Part 3

A baby’s clothing ought to be light, warm, loose, and free from pins. (1.) _It should be light_, without being too airy. Many infants’ clothes are both too long and too cumbersome. It is really painful to see how some poor little babies are weighed down with a weight of clothes. They may be said to “bear the burden,” and that a heavy one, from the very commencement of their lives! How absurd, too, the practice of making them wear _long_ clothes. Clothes to cover a child’s feet, and even a little beyond, may be desirable; but for clothes, when the infant is carried about, to reach to the ground, is foolish and cruel in the extreme. I have seen a delicate baby almost ready to faint under the infliction. (2.) _It should be warm_, without being too warm. The parts that ought to be kept warm are the chest, the bowels, and the feet. If the infant be delicate, especially if he be subject to inflammation of the lungs, he ought to wear a fine flannel, instead of his usual shirts, which should be changed as frequently. (3.) _The dress should be loose_, so as to prevent any pressure upon the blood-vessels, which would otherwise impede the circulation, and thus hinder a proper development of the parts. It ought to be loose about the chest and waist, so that the lungs and the heart may have free play. It should be loose about the stomach, so that digestion may not be impeded; it ought to be loose about the bowels, in order that the spiral motion of the intestines may not be interfered with; hence the importance of putting on a belly-band moderately slack; it should be loose about the sleeves, so that the blood may course, without let or hindrance, through the arteries and veins; it ought to be loose, then, everywhere, for nature delights in freedom from restraint, and will resent, sooner or later, any interference. Oh that a mother would take common sense, and not custom, as her guide! (4.) _As few pins_ should be used in the dressing of a baby as possible. Inattention to this advice has caused many a little sufferer to be thrown into convulsions.

The generality of mothers use no pins in the dressing of their children; they tack with a needle and thread every part that requires fastening. They do not even use pins to fasten the baby’s napkins. They make the diapers with loops and tapes, and thus altogether supersede the use of pins in the dressing of an infant. The plan is a good one, takes very little extra time, and deserves to be universally adopted. If pins be used for the napkins, they ought to be the Patent Safety Pins.

25. _Is there any necessity for a nurse being particular in airing an infant’s clothes before they are put on? If she were less particular, would it not make him more hardy?_

A nurse cannot be too particular on this head. A baby’s clothes ought to be well aired the day before they are put on, as they should _not_ be put on warm from the fire. It is well, where it can be done, to let him have clean clothes daily. Where this cannot be afforded, the clothes, as soon as they are taken off at night, ought to be well aired, so as to free them from the perspiration, and that they may be ready to put on the following morning. It is truly nonsensical to endeavor to harden a child, or any one else, by putting on damp clothes!

26. _What is your opinion of caps for an infant?_

The head ought to be kept cool; caps, therefore, are unnecessary. If caps be used at all, they should only be worn for the first month in summer, or for the first two or three months in winter. If a babe take to caps, it requires care in leaving them off, or he will catch cold. When you are about discontinuing them, put a thinner and a thinner one on, every time they are changed, until you leave them off altogether.

But remember, my opinion is, that a child is better _without_ caps; they only heat his head, cause undue perspiration, and thus make him more liable to catch cold.

If a babe does not wear a cap in the day, it is not at all necessary that he should wear one at night. He will sleep more comfortably without one, and it will be better for his health. Moreover, night-caps injure both the thickness and the beauty of the hair.

27. _Have you any remarks to make on the clothing of an infant, when, in the winter time, he is sent out for exercise?_

Be sure that he is well wrapped up. He ought to have under his cloak a knitted worsted spencer, which should button behind; and if the weather be very cold, a shawl over all; and, provided it be dry above, and the wind be not in the east or in the northeast, he may then brave the weather. He will then come from his walk refreshed and strengthened, for cold air is an invigorating tonic. In a subsequent conversation I will indicate the proper age at which a child should be first sent out to take exercise in the open air.

