food, the baby will most likely have acquired slight stomach ailments that may be troublesome for some time, because in this case both the quality and the quantity were no doubt wrong. Constipation in the mother will also cause trouble. The child will develop colic and extreme irritability until the mother's condition is relieved.
Each of these conditions affecting the milk of the nursing mother usually demands a change of food for the baby, and the substitution of the proper artificial food will invariably immediately correct the trouble. In some cases, however, the quality of the mother's milk is not dependent upon a temporary temperamental condition, but is caused by errors in diet, or conduct, or both. The milk of a physically tired, worn-out mother, is not good, no matter whether the exhaustion is caused by actualphysical labor or by the exactions of a strenuous social programme. The milk of a mother who persists in eating irregularly, or who willfully caters to an appetite which craves the rich, highly seasoned articles of diet, or who attempts to satisfy a legitimate hunger by drinking large quantities of stale tea or coffee and eating bread, is unfit for her baby.
These cases are amenable to the proper treatment, which of course means, that the mother must change her conduct if at fault, and live strictly upon the diet prescribed elsewhere for nursing mothers.
If these troubles occur in babies who have been fed exclusively upon artificial food, an entire change of food is frequently necessary.
Baby's first journey out of doors depends upon so many contingencies that no specific age can be given when it would be perfectly safe to take it.
First, the weather and season of the year should be considered. The baby should not be taken out at all when it is wet, or foggy, or very humid; nor when it is extremely cold.
Second, the vigor or vitality of the individual child must be considered. Some children can safely be taken out if the weather is propitious when two weeks old, others cannot be taken out without risk until they are two months old, regardless of the weather conditions. If a child is robust at birth, and nurses well, and increases in weight from the beginning, he can be taken out when he is two weeks old while the sun shines during the middle of the day. If a child is small and puny when born, and begins to have nursing troubles from the beginning, does not increase in weight, is fretting, and crying, and sleeps spasmodically, it would be unsafe to take it out before the sixth week unless it is at a season of the year which would justify exposure to the sunshine.
The question of suitable clothing will be important, and will decide the advisability as to when the baby should go out. Every baby should be dressed in woolweather is not too distinctly bad. Remember always to [Transcriber's note: words missing in text] from neck to ankles. Its head should be warmly clad. Dressed thus and well wrapped in blankets, a healthy child is ready for an out-door trip at any time, if the [Transcriber's note: words missing in text] have plenty of blankets below the child as well as above it, if it is in a baby carriage. In very cold weather the child should be buried in blankets, and a hot water bottle can be wrapped in near his feet. Great care must be taken that the water in the bottle is not too hot, and that it does not actually touch the skin. No matter how many or how few blankets are used, the face should be exposed directly to the fresh air. When the air is very gusty, or high, a light veil can be laid over the face, but never at any other time.
Air Baths for Babies.—Babies necessarily require plenty of exercise and plenty of fresh air, as has been pointed out. It is a splendid custom to allow the baby to lie naked after his bath for half an hour. If the room is comfortably warm, select a spot that is free from draughts, and lay the baby on a pillow or two and let him kick and coo. In the sun by the window, his head and especially the eyes shaded from the direct rays of the sun, is an excellent place in the summer time. The influence of the direct sun rays on the little naked body is conducive to good sturdy health, good nerves, and sound sleep.
Baby's Bed—The Proper Way to Lay Baby in Bed—Baby Should Sleep by Itself—How Long Should a Baby Sleep—Why a Baby Cries—The Habitual Crier—The Habit of Feeding Baby Every Time it Cries—The Habit of Walking the Floor with Baby Every Time it Cries—Jouncing, or Hobbling Baby—Baby Needs Water to Drink—The Evil Habit of Kissing Baby—Establishing Toilet Habits—Baby's Comforter—What can be Done to Lessen the Evil Effects of the Comforter Habit—Beef Juice—Beef Juice by the Cold Process—Mutton Broth—Mutton Broth with Cornstarch or Arrowroot—Chicken, Veal, and Beef Broths—Scraped Beef or Meat Pulp—Junket or Curds and Whey—Whey—Barley Water—Barley Water Gruel or Barley Jelly—Rice, Wheat or Oat Water—Imperial Granum—Albumen Water—Dried Bread—Coddled Egg.
