Part 6

I would apply no external application to cure it, as I should look upon it as an effort of the constitution to relieve itself; and should expect, if the “breaking-out” were repelled, that either convulsions, or bronchitis, or inflammation of the lungs, or water on the brain would be the consequence.

The only plan I should adopt would be, to be more careful in his diet: to give him less meat (if he be old enough to eat animal food), and to give him, once or twice a week, a few doses of mild aperient medicine; and, if the irritation from the “breaking-out” be great, to bathe it occasionally either with a little warm milk and water, or with rose water.

EXERCISE.

74. _Do you recommend exercise in the open air for a baby? and if so, how soon after birth?_

I am a great advocate for having exercise in the open air. “The infant in arms makes known its desire for fresh air by restlessness—it cries, for it cannot speak its wants: is taken abroad, and is quiet.”

The age at which he ought to commence taking exercise will, of course, depend upon the season and upon the weather. If it be summer, and the weather be fine, he should be carried in the open air a week or a fortnight after birth; but if it be winter, he ought not, on any account, to be taken out under the month, and not even then, unless the weather be mild for the season, and it be the middle of the day. At the end of two months he should breathe the open air more frequently. And after the expiration of three months he ought to be carried out _every day_, even if it be wet under foot, provided it be fine above, and the wind be neither in an easterly nor in a northeasterly direction; by doing so we shall make him strong and hearty, and give the skin that mettled appearance which is so characteristic of health. He must, of course, be well clothed.

I cannot help expressing my disapprobation of the practice of smothering up an infant’s face with a handkerchief, with a veil, or with any other covering, when he is taken out into the air. If his face be so muffled up, he may as well remain at home; as, under such circumstances, it is impossible for him to receive any benefit from the invigorating effects of the fresh air.

75. _Can you devise any method to induce a baby himself to take exercise?_

He must be encouraged to use muscular exertion; and, for this purpose, he ought to be frequently laid either upon a rug, or carpet, or the floor: he will then stretch his limbs and kick about with perfect glee. It is a pretty sight, to see a little fellow kicking and sprawling on the floor. He crows with delight, and thoroughly enjoys himself: it strengthens his back; it enables him to stretch his limbs, and to use his muscles; and is one of the best kinds of exercise a very young child can take. While going through his performances, his diaper, if he wear one, should be unfastened, in order that he might go through his exercises untrammeled. By adopting the above plan, the babe quietly enjoys himself—his brain is not over-excited by it; this is an important consideration, for both mothers and nurses are apt to rouse and excite very young children, to their manifest detriment. A babe requires rest, and not excitement. How wrong it is, then, for either a mother or a nurse to be exciting and rousing a new-born babe. It is most injurious and weakening to his brain. In the early period of his existence his time ought to be almost entirely spent in sleeping and in sucking!

76. _Do you approve of tossing an infant much about?_

I have seen a child tossed up nearly to the ceiling! Can anything be more cruel or absurd? Violent tossing of a young babe ought never to be allowed: it only frightens him, and has been known to bring on convulsions. He should be gently moved up and down (not tossed): such exercise causes a proper circulation of the blood, promotes digestion, and soothes to sleep. He must always be kept quiet immediately after taking the breast: if he be tossed _directly_ afterward, it interferes with his digestion, and is likely to produce sickness.

SLEEP.

77. _Ought the infant’s sleeping apartment to be kept warm?_

The lying-in room is generally kept too warm, its heat being, in many instances, more that of an oven than of a room. Such a place is most unhealthy, and is fraught with danger both to the mother and the baby. We are not, of course, to run into an opposite extreme, but are to keep the chamber at a moderate and comfortable temperature. The door ought occasionally to be left ajar, in order the more effectually to change the air and thus to make it more pure and sweet.

