Part 2

Certainly. I deem it to be your imperative duty to _study_ the subject well. The proper management of children is a vital question,—a mother’s question,—and the most important that can be brought under the consideration of a parent; and, strange to say, it is one that has been more neglected than any other. How many mothers undertake the responsible management of children without previous instruction, or without forethought; they undertake it as though it may be learned either by intuition or by instinct or by affection! The consequence is, that frequently they are in a sea of trouble and uncertainty, tossing about without either rule or compass; until, too often, their hopes and treasures are shipwrecked and lost!

The care and management, and consequently the health and future well-doing of the child, principally devolve upon the mother; “for it is the mother after all that has most to do with the making or the marring of the man.” Dr. Guthrie justly remarks that—“Moses might never have been the man he was unless he had been nursed by his own mother. How many celebrated men have owed their greatness and their goodness to a mother’s training!” Napoleon owed much to his mother. “‘The fate of a child,’ said Napoleon, ‘is always the work of his mother;’ and this extraordinary man took pleasure in repeating, that to his mother he owed his elevation. All history confirms this opinion.... The character of the mother influences the children more than that of the father, because it is more exposed to their daily, hourly observation.”

I am not overstating the importance of the subject in hand when I say that a child is the most valuable treasure in the world, that “he is the precious gift of God,” that he is the source of a mother’s greatest and purest enjoyment, that he is the strongest bond of affection between her and her husband, and that

“A babe in a house is a well-spring of pleasure, A messenger of peace and love.”

In the writing of the following pages I have had one object constantly in view—namely, health—

“That salt of life, which does to all a relish give; Its standing pleasure, and intrinsic wealth, The body’s virtue, and the soul’s good fortune—health.”

ABLUTION.

3. _Is a new-born infant, for the first time, to be washed in warm or in cold water?_

It is not an uncommon plan to use _cold_ water from the first, under the impression of its strengthening the child. This appears to be a cruel and barbarous practice, and is likely to have a contrary tendency. Moreover, it frequently produces either inflammation of the eyes, or stuffing of the nose, or inflammation of the lungs, or looseness of the bowels. Although I do not approve of _cold_ water, we ought not to run into an opposite extreme, as _hot_ water would weaken and enervate the babe, and thus would predispose him to disease. Lukewarm _rain_ water will be the best to wash him with. This, if it be summer, should have its temperature gradually lowered, until it be quite cold; if it be winter, a _dash_ of warm water ought still to be added, to take off the chill.

It will be necessary to use soap—Castile soap being the best for the purpose—it being less irritating to the skin than the ordinary soap. Care should be taken that it does not get into the eyes, as it may produce either inflammation or smarting of those organs.

If the skin be delicate, or if there be any excoriation or “breaking-out” on the skin, then Glycerin soap, instead of the Castile soap, ought to be used.

4. _At what age do you recommend a mother to commence washing her infant in the tub or in the nursery-basin?_

As soon as the naval-string comes away. Do not be afraid of water,—and that in plenty,—as it is one of the best strengtheners to a child’s constitution. How many infants suffer, for the want of water, from excoriation!

A nursery-basin (Wedgwood’s make is considered the best) holding either six or eight quarts of water, and which will be sufficiently large to hold the whole body of the child. The basin is generally fitted into a wooden frame, which will raise it to a convenient height for the washing of the baby.

Sir Charles Locock strongly recommends that an infant should be washed _in a tub_ from the _very_ commencement. He says: “All those that I superintend _begin_ with a tub.”—_Letter to the Author._

5. _Which do you prefer—flannel or sponge—to wash a child with?_

For the first part of the washing a piece of flannel is very useful—that is to say, to use with the soap, and to loosen the dirt and the perspiration; but for the finishing-up process, a sponge—a large sponge—is superior to flannel, to wash all away, and to complete the bathing. A sponge cleanses and gets into all the nooks, corners, and crevices of the skin. Besides, sponge, to finish up with, is softer and more agreeable to the tender skin of a child than flannel. Moreover, a sponge holds more water than flannel, and thus enables you to stream the water more effectually over him. A large sponge will act like a miniature shower bath, and will thus brace and strengthen him.

6. _To prevent a new-born babe from catching cold, is it necessary to wash his head with brandy?_

It is _not_ necessary. The idea that it will prevent cold is erroneous, as the rapid evaporation of heat which the brandy causes is more likely to give than to prevent cold.

