I have known many puny, delicate children who had not strength to hold the nipple in their mouths, but who could take milk and water (as above recommended) by tea-spoonfuls only at a time, with steady perseverance, and giving it every half hour or hour (according to the quantity swallowed), at length be able to take the breast, and eventually become strong and hearty children; but such cases require unwearied watching, perseverance, and care. Bear in mind, then, that the smaller the quantity of the milk and water given at a time, the oftener must it be administered, as, of course, the babe must have a certain quantity of food to sustain life.
38. What ought to be the diet either of a wet-nurse, or of a mother, who is suckling?
It is a common practice to cram a wet-nurse with food, and to give her strong ale to drink, to make good nourishment and plentiful milk! This practice is absurd; for it either, by making the nurse feverish, makes the milk more sparing than usual, or it causes the milk to be gross and unwholesome. On the other hand, we must not run into an opposite extreme. The mother, or the wet-nurse, by using those means most conducive to her own health, will best advance the interest of her little charge.
A wet-nurse, ought to live somewhat in the following way:—Let her for breakfast have black tea, with one or two slices of cold meat, if her appetite demand it, but not otherwise. It is customary for a wet-nurse to make a hearty luncheon; of this I do not approve. If she feel either faint or low at eleven o'clock, let her have either a tumbler of porter, or of mild fresh ale, with a piece of dry toast soaked in it. She ought not to dine later than half-past one or two o'clock; she should eat, for dinner, either mutton or beef, with either mealy potatoes, or asparagus, or French beans, or secale, or turnips, or broccoli, or cauliflower, and stale bread. Rich pastry, soups, gravies, high-seasoned dishes, salted meats, greens, and cabbage, must one and all be carefully avoided; as they only tend to disorder the stomach, and thus to deteriorate the milk.
It is a common remark, that "a mother who is suckling may eat anything." I do not agree with this opinion. Can impure or improper food make pure and proper milk, or can impure and improper milk make good blood for an infant, and thus good health?
The wet-nurse ought to take with her dinner a moderate quantity of either sound porter, or of mild (but not old or strong) ale. Tea should be taken at half past five or six o'clock; supper at nine, which should consist either of a slice or two of cold meat, or of cheese if she prefer it, with half a pint of porter or of mild ale; occasionally a basin of gruel may with advantage be substituted. Hot and late suppers are prejudicial to the mother, or to the wet-nurse, and, consequently, to the child. The wet-nurse ought to be in bed every night by ten o'clock.
It might be said, that I have been too minute and particular in my rules for a wet-nurse; but when it is considered of what importance good milk is to the well-doing of an infant, in making him strong and robust, not only now, but as he grows up to manhood, I shall, I trust, be excused for my prolixity.
39. Have you any more hints to offer with regard to the management of a wet-nurse?
A wet-nurse is frequently allowed to remain in bed until a late hour in the morning, and during the day to continue in the house, as if she were a fixture! How is it possible that any one, under such treatment, can continue healthy! A wet nurse ought to rise early, and, if the weather and season will permit, take a walk, which will give her an appetite for breakfast, and will make a good meal for her little charge. This, of course, cannot, during the winter mouths, be done; but even then, she ought, some part of the day, to take every opportunity of walking out; indeed, in the summer time she should live half the day in the open air.
She ought strictly to avoid crowded rooms; her mind should be kept calm and unruffled, as nothing disorders the milk so much as passion, and other violent emotions of the mind; a fretful temper is very injurious, on which account you should, in choosing your wet-nurse, endeavour to procure one of a mild, calm, and placid disposition. [Footnote: "'The child is poisoned.'
'Poisoned! by whom?'
'By you. You have been fretting.'
'Nay, indeed, mother. How can I help fretting!'
'Don't tell me, Margaret. A nursing mother has no business to fret. She must turn her mind away from her grief to the comfort that lies in her lap. Know you not that the child pines if the mother vexes herself?'"—The Cloister and the Hearth. By Charles Reade.]
A wet-nurse ought never to be allowed to dose her little charge either with Godfrey's Cordial, or with Dalby's Carminative, or with Syrup of White Poppies, or with medicine of any kind whatever. Let her thoroughly understand this, and let there be no mistake in the matter. Do not for one moment allow your children's health to be tampered and trifled with. A baby's health is too precious to be doctored, to be experimented upon, and to be ruined by an ignorant person.
40. Have the goodness to state at what age a child ought to be weaned?
This, of course, must depend both upon the strength of the child, and upon the health of the parent; on an average, nine months is the proper time. If the mother be delicate, it may be found necessary to wean the infant at six months; or if he be weak, or labouring under any disease, it may be well to continue suckling him for twelve months; but after that time, the breast will do him more harm than good, and will, moreover, injure the mother's health, and may, if she be so predisposed, excite consumption.