A new-born babe, then, ought to be kept comfortably warm, but not very warm. It is folly in the extreme to attempt to harden a very young child either by allowing him, in the winter time, to be in a bed-room without a fire, or by dipping him in _cold_ water, or by keeping him with scant clothing on his bed. The temperature of a bed-room, in the winter time, should be, as nearly as possible, at 60° Fahr. Although the room should be comfortably warm, it ought, from time to time, to be properly ventilated. An unventilated room soon becomes foul, and, therefore, unhealthy. How many in this world, both children and adults, are “poisoned with their own breaths!”

An infant should not be allowed to look at the glare either of a fire or of a lighted candle, as the glare tends to weaken the sight, and sometimes brings on an inflammation of the eyes. In speaking to and in noticing a baby, you ought always to stand _before_ and not _behind_ him, or it might make him squint.

78. _Ought a babe to lie alone from the first?_

Certainly not. At first—say for the first few months—he requires the warmth of another person’s body, especially in the winter; but care must be taken not to overlay him, as many infants, from carelessness in this particular, have lost their lives. After the first few months, he had better lie alone, on a horse-hair mattress.

79. _Do you approve of rocking an infant to sleep?_

I do not. If the rules of health be observed, he will sleep both soundly and sweetly without rocking; if they be not, the rocking might cause him to fall into a feverish, disturbed slumber, but not into a refreshing, calm sleep. Besides, if you once take to that habit, he will not go to sleep without it.

80. _Then don’t you approve of a rocking-chair, and of rockers to the cradle?_

Certainly not: a rocking-chair, or rockers to the cradle, may be useful to a lazy nurse or mother, and may induce a child to sleep, but that restlessly, when he does not need sleep, or when he is wet and uncomfortable, and requires “changing;” but will not cause him to have that sweet and gentle and exquisite slumber so characteristic of a baby who has no artificial appliances to make him sleep. No! rockers are perfectly unnecessary, and the sooner they are banished the nursery the better will it be for the infant community. I do not know a more wearisome and monotonous sound than the everlasting rockings to and fro in some nurseries; they are often accompanied by a dolorous lullaby from the nurse, which adds much to the misery and depressing influence of the performance.

81. _While the infant is asleep, do you advise the head of the crib to be covered with a handkerchief, to shade his eyes from the light, and, if it be summer time, to keep off the flies?_

If the head of the crib be covered, the baby cannot breathe freely; the air within the crib becomes contaminated, and thus the lungs cannot properly perform their functions. If his sleep is to be refreshing, he must breathe pure air. I do not even approve of a head to a crib. A child is frequently allowed to sleep on a bed with the curtains drawn completely close, as though it were dangerous for a breath of air to blow upon him! This practice is most injurious. An infant must have the full benefit of the air of the room; indeed, the bed-room door ought to be frequently left ajar, so that the air of the apartment may be changed—taking care, of course, not to expose him to a draught. If the flies while he is asleep, annoy him, let a _net_ veil be thrown over his face, as he can readily breathe through net, but not through a handkerchief. I have somewhere read that if a cage containing a canary, be suspended at night within a bed where a person is sleeping, and the curtains be drawn closely around, that the bird will, in the morning, in all probability be found dead!

82. _Have you any suggestions to offer as to the way a babe should be dressed when he is put down to sleep?_

Whenever he be put down to sleep, be more than usually particular that his dress be loose in every part; be careful that there be neither strings nor bands to cramp him. Let him, then, during repose, be more than ordinarily free and unrestrained—

“If, while in cradled rest your infant sleeps, Your watchful eye unceasing vigils keeps, Lest cramping bonds his pliant limbs constrain, And cause defects that manhood may retain.”

83. _Is it a good sign for a young child to sleep much?_

A babe who sleeps a great deal thrives much more than one who does not. I have known many children who were born small and delicate, but who slept the greatest part of their time, become strong and healthy. On the other hand, I have known those who were born large and strong, yet who slept but little, become weak and unhealthy.

The common practice of a nurse allowing a baby to sleep upon her lap is a bad one, and ought never to be countenanced. He sleeps cooler, more comfortably, and soundly in his crib.

