CHAPTER XXVI.

THE CARE OF INFANTS.

The topic of this chapter may well be prefaced by an extract from Herbert Spencer on the treatment of offspring. He first supposes that some future philosophic speculator, examining the course of education of the present period, should find nothing relating to the training of children, and that his natural inference would be that our schools were all for monastic orders, who have no charge of infancy and childhood. He then remarks, “Is it not an astonishing fact that, though on the treatment of offspring depend their lives or deaths and their moral welfare or ruin, yet that so little instruction on the treatment of offspring is ever given to those who will hereafter be parents? Is it not monstrous that the fate of a new generation should be left to the chances of unreasoning custom, or impulse, or fancy, joined with the suggestions of ignorant nurses and the prejudiced counsel of grandmothers?

“If a merchant should commence business without any knowledge of arithmetic or book-keeping, we should exclaim at his folly, and look for disastrous consequences. Or if, without studying anatomy, a man set up as a surgeon, we should wonder at his audacity, and pity his patients. But that parents should commence the difficult work of rearing children without giving earnest attention to the principles, physical, moral, or intellectual, which ought to guide them, excites neither surprise at the actors nor pity for the victims.

“To tens of thousands that are killed add hundreds of thousands that survive with feeble constitutions, and millions not so strong as they should be; and you will have some idea of the curse inflicted on their offspring by parents ignorant of the laws of life. Do but consider for a moment that the regimen to which children are subject is hourly telling upon them to their life-long injury or benefit, and that there are twenty ways of going wrong to one way of going right, and you will get some idea of the enormous mischief that is almost everywhere inflicted by the thoughtless, hap-hazard system in common use.

“When sons and daughters grow up sickly and feeble, parents commonly regard the event as a visitation of Providence. They assume that these evils come without cause, or that the cause is supernatural. Nothing of the kind. In some cases causes are inherited, but in most cases foolish management is the cause. Very generally parents themselves are responsible for this pain, this debility, this depression, this misery. They have undertaken to control the lives of their offspring, and with cruel carelessness have neglected to learn those vital processes which they are daily affecting by their commands and prohibitions. In utter ignorance of the simplest physiological laws, they have been, year by year, undermining the constitutions of their children, and so have inflicted disease and premature death, not only on them but also on their descendants.

“Equally great are the ignorance and consequent injury, when we turn from the physical to the moral training. Consider the young, untaught mother and her nursery legislation. A short time ago she was at school, where her memory was crammed with words and names and dates, and her reflective faculties scarcely in the slightest degree exercised—where not one idea was given her respecting the methods of dealing with the opening mind of childhood, and where her discipline did not in the least fit her for thinking out methods of her own. The intervening years have been spent in practicing music, fancy-work, novel-reading, and party-going, no thought having been given to the grave responsibilities of maternity, and scarcely any of that solid intellectual culture obtained which would fit her for such responsibilities; and now see her with an unfolding human character committed to her charge, see her profoundly ignorant of the phenomena with which she has to deal, undertaking to do that which can be done but imperfectly even with the aid of the profoundest knowledge!”

In view of such considerations, every young lady ought to learn how to take proper care of an infant; for, even if she is never to become the responsible guardian of a nursery, she will often be in situations where she can render benevolent aid to others in this most fatiguing and anxious duty.

The writer has known instances in which young ladies, who had been trained by their mothers properly to perform this duty, were in some cases the means of saving the lives of infants, and in others, of relieving sick mothers from intolerable care and anguish by their benevolent aid.

On this point Dr. Combe remarks: “All women are not destined, in the course of nature, to become mothers; but how very small is the number of those who are unconnected, by family ties, friendship, or sympathy, with the children of others! How very few are there who, at some time or other of their lives, would not find their usefulness and happiness increased, by the possession of a kind of knowledge intimately allied to their best feelings and affections! And how important is it to the mother herself, that her efforts should be seconded by intelligent instead of ignorant assistants!”

In order to be prepared for such benevolent ministries, every young lady should improve the opportunity, whenever it is afforded her, for learning how to wash, dress, and tend a young infant; and whenever she meets with such a work as Dr. Combe’s, on the management of infants, she ought to read it, and _remember_ its contents.

The directions that follow have been taken from standard medical writers, or have been examined and approved by the highest class of physicians, and also by judicious and experienced mothers.