28. _At what age ought an infant “to be shortened?”_

This, of course, will depend upon the season. In the summer, the right time “for shortening a babe,” as it is called, is at the end of two months; in the winter, at the end of three months. But if the right time for “shortening” a child should happen to be in the spring, let it be deferred until the end of May. The English springs are very trying and treacherous; and sometimes, in April, the weather is almost as cold, and the wind as biting, as in winter. It is treacherous, for the sun is hot, and the wind, which is at this time of the year frequently easterly, is keen and cutting. I should far prefer “to shorten” a child in the winter than in the early spring.

DIET.

29. _Are you an advocate for putting a baby to the breast soon after birth, or for waiting, as many do, until the third day?_

The infant ought to be put to the breast soon after birth; the interest, both of the mother and of the child, demands it. It will be advisable to wait three or four hours, that the mother may recover from her fatigue; and then the babe must be put to the breast. If this be done, he will generally take the nipple with avidity.

It might be said that at so early a period there is no milk in the breast; but such is not usually the case. There generally is a _little_ from the very beginning; which acts on the baby’s bowels like a dose of purgative medicine, and appears to be intended by nature to cleanse the system. But, provided there be no milk at first, the very act of sucking not only gives the child a notion, but, at the same time, causes a draught (as it is usually called) in the breast, and enables the milk to flow easily.

Of course, if there be _no_ milk in the breast—the babe having been applied once or twice to determine the fact—then you must wait for a few hours before applying him again to the nipple, that is to say, until the milk be secreted.

An infant who, for two or three days, is kept from the breast, and who is fed upon gruel, generally becomes feeble, and frequently, at the end of that time, will not take the nipple at all. Besides, there is a thick cream (similar to the biestings of a cow), which, if not drawn out by the child, may cause inflammation and gathering of the bosom, and, consequently, great suffering to the mother. Moreover, placing him _early_ to the breast moderates the severity of the mother’s after-pains, and lessens the risk of her flooding. A new-born babe must _not_ have gruel given to him, as it disorders the bowels, causes a disinclination to suck, and thus makes him feeble.

30. _If an infant show any disinclination to suck, or if he appear unable to apply his tongue to the nipple, what ought to be done?_

Immediately call the attention of the medical man to the fact, in order that he may ascertain whether he be tongue-tied. If he be, the simple operation of dividing the bridle of the tongue will remedy the defect, and will cause him to take the nipple with ease and comfort.

31. _Provided there be no milk_ AT FIRST, _what ought then to be done_?

Wait with patience: the child (if the mother has no milk) will not, for at least twelve hours, require artificial food. In the generality of instances, then, artificial food is not at all necessary; but if it should be needed, one-third of new milk and two-thirds of warm water, slightly sweetened with loaf sugar (or with brown sugar, if the babe’s bowels have not been opened), should be given, in small quantities at a time, every four hours, until the milk be secreted, and then it must be discontinued. The infant ought to be put to the nipple every four hours, but not oftener, until he be able to find nourishment.

If, after the application of the child for a few times, he is unable to find nourishment, then it will be necessary to wait until the milk be secreted. As soon as it is secreted, he must be applied, with great regularity, _alternately_ to each breast.

I say _alternately_ to each breast. _This is most important advice._ Sometimes a child, for some inexplicable reason, prefers one breast to the other, and the mother, to save a little contention, concedes the point, and allows him to have his own way. And what is frequently the consequence?—a gathered breast!

We frequently hear of a babe having no notion of sucking. This “no notion” may generally be traced to bad management, to stuffing him with food, and thus giving him a disinclination to take the nipple at all.

32. _How often should a mother suckle her infant?_

A mother generally suckles her baby too often, having him almost constantly at the breast. This practice is injurious both to parent and to child. The stomach requires repose as much as any other part of the body; and how can it have it if it be constantly loaded with breast-milk? For the first month, he ought to be suckled about every hour and a half; for the second month, every two hours,—gradually increasing, as he becomes older, the distance of time between, until at length he has it about every four hours.