The younger an infant is the more he generally sleeps, so that during the early months he is seldom awake, and then only to take the breast. It may be interesting to a mother to know the average weight of new-born infants. There is a paper on the subject in the _Medical Circular_ and which has been abridged in _Braithwaite’s Retrospect of Medicine_. The following are extracts: “Dr. E. von Siebold presents a table of the weights of 3000 infants (1586 male and 1414 female), weighed immediately after birth. From this table (for which we have not space) it results that by far the greater number of the children (2215) weighed between 6 and 8 lbs. From 5¾ to 6 lbs. the number rose from 99 to 268; and from 8 to 8¼ lbs. they fell from 226 to 67, and never rose again at any weight to 100. From 8¾ to 9½ lbs. they sank from 61 to 8, rising, however, at 9½ lbs. to 21. Only six weighed 10 lbs., one 10¾ lbs., and two 11 lbs. The author has never but once met with a child weighing 11¾ lbs. The most frequent weight in the 3000 was 7 lbs., numbering 426. It is a remarkable fact, that until the weight of 7 lbs. the female infants exceeded the males in number, the latter thenceforward predominating.

“... From these statements, and those of various other authors here quoted, the conclusion may be drawn that the normal weight of a mature new-born infant is not less than 6 nor more than 8 lbs., the average weight being 6½ or 7 lbs., the smaller number referring to female and the higher to male infants.”

84. _How is it that much sleep causes a young child to thrive so well?_

If there be pain in any part of the body, or if any of the functions be not properly performed, he sleeps but little. On the contrary, if there be exemption from pain, and if there be a due performance of all the functions, he sleeps a great deal; and thus the body becomes refreshed and invigorated.

85. _As much sleep is of such advantage, if an infant sleep but little, would you advise composing medicine to be given to him?_

Certainly not. The practice of giving composing medicine to a young child cannot be too strongly reprobated. If he does not sleep enough, the mother ought to ascertain if the bowels be in a proper state, whether they be sufficiently opened that the motions be of a good color—namely, a bright yellow, inclining to orange color—and free from slime or from had smell. An occasional dose of rhubarb and magnesia is frequently the best composing medicine he can take.

86. _We often hear of Coroner’s inquests upon infants who have been found dead in bed—accidentally overlaid: what is usually the cause?_

Suffocation, produced either by ignorance or by carelessness. From _ignorance_ in mothers, in their not knowing the common laws of life, and the vital importance of free and unrestricted respiration, not only when babies are up and about, but when they are in bed and asleep. From _carelessness_, in their allowing young and thoughtless servants to have the charge of infants at night; more especially as young girls are usually heavy sleepers, and are thus too much overpowered with sleep to attend to their necessary duties.

A foolish mother sometimes goes to sleep while allowing her child to continue sucking. The unconscious babe, after a time, looses the nipple, and buries his head in the bedclothes. She awakes in the morning, finding, to her horror, a corpse by her side! A mother ought, therefore, never to go to sleep until her child has finished sucking.

_The following are a few rules to prevent an infant from being accidentally overlaid_: (1.) Let your baby, while asleep, have plenty of room in bed. (2.) Do not allow him to be too near to you; or if he be unavoidably near to you (from the small size of the bed), let his face be turned to the opposite side. (3.) Let him lie fairly either on his side or on his back. (4.) Be careful to ascertain that his mouth be not covered with the bedclothes; and (5.) Do not smother his face with clothes, as a plentiful supply of pure air is as necessary when he is awake, or even more so, than when he is asleep. (6.) Never let him lie low in the bed. (7.) Let there be _no_ pillow near the one his head is resting on, lest he roll to it, and thus bury his head in it. Remember, a young child has neither the strength nor the sense to get out of danger; and, if he unfortunately either turn on his face, or bury his head in a pillow that is near, the chances are that he will be suffocated, more especially as these accidents usually occur at night, when the mother or the nurse is fast asleep. (8.) Never intrust him at night to a young, giddy, and thoughtless servant.

THE BLADDER AND THE BOWELS OF AN INFANT.