41. How would you recommend a mother to act when, she weans her child?
She ought, as the word signifies, do it gradually—that is to say, she should, by degrees, give him less and less of the breast, and more and more of artificial food; at length, she must only suckle him at night; and lastly, it would be well for the mother either to send him away, or to leave him at home, and, for a few days, to go away herself.
A good plan is, for the nurse-maid to have a half-pint bottle of new milk—which has been previously boiled [Footnote: The previous boiling of the milk will prevent the warmth of the bed turning the milk sour, which it otherwise would do.]—in the bed, so as to give a little to him in lieu of the breast. The warmth of the body will keep the milk of a proper temperature, and will supersede the use of lamps, of candle-frames, and of other troublesome contrivances.
42. While a mother is weaning her infant, and after she have weaned him, what ought to be his diet?
Any one of the foods recommended in answer to question 34.
43. If a child be suffering severely from "wind," is there any objection to the addition of a small quantity either of gin or of peppermint to his food to disperse it?
It is a murderous practice to add either gin or peppermint of the shops (which is oil of peppermint dissolved in spirits) to his food. Many children have, by such a practice, been made puny and delicate, and have gradually dropped into an untimely grave. An infant who is kept, for the first five or six months, entirely to the breast—more especially if the mother be careful in her own diet—seldom suffers from "wind;" those, on the contrary, who have much or improper food, [Footnote: For the first five or six months never, if you can possibly avoid it, give artificial food to an infant who is sucking. There is nothing, in the generality of cases, that agrees, for the first few months, like the mother's milk alone.] suffer severely.
Care in feeding, then, is the grand preventative of "wind;" but if, notwithstanding all your precautions, the child be troubled with flatulence, the remedies recommended under the head of Flatulence will generally answer the purpose.
44. Have you any remarks to make on sugar for sweetening a baby's food?
A small quantity of sugar in an infant's food is requisite, sugar being nourishing and fattening, and making cow's milk to resemble somewhat, in its properties human milk; but, bear in mind, it must be used sparingly. Much sugar cloys the stomach, weakens the digestion, produces acidity, sour belchings, and wind:—
"Things sweet to taste, prove in digestion sour."
Shakspeare.
If a babe's bowels be either regular or relaxed, lump sugar is the best for the purpose of sweetening his food; if his bowels are inclined to be costive, raw sugar ought to be substituted for lump sugar, as raw sugar acts on a young babe as an aperient, and, in the generality of cases, is far preferable to physicking him with opening medicine. An infant's bowels, whenever it be practicable (and it generally is), ought to be regulated by a judicious dietary rather than by physic.
VACCINATION AND RE-VACCINATION.
45. Are you an advocate for vaccination?
Certainly. I consider it to be one of the greatest blessings ever conferred upon mankind. Small-pox, before vaccination was adopted, ravaged the country like a plague, and carried off thousands annually; and those who did escape with their lives were frequently made loathsome and disgusting objects by it. Even inoculation (which is cutting for the small-pox) was attended with danger, more especially to the unprotected—as it caused the disease to spread like wildfire, and thus it carried off immense numbers.
Vaccination is one, and an important cause of our increasing population; small-pox, in olden times, decimated the country.
46. But vaccination does not always protect a child from, small-pox?
I grant you that it does not always protect him, neither does inoculation; but when he is vaccinated, if he take the infection, he is seldom pitted, and very rarely dies, and the disease assumes a comparatively mild form. There are a few, very few fatal cases recorded after vaccination, and these may be considered as only exceptions to the general rule; and, possibly, some of these may be traced to the arm, when the child was vaccinated, not having taken proper effect.
If children, and adults were re-vaccinated,—say every seven years after the first vaccination,—depend upon it, even these rare cases would not occur, and in a short time small-pox would be known only by name.
47. Do you consider it, then, the imperative duty of a mother, in every case, to have, after the lapse of every seven years, her children re-vaccinated?
I decidedly do: it would be an excellent plan for every person, once every seven years to be re-vaccinated, and even oftener, if small-pox be rife in the neighbourhood. Vaccination, however frequently performed, can never do the slightest harm, and might do inestimable good. Small-pox is both a pest and a disgrace, and ought to be constantly fought and battled with, until it be banished (which it may readily be) the kingdom.
I say that small-pox is a pest; it is worse than the plague, for if not kept in subjection, it is more general—sparing neither young nor old, rich nor poor, and commits greater ravages than the plague ever did. Small-pox is a disgrace: it is a disgrace to any civilised land, as there is no necessity for its presence, if cow-pox were properly and frequently performed, small-pox would be unknown. Cow-pox is a weapon to conquer small-pox and to drive it ignominiously from the field.
My firm belief, then, is, that if every person were, every seven years, duly and properly vaccinated, small-pox might be utterly exterminated; but as long as there are such lax notions on the subject, and such gross negligence, the disease will always be rampant, for the poison of small-pox never slumbers nor sleeps, but requires the utmost diligence to eradicate it. The great Dr Jenner, the discoverer of cow-pox as a preventative of small-pox, strongly advocated the absolute necessity of every person being re-vaccinated once every seven years, or even, oftener, if there was an epidemic of small-pox in the neighbourhood.