If a baby were suckled at stated periods, he would only look for the bosom at those times, and be satisfied. A mother is frequently in the habit of giving the child the breast every time he cries, regardless of the cause. The cause too frequently is, that he has been too often suckled—his stomach has been overloaded; the little fellow is constantly in pain, and he gives utterance to it by cries. How absurd is such a practice! We may as well endeavor to put out a fire by feeding it with fuel. An infant ought to be accustomed to regularity in every thing—in times for suckling, for sleeping, etc. No children thrive so well as those who are thus early taught.

33. _Where the mother is_ MODERATELY _strong, do you advise that the infant should have any other food than the breast_?

Artificial food must not, for the first three or four months, be given, if the parent be _moderately_ strong; of course, if she be feeble, a _little_ food will be necessary. Many delicate women enjoy better health while suckling than at any other period of their lives.

34. _What food is the best substitute for a mother’s milk?_

The food that suits one infant will not agree with another. (1.) The one that I have found the most generally useful, is made as follows: Boil the crumb of bread for two hours in water, taking particular care that it does not burn; then add only a _little_ lump sugar (or _brown_ sugar, if the bowels be costive), to make it palatable. When he is five or six months old, mix a little new milk—the milk of ONE cow—with it, gradually, as he becomes older, increasing the quantity until it be nearly all milk, there being only enough water to boil the bread; the milk should be poured boiling hot on the bread. Sometimes the two milks—the mother’s and the cow’s milk—do not agree; when such is the case, let the milk be left out, both in this and in the foods following, and let the food be made with water instead of with milk and water. In other respects, until the child is weaned, let it be made as above directed; when he is weaned, good fresh cow’s milk MUST, as previously recommended, be used. (2.) Or, cut thin slices of bread into a basin, cover the bread with _cold_ water, place it in an oven for two hours to bake; take it out, beat the bread up with a fork, and then slightly sweeten it. This is an excellent food. (3.) If the above should not agree with the infant (although, if properly made, they almost invariably do), “tous-les-mois” may be given. (4.) Or, Robb’s Biscuit, as it is “among the best bread compounds made out of wheat-flour, and is almost always readily digested.”—_Routh._ “Tous-les-mois” is the starch obtained from the tuberous roots of various species of _canna_; and is imported from the West Indies. It is very similar to arrow-root. I suppose it is called “tous-les-mois,” as it is good to be eaten all the year round.

(5.) Another good food is the following: Take about a pound of flour, put it in a cloth, tie it up tightly, place it in a saucepanful of water, and let it boil for four or five hours; then take it out, peel off the outer rind, and the inside will be found quite dry, which grate. (6.) Another way of preparing an infant’s food, is to bake flour—biscuit flour—in a slow oven, until it be of a light fawn color. (7.) An excellent food for a baby, is baked crumbs of bread. The manner of preparing it is as follows: Crumb some bread on a plate; put it a little distance from the fire to dry. When dry, rub the crumbs in a mortar, and reduce them to a fine powder; then pass them through a sieve. Having done which, put the crumbs of bread into a slow oven, and let them bake until they be of a light fawn color. A small quantity either of the boiled, or of the baked flour, or of the baked crumb of bread, ought to be made into food in the same way as gruel is made, and should then be slightly sweetened, according to the state of the bowels, either with lump or with brown sugar.