Baby's Bed—The Proper Way to Lay Baby in Bed—Baby Should Sleep by Itself—How Long Should a Baby Sleep—Why a Baby Cries—The Habitual Crier—The Habit of Feeding Baby Every Time it Cries—The Habit of Walking the Floor with Baby Every Time it Cries—Jouncing, or Hobbling Baby—Baby Needs Water to Drink—The Evil Habit of Kissing Baby—Establishing Toilet Habits—Baby's Comforter—What can be Done to Lessen the Evil Effects of the Comforter Habit—Beef Juice—Beef Juice by the Cold Process—Mutton Broth—Mutton Broth with Cornstarch or Arrowroot—Chicken, Veal, and Beef Broths—Scraped Beef or Meat Pulp—Junket or Curds and Whey—Whey—Barley Water—Barley Water Gruel or Barley Jelly—Rice, Wheat or Oat Water—Imperial Granum—Albumen Water—Dried Bread—Coddled Egg.
The Proper Way to Lay Baby in Its Bed.—The baby should be accustomed to sleep by itself from the day of its birth. Mothers have been known to smother their babies during sleep. The mother may pull the bed-clothing over the baby's head during the night and thus deprive it fresh air. A mother is much more apt to nurse her baby regularly and to do it more efficiently, if she is compelled to get up to do it. If she occupies the same bed with baby, she may fall asleep while nursing him; the baby consequently nurses too long, fills his stomach too full, and soon develops indigestion and colic in addition to acquiring a very bad habit.
For the first few weeks an ordinary basket arrangement is all that is necessary. As soon as the baby begins to move around it should have a regular baby crib, so that possible accidents may be avoided.
When the baby is placed in bed after a feeding, it should be laid upon its back, being tilted slightly toward its right side. By placing a soft, small pillow, under itsleft side, the baby will rest more on its right side, which is the proper position. The reason of this is because the liver of a child grows quicker and larger than any other organ, and it is on the right side. By placing the child on this side, it prevents the heavy liver from sagging over on the little full stomach. If the child were laid on its left side, the liver would crowd the full stomach and embarrass the heart, and cause pain and restlessness. Frequently a change of position fully to the right side, when a child has been restless or crying, and especially if it has been lying on its back, will at once relieve it and allow it to go to sleep again. It is the knowledge of these little things that count in babyhood.
How Long Should a Baby Sleep?—A perfectly healthy baby should sleep, while very young, eighteen or twenty hours out of the twenty-four. As it grows older it will sleep less. It should have, and nothing should interfere with its having, two sound naps every day,—one in the forenoon after its bath, and the other in the afternoon. When four or five months old, it should also sleep from 7p. m.until 10p. m., then it should be fed and allowed to sleep until morning. It has been aptly said, that, "a child might easily overeat, but he practically never oversleeps." During the second year a child should sleep twelve hours at night, and about two hours during the day. The twelve-hour night rest should be continued until the child is six years of age. The practice of taking a nap at noon is a very good one, and it should be encouraged as long as possible. It can usually be kept up until the child begins school life. The strenuous activity of childhood, makes some such rest highly desirable, and the result will necessarily be a stronger body, a better disposition, and firmer nerves than otherwise. The practice of retiring early should be strictly enforced during childhood. Children of two years of age, should retire at 6:30p. m., or at latest at 7p. m., those from three to five years, may remain up an additional hour. At thirteen or fourteen the regular bedtime should be at 8:30p. m.There is no justification for the late hours which growing children are allowed to keep, especially in large cities.
Regular sleep is largely a matter of habit, and if the infant is started right, with suitable feedings, given at definite times, followed by the proper periods of sleep, but little trouble will be experienced with sleeplessness. When sleep is disturbed and broken, it means bad habits, unsuitable food, minor forms of indigestion, or positive illness of some kind. Sleep is absolutely essential in infancy and all through childhood for purposes of growth. It is wrong to permit a child to sleep too much during the day; it will become a habit, and it will not sleep well during the night as a consequence. In order to prevent or break this habit, the child should be kept in a well-lighted room and should be amused and entertained so as to keep it awake. The nap during the middle of the day is an exceedingly important factor in keeping the average child in good physical condition. It is a valuable adjunct in preventing, and in treating, nervousness in children. Children who are anemic should be encouraged to sleep long and freely in well-aired rooms.
Why a Baby Cries.—As has been stated, every healthy baby should cry for half an hour each day. Nature suggests, demands this as an essential exercise. Muscular movements involving a greater part of the whole body accompany the act of crying and furnish this necessary exercise. It is of great importance to an adequate and uniform development of the lungs; deep breathing is necessary to lusty crying, hence the lungs are expanded and the blood renewed and oxygenated. Crying is also of material aid in moving the baby's bowels. Babies in perfect health will, however, cry under any of the following circumstances, and doubtless under circumstances of lesser importance and frequency when frightened or uncomfortable from hunger or position, soiled napkins, inflamed buttocks, earache, pain, from heat or cold, unsuitable clothing, and during difficult bowel movement, when displeased or angry. Children slightly but painfully ill may cry incessantly for an hour or two. Thus, with intestinal colic, when the cry is loud and continuous until the child is relieved or until he falls asleep from exhaustion.