48. Are you not likely to catch not only the cow-pox, but any other disease that the child has from whom the matter is taken?
The same objection holds good in cutting for small pox (inoculation)—only in a ten-fold degree—small-pox being such a disgusting complaint. Inoculated small-pox frequently produced and left behind inveterate "breakings-out," scars, cicatrices, and indentations of the skin, sore eyes, blindness, loss of eyelashes, scrofula, deafness—indeed, a long catalogue of loathsome diseases. A medical man, of course, will be careful to take the cow-pox matter from a healthy child.
49. Would it not be well to take the matter direct from the cow?
If a doctor be careful—which, of course, he will be—to take the matter from a healthy child, and from a well-formed vesicle, I consider it better than taking it direct from the cow, for the following reasons:—The cow-pox lymph, taken direct from the cow, produces much more violent symptoms than after it has passed through several persons; indeed, in some cases, it has produced effects as severe as cutting for the small-pox, besides, it has caused, in many cases, violent inflammation and even sloughing of the arm. There are also several kinds of spurious cow-pox to which the cow is subject, and which would be likely to be mistaken for the real lymph. Again, if even the genuine matter were not taken from the cow exactly at the proper time, it would he deprived of its protecting power.
50. At what age do you recommend an infant to be first vaccinated?
When he is two months old, as the sooner he is protected the better. Moreover, the older he is the greater will be the difficulty in making him submit to the operation, and in preventing his arm from being rubbed, thus endangering the breaking of the vesicles, and thereby interfering with its effects. If small-pox be prevalent in the neighbourhood, he may, with perfect safety, be vaccinated at the month's end; indeed if the small-pox be near at hand, he must be vaccinated, regardless of his age, and regardless of everything else, for small-pox spares neither the young nor the old, and if a new-born babe should unfortunately catch the disease, he will most likely die, as at his tender age he would not have strength to battle with such a formidable enemy. "A case, in the General Lying-in-Hospital, Lambeth, of small-pox occurred in a woman a few days after her admission, and the birth of her child. Her own child was vaccinated when only four days old, and all the other infants in the house varying from one day to a fortnight and more. All took the vaccination; and the woman's own child, which suckled her and slept with her; and all escaped the small pox." [Footnote: Communicated by Sir Charles Locock to the Author.]
51. Do you consider that taking of matter from a child's arm weakens the effect of vaccination on the system?
Certainly not, provided it has taken effect in more than one place. The arm is frequently much inflamed, and vaccinating other children from it abates the inflammation, and thus affords relief. It is always well to leave one vesicle undisturbed.
52. If the infant have any "breaking out" upon the skin, ought that to be a reason for deferring the vaccination?
It should, as two skin diseases cannot well go on together; hence the cow-pox might not take, or, if it did, might not have its proper effect in preventing small-pox. "It is essential that the vaccine bud or germ have a congenial soil, uncontaminated by another poison, which, like a weed, might choke its healthy growth."—Dendy. The moment the skin be free from the breaking-out, he must be vaccinated. A trifling skin affection, like red gum, unless it be severe, ought not, at the proper age to prevent vaccination. If small-pox be rife in the neighbourhood, the child must be vaccinated, regardless of any "breaking-out" on the skin.
53. Does vaccination make a child poorly?
At about the fifth day after vaccination, and for three or four days, he is generally a little feverish; the mouth is slightly hot, and he delights to have the nipple in his mouth. He does not rest so well at night; he is rather cross and irritable; and, sometimes, has a slight bowel-complaint. The arm, about the ninth or tenth day, is usually much inflamed—that is to say it is, for an inch or two or more around the vesicles, red, hot, swollen, and continues in this state for a day or two, at the end of which time the inflammation gradually subsides. It might be well to state that the above slight symptoms are desirable, as it proves that the vaccination has had a proper effect on his system, and that, consequently, he is more likely to be thoroughly protected from any risk of catching small-pox.
54. Do you approve, either during or after vaccination, of giving medicine, more especially if he be a little feverish?
No, as it would be likely to work off some of its effects, and thus would rob the cow-pox of its efficacy on the system. I do not like to interfere with vaccination in any way whatever (except, at the proper time, to take a little matter from the arm), but to allow the pock to have full power upon his constitution.
What do you give the medicine for? If the matter that is put into the arm be healthy, what need is there of physic! And if the matter be not of good quality, I am quite sure that no physic will make it so! Look, therefore, at the case in whatever way you like, physic after vaccination is not necessary; but, on the contrary, hurtful. If the vaccination produce slight feverish attack, it will, without the administration of a particle of medicine, subside in two or three days.
