Chapter 23

6. BAD BREAST.--A gathered bosom, or "bad breast," as it is sometimes called, is more likely to occur after a first confinement and during the first month. Great care, therefore, ought to be taken to avoid such a misfortune. A gathered breast is frequently owing to the carelessness of a mother in not covering her bosoms during the time she is suckling. Too much attention cannot be paid to keeping the breasts comfortably warm. This, during the act of nursing, should be done by throwing either a shawl or a square of flannel over the neck, shoulders, and bosoms.

7. ANOTHER CAUSE.--Another cause of gathered breasts arises from a mother sitting up in bed to suckle her babe. He ought to be accustomed to take the bosom while she is lying down; if this habit is not at first instituted, it will be difficult to adopt it afterwards. Good habits may be taught a child from earliest babyhood.

8. FAINTNESS.--When a nursing mother feels faint, she ought immediately to lie down and take a little nourishment; a cup of tea with the yolk of an egg beaten up in it, or a cup of warm milk, or some beef-tea, any of which will answer the purpose extremely well. Brandy, or any other spirit we would not recommend, as it would only cause, as soon as the immediate effects of the stimulant had gone off, a greater depression to ensue; not only so, but the frequent taking of brandy might become a habit a necessity which would be a calamity deeply to be deplored!

9. STRONG PURGATIVES.--Strong purgatives during this period are highly improper, as they are apt to give pain to the infant, as well as to injure the mother. If it be absolutely necessary to give physic, the mildest, such as a dose of castor oil, should be chosen.

10. HABITUALLY COSTIVE.--When a lady who is nursing is habitually costive, she ought to eat brown instead of white bread. This will, in the majority of cases, enable her to do without an aperient. The brown bread may be made with flour finely ground all one way; or by mixing one part of bran and three parts of fine wheaten flour together, and then making it in the usual way into bread. Treacle instead of butter, on the brown bread increases its efficacy as an aperient; and raw should be substituted for lump sugar in her tea.

11. TO PREVENT CONSTIPATION.--Stewed prunes, or stewed French plums, or stewed Normandy pippins, are excellent remedies to prevent constipation. The patient ought to eat, every morning, a dozen or fifteen of them. The best way to stew either prunes or French plums, is the following: Put a pound of either prunes or French plums, and two tablespoonfuls of raw sugar, into a brown jar; cover them with water; put them into a slow oven, and stew them for three or four hours. Both stewed rhubarb and stewed pears often act as mild and gentle aperients. Muscatel raisins, eaten at dessert, will oftentimes without medicine relieve the bowels.

12. COLD WATER--A tumblerful of cold water, taken early every morning, sometimes effectually relieves the bowels; indeed, few people know the value of cold water as an aperient it is one of the best we possess, and, unlike drug aperients, can never by any possibility do any harm. An injection of warm water is one of the best ways to relieve the bowels.

13. WELL-COOKED VEGETABLES.--Although a nursing mother ought, more especially if she be costive, to take a variety of well-cooked vegetables, such as potatoes, asparagus, cauliflower, French beans, spinach, stewed celery and turnips; she should avoid eating greens, cabbages, and pickles, as they would be likely to affect the babe, and might cause him to suffer from gripings, from pain, and "looseness" of the bowels.

14. SUPERSEDE THE NECESSITY OF TAKING PHYSIC.--Let me again--for it cannot be too urgently insisted upon--strongly advise a nursing mother to use every means in the way of diet, etc., to supersede the necessity of taking physic (opening medicine), as the repetition of aperients injures, and that severely, both herself and child. Moreover, the more opening medicine she swallows, the more she requires; so that if she once gets into the habit of regularly taking physic, the bowels will not act without them. What a miserable existence to be always swallowing physic!

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HOME LESSONS IN NURSING SICK CHILDREN.

1. MISMANAGEMENT.--Every doctor knows that a large share of the ills to which infancy is subject are directly traceable to mismanagement. Troubles of the digestive system are, for the most part due to errors, either in the selection of the food or in the preparation of it.

2. RESPIRATORY DISEASES.--Respiratory diseases or the diseases of the throat and lungs have their origin, as a rule, in want of care and judgment in matters of clothing, bathing and exposure to cold and drafts. A child should always be dressed to suit the existing temperature of the weather.