7. _Ought that tenacious, paste-like substance, adhering to the skin of a new-born babe, to be washed off at the first dressing?_

It should, provided it be done with a soft sponge and with care. If there be any difficulty in removing the substance, gently rub it, by means of a flannel, either with a little lard, or fresh butter, or sweet oil. After the parts have been well smeared and gently rubbed with the lard, or oil, or butter, let all be washed off together, and be thoroughly cleansed away, by means of a sponge and soap and warm water, and then, to complete the process, gently put him for a minute or two in his tub. If this paste-like substance be allowed to remain on the skin, it might produce either an excoriation or a “breaking-out.” Besides, it is impossible, if that tenacious substance be allowed to remain on it, for the skin to perform its proper functions.

Mrs. Baines (who has written so much and so well on the Management of Children), in a _Letter_ to the Author, recommends flannel to be used in the _first_ washing of an infant, which flannel ought afterward to be burned; and that the sponge should be only used to complete the process, to clear off what the flannel had already loosened. She also recommends that every child should have his own sponge, each of which should have a particular distinguishing mark upon it, as she considers the promiscuous use of the same sponge to be a frequent cause of _ophthalmia_ (inflammation of the eyes). The sponges cannot be kept too clean.

8. _Have you any general observations to make on the washing of a new-born infant?_

A babe ought, every morning of his life, to be thoroughly washed from head to foot; and this can only be properly done by putting him bodily either into a tub, or into a bath, or into a large nursery-basin half filled with water. The head, before placing him in the bath, should be first wetted (but not dried); then immediately put him into the water, and, with a piece of flannel well soaked, cleanse his whole body, particularly his armpits, between his thighs, his groins, and his hams; then take a large sponge in hand, and allow the water from it, well filled, to stream all over his body, particularly over his back and loins. Let this advice be well observed, and you will find the plan most strengthening to your child. The skin must, after every bath, be thoroughly but quickly dried with warm, dry, soft towels, first enveloping the child in one, and then gently absorbing the moisture with the towel, not roughly scrubbing and rubbing his tender skin as though a horse were being rubbed down.

The ears must after each ablution be carefully and well dried with a soft dry napkin; inattention to this advice has sometimes caused a gathering in the ear—a painful and distressing complaint; and at other times it has produced deafness.

Directly after the infant is dried, all the parts that are at all likely to be chafed ought to be well powdered. After he is well dried and powdered, the chest, the back, the bowels, and the limbs should be gently rubbed, taking care not to expose him unnecessarily during such friction.

He ought to be partially washed every evening; indeed it may be necessary to use a sponge and a little warm water frequently during the day, namely, each time after the bowels have been relieved. _Cleanliness is one of the grand incentives to health_, and therefore cannot be too strongly insisted upon. If more attention were paid to this subject, children would be more exempt from chafings, “breakings-out,” and consequent suffering, than they at present are. After the second month, if the babe be delicate, the addition of two handfuls of table salt to the water he is washed with in the morning will tend to brace and strengthen him.

With regard to the best powder to dust an infant with, there is nothing better for general use than starch—the old-fashioned starch _made of wheaten flour_—reduced by means of a pestle and mortar to a fine powder; or Violet Powder, which is nothing more than finely-powdered starch scented, and which may be procured of any respectable chemist. Some mothers are in the habit of using white lead; but as this is a poison, it ought _on no account_ to be resorted to. In one case related by Koop (_Journ. de Pharm._, xx. 603), a child was destroyed by it.

9. _If the parts about the groin and fundament be excoriated, what is then the best application?_

After sponging the parts with tepid _rain_ water, holding him over his tub, and allowing the water from a well-filled sponge to stream over the parts, and then drying them with a soft napkin (not rubbing, but gently dabbing with the napkin), there is nothing better than dusting the parts frequently with finely-powdered Native Carbonate of Zinc. The best way of using this powder is, tying up a little of it in a piece of muslin, and then gently dabbing the parts with it.

Remember excoriations are generally owing to the want of water—to the want of an abundance of water. An infant who is every morning well soused and well swilled with water, seldom suffers either from excoriations or from any other of the numerous skin diseases. Cleanliness, then, is the grand preventive of, and the best remedy for, excoriations. Naaman the Syrian was ordered “to wash and be clean,” and he was healed, “and his flesh came again like unto the flesh of a little child, and he was clean.” This was, of course, a miracle; but how often does water, without any special intervention, act miraculously both in preventing and in curing skin diseases!

An infant’s clothes, napkins especially, ought never to be washed with soda; the washing of napkins with soda is apt to produce excoriations and breakings-out. “As washerwomen often deny that they use soda, it can be easily detected by simply soaking a clean napkin in fresh water and then tasting the water; if it be brackish and salt, soda has been employed.” [Communicated by Sir Charles Locock to the Author.]