55. Have you any directions to give respecting the arm AFTER vaccination?
The only precaution necessary is to take care that the arm be not rubbed; otherwise the vesicles may be prematurely broken, and the efficacy of the vaccination may be lessened. The sleeve, in vaccination, ought to be large and soft, and should not be tied up. The tying up of a sleeve makes it hard, and is much more likely to rub the vesicles than if it were put on the usual way.
56. If the arm, AFTER vaccination, be much inflamed, what ought to be done?
Smear frequently, by means of a feather or a camel's hair brush, a little cream on the inflamed part. This simple remedy will afford great comfort and relief.
57. Have the goodness to describe the proper appearance, after the falling-off of the scab of the arm?
It might be well to remark, that the scabs ought always to be allowed to fall off of themselves. They must not, on any account, be picked or meddled with. With regard to the proper appearance of the arm, after the falling-off of the scab, "a perfect vaccine scar should be of small size, circular, and marked with radiations and indentations."— Gregory.
DENTITION
58. At what time does dentition commence?
The period at which it commences is uncertain. It may, as a rule, be said that a babe begins to cut his teeth at seven months old. Some have cut teeth at three months; indeed, there are instances on record of infants having been born with teeth. King Richard the Third is said to have been an example. Shakspeare notices it thus:—
"YORK.—Marry, they say my uncle grew so fast,
That he could gnaw a crust at two hours old.
'Twas full two years ere I could get a tooth,
Grandam, this would have been a biting jest."
When a babe is born with teeth, they generally drop out. On the other hand, teething, in some children does not commence until they are a year and a half or two years old, and, in rare cases, not until they are three years old. There are cases recorded of adults who have never cut any teeth. An instance of the kind came under my own observation.
Dentition has been known to occur in old age. A case is recorded by M. Carre, in the Gazette Medicale de Paris (Sept 15, 1860), of an old lady, aged eighty-five, who cut several teeth after attaining that age!
59. What is the number of the FIRST set of teeth, and in what order do they generally appear?
The first or temporary set consists of twenty. The first set of teeth are usually cut in pairs. "I may say that nearly invariably the order is—1st, the lower front incissors [cutting teeth], then the upper front, then the upper two lateral incissors, and that not uncommonly a double tooth is cut before the two lower laterals; but at all events the lower laterals come 7th and 8th, and, not 5th and 6th, as nearly all books on the subject testify." [Footnote: Sir Charles Locock in a Letter to the Author.] Then the first grinders, in the lower jaw, afterwards the first upper grinders, then the lower corner-pointed or canine teeth, after which the upper corner or eye-teeth, then the second grinders in the lower jaw, and lastly, the second grinders of the upper jaw. They do not, of course, always appear in this rotation. Nothing is more uncertain than the order of teething. A child seldom cuts his second grinders until after he is two years old. He is, usually, from the time they first appear, two years in cutting the first set of teeth. As a rule, therefore, a child of two years old has sixteen, and one of two years and a half old, twenty teeth.
60. If an infant be feverish or irritable, or otherwise poorly, and if the gums be hot, swollen, and tender, are you an advocate for their being lanced?
Certainly; by doing so he will, in the generality of instances, be almost instantly relieved.
61. But it has been stated that lancing the gums hardens them?
This is a mistake—it has a contrary effect. It is a well-known fact, that a part which has been divided gives way much more readily than one which has not been cut. Again, the tooth is bound down by a tight membrane, which, if not released by lancing, frequently brings on convulsions. If the symptoms be urgent, it may be necessary from time to time to repeat the lancing. It would, of course, be the height of folly to lance the gums unless they be hot and swollen, and unless the tooth, or the teeth, be near at hand. It is not to be considered a panacea for every baby's ill, although, in those cases where the lancing of the gums is indicated, the beneficial effect is sometimes almost magical.
62. How ought the lancing of a child's gums to be performed?
The proper person, of course, to lance his gums is a medical man. But if, perchance, you should be miles away and be out of the reach of one, it would be well for you to know how the operation ought to be performed. Well, then, let him lie on the nurse's lap upon his back, and let the nurse take hold of his hands in order that he may not interfere with the operation.
Then, if it be the upper gum that requires lancing, you ought to go to the head of the child, looking over, as it were, and into his mouth, and should steady the gum with the index finger of your left hand; then, you should take hold of the gum-lancet with your right hand—holding as if it were a table-knife at dinner—and cut firmly along the inflamed and swollen gum and down to the tooth, until the edge of the gum-lancet grates on the tooth. Each incision ought to extend along the ridge of the gum to about the extent of each expected tooth.
If it be the lower gum that requires lancing, you must go to the side of the child, and should steady the outside of the jaw with the fingers of the left hand, and the gum with the left thumb, and then you should perform the operation as before directed.
Although the lancing of the gums, to make it intelligible to a non-professional person, requires a long description, it is, in point of fact, a simple affair, is soon performed, and gives but little pain.