3. NERVOUS DISEASES.--Nervous diseases are often aggravated if not caused by over-stimulation of the brain, by irregular hours of sleep, or by the use of "soothing" medicines, or eating indigestible food.

4. SKIN AFFECTIONS.--Skin affections are generally due to want of proper care of the skin, to improper clothing or feeding, or to indiscriminate association with nurses and Children, who are the carriers of contagious diseases.

5. PERMANENT INJURY.--Permanent injury is often caused by lifting the child by one hand, allowing it to fall, permitting it to play with sharp instruments, etc.

6. RULES AND PRINCIPLES.--Every mother should understand the rules and principles of home nursing. Children are very tender plants and the want of proper knowledge is often very disastrous if not fatal. Study carefully and follow the principles and rules which are laid down in the different parts of this work on nursing and cooking for the sick.

7. WHAT A MOTHER SHOULD KNOW:

I. INFANT FEEDING.--The care of milk, milk sterilization, care of bottles, preparation of commonly employed infant foods, the general principles of infant feeding, with rules as to quality and frequency.

II. BATHING.--The daily bath; the use of hot, cold and mustard baths.

III. HYGIENE OF THE SKIN. Care of the mouth, eyes and ears. Ventilation, temperature, cleanliness, care of napkins, etc.

IV. TRAINING OF CHILDREN in proper bodily habits. Simple means of treatment in sickness, etc.

8. THE CRY OF THE SICK CHILD.--The cry of the child is a language by which the character of its suffering to some extent may be ascertained. The manner in which the cry is uttered, or the pitch and tone is generally a symptom of a certain kind of disease.

9. STOMACHACHE.--The cry of the child in suffering with pain of the stomach is loud, excitable and spasmodic. The legs are drawn up and as the pain ceases, they are relaxed and the child sobs itself to sleep, and rests until awakened again by pain.

10. LUNG TROUBLE.--When a child is suffering with an affection of the lungs or throat, it never cries loudly or continuously. A distress in breathing causes a sort of subdued cry and low moaning. If there is a slight cough it is generally a sign that there is some complication with the lungs.

11. DISEASE OF THE BRAIN.--In disease of the brain the cry is always sharp, short and piercing. Drowsiness generally follows each spasm of pain.

12. FEVERS.--Children rarely cry when suffering with fever unless they are disturbed. They should be handled very gently and spoken to in a very quiet and tender tone of voice.

13. THE CHAMBER OF THE SICK ROOM.--The room of the sick child should be kept scrupulously clean. No noise should disturb the quiet and rest of the child. If the weather is mild, plenty of fresh air should be admitted; the temperature should be kept at about 70 degrees. A thermometer should be kept in the room, and the air should be changed several times during the day. This may be done with safety to the child by covering it up with woolen blankets to protect it from draft, while the windows and doors are opened. Fresh air often does more to restore the sick child than the doctor's medicine. Take the best room in the house. If necessary take the parlor, always make the room pleasant for the sick.

14. VISITORS.--Carefully avoid the conversation of visitors or the loud and boisterous playing of children in the house. If there is much noise about the house that cannot be avoided, it is a good plan to put cotton in the ears of the patient.

15. LIGHT IN THE ROOM.--Light has a tendency to produce nervous irritability, consequently it is best to exclude as much daylight as possible and keep the room in a sort of twilight until the child begins to improve. Be careful to avoid any odor coming from a burning lamp in the night. When the child begins to recover, give it plenty of sunlight. After the child begins to get better let in all the sunlight the windows will admit. Take a south room for the sick bed.

16. SICKNESS IN SUMMER.--If the weather is very hot it is a good plan to dampen the floors with cold water, or set several dishes of water in the room, but be careful to keep the patient out of the draft, and avoid any sudden change of temperature.

17. BATHING.--Bathe every sick child in warm water once a day unless prohibited by the doctor. If the child has a spasm or any attack of a serious nervous character in absence of the doctor, place him in a hot bath at once. Hot water is one of the finest agencies for the cure of nervous diseases.

18. SCARLET FEVER AND MEASLES.--Bathe the child in warm water to bring out the rash, and put in about a dessertspoonsful of mustard into each bath.