The healthy, well trained child seldom causes trouble;it is the rule for it to be happy and good natured in its own way.
The Habitual Crier.—If a child becomes a habitual crier, it is because it is uncomfortable and unhappy. There are restless, often vigorous, crying, whining infants, and the trouble, as a rule, is in the intestinal tract. Badly managed, "spoiled babies" cry from inattention, and when left alone. If they are taken up and talked to, the crying ceases, thus proving that it was not pain or discomfort that was causing the crying. In the case of the habitual crier we try to find out the cause of the bowel trouble and cure it; the spoiled infant we discipline rigidly, or leave it alone if its parents prefer that kind of baby.
The Habit of Feeding Baby Every Time It Cries.—The habit of regular feeding will, if persisted in and successfully established, render advice on this subject unnecessary. So also will the explanation of the evil of overfeeding have its effect on mothers. Apart from these reasons, however, the habit of feeding baby every time it cries is a pernicious one, and no doubt the mother, who will be striving to faithfully follow instructions, will have to overcome the advice of meddling friends who will regard it as a cruelty to allow the baby to cry. Do not give in to these busy-bodies; insist on attending to your own affairs, but be absolutely sure baby is not crying for a just cause. A child can only cry; that is its only language, but it cries for many things other than the nipple or the bottle. Examine it carefully,—a wet diaper a pin, an uncomfortable position, a drink of water, any of these may be the cause.
It is just as essential that a child should cry as that it should sleep. Every healthy child should cry for twenty or thirty minutes every twenty-four hours. Nature calls for this as an exercise in order to develop the lungs; therefore, if there is no just cause for the crying you must regard it as a necessary evil, even if you look upon it as a domestic affliction.
The Habit of Walking the Floor With Baby Every Time It Cries.—This is another habit that is indulged in to the sorrow and ridicule of the race. If you are avictim of this habit, you have yourself to blame. It is a matter of education, or habit, pure and simple, and, like all bad habits, it is difficult to break away from. In the preceding paragraph, you have been told that when baby wants something, or is uncomfortable, it employs the language nature gave it,—it cries. No child ever cried to be walked up and down the floor in the dead of the night. Begin at the beginning, when it first cries, find out why it is crying. Offer it a little water if it is not feeding time. Examine its diaper and if soiled change it. It may be overdressed and consequently hot, perspiring, and uncomfortable; change its position. Find out if any pin is open and hurting it; loosen the binder so it can breathe easily. If it is a colicky child follow the instructions given in the treatment of colic. Be patient the first few nights, and be thorough, because you may discover why it cries and each discovery will help you next time. If you discover something wrong, some reasonable excuse for the crying, does it not prove the folly of walking the floor? If it wants a drink of water, or if its diaper is wet, how is walking the floor going to cure it, or how can you expect the baby to stop crying when you so unjustly construe its reasonable and its only way of asking a favor? If walking the floor stops its crying, it stops it by exhausting the child, not by relieving it of its little ailment.
Jouncing or Hobbling Baby.—This is another habit that should be frowned upon. So many persons are addicted to this form of baby torture, that it is astonishing more immediate harm does not result from it. Be particularly careful not to indulge in it, or permit anyone else to do it immediately after feeding. If you form the habit of putting baby down at once after each feeding, as you have been instructed to do, the opportunity to jounce it will not exist. A little reasoning will clearly convince you that to subject a baby to violent exercise when its stomach is full would interrupt digestion and so shake the full stomach hat it would distend it and cause indigestion. You would not think of exercising yourself after a meal; why exercise a baby?
Baby Needs Water to Drink.—Boil a quantity ofwater each morning, put in a clean bottle, and keep in a cool place. Give the baby some, three or four times daily between feedings. One teaspoonful is enough to begin with, and as it grows older it will take more. It may not always take the water but it will take what it wants, and it needs some every day; it is therefore your duty, inasmuch as baby cannot ask for it, to offer it regularly each day as part of your daily routine.
A child should never be kissed on the mouth by anyone, not even its own parents.
Kissing should not be allowed among children. If any kissing is done it should be on the brow, never on the mouth, hands, or fingers.
Many diseases are carried by this pernicious habit, and you cannot afford to have baby's health jeopardized by this promiscuous and unnecessary liberty.