63. If teething cause convulsions, what ought to be done?
The first thing to be done (after sending for a medical man) is to freely dash water upon the face, and to sponge the head with cold water, and as soon as warm water can be procured, to put him into a warm bath [Footnote: For the precautions to be used in putting a child into a warm bath, see the answer to question on "Warm Baths."] of 98 degrees Fahrenheit. If a thermometer be not at hand, [Footnote: No family, where there are young children, should be without Fahrenheit's thermometer.] you must plunge your own elbow into the water: a comfortable heat for your elbow will be the proper heat for the infant. He must remain in the bath for a quarter of an hour, or until the fit be at an end. The body must, after coming out of the bath, be wiped with warm and dry and coarse towels; he ought then to be placed in a warm blanket. The gums must be lanced, and cold water should be applied to the head. An enema, composed of table salt, of olive oil, and warm oatmeal gruel—in the proportion of one table-spoonful of salt, of one of oil, and a tea-cupful of gruel—ought then to be administered, and should, until the bowels have been well opened, be repeated every quarter of an hour; as soon as he comes to himself a dose of aperient medicine ought to be given.
It may be well, for the comfort of a mother, to state that a child in convulsions is perfectly insensible to all pain whatever; indeed, a return to consciousness speedily puts convulsions to the rout.
64. A nurse is in the habit of giving a child, who is teething, either coral, or ivory, to bite: do you approve of the plan?
I think it a bad practice to give him any hard, unyielding substance, as it tends to harden the gums, and, by so doing, causes the teeth to come through with greater difficulty. I have found softer substances, such as either a piece of wax taper, or an India-rubber ring, or a piece of the best bridle leather, or a crust of bread, of great service. If a piece of crust be given as a gum-stick, he must, while biting it, be well watched, or by accident he might loosen a large piece of it, which might choke him. The pressure of any of these excites a more rapid absorption of the gum, and thus causes the tooth to come through more easily and quickly.
65. Have you any objection to my baby, when he is cutting his teeth, sucking his thumb?
Certainly not: the thumb is the best gum-stick in the world:—it is convenient; it is handy (in every sense of the word): it is of the right size, and of the proper consistence, neither too hard nor too soft; there is no danger, as of some artificial gum-sticks, of its being swallowed, and thus of its choking the child. The sucking of the thumb causes the salivary glands to pour out their contents, and thus not only to moisten the dry mouth, but assist the digestion; the pressure of the thumb eases, while the teeth are "breeding," the pain and irritation of the gums, and helps, when the teeth are sufficiently advanced, to bring them through the gums. Sucking of the thumb will often make a cross infant contended and happy, and will frequently induce a restless babe to fall into a sweet refreshing sleep. Truly may the thumb be called a baby's comfort. By all means, then, let your child suck his thumb whenever he likes, and as long as he chooses to do so.
There is a charming, bewitching little picture of a babe sucking his thumb in Kingsley's Water Babies, which I heartily commend to your favourable notice and study.
66. But if an infant be allowed to suck his thumb, will it not be likely to become a habit, and stick to him for years—until, indeed, he become a big boy?
After he have cut the whole of his first set of teeth, that is to say, when he is about two years and a half old, he might, if it be likely to become a habit, be readily cured by the following method, namely, by making a paste of aloes and water, and smearing it upon his thumb. One or two dressings will suffice as after just tasting the bitter aloes he will take a disgust to his former enjoyment, and the habit will at once be broken.
Many persons I know have an objection to children sucking their thumbs, as for instance,—
"Perhaps it's as well to keep children from plums, And from pears in the season, and sucking their thumbs." [Footnote: Ingoldsby Legends.]
My reply is,—
P'rhaps 'tis as well to keep children from pears;
The pain they might cause, is oft follow'd by tears;
'Tis certainly well to keep them from plums;
But certainly not from sucking their thumbs!
If a babe suck his thumb
'Tis an ease to his gum;
A comfort; a boon; a calmer of grief;
A friend in his need—affording relief;
A solace; a good; a soother of pain;
A composer to sleep; a charm; and a gain.
'Tis handy, at once, to his sweet mouth to glide;
When done with, drops gently down by his side;
'Tis fix'd, like an anchor, while the babe sleeps.
And the mother, with joy, her still vigil keeps.
67. A child who is teething dribbles, and thereby wets his chest, which frequently causes him to catch cold; what had better be done?
Have in readiness to put on several flannel dribbling bibs, so that they may be changed as often as they become wet; or, if he dribble very much, the oiled silk dribbling-bibs, instead of the flannel ones, may be used, and which may be procured at any baby-linen ware house.
68. Do you approve of giving a child, during teething, much fruit?
No; unless it be a few ripe strawberries or raspberries, or a roasted apple, or the juice of five or six grapes—taking care that he does not swallow either the seeds or the skin—or the insides of ripe gooseberries, or an orange. Such fruits, if the bowels be in a costive state, will be particularly useful.
All stone fruit, raw apples or pears, ought to be carefully avoided, as they not only disorder the stomach and the bowels,—causing convulsions, gripings, &c.,—but they have the effect of weakening the bowels, and thus of engendering worms.