Says Dr. Combe: “Nearly one half of the deaths occurring during the first two years of existence are ascribable to mismanagement, and to errors in diet. At birth, the stomach is feeble, and as yet unaccustomed to food; its cravings are consequently easily satisfied, and frequently renewed.” “At that early age, there ought to be no fixed time for giving nourishment. The stomach can not be thus satisfied.” “The active call of the infant is a sign, which needs never be mistaken.”

“But care must be taken to determine between the crying of pain or uneasiness, and the call for food; and the practice of giving an infant food to stop its cries is often the means of increasing its sufferings. After a child has satisfied its hunger, from two to four hours, according to the age, should intervene before another supply is given.

“At birth, the stomach and bowels, never having been used, contain a quantity of mucous secretion, which requires to be removed. To effect this, Nature has rendered the first portions of the mother’s milk purposely watery and laxative. Nurses, however, distrusting Nature, often hasten to administer some active purgative; and the consequence often is, irritation in the stomach and bowels, not easily subdued.” It is only where the child is deprived of its mother’s milk, as the first food, that some gentle laxative should be given.

“It is a common mistake to suppose that because a woman is nursing, she ought to live very fully, and to add an allowance of wine, porter, or other fermented liquor, to her usual diet. The only result of this plan is, to cause an unnatural fullness in the system, which places the nurse on the brink of disease, and retards rather than increases the food of the infant. More will be gained by the observance of the ordinary laws of health than by any foolish deviation, founded on ignorance.”

There is no point on which medical men so emphatically lift the voice of warning as in reference to administering medicines to infants. It is so difficult to discover what is the matter with an infant, its frame is so delicate and so susceptible, and slight causes have such a powerful influence, that it requires the utmost skill and judgment to ascertain what would be proper medicines, and the proper quantity to be given.

Says Dr, Combe: “That there are cases in which active means must be promptly used to save the child, is perfectly true. But it is not less certain that these are cases of which no mother or nurse ought to attempt the treatment. As a general rule, where the child is well managed, medicine of any kind is very rarely required; and if disease were more generally regarded in its true light, not as something thrust into the system, which requires to be expelled by force, but as an aberration from a natural mode of action, produced by some external cause, we should be in less haste to attack it by medicine, and more watchful in its prevention. Accordingly, where a constant demand for medicine exists in a nursery, the mother may rest assured that there is something essentially wrong in the treatment of her children.

“Much havoc is made among infants by the abuse of medicines, which procure momentary relief but end by producing incurable disease; and it has often excited my astonishment to see how recklessly remedies of this kind are had recourse to, on the most trifling occasions, by mothers and nurses, who would be horrified if they knew the nature of the power they are wielding, and the extent of injury they are inflicting.”

Instead, then, of depending on medicine for the preservation of the health and life of an infant, the following precautions and preventives should be adopted:

“Take particular care of the _food_ of an infant. If it is nourished by the mother, her own diet should be simple, nourishing, and temperate. If the child be brought up ‘by hand,’ the milk of a new milch-cow, mixed with one-third water, and sweetened a little with _white_ sugar, should be the only food given, until the teeth come. This is more suitable than any preparations of flour or arrow-root, the nourishment of which is too highly concentrated. Never give a child _bread_, _cake_, or _meat_, before the teeth appear. If the food appear to distress the child after eating, first ascertain if the milk be really from a new milch-cow, as it may otherwise be too old. Learn, also, whether the cow lives on proper food. Cows that are fed on _still-slops_, as is often the case in cities, furnish milk which is very unhealthful.”

Be sure and keep a good supply of pure and fresh air in the nursery. On this point Dr. Bell remarks, respecting rooms constructed without fire-places and without doors or windows to let in pure air from without, “The sufferings of children of feeble constitutions are increased beyond measure by such lodgings as these. An action, brought by the commonwealth, ought to lie against those persons who build houses for sale or rent, in which rooms are so constructed as not to allow of free ventilation; and a writ of lunacy taken out against those who, with the common-sense experience which all have on this head, should spend any portion of their time, still more, should sleep, in rooms thus nearly air-tight.”

After it is a month or two old, take an infant out to walk, or ride, in a little wagon, every fair and warm day; but be very careful that its feet, and every part of its body, are kept warm; and be sure that its eyes are well protected from the light. Weak eyes, and sometimes blindness, are caused by neglecting this precaution. Keep the head of an infant cool, never allowing too warm bonnets, nor permitting it to sink into soft pillows when asleep. Keeping an infant’s head too warm very much increases nervous irritability, and this is the reason why medical men forbid the use of caps for infants. But the head of an infant should, especially while sleeping, be protected from draughts of air, and from getting cold.