(8.) Baked flour sometimes produces constipation; when such is the case, Mr. Appleton of Budleigh Salterton, Devon, wisely recommends a mixture of baked flour and prepared oatmeal, in the proportion of two of the former and one of the latter. He says: “To avoid the constipating effects, I have always had mixed, before baking, one part of prepared oatmeal with two parts of flour; this compound I have found both nourishing, and regulating to the bowels. One tablespoonful of it, mixed with a quarter of a pint of milk, or milk and water, when well boiled, flavored, and sweetened with white sugar, produces a thick, nourishing, and delicious food for infants or invalids.” He goes on to remark: “I know of no food, after repeated trials, that can be so strongly recommended by the profession to all mothers in the rearing of their infants, without or with the aid of the breast, at the same time relieving them of much draining and dragging while nursing with an insufficiency of milk, as baked flour and oatmeal.” If there is any difficulty in obtaining _prepared_ oatmeal, Robertson’s Patent Groats will answer equally as well.

(9.) A ninth food may be made with “Farinaceous Food for Infants, prepared by Hards of Dartford.” If Hards’ Farinaceous Food produces costiveness—as it sometimes does—let it be mixed either with equal parts or with one-third of Robertson’s Patent Groats. The mixture of the two together makes a splendid food for a baby. (10.) A tenth, and an excellent one, may be made with rusks, boiled for an hour in water, which ought then to be well beaten up by means of a fork, and slightly sweetened with lump sugar. Great care should be taken to select good rusks, as few articles vary so much in quality. (11.) An eleventh is—the top crust of a baker’s loaf, boiled for an hour in water, and then moderately sweetened with lump sugar. If, at any time, the child’s bowels should be costive, _raw_ must be substituted for _lump_ sugar. (12.) Another capital food for an infant, is that made by Lemann’s Biscuit Powder. (13.) Or, Brown and Polson’s Patent Corn Flour will be found suitable. The Queen’s cook, in his recent valuable work, gives the following formula for making it: “To one dessertspoonful of Brown & Polson, mixed with a wineglassful of cold water, add half a pint of boiling water; stir over the fire for five minutes; sweeten lightly, and feed the baby; but if the infant is being brought up by the hand, this food should then be mixed with milk—not otherwise.”

(14.) The following is a good and nourishing food for a baby: Soak, for an hour, some _best_ rice in cold water; strain, and add fresh water to the rice; then let it simmer till it will pulp through a sieve; put the pulp and the water in a saucepan, with a lump or two of sugar, and again let it simmer for a quarter of an hour; a portion of this should be mixed with one-third of fresh milk, so as to make it of the consistence of good cream.

When the baby is five or six months old, new milk should be added to any of the above articles of food, in a similar way to that recommended for boiled bread.

(15.) For a delicate infant, lentil powder, better known as Du Barry’s “Revalenta Arabica,” is invaluable. It ought to be made into food, with new milk, in the same way that arrow-root is made, and should be moderately sweetened with loaf sugar. Whatever food is selected ought to be given by means of a nursing-bottle.

If a child’s bowels be relaxed and weak, or if the motions be offensive, the milk _must_ be boiled. The following (16.) is a good food when an infant’s bowels are weak and relaxed: “Into five large spoonfuls of the purest water rub smooth one dessertspoonful of fine flour. Set over the fire five spoonfuls of new milk, and put two bits of sugar into it; the moment it boils, pour it into the flour and water, and stir it over a slow fire twenty minutes.”

Where there is much emaciation, I have found (17.) genuine arrow-root a very valuable article of food for an infant, as it contains a great deal of starch, which starch helps to form fat and to evolve caloric (heat)—both of which a poor, emaciated, chilly child stands so much in need of. It must be made with good fresh milk, and ought to be slightly sweetened with loaf sugar; a small pinch of table salt should be added to it.

I have given you a large and well-tried infant’s dietary to choose from, as it is sometimes difficult to fix on one that will suit; but remember, if you find one of the above to agree, keep to it, as a baby requires a simplicity in food—a child a greater variety.

Let me, in this place, insist upon the necessity of great care and attention being observed in the preparation of any of the above articles of diet. A babe’s stomach is very delicate, and will revolt at either ill-made, or lumpy, or burnt food. Great care ought to be observed as to the cleanliness of the cooking utensils. The above directions require the strict supervision of the mother.