69. Is a child, during teething, more subject to disease, and, if so, to what complaints, and in what manner may they be prevented?
The teeth are a fruitful source of suffering and of disease; and are, with truth, styled "our first and our last plagues." Dentition is the most important period of a child's life, and is the exciting cause of many infantile diseases; during this period, therefore, he requires constant and careful watching. When we consider how the teeth elongate and enlarge in his gums, pressing on the nerves and on the surrounding parts, and thus how frequently they produce pain, irritation, and inflammation; when we further contemplate what sympathy there is in the nervous system, and how susceptible the young are to pain, no surprise can be felt, at the immense disturbance, and the consequent suffering and danger frequently experienced by children while cutting their first set of teeth. The complaints or the diseases induced by dentition are numberless, affecting almost every organ of the body,—the brain, occasioning convulsions, water on the brain, &c.; the lungs, producing congestion, inflammation, cough, &c.; the stomach, exciting sickness, flatulence, acidity, &c,; the bowels, inducing griping, at one time costiveness, and at another time purging; the skin, causing "breakings-out."
To prevent these diseases, means ought to be used to invigorate a child's constitution by plain, wholesome food, as recommended under the article of diet; by exercise and fresh air; [Footnote: The young of animals seldom suffer from cutting their teeth—and what is the reason? Because they live in the open air, and take plenty of exercise; while children are frequently cooped up in close rooms, and are not allowed the free use of their limbs. The value of fresh air is well exemplified in the Registrar-General's Report for 1843; he says that in 1,000,000 deaths, from all diseases, 616 occur in the town from teething while 120 only take place in the country from the same cause.] by allowing him, weather permitting, to be out of doors a great part of every day; by lancing the gums when they get red, hot, and swollen; by attention to the bowels, and if he suffer more than usual, by keeping them rather in a relaxed state by any simple aperient, such as either castor oil, or magnesia and rhubarb, &c.; and, let me add, by attention to his temper: many children are made feverish and ill by petting and spoiling them. On this subject I cannot do better than refer you to an excellent little work entitled Abbot's Mother of Home, wherein the author proves the great importance of early training.
70. Have the goodness to describe the symptoms and the treatment of Painful Dentition?
Painful dentition may be divided into two forms—(1) the Mild; and (2) the Severe. In the mild form the child is peevish and fretful, and puts his fingers, and everything within reach, to his mouth, he likes to have his gums rubbed, and takes the breast with avidity, indeed it seems a greater comfort to him than ever. There is generally a considerable flow of saliva, and he has frequently a more loose state of bowels than is his wont.
Now, with regard to the more severe form of painful dentition—The gums are red, swollen, and hot, and he cannot without expressing pain bear to have them touched, hence, if he be at the breast, he is constantly loosing the nipple. There is dryness of the mouth, although before there had been a great flow of saliva. He is feverish, restless, and starts in his sleep. His face is flashed. His head is heavy and hot. He is sometimes convulsed. [Footnote: See answer to Question 63.] He is frequently violently griped and purged, and suffers severely from flatulence. He is predisposed to many and severe diseases.
The treatment, of the mild form, consists of friction, of the gum with the finger, with a little "soothing syrup," as recommended by Sir Charles Locock, [Footnote: Soothing syrup—Some of them probably contain opiates, but a perfectly safe and useful one is a little Nitrate of Potass in syrup of Roses—one scruple to half an ounce.—Communicated by Sir Charles Locock to the Author. This 'soothing syrup' is not intended to be given us a mixture but to be used as an application to rub the gums with. It may be well to state that it is a perfectly harmless remedy even if a little of it were swallowed by mistake.] a tepid bath of about 92 degrees Fahrenheit, every night at bed time, attention to diet and to bowels, fresh air and exercise. For the mild form, the above plan will usually be all that is required. If he dribble, and the bowels be relaxed, so much the better. The flow of saliva and the increased action of the bowels afford relief, and therefore must not be interfered with. In the mild form, lancing of the gums is not desirable. The gums ought not to be lanced, unless the teeth be near at hand, and unless the gums be red, hot, and swollen.
In the severe form a medical man should be consulted early, as more energetic remedies will be demanded; that is to say, the gums will require to be freely lanced, warm baths to be used, and medicines to be given, to ward off mischief from the head, from the chest, and from the stomach.
If you are living in the town, and your baby suffers much from teething, take him into the country. It is wonderful what change of air to the country will often do, in relieving a child who is painfully cutting his teeth. The number of deaths in London, from teething, is frightful; it is in the country comparatively trifling.
71. Should an infant be purged during teething or indeed, during any other time, do you approve of either absorbent or astringent medicines to restrain it?
Certainly not. I should look upon, the relaxation as an effort of nature to relieve itself. A child is never purged without a cause; that cause, in the generality of instances, is the presence of either some undigested food, or acidity, or depraved motions, that want a vent.