87. _Have you any hints to offer respecting the bowels and the bladder of an infant during the first three months of his existence?_

A mother ought daily to satisfy herself as to the state of the bladder and the bowels of her child. She herself should inspect the motions, and see that they are of a proper color (bright yellow, inclining to orange) and consistence (that of thick gruel), that they are neither slimy, nor curdled, nor green; if they should be either the one or the other, it is a proof that she herself has, in all probability, been imprudent in her diet, and that it will be necessary for the future that she be more careful both in what she eats and in what she drinks.

She ought, moreover, to satisfy herself that the urine does not smell strongly, that it does not stain the napkins, and that he make a sufficient quantity.

A frequent cause of a child crying is, he is wet and uncomfortable, and wants drying and changing, and the only way he has of informing his mother of the fact is by crying lustily, and thus telling her in most expressive language of her thoughtlessness and carelessness.

88. _How soon may an infant dispense with napkins?_

A baby three months and upward, ought to be held out at least a dozen times during the twenty-four hours; if such a plan were adopted, napkins might at the end of three months be dispensed with—a great _desideratum_—and he would be inducted into clean habits—a blessing to himself, and a comfort to all around, and a great saving of dresses and of furniture. “Teach your children to be clean. A dirty child is the mother’s disgrace.” Truer words were never written: A DIRTY CHILD IS THE MOTHER’S DISGRACE!

AILMENTS, DISEASE, ETC.

89. _A new-born babe frequently has a collection of mucus in the air-passages, causing him to wheeze: is it a dangerous symptom?_

No, not if it occur _immediately_ after birth; as soon as the bowels have been opened, it generally leaves him, or even before, if he give a good cry, which as soon as he is born he usually does. If there be any mucus either within or about the mouth, impeding breathing, it must with a soft handkerchief be removed.

90. _Is it advisable, as soon as an infant is born, to give him medicine?_

It is now proved that the giving of medicine to a babe _immediately_ after birth is unnecessary, nay, that it is hurtful—that is, provided he be early put to the breast, as the mother’s _first_ milk is generally sufficient to open the bowels. Sir Charles Locock makes the following sensible remarks on the subject: “I used to limit any aperient to a new-born infant to those which had not the first milk, and who had wet-nurses whose milk was, of course, some weeks old; but for many years I have never allowed any aperient at all to any new-born infant, and I am satisfied it is the safest and the wisest plan.”

This advice of Sir Charles Locock—_to give no aperient to a new-born infant_—is most valuable, and ought to be strictly followed. By adopting his recommendation much after-misery might be averted. If a new-born babe’s bowels be costive, rather than give him an aperient, try the effect of a little moist sugar dissolved in a little water; that is to say, dissolve half a teaspoonful of pure unadulterated _raw_ sugar in a teaspoonful of warm water, and administer it to him; if in four hours it should not operate, repeat the dose. Butter and raw sugar is a popular remedy, and is sometimes used by a nurse to open the bowels of a new-born babe, and where there is costiveness answers the purpose exceedingly well, and is far superior to castor oil. Try, by all means to do, if possible, without a particle of opening medicine. If you once begin to give aperients, you will have frequently to repeat them. Opening physic leads to opening physic, until at length his stomach and bowels will become a physic shop! Let me, then, emphatically say, avoid, if possible, giving a new-born babe a drop or a grain of opening medicine. If from the first you refrain from giving an aperient, he seldom requires one afterward. It is the _first_ step that is so important to take in this as in all other things.

If a new-born babe has _not_ for twelve hours made water, the medical man ought to be informed of it, in order that he may inquire into the matter and apply the proper remedies. Be particular in attending to these directions, or evil consequences will inevitably ensue.

91. _Some persons say that new-born female infants have milk in their bosoms, and that it is necessary to squeeze them, and apply plasters to disperse the milk._

The idea of there being real milk in a baby’s breast is doubtful, the squeezing of the bosom is barbarous, and the application of plasters is useless. “Without actually saying,” says Sir Charles Locock, “there is milk secreted in the breasts of infants, there is undoubtedly not rarely considerable swelling of the breasts both in _female_ and _male_ infants, and on squeezing them a serous fluid oozes out. I agree with you that the nurses should never be allowed to squeeze them, but be ordered to leave them alone.”