19. DRINKS.--If a child is suffering with fevers, let it have all the water it wants. Toast-water will be found nourishing. When the stomach of the child is in an irritable condition, nourishments containing milk or any other fluid should be given very sparingly. Barley-water and rice-water are very soothing to an irritable stomach.

20. FOOD.--Mellin's Food and milk is very nourishing if the child will take it. Oatmeal gruel, white of eggs, etc. are excellent and nourishing articles. See "How to cook for the Sick."

21. EATING FRUIT.--Let children who are recovering from sickness eat moderately of good fresh fruit. Never let a child, whether well or sick, eat the skins of any kind of fruit. The outer covering of fruit was not made to eat, and often has poisonous matter very injurious to health upon its surface. Contagious and infectious diseases are often communicated in that way.

22. SUDDEN STARTINGS with the thumbs drawn into the palms, portend trouble with the brain, and often end in convulsions, which are far more serious in infants than in children. Convulsions in children often result from a suppression of urine. If you have occasion to believe that such is the case, get the patient to sweating as soon as possible. Give it a hot bath, after which cover it up in bed and put bags of hot salt over the lower part of the abdomen.

23. SYMPTOMS OF INDIGESTION.--If the baby shows symptoms of indigestion, do not begin giving it medicine. It is wiser to decrease the quantity and quality of the food and let the little one omit one meal entirely, that his stomach may rest. Avoid all starchy foods, as the organs of digestion are not sufficiently developed to receive them.

A TABLE FOR FEEDING A BABY ON MODIFIED MILK.

2d week: Top Milk 1-1/2 oz. Milk Sugar 4 teaspoons Barley Gruel 10 oz. Cream 2-3/4 oz. Lime Water 2 oz. 1-1/2 oz. at feeding 10 times a day

3d week: Top Milk 6 oz. Milk Sugar 5-1/2 teaspoons Barley Gruel 18 oz. Lime Water 4 oz. 2 oz. at feeding 10 times a day

4th to 8th week: Top Milk 9 oz. Milk Sugar 8 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 3 oz. at feeding 8 times a day

9th to 12th week: Top Milk 11 oz. Milk Sugar 7-1/2 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 3 oz. at feeding 8 times a day

4th month: Top Milk 13 oz. Milk Sugar 7 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 3 to 4 oz. at feeding 7 times a day

5th to 7th month: Top Milk 15 oz. Milk Sugar 6-1/2 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 4 to 5 oz. at feeding 6 times a day

7th to 9th month: Top Milk 17 oz. Milk Sugar 6 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 6 to 7 oz. at feeding 6 times a day

Top Milk--Let your quart of milk stand until the cream has risen, then pour off number of ounces required.

Sugar of Milk may be purchased at your local druggist's.

Gruel is prepared by cooking one level tablespoon of any good barley flour in a pint of water with a pinch of salt. When partly cooled add to the milk.

NURSING.

Period: 1st and 2d day Nursing in 24 hours: 4 Interval by day: 6 hrs. Night nursings 10 p.m. to 6 a.m.: 1

Period: 3 days to 4 weeks Nursing in 24 hours: 10 Interval by day: 2 hrs. Night nursings 10 p.m. to 6 a.m.: 1

Period: 4 weeks to 2 mo. Nursing in 24 hours: 8 Interval by day: 2-1/2 hrs. Night nursings 10 p.m. to 6 a.m.: 1

Period: 2 to 5 mo. Nursing in 24 hours: 7 Interval by day: 3 hrs. Night nursings 10 p.m. to 6 a.m.: 1

Period: 5 to 12 mo. Nursing in 24 hours: 6 Interval by day: 3 hrs. Night nursings 10 p.m. to 6 a.m.: 0

SCHEDULE FOR FEEDING HEALTHY INFANTS DURING FIRST YEAR

Age: 2d to 7th day Interval between meals by day: 2 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 10 Quantity for one feeding: 1 to 1-1/2 ounces Quantity in 24 hours: 10 to 15 ounces

Age: 2d and 3d week Interval between meals by day: 2 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 10 Quantity for one feeding: 1-1/2 to 3 ounces Quantity in 24 hours: 15 to 30 ounces