Be very careful of the skin of an infant, as nothing tends so effectually to prevent disease. For this end, it should be washed all over every morning, and then gentle friction should be applied with the hand, to the back, stomach, bowels, and limbs. The head should be thoroughly washed every day, and then brushed with a soft hair-brush, or combed with a fine comb. If, by neglect, dirt accumulates under the hair, apply with the finger the yelk of an egg, and then the fine comb will remove it all without any trouble.

Dress the infant so that it will be always warm, but not so as to cause perspiration. Be sure and keep its feet always warm; and for this often warm them at a fire, and use long dresses. Keep the neck and arms covered. For this purpose, wrappers, open in front, made high in the neck, with long sleeves, to put on over the frock, are now very fashionable.

It is better for both mother and child, that it should not sleep on the mother’s arm at night, unless the weather be extremely cold. This practice keeps the child too warm, and leads it to seek food too frequently. A child should ordinarily take nourishment but once or twice in the night. A crib beside the mother, with plenty of warm and light covering, is best for the child; but the mother must be sure that it is always kept warm.

Never cover a child’s head so that it will inhale the air of its own lungs. In very warm weather, especially in cities, great pains should be taken to find fresh and cool air by rides and sailing. Walks in a public square in the cool of the morning, and frequent excursions in ferry or steamboats, would often save a long bill for medical attendance. In hot nights, the windows should be kept open, and the infant laid on a mattress, or on folded blankets. A bit of straw matting, laid over a feather-bed and covered with the under sheet, makes a very cool bed for an infant.

Cool bathing, in hot weather, is very useful; but the water should be very little cooler than the skin of the child. When the constitution is delicate, the water should be slightly warmed. Simply sponging the body freely in a tub, answers the same purpose as a regular bath. In very warm weather this should be done two or three times a day, always waiting two or three hours after food has been given.

“When the stomach is peculiarly irritable, (from teething,) it is of paramount necessity to withhold all the nostrums which have been so falsely lauded as ‘sovereign cures for _cholera infantum_.’ The true restoratives for a child threatened with disease are cool air, cool bathing, and cool drinks of simple water, in addition to _proper_ food, at stated intervals.”

In many cases, change of air from sea to mountain, or the reverse, has an immediate healthful influence and is superior to every other treatment. Do not take the advice of mothers who tell of this, that, and the other thing, which have proved excellent remedies in their experience. Children have different constitutions, and there are multitudes of different causes for their sickness; and what might cure one child, might kill another which _appeared_ to have the same complaint. A mother should go on the general rule of giving an infant very little medicine, and then only by the direction of a discreet and experienced physician. And there are cases when, according to the views of the most distinguished and competent practitioners, physicians themselves are much too free in using medicines, instead of adopting preventive measures.

Do not allow a child to form such habits that it will not be quiet unless tended and amused. A healthy child should be accustomed to lie or sit in its cradle much of the time; but it should occasionally be taken up and tossed, or carried about for exercise and amusement. An infant should be encouraged to _creep_, as an exercise very strengthening and useful. If the mother fears the soiling of its nice dresses, she can keep a long slip or apron which will entirely cover the dress, and can be removed when the child is taken in the arms. A child should not be allowed, when quite young, to bear its weight on its feet very long at a time, as this tends to weaken and distort the limbs.

Many mothers, with a little painstaking, succeed in putting their infants into their cradle while awake, at regular hours for sleep; and induce regularity in other habits, which saves much trouble. During this training process a child may cry, at first, a great deal; but, for a healthy child, this use of the lungs does no harm, and tends rather to strengthen than to injure them, unless it becomes exceedingly violent. A child who is trained to lie or sit and amuse itself, is happier than one who is carried and tended a great deal, and thus rendered restless and uneasy when not so indulged.

The most critical period in the life of an infant is that of dentition or teething, especially at the early stages. An adult has thirty-two teeth, but young children have only twenty, which gradually loosen and are followed by the permanent teeth. When the child has ten teeth on each jaw, all that are added are the permanent set, which should be carefully preserved; this caution is needful, as sometimes decay in the first double teeth of the second set are supposed to be of the transient set, and are so neglected, or are removed instead of being preserved by plugging. When the first teeth rise so as to press against the gums, there is always more or less inflammation, causing nervous fretfulness, and the impulse to put every thing into the mouth. Usually there is disturbed sleep, a slight fever, and greater flow of saliva; this is often relieved by letting the child have ice to bite, tied in a rag.

