Part 67

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.

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THE CRY-HOW TO DISTINGUISH IT.

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.

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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.

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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.

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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.

INFANTS' FEEDING.

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.

NURSING.

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.

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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.

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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.

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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.

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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.

LOOSE STOOLS IN NURSING BABIES.

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.

WEANING.

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.

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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.