Age: 4th and 5th weeks Interval between meals by day: 2-1/2 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 8 Quantity for one feeding: 2-1/2 to 4 ounces Quantity in 24 hours: 20 to 32 ounces

Age: 6th to 9th week Interval between meals by day: 2-1/2 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 8 Quantity for one feeding: 3 to 5 ounces Quantity in 24 hours: 24 to 40 ounces

Age: 9th week to 5th mo. Interval between meals by day: 3 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 7 Quantity for one feeding: 4 to 6 ounces Quantity in 24 hours: 28 to 42 ounces

Age: 5th to 9th month Interval between meals by day: 3 hours Night feedings 10 p.m. to 7 a.m.: 0 No. of feedings in 24 hours: 6 Quantity for one feeding: 5 to 7-1/2 ounces Quantity in 24 hours: 30 to 45 ounces

Age: 9th to 12th month Interval between meals by day: 4 hours Night feedings 10 p.m. to 7 a.m.: 0 No. of feedings in 24 hours: 5 Quantity for one feeding: 7 to 9 ounces Quantity in 24 hours: 35 to 45 ounces

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HOW TO KEEP A BABY WELL.

1. The mother's milk is the natural food, and nothing can fully take its place.

2. The infant's stomach does not readily accommodate itself to changes in diet; therefore, regularity in quality, quantity and temperature is extremely necessary.

3. Not until a child is a year old should it be allowed any food except that of milk, and possibly a little cracker or bread, thoroughly soaked and softened.

4. Meat should never be given to very young children. The best artificial food is cream, reduced and sweetened with sugar and milk. No rule can be given for its reduction. Observation and experience must teach that, because every child's stomach is governed by a rule of its own.

5. A child can be safely weaned at one year of age, and sometimes less. It depends entirely upon the season, and upon the health of the child.

6. A child should never be weaned during the warm weather, in June, July or August.

7. When a child is weaned it may be given, in connection with the milk diet, some such nourishment as broth, gruel, egg, or some prepared food.

8. A child should never be allowed to come to the table until two years of age.

9. A child should never eat much starchy food until four years old.

10. A child should have all the water it desires to drink, but it is decidedly the best to boil the water first, and allow it to cool. All the impurities and disease germs are thereby destroyed. This one thing alone will add greatly to the health and vigor of the child.

11. Where there is a tendency to bowel disorder, a little gum arabic, rice, or barley may be boiled with the drinking water.

12. If the child uses a bottle it should be kept absolutely clean. It is best to have two or three bottles, so that one will always be perfectly clean and fresh.

13. The nipple should be of black or pure rubber, and not of the white or vulcanized rubber; it should fit over the top of the bottle. No tubes should ever be used; it is impossible to keep them clean.

14. When the rubber becomes coated, a little coarse salt will clean it.

15. Babies should be fed at regular times. They should also be put to sleep at regular hours. Regularity is one of the best safeguards to health.

16. Milk for babies and children should be from healthy cows. Milk from different cows varies, and it is always better for a child to have milk from the same cow. A farrow cow's milk is preferable, especially if the child is not very strong.

17. Many of the prepared foods advertised for children are of little benefit. A few may be good, but what is good for one child may not be for another. So it must be simply a matter of experiment if any of the advertised foods are used.

18. It is a physiological fact that an infant is always healthier and better to sleep alone. It gets better air and is not liable to suffocation.

19. A healthy child should never be fed in less than two hours from the last time they finished before, gradually lengthening the time as it grows older. At 4 months 3-1/2 or 4 hours; at 5 months a healthy child will be better if given nothing in the night except, perhaps, a little water.

20. Give an infant a little water several times a day.

21. A delicate child the first year should be oiled after each bath. The oiling may often take the place of the bath, in case of a cold.

22. In oiling a babe, use pure olive oil, and wipe off thoroughly after each application. For nourishing a weak child use also olive oil.

23. For colds, coughs, croup, etc., use goose oil externally and give a teaspoonful at bed-time.

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HOW TO PRESERVE THE HEALTH AND LIFE OF YOUR INFANT DURING HOT WEATHER.

_BATHING._

1. Bathe infants daily in tepid water and even twice a day in hot weather.

If delicate they should be sponged instead of immersing them in water, but cleanliness is absolutely necessary for the health of infants.