Broths have been recommended, but, for my own part, I think that, for a _young_ infant, they are objectionable; they are apt to turn acid on the stomach, and to cause flatulence and sickness; they sometimes disorder the bowels and induce griping and purging.

Whatever artificial food is used ought to be given by means of a bottle, not only as it is a more natural way than any other of feeding a baby, as it causes him to suck as though he were drawing it from the mother’s breast, but as the act of sucking causes the salivary glands to press out their contents, which materially assists digestion. Moreover, it seems to satisfy and comfort him more than it otherwise would do.

The food ought to be of the consistence of good cream, and should be made fresh and fresh. It ought to be given milk-warm. Attention must be paid to the cleanliness of the vessel, and care should be taken that the milk be that of ONE cow, and that it be new and of good quality; for if not, it will turn acid and sour, and disorder the stomach, and will thus cause either flatulence or looseness of the bowels, or perhaps convulsions. I consider it to be of immense importance to the infant, that the milk be had from ONE cow. A writer in the _Medical Times and Gazette_, speaking on this subject, makes the following sensible remarks: “I do not know if a practice common among French ladies, when they do not nurse, has obtained the attention among ourselves which it seems to me to deserve. When the infant is to be fed with cow milk, that from various cows is submitted to examination by the medical man, and, if possible, tried on some child, and when the milk of any cow has been chosen, no other milk is ever suffered to enter the child’s lips, for a French lady would as soon offer to her infant’s mouth the breasts of half-a-dozen wet-nurses in the day, as mix together the milk of various cows, which must differ even as the animals themselves, in its constituent qualities. Great attention is also paid to the pasture, or other food of the cow thus appropriated.”

The only way to be sure of having it from _one_ cow, is (if you have not a cow of your own) to have the milk from a _respectable_ cow-keeper, and to have it brought to your house in a can of your own (the London milk-cans being the best for the purpose). The better plan is to have two cans and to have the milk fresh, and fresh every night and morning. The cans, after each time of using, ought to be scalded out; and, once a week, the can should be filled with _cold_ water, and the water should be allowed to remain in it until the can be again required.

Very little sugar should be used in the food, as much sugar weakens the digestion. A small pinch of table salt ought to be added to whatever food is given, as “the best savor is salt.” Salt is most wholesome—it strengthens and assists digestion, prevents the formation of worms, and, in small quantities, may with advantage be given (if artificial food be used) to the youngest baby.

35. _Where it is found to be absolutely necessary to give an infant artificial food_ WHILE SUCKLING, _how often ought he to be fed_?

Not oftener than twice during the twenty-four hours, and then only in _small_ quantities at a time, as the stomach requires rest, and at the same time can manage to digest a little food better than it can a great deal.

Let me again urge upon you the importance, if it be at all practicable, of keeping the child _entirely_ to the breast for the first three or four months of his existence. Remember there is no _real_ substitute for a mother’s milk; there is no food so well adapted to his stomach; there is no diet equal to it in developing muscle, in making bone, or in producing that beautiful plump rounded contour of the limbs; there is nothing like a mother’s milk _alone_ in making a child contented and happy, in laying the foundation of a healthy constitution, in preparing the body for a long life, in giving him tone to resist disease, or in causing him to cut his teeth easily and well; in short, _the mother’s milk is the greatest temporal blessing an infant can possess_.

As a general rule, therefore, when the child and the mother are tolerably strong, he is better _without artificial_ food until he has attained the age of three or four months; then it will usually be necessary to feed him twice a day, so as gradually to prepare him to be weaned (if possible) at the end of nine months. The food mentioned in the foregoing conversation will be the best for him, commencing _without_ the cow’s milk, but gradually adding it, as less mother’s milk and more artificial food be given.

36. _When the mother is not able to suckle her infant herself, what ought to be done?_