The better plan is, in such a case, to give a dose of aperient medicine, such as either castor oil, or magnesia and rhubarb; and thus work it off. IF WE LOCK UP THE BOWELS, WE CONFINE THE ENEMY, AND THUS PRODUCE MISCHIEF. [Footnote: I should put this in capitals, it is so important and is often mistaken.—C. Locock.] If he be purged more than usual, attention should be paid to the diet—if it be absolutely necessary to give him artificial food while suckling—and care must be taken not to overload the stomach.
72. A child is subject to a slight cough during dentition—called by nurses "tooth-cough"—which a parent would not consider of sufficient importance to consult a doctor about: pray tell me, is there any objection to a mother giving her child a small quantity either of syrup of white poppies, or of paregoric, to ease it?
A cough is an effort of nature to bring up any secretion from the lining membrane of the lungs, or from the bronchial tubes, hence it ought not to be interfered with. I have known the administration of syrup of white poppies, or of paregoric, to stop the cough, and thereby to prevent the expulsion of the phlegm, and thus to produce either inflammation of the lungs, or bronchitis. Moreover, both paregoric and syrup of white poppies are, for a young child, dangerous medicines (unless administered by a judicious medical man), and ought never to be given by a mother.
In the month of April 1844, I was sent for, in great haste, to an infant, aged seventeen months, who was labouring under convulsions and extreme drowsiness, from the injudicious administration of paregoric, which had been given to him to ease a cough. By the prompt administration of an emetic he was saved.
73. A child, who is teething, is subject to a "breaking-out," more especially behind the ears—which is most disfiguring, and frequently very annoying what would you recommend?
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 his 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 he 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 north-easterly direction. By doing so we shall make him strong and hearty, and give the skin that mottled 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 babe 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 untrammelled. 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 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 exercises 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 afterwards, 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 bedroom without a fire, or by dipping him in cold water, or by keeping him with scant clothing on his bed. The temperature of a bedroom, in the winter time, should be, as nearly as possible, at 60 deg. 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 babe 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 [Footnote: 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!] 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.
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, whilst in cradled rest your infant sleeps.
Your watchful eyes unceasing vigil 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 [Footnote: 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 (April 10, 1861) and which has been abridged in Braithwaite's Retrospect of Medicine (July and December 1861). 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 5 3/4 to 6 lbs. the number rose from 99 to 268, and from 8 to 8 1/4 lbs. they fell from 226 to 67, and never rose again at any weight to 100. From 8 3/4 to 9 1/2 lbs. they sank from 61 to 8, rising however at 9 1/2 lbs. to 21. Only six weighed 10 lbs., one 10 3/4 lbs. and two 11 lbs. The author has never but once met with a child weighing 11 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 six nor more than 8 lbs., the average weight being 6 1/2 or 7 lbs., the smaller number referring to female and the higher to male infants."] 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.
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 he 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 colour—namely, a bright yellow, inclining to orange colour—and free from slime or from bad 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 tune, looses the nipple, and buries his head in the bed-clothes. She awakes in the morning, finding, to her horror, a corpse by her side, with his nose flattened, and a frothy fluid, tinged with, blood, exuding from his lips. A mother ought, therefore, never to go to sleep until her child have 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 the bed. (2.) Do not allow him to be too near to you; or if he he unavoidably near 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 bed-clothes; 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 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 colour (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 diapers, and that he makes 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 diapers?
A babe of three months and upwards, ought to be held out, at least, a dozen times during the twenty-four hours; if such a plan were adopted, diapers 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," [Footnote: Hints on Household Management, By Mrs C. L. Balfour.] 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 [Footnote: In a Letter to the Author.] makes the following sensible remarks on this 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."
The 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 tea-spoonful of pure unadulterated raw sugar in a tea-spoonful 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 gram of opening medicine. If from the first you refrain from giving an aperient, he seldom requires one afterwards. It is the first step, in this as in all other things, that is so important to take.
If a new-born babe have 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." [Footnote: Letter to the Author.]
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, Costivenesa, Flatulence, Gripings, Hiccup, Looseness of the Bowels (Diarrhoea), 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, afterwards, 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 table-spoonfuls 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 luke-warm 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 of 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 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 labouring 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 46.
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 tea-spoonful 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 tea-spoonful 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.
What to do in a case of convulsions from hooping cough—There is nothing better than dashing cold water on the face, and immersing him in a warm bath of 98 degrees Fahr. If he be about his teeth, and they be plaguing him, let the gums be both freely and frequently lanced. Convulsions seldom occur in hooping-cough, unless the child be either very young or exceedingly delicate. Convulsions attending an attack of hooping-cough make it a serious complication, and requires the assiduous and skilful attention of a judicious medical man.
What NOT to do in such a case—Do not apply leeches, the babe requires additional strength, and not to be robbed of it, and do not attempt to treat the case yourself.
95. What are the best remedies for the Costiveness of an infant?
I strongly object to the frequent administration of opening medicine, as the repetition of it increases the mischief to a tenfold degree.