10. _Who is the proper person to wash and dress the babe?_

The monthly nurse, as long as she is in attendance; but afterward the mother, unless she should happen to have an experienced, sensible, thoughtful nurse, which, unfortunately, is seldom the case. [“The Princess of Wales might have been seen on Thursday taking an airing, in a brougham in Hyde Park, with her baby—the future King of England—on her lap, without a nurse, and accompanied only by Mrs. Bruce. The Princess seems a very pattern of mothers, and it is whispered among the ladies of the Court that every evening the mother of this young gentleman may be seen in a flannel dress, in order that she may properly wash and put on baby’s night-clothes and see him safely in bed. It is a pretty subject for a picture.”—_Pall Mall Gazette._]

11. _What is the best kind of apron for a mother, or for a nurse to wear, while washing the infant?_

Flannel—a good, thick, soft flannel, usually called bath-coating—apron, made long and full, and which of course ought to be well dried every time before it is used.

12. _Perhaps you will kindly recapitulate, and give me further advice on the subject of the ablution of my babe?_

Let him by all means, then, as soon as the navel-string has separated from the body, be bathed either _in_ his tub, or _in_ his bath, or _in_ his large nursery-basin; for if he is to be strong and hearty, _in_ the water every morning he must go. The water ought to be slightly warmer than new milk. It is dangerous for him to remain for a long period in his bath; this, of course, holds good in a tenfold degree if the child has either a cold, or a pain in his bowels. Take care that, immediately after he comes out of his tub, he is well dried with warm towels. It is well to let him have his bath the first thing in the morning, and before he has been put to the breast; let him be washed before he has his breakfast; it will refresh him and give him an appetite. Besides, he ought to have his morning ablution on an empty stomach, or it may interfere with digestion, and might produce sickness and pain. In putting him in his tub, let his head be the first part washed. We all know, that in bathing in the sea, how much better we can bear the water if we first wet our head; if we do not do so, we feel shivering and starved and miserable. Let there be no dawdling in the washing; let it be quickly over. When he is thoroughly dried with warm _dry_ towels, let him be well rubbed with the warm hand of the mother or of the nurse. As I previously recommended, while drying him and while rubbing him, let him repose and kick and stretch either on the warm flannel apron, or else on a small blanket placed on the lap. One bathing in the tub, and that in the morning, is sufficient, and better than night and morning. During the day, as I before observed, he may, after the action either of his bowels or of his bladder, require several spongings of lukewarm water, _for cleanliness is a grand incentive to health and comeliness_.

Remember it is absolutely necessary to every child from his earliest babyhood to have a bath, to be immersed every morning of his life in the water. This advice, unless in cases of severe illness, admits of no exception. Water to the body—to the whole body—is a necessity of life, of health, and of happiness; it wards off disease, it braces the nerves, it hardens the frame, it is the finest tonic in the world. Oh, if every mother would follow to the very letter this advice, how much misery, how much ill health, might then be averted!

MANAGEMENT OF THE NAVEL.

13. _Should the navel-string be wrapped in_ SINGED _rag_?

There is nothing better than a piece of fine old linen rag, _unsinged_; when singed, it frequently irritates the infant’s skin.

14. _How ought the navel-string to be wrapped in the rag?_

Take a piece of soft linen rag, about three inches wide and four inches long, and wrap it neatly round the navel-string, in the same manner you would around a cut finger, and then, to keep on the rag, tie it with a few rounds of whity-brown thread. The navel-string thus covered should, pointing upward, be placed on the belly of the child, and must be secured in its place by means of a flannel belly-band.

15. _If, after the navel-string has been secured, bleeding should (in the absence of the medical man) occur, how must it be restrained?_

The nurse or the attendant ought immediately to take off the rag, and tightly, with a ligature composed of four or five whity-brown threads, retie the navel-string; and to make assurance doubly sure, after once tying it, she should pass the threads a second time around the navel-string and tie it again; and after carefully ascertaining that it no longer bleeds, fasten it up in the rag as before. Bleeding of the navel-string rarely occurs, yet if it should do so—the medical man not being at hand—the child’s after-health, or even his life, may, if the above directions be not adopted, be endangered.

16. _When does the navel-string separate from the child?_

From five days to a week after birth; in some cases not until ten days or a fortnight, or even, in rare cases, not until three weeks.

17. _If the navel-string does not at the end of a week come away, ought any means to be used to cause the separation?_

Certainly not; it ought always to be allowed to drop off, which, when in a fit state, it will readily do. Meddling with the navel-string has frequently cost the babe a great deal of suffering, and in some cases even his life.