_CLOTHING._

2. Put no bands in their clothing, but make all garments to hang loosely from the shoulders, and have all their clothing _scrupulously clean_; even the diaper should not be re-used without rinsing.

_SLEEP ALONE._

3. The child should in all cases sleep by itself on a cot or in a crib and retire at a regular hour. A child _always_ early taught to go to sleep without rocking or nursing is the healthier and happier for it. Begin _at birth_ and this will be easily accomplished.

_CORDIALS AND SOOTHING SYRUPS._

4. Never give cordials, soothing syrups, sleeping drops etc., without the advice of a physician. A child that frets and does not sleep is either hungry or ill. _If ill it needs a physician._ Never give candy or cake to quiet a small child, they are sure to produce disorders of the stomach, diarrhoea or some other trouble.

_FRESH AIR._

5. Children should have plenty of fresh air summer as well as winter. Avoid the severe hot sun and the heated kitchen for infants in summer. Heat is the great destroyer of infants.

_CLEAN HOUSES._

6. Keep your house clean and cool and well aired night and day. Your cellars cleared of all rubbish and white-washed every spring, your drains cleaned with strong solution of copperas or chloride of lime, poured down them once a week. Keep your gutters and yards clean and insist upon your neighbors doing the same.

_EVACUATIONS OF A CHILD._

The healthy motion varies from light orange yellow to greenish yellow, in number, two to four times daily. Smell should never be offensive. Slimy mucous-like jelly passages indicate worms. Pale green, offensive, acrid motions indicate disordered stomach. Dark green indicate acid secretions and a more serious trouble.

Fetid dark brown stools are present in chronic diarrhoea Putty-like pasty passages are due to aridity curdling the milk or to torpid liver.

_BREAST MILK._

7. Breast milk is the only proper food for infants until after the second summer. If the supply is small keep what you have and feed the child in connection with it, for if the babe is ill this breast milk may be all that will save its life.

_STERILIZED MILK._

8. Milk is the best food. Goat's milk best, cows milk next. If the child thrives on this _nothing else_ should be given during the hot weather, until the front teeth are cut. Get fresh cow's milk twice a day if the child requires food in the night, pour it into a glass fruit jar with one-third pure water for a child under three months old, afterwards the proportion of water may be less and less, also a trifle of sugar may be added.

Then place the jar in a kettle or pan of cold water, like the bottom of an oatmeal kettle. Leave the cover of the jar loose. Place it on the stove and let the water come to a boil and boil ten minutes, screw down the cover tight and boil ten minutes more, then remove from the fire, and allow it to cool in the water slowly so as not to break the jar. When partly cool put on the ice or in a cool place, and keep tightly covered except when the milk is poured out for use. The glass jar must be kept perfectly clean and washed and scalded carefully before use. A tablespoonful of lime water to a bottle of milk will aid indigestion. Discard the bottle as soon as possible and use a cup which you know is clean, whereas a bottle must be kept in water constantly when not in use, or the sour milk will make the child sick. Use no tube for it is exceedingly hard to keep it clean, and if pure milk cannot be had, condensed milk is admirable and does not need to be sterilized as the above.

_DIET._

9. Never give babies under two years old such food if grown persons eat. Their chief diet should be milk, wheat bread and milk, oatmeal, possibly a little rare boiled egg, but always and chiefly milk. Germ wheat is also excellent.

_EXERCISE._

10. Children should have exercise in the house as well as outdoors, but should not be jolted and jumped and jarred in rough play, not rudely rocked in the cradle, nor carelessly trundled over bumps in their carriages. They should not be held too much in the arms, but allowed to crawl and kick upon the floor and develop their limbs and muscles. A child should not be lifted by its arms nor dragged along by one hand after it learns to take a few feeble steps, but when they do learn to walk steadily it is the best of all exercise, especially in the open air.

Let the children as they grow older romp and play in the open air all they wish, girls as well as boys. Give the girls an even chance for health, while they are young at least, and don't mind about their complexion.

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INFANT TEETHING.

1. REMARKABLE INSTANCES.--There are instances where babies have been born with teeth, and, on the other hand, there are cases of persons who have never had any teeth at all; and others that had double teeth all around in both upper and lower jaws, but these are rare instances, and may be termed as a sort of freaks of nature.