What to do.—If a babe, after the first few months, were held out, and if, at regular intervals, he were put upon his chair, costiveness would not so much prevail. It is wonderful how soon the bowels, in the generality of cases, by this simple plan, may be brought into a regular state. Besides, it inducts an infant into clean habits, I know many careful mothers who have accustomed their children, after the first three months, to do without diapers altogether. It causes at first a little trouble, but that trouble is amply repaid by the good consequences that ensue; among which must be named the dispensing with such encumbrances as diapers. Diapers frequently chafe, irritate, and gall the tender skin of a baby. But they cannot of course, at an early age be dispensed with, unless a mother have great judgment, sense, tact, and perseverance, to bring her little charge into the habit of having his bowels relieved and his bladder emptied every time he is either held out or put upon his chair.
Before giving an infant a particle of aperient medicine, try, if the bowels are costive, the effect of a little raw sugar and water, either half a tea-spoonful of raw sugar dissolved in a tea-spoonful or two of water, or give him, out of your fingers, half a tea-spoonful of raw sugar to eat. I mean by raw sugar, not the white, but the pure and unadulterated sugar, and which you can only procure from a respectable grocer. If you are wise, you will defer as long as you can giving an aperient. If you once begin, and continue it for a while, opening medicine becomes a dire necessity, and then woe betide the poor unfortunate child. Or, give a third of a tea-spoonful of honey, early in the morning, occasionally. Or administer a warm water enema—a tablespoonful, or more, by means of a 2 oz. India Rubber Enema Bottle.
What NOT to do.—There are two preparations of mercury I wish to warn you against administering of your own accord, viz.—(1) Calomel, and a milder preparation called (2) Grey-powder (mercury with chalk). It is a common practice in this country to give calomel, on account of the readiness with which it can be administered it being small in quantity, and nearly tasteless. Grey powder also, is, with many mothers, a favourite in the nursery. It is a medicine of immense power—either for good or for evil, in certain cases it is very valuable, but in others, and in the great majority, it is very detrimental. This practice, then, of a mother giving mercury, whether in the form either of calomel or of grey powder, cannot be too strongly reprobated, as the frequent administration either of the one or of the other weakens the body, predisposes it to cold, and frequently excites king's-evil—a disease too common in this country. Calomel and grey-powder, then, ought never to be administered unless ordered by a medical man.
Syrup of buckthorn and jalap are also frequently given, but they are griping medicines for a baby, and ought to be banished from the nursery.
The frequent repetition of opening medicines, then, in any shape or form, very much interferes with digestion, they must, therefore, be given as seldom as possible.
Let me, at the risk of wearying you, again urge the importance of your avoiding, as much as possible, giving a babe purgative medicines. They irritate beyond measure the tender bowels of an infant, and only make him more costive afterwards, they interfere with his digestion, and are liable to give him cold. A mother who is always, of her own accord, quacking her child with opening physic, is laying up for her unfortunate offspring a debilitated constitution—a miserable existence.
For further information on this important subject see the 3d edition of Counsel to a Mother (being the companion volume of Advice to a Mother), on the great importance of desisting from irritating, from injuring, and from making still more costive, the obstinate bowels of a costive child,—by the administration of opening medicine,—however gentle and well-selected the aperients might be. Oh, that the above advice could be heard, and be acted upon, through the length and the breadth of the land, how much misery and mischief would then be averted!
96. Are there any means of preventing the Costiveness of an infant?
If greater care were paid to the rules of health, such as attention to diet, exercise in the open air, thorough ablution of the whole body—more especially when he is being washed—causing the water, from a large and well-filled sponge, to stream over the lower part of his bowels; the regular habit of causing him, at stated periods, to be held out, whether he want or not, that he may solicit a stool. If all these rules were observed, costiveness would not so frequently prevail, and one of the miseries of the nursery would be done away with.
Some mothers are frequently dosing their poor unfortunate babes either with magnesia to cool them, or with castor oil to heal their bowels! Oh, the folly of such practices! The frequent repetition of magnesia, instead of cooling an infant, makes him feverish and irritable. The constant administration of castor oil, instead of healing the bowels, wounds them beyond measure. No! it would be a blessed thing if a babe could be brought up without giving ham a particle of opening medicine; his bowels would then act naturally and well: but then, as I have just now remarked, a mother, must be particular in attending to Nature's medicines—to fresh air, to exercise, to diet, to thorough ablution, &c. Until that time comes, poor unfortunate babies must be, occasionally, dosed with an aperient.
97. What are the causes of, and remedies for, Flatulence?
Flatulence most frequently occurs in those infants who live on artificial food, especially if they be over-fed. I therefore beg to refer you to the precautions I have given, when speaking of the importance of keeping a child for the first five or six months entirely to the breast; and, if that be not practicable, of the times of feeding, and of the best kinds of artificial food, and of those which are least likely to cause "wind."