18. _The navel is sometimes a little sore after the navel-string comes away; what ought then to be done?_

A little simple cerate should be spread on lint, and be applied every morning to the part affected; and a white-bread poultice, every night, until it be quite healed.

19. _What are the causes of a rupture of the navel? What ought to be done? Can it be cured?_

(1.) A rupture of the navel is sometimes occasioned by a meddlesome nurse. She is very anxious to cause the navel-string to separate from the infant’s body, more especially when it is longer in coming away than usual. She, therefore, before it is in a fit state to drop off, forces it away. (2.) The rupture, at another time, is occasioned by the child incessantly crying. A mother, then, should always bear in mind that a rupture of the navel is often caused by much crying, and that it occasions much crying; indeed, it is a frequent cause of incessant crying. A child, therefore, who, without any assignable cause, is constantly crying, should have his navel carefully examined.

A rupture of the navel ought always to be treated early—the earlier the better. Ruptures of the navel can only be _cured_ in infancy and in childhood. If it be allowed to run on until adult age, a _cure_ is impossible. Palliative means can then only be adopted.

The best treatment is a Burgundy pitch plaster, spread on a soft piece of wash-leather about the size of the top of a tumbler, with a properly adjusted pad (made from the plaster) fastened on the center of the plaster, which will effectually keep up the rupture, and in a few weeks will cure it. It will be necessary, from time to time, to renew the plaster until the cure be effected. These plasters will be found both more efficacious and pleasant than either a truss or an elastic bandage; which latter appliances sometimes gall, and do more harm than they do good.

20. _If a child has a groin rupture (an inguinal rupture), can that also be cured?_

Certainly, if, soon after birth, it be properly attended to. Consult a medical man, and he will supply you with a well-fitting truss, _which will eventually cure him_. If the truss be properly made (under the directions of an experienced surgeon) by a skillful surgical-instrument maker, a beautiful, nicely fitting truss will be supplied, which will take the proper and exact curve of the lower part of the infant’s belly, and will thus keep on without using any under-strap whatever—a great desideratum, as these under-straps are so constantly wetted and soiled as to endanger the patient constantly catching cold. But if this under-strap is to be superseded, the truss must be made exactly to fit the child—to fit him like a ribbon; which is a difficult thing to accomplish, unless it be fashioned by a skillful workman. It is only lately that these trusses have been made without under-straps. Formerly the under-straps were indispensable necessaries.

These groin ruptures require great attention and supervision, as the rupture (the bowel) must, before putting on the truss, be cautiously and thoroughly returned into the belly; and much care should be used to prevent the chafing and galling of the tender skin of the babe, which an ill-fitting truss would be sure to occasion. But if care and skill be bestowed on the case, a perfect cure might in due time be insured. The truss must not be discontinued until a _perfect_ cure be effected.

Let me strongly urge you to see that my advice is carried out to the very letter, as a groin rupture can only be _cured_ in infancy and in childhood. If it be allowed to run on, unattended to, until adult age, he will be obliged to wear a truss _all his life_, which would be a great annoyance and a perpetual irritation to him.

CLOTHING.

21. _Is it necessary to have a flannel cap in readiness to put on as soon as a babe is born?_

Sir Charles Locock considers that a flannel cap is _not_ necessary, and asserts that all his best nurses have long discarded flannel caps. Sir Charles states that since the discontinuance of flannel caps infants have not been more liable to inflammation of the eyes.

Such authority is, in my opinion, conclusive. My advice, therefore, to you is, by all means discontinue the use of flannel caps.

22. _What kind of a belly-band do you recommend—a flannel or a calico one?_

I prefer flannel, for two reasons—first, on account of its keeping the child’s bowels comfortably warm; and, secondly, because of its not chilling him (and thus endangering cold, etc.) when he wets himself. The belly-band ought to be moderately but not tightly applied, as, if tightly applied, it would interfere with the necessary movements of the bowels.

23. _When should the belly-band be discontinued?_

When the child is two or three months old. The best way of leaving it off is to tear a strip off daily for a few mornings, and then to leave it off altogether. “Nurses who take charge of an infant when the monthly nurse leaves are frequently in the habit of at once leaving off the belly-band, which often leads to ruptures when the child cries or strains. It is far wiser to retain it too long than too short a time; and when a child catches hooping-cough while still very young, it is safer to resume the belly-band.” [Communicated by Sir Charles Locock to the Author.]

24. _Have you any remarks to make on the clothing of an infant?_