Sometimes the disorder of the mouth extends to the whole system. In difficult teething, one symptom is the jerking back of the head when taking the breath, as if in pain, owing to the extreme soreness of the gums. This is, in extreme cases, attended with increased saliva and a gummy secretion in the corners of the eyes, itching of the nose, redness of cheeks, rash, convulsive twitching of lips and the muscles generally, fever, constipation, and sometimes by a diarrhea, which last is favorable if slight; difficulty of breathing, dilation of the pupils of the eyes, restless motion and moaning; and finally, if not relieved, convulsions and death. The most effective relief is gained by lancing the gums. Every woman, and especially every mother, should know the time and order in which the infant teeth come, and, when any of the above symptoms appear, should examine the mouth, and if a gum is swollen and inflamed, should either have a physician lance it, or if this can not be done, should perform the operation herself. A sharp pen-knife and steady hand, making an incision to touch the rising tooth, will cause no more pain than a simple scratch of the gum, and usually will give speedy relief.

The temporary teeth should not be removed until the new ones appear, as it injures the jaw and coming teeth; but as soon as a new tooth is seen pressing upward, the temporary tooth should be removed, or the new tooth will come out of its proper place. If there is not room where the new tooth appears, the next temporary tooth must be taken out. Great mischief has been done by removing the first teeth before the second appear, thus making a contraction of the jaw.

Most trouble with the teeth of young children comes from neglect to use the brush to remove the tartar that accumulates near the gum, causing disease and decay. This disease is sometimes called _scurvy_, and is shown by an accumulation around the teeth and by inflamed gums that bleed easily. Removal of the tartar by a dentist and cleaning the teeth after every meal with a brush will usually cure this evil, which causes loosening of the teeth and a bad breath.

Much injury is often done to teeth by using improper tooth-powder. The tooth-brush should be used after every meal, and floss silk pressed between the teeth to remove food lodged there. This method will usually save the teeth from decay till old age, and there is no need of tooth-powder.

When an infant seems ill during the period of dentition, the following directions from an experienced physician may be of service. It is now an accepted principle of the medical world that fevers are to be reduced by cold applications; but an infant demands careful and judicious treatment in this direction; some have extremely sensitive nerves, and cold is painful. For such, tepid sponging should be used near a fire, and the coldness increased gradually. The sensations of the child should be the guide. Usually, but not always, children that are healthy will learn by degrees to prefer cold water, and then it may safely be used.

When an infant becomes feverish, wrapping its body in a towel wrung out in tepid or cold water, and then keeping it warm in a woolen blanket, is a very safe and soothing remedy.

In case of constipation, this preparation of food is useful:

One table-spoonful of unbolted flour wet with cold water. Add one pint of hot water, and boil twenty minutes. Add, when taken up, one pint of milk. If the stomach seems delicate and irritable, strain out the bran, but in most cases retain it.

Where the mother’s milk fails, and good cow’s milk can not be insured, there are preparations of Oat-meal and barley-meal that are next best. These may be used when the mother’s milk is injured by ill health. A trial must be made to see which is best. Make a thin gruel, and add half a tea-spoonful of condensed milk, or four great spoonfuls of milk to a coffee-cup of the gruel for a young infant, and a full one for an older child.

In case of diarrhea, walk with the child in arms a great deal in the open air, and give it rice-water to drink.

The warmth and vital influences of the nurse are very important, and make this mode of exercise both more soothing and more efficacious, especially in the open air, the infant being warmly clad.

In case of feverishness from teething or from any other cause, wrap the infant in a towel wrung out in tepid water, and then wrap it in a woolen blanket. The water may be cooler according as the child is older and stronger. The evaporation of the water draws off the heat, while the moisture soothes the nerves, and usually the child will fall into a quiet sleep. As soon as it becomes restless, change the wet towel and proceed as before.

The leading physicians of Europe and of this country, in all cases of fevers, use cool water to reduce them, by this and other modes of application. This method is more soothing than any other, and is as effective for adults as for infants.

Some of the most distinguished physicians of New York who have examined this chapter give their full approval of the advice given. If there is still distrust as to this mode of using water to reduce fevers, it will be advantageous to read an address on the use of cold applications in fevers, delivered by Dr. William Neftel, before the New York Academy of Medicine, published in the _New York Medical Record_ for November, 1868; this can be obtained by inclosing twenty cents to the editor, with the post-office address of the applicant.