92. _Have the goodness to mention the_ SLIGHT _ailments which are not of sufficient importance to demand the assistance of a medical man_?

I deem it well to make the distinction between _serious_ and _slight_ ailments; I am addressing a mother. With regard to _serious_ ailments, I do not think myself justified, except in certain _urgent_ cases, in instructing a parent to deal with them. It might be well to make a mother acquainted with the _symptoms_, but not with the _treatment_, in order that she might lose no time in calling in medical aid. This I hope to have the pleasure of doing in future conversations.

_Serious_ diseases, _with a few exceptions_, and which I will indicate in subsequent conversations, ought never to be treated by a parent, not even in the _early_ stages, for it is in the early stages that the most good can generally be done. It is utterly impossible for any one who is not trained to the medical profession to understand a _serious_ disease in all its bearings, and thereby to treat it satisfactorily.

There are some exceptions to these remarks. It will be seen, in future conversations, that Sir Charles Locock considers that a mother ought to be made acquainted with the _treatment_ of _some_ of the more _serious_ diseases, where delay in obtaining _immediate_ medical assistance might be death. I bow to his superior judgment, and have supplied the deficiency in subsequent conversations.

The ailments and the diseases of infants, such as may, in the absence of the doctor, be treated by a parent, are the following: Chafings, Convulsions, Costiveness, Flatulence, Gripings, Hiccup, Looseness of the Bowels (Diarrhœa), Dysentery, Nettle-rash, Red-gum, Stuffing of the Nose, Sickness, Thrush. In all these complaints I will tell you—_What to do_, and—_What_ NOT _to do_.

93. _What are the causes and the treatment of chafing?_

The want of water: inattention and want of cleanliness are the usual causes of chafing.

_What to do._—The chafed parts ought to be well and thoroughly sponged with tepid _rain_ water—allowing the water from a well-filled sponge to stream over them—and, afterward, they should be thoroughly but tenderly dried with a soft towel, and then be dusted, either with finely-powdered starch made of wheaten flour, or with violet powder, or with finely-powdered native carbonate of zinc, or they should be bathed with finely-powdered fuller’s-earth and tepid water.

If, in a few days, the parts be not healed, discontinue the above treatment, and use the following application: Beat up well together the whites of two eggs, then add, drop by drop, two tablespoonfuls of brandy. When well mixed put it into a bottle and cork it up. Before using it let the excoriated parts be gently bathed with lukewarm rain water, and, with a soft napkin, be tenderly dried; then, by means of a camel’s-hair brush, apply the above liniment, having first shaken the bottle.

But bear in mind, after all that can be said and done, _that there is nothing in these cases like water_—there is nothing like keeping the parts clean, and the only way of _thoroughly_ effecting this object is _by putting him every morning_ INTO _his tub_.

_What_ NOT _to do_.—Do not apply white lead, as it is a poison. Do not be afraid of using _plenty_ of water, as cleanliness is one of the most important items of the treatment.

94. _What are the causes of convulsions in an infant?_

Stuffing him, in the early months of his existence, _with food_, the mother having plenty of breast-milk the while; the constant physicking of a child by his own mother; teething; hooping-cough, when attacking a very young baby.

I never knew a case of convulsions occur—say for the first four months (except in very young infants laboring under hooping-cough)—where children lived on the breast-milk alone, and where they were _not_ frequently quacked by their mothers!

For the treatment of the convulsions from teething, see page 61.

_What to do_ in a case of convulsions which has been caused by feeding an infant either with too much or with _artificial_ food. Give him, every ten minutes, a teaspoonful of ipecacuanha wine, until free vomiting be excited, then put him into a warm bath (see Warm Baths); and when he comes out of it administer to him a teaspoonful of castor oil, and repeat it every four hours until the bowels be well opened.

_What_ NOT _to do_.—Do not, for at least a month after the fit, give him artificial food, but keep him entirely to the breast. Do not apply leeches to the head.