When baby reaches the age of three months, a regular systemized effort should be made to educate it to "habits of cleanliness." Nothing can be done in this direction previous to this age, as a child at that period of its life is scarcely conscious of the natural functions of its body. Each time a baby, after the third month, is making an effort to move its bowels, the nurse or mother should go to it as it lies in its crib, and talk to it by making a certain sound or say a certain word—whichever word or words you want to educate your child to say, when it wants to move its bowels. By constant attention and effort in this direction, a child with quick perception and initiative will soon associate the sound and the function, and it will begin to make the sound when the function is about to be performed. As soon as it begins to make this sound, if prior to the act of moving the bowels, the child should be immediately taken up and held on a chamber, into which some hot water has been put, and encouraged torelieve itself, the nurse or mother still repeating the sound, or word, or words.
Having successfully accomplished this programme a number of times, the child should be encouraged and petted every time it gives a satisfactory warning, and discouraged and reproved every time it wets or soils its napkin. A little later, say about six months, the child should be held on the chamber at a certain time each morning and evening, thus encouraging it to move its bowels regularly twice daily. The careful carrying out of a scheme such as the above will establish regular, cleanly habits, and will to a very large extent guard against constipation in the future.
Baby's Comforter.—The discovery and introduction of the comforter or rubber teat was an unfortunate episode in someone's life. By the careless, conscienceless nurse, or thoughtless mother, it is regarded as a real comfort and blessing. Any temporary comfort, however, which the nurse or mother may enjoy as a result of its use, is at the expense of the health of the child. Its use is a serious reflection upon the good intention and intelligence of the mother who permits her child to use one. It is a bad habit from every viewpoint possible. In order that mothers, open to conviction and capable of reasoning, may appreciate the character of the harm done by the use of the comforter, we will briefly record these conditions:
1st. The constant sucking pulls upon the delicate structures of the mouth and throat, and so impairs the health tone of these structures that they become flaccid and feebly nourished. This to a certain degree causes adenoids, enlarged tonsils, loose palate and weak throat, with the constant tendency to winter colds and coughs, and to catarrh.
2nd. It causes an excessive flow of saliva. Saliva should only be stimulated previous to stomach digestion. By causing an excessive flow of saliva into an empty stomach, the digestive powers are interfered with, and seriously weakened. Stomach trouble, and consequently intestinal disease, may therefore be caused by the seemingly innocent comforter.
3rd. A constantly used comforter always causes disease of the mouth. Mucous erosions, canker sores, little ulcers, etc., are produced in this way.
4th. The use of the comforter makes it impossible to put the child to sleep, or even to leave it alone, without first placing it in its mouth.
5th. To stifle a baby's cry, by pushing the comforter into its mouth, is as bad as giving it chloroform to mask a serious and dangerous pain. If may have a just reason for crying, as is explained elsewhere, and if that reason is not searched for and found, it may mean serious trouble later.
6th. Actual deformities of the mouth are produced by constant use of the comforter. The continuous sucking affects the gums, pushes them out of shape and position, and the teeth as a consequence come at wrong angles, thus causing unsightly deformities, which last throughout the life of the child.
7th. The worst fault of the comforter is to be found in its uncleanliness. We are quite satisfied that the use of the comforter will be legislated against one of these days. If preventive medicine means anything, it must certainly reckon with the comforter in the very near future. Have you ever watched your baby suck on its comforter? If you have, you must have noted the tireless energy with which it works its tiny jaws and tongue. Suddenly the comforter slips from the little mouth and baby begins to cry, attracting the attention of the mother, or nurse, or little sister, who promptly, recognizing the trouble, pounces on the offending comforter, which has fallen to the floor, and with a perfunctory wipe replaces it in baby's mouth. It is done just as we have written it, many thousand times, and yet the problem of infant mortality is represented as a vexatious mystery. The newspapers solicit charitable aid, and write eloquent appeals regarding the necessity of sending a few babies to the seashore in the summer time or to supply a few with ice during the hot spells. A hundred other energetic enthusiasts send forth their laudable effort to raise the standard of child hygiene, yet the manufacturers of the comforter, and the ignorant mother and nurse who use it,do more harm in one day than all the honest effort of these combined forces can neutralize in a year.
The rubber comforter is one of the most fertile causes of infection and illness in babies because of the peculiar adaptability to collecting germs which it possesses.
When the comforter is finally discarded the habit of sucking is so firmly established that the child will suck its thumb for many years after. This results in further disease and deformity to the growing mouth and throat, and also to the thumb.
After a child has used a pacifier or comforter for some time it invariably becomes a mouth breather. A mouth-breathing child is very apt to catch cold and as a consequence of the habit may become catarrhal or tubercular.
What Can be Done to Lessen the Evil Effects of the "Comforter" Habit?—It is a most difficult habit to cure when once established. The very least that can be done is to keep the comforter scrupulously clean, washing it several times daily. To have not one, but two or three, kept in a saturated solution of boracic acid, ready to put into the baby's mouth should one be required to replace another that has fallen out. We should furnish a large shield to prevent it being swallowed. We can try the method of weaning the baby from the comforter by tying a ribbon to it and to the child's bodice. The system is gradually to shorten the ribbon until it becomes too short for the baby to suck in comfort. It will then gradually grow away from the habit.
Beef Juice.—Take one pound of round steak and broil it slightly. Press the juice out with a lemon squeezer, or, with a meat-press. Season with salt and serve hot or cold as desired. If it is heated after it has once been cold, it should not be overheated as this will coagulate the albumen which will appear as flakes floating on the surface of the juice.
Beef Juice by the Cold Process.—Take one pound of finely chopped round steak, six ounces of cold water, a pinch of salt; place in a covered jar and stand on ice, or in a cool place, six hours. This mixture should be shaken from time to time. Strain and squeeze all the juice out by placing the meat in a coarse cloth and twisting it very hard. Season and feed as above.
Beef juice made in this way is more nutritious than that made from the steak when broiled; it is not, however, quite so palatable.
Beef juice made in either of the above ways is much more nutritious than the beef extracts sold ready to use.
Mutton Broth.—Take one pound of finely chopped lean mutton, including some of the bone, one pint of cold water and a pinch of salt, cook for three hours over a slow fire down to half a pint, adding water to make up this quantity if necessary; strain through muslin. When it is cold remove the fat and add more salt if required. It may be fed warm or cold in the form of a jelly.
Mutton Broth With Cornstarch or Arrowroot.—Add to the above sufficient cornstarch or arrowroot to thicken, cook for ten minutes and then add three ounces of milk, or one ounce of thick cream, to a half pint of broth. This makes a nutritious and extremely palatable broth.
Chicken, Veal, and Beef Broths.—These may be made and used in the same way as mutton broth.
Scraped Beef or Meat Pulp.—Take a rare piece of round or sirloin steak, cut the outer part away, scrape or shred with a blunt knife. Cutting the meat into small pieces is not satisfactory. One teaspoonful to one tablespoonful may be given well salted, to a child a year and a half old. It is best to begin with a small dose and work up to the larger to accustom the digestive apparatus to its use.
Junket, or Curds and Whey.—Take one pint of warm fresh cow's milk, a pinch of salt, a teaspoonful of granulated sugar, to which add two teaspoonfuls of Fairchild's essence of pepsin and allow the mixture to stand until firmly coagulated—this may take about twenty minutes—place in the ice box until thoroughly cold. Nutmeg may be added for older children and adults.
Whey.—The coagulated milk prepared as above is broken up with a fork and the whey is strained off through cheesecloth. If a stimulant is desired, brandy, in the proportion of one teaspoonful to six tablespoonfuls of the whey may be added.
Barley Water.—One level tablespoonful of Robinson's barley is rubbed up with a little cold water, to this is added one pint of boiled water containing a pinch of salt. The mixture should be stirred while the water is being added. Cook for thirty minutes in a double boiler and strain. Enough boiling water should be added to the mixture to make up the full pint if any has boiled away.
Barley Gruel or Barley Jelly.—Repeat the above process, but instead of using one tablespoonful of the barley powder, use from two to four according to the consistency of the gruel or jelly desired.
Barley water may be made from the grains. A formula for this process will be found in the chapter on artificial feeding.
Rice, Wheat, or Oat Water.—These are made from the rice,wheat, or oat flour in the same way as barley water described above. They may be made from the grains also, using the same proportions as in the making of barley water.
Imperial Granum.—This is prepared in the same way as the barley flour above described.
Albumen Water.—Take half a pint of cold water, the white of one fresh egg, a pinch of salt, and a teaspoonful of brandy, shake and feed from a spoon or from a bottle. This is frequently used in cases of vomiting, or in irritable stomachs. It is often retained when all other food is rejected.
Dried Bread.—Cut either stale or fresh bread into thin slices and place in the open oven. When it is dried and crisp but not browned it may be given to children in preference to crackers.
Coddled Egg.—A fresh egg with the shell intact is placed in boiling water which is immediately removed from the fire. The egg is allowed to remain in the water for eight minutes when it is ready for use. The white only should be used if the digestion is poor.