Better babies and their care

The suggestions and remedies offered in this chapter are not to be mistaken by the inexperienced mother as a substitute for the attention and prescription of the family physician in case of baby’s illness. They are given because hundreds of mothers, who will read this book, live miles from a town or village. The arrival of the physician is a matter of hours, and, in the meantime, an ailment may make rapid progress.

Up-to-date doctors use comparatively little medicine in treating babies. They lay more stress on preventive medicine, and fortifying the baby so that it will throw off germs, contagion, etc. The prevention of disease in babies has been practically outlined in the preceding chapters. If a baby is properly fed and cared for, its illnesses will be few and slight, yielding promptly to simple treatment. The healthy baby can even come in contact with a contagious disease and not take it.

The veil of mystery which has so long surrounded the practice of medicine is gradually being lifted by physicians themselves, who talk freely to mothers about the use of simple medicines, and advise them how to act in an emergency before the arrival of the family physician. This is the sort of advice contained in this chapter. It is to be followed only when a physician is not at hand, or when the case yields quickly to simple remedies. There is no reason why an intelligent mother should not know how to treat small ailments or symptoms of serious illness until the physician arrives to relieve her of the responsibility.

Certain drugs should be found in every nursery, and these are the pure, unadulterated drugs prescribed by practicing physicians; they are not patent medicines:

As cathartics, have castor-oil, calomel, milk of magnesia, citrate of magnesia.

For croup and violent attacks of indigestion, which come from overloading the stomach with rich food, especially in older children, have syrup of ipecac.

For coughing have liquid peptonoids and creosote. The latter can be put up by any registered pharmacist. Many physicians recommend the combination prepared by the Arlington Chemical Company, Yonkers, New York.

Of all the remedies named castor-oil is, perhaps, the most important, as it is the safest laxative for children of all ages.

Phillips’ Milk of Magnesia is recommended for very young babies; but castor-oil is the all-round dependable cathartic.

Perhaps the most common ailment in the average home is indigestion, accompanied by looseness of the bowels. This trouble has been discussed in Chapter VI, “Guarding the Baby’s Diet,” but it is repeated here for that mother who, in a moment of alarm, turns to the chapter on ailments for immediate help.

If the attack is not severe, with perhaps three loose passages a day, it may be corrected through the diet of the mother, or, in a bottle-fed baby, by changing the modification of the milk. The malt-sugar should be omitted; skimmed milk instead of whole or plain milk should be used, and the milk may be boiled for four or five minutes.

If the diarrhea persists in spite of this change in the food, and there is fever or evidence of pain, the food should be stopped, either breast milk or bottle milk, and boiled water, in small quantities, should be given for ten or twelve hours; then barley water for ten hours more. The child will not suffer from hunger, because it cannot retain food of any sort.

Give castor-oil in the following doses:

If the child cannot retain castor-oil, then try calomel:

For the child between one and three months, one-half grain, taken at the rate of one-eighth grain in each dose, ten to fifteen minutes apart; this means four one-eighth grain tablets. The tablets should be dissolved in water.

From three to six months, three-fourths of a grain may be given.

At one year, one grain, in doses of one-tenth grain each, fifteen minutes apart.

For the infant, calomel followed by a warm enema will carry off the poison in the intestines. For an older child the calomel must be followed by half a glass of citrate of magnesia, given early in the morning, to thoroughly cleanse the intestines.

Severe vomiting is treated exactly like intestinal indigestion, by the use of cathartics. If either diarrhea or vomiting does not yield to this treatment within twenty-four hours a physician should be summoned. Severe vomiting may be a symptom of an acute and serious attack of illness.

Following on the trail of indigestion and intestinal trouble come anemia and malnutrition. The anemic child, suffering with malnutrition, as the result of improper feeding, loses weight steadily, has vomiting and diarrhea, sleeps badly, is listless and pallid. The pallor is due to a lack of red corpuscles in the blood. It is, therefore, important that all digestive troubles should be corrected promptly before they develop into the dreaded forms of malnutrition and marasmus.

A very common ailment in the modern nursery, especially among bottle-fed babies, is constipation. This is due entirely to improper diet. It can be permanently eradicated only through a change in diet. The child may be given temporary relief through the use of suppositories and massage, never through the use of violent cathartics. To secure an immediate movement of the bowels use an injection of sweet-oil, glycerine, or soap and water. To give the sweet-oil use a bulb syringe and one tablespoonful of the sweet-oil, warm. If glycerine is used, one-half teaspoonful may be mixed with one tablespoonful of warm water. If soap and water are used, make a warm suds of pure white soap, and inject about a teacupful.

Glycerine suppositories, which can be bought at any reliable drugstore, act quickly, but they may also irritate the rectum. The best suppositories for use in chronic constipation in infants are the gluten suppositories, made by the Health Food Company. They act more slowly than glycerine suppositories, and the mother must not look for an action of the bowels for at least two hours.

Neither injections nor suppositories should be depended upon for the permanent relief of constipation; they are makeshifts at best, and their continued use weakens the muscles of the rectum. The diet must be corrected and the causes of the trouble eradicated.

An ailment which is frequently recurrent, and is a severe drain on the baby’s system, is the common every-day cold. In considering this illness, bear in mind that it is contagious. It can be prevented, first, by not allowing the child to come in contact with adults or other children who have colds, and, second, by keeping him in such fine physical condition that he can resist the infection when exposed to it. To harden the child against colds give him plenty of cool, fresh air. This means sleeping in a cool room; wearing light-weight clothing, so that he will not perspire; bathing in warm, not hot, water. The city child is apt to take cold because the nursery is heated by steam. The air is very dry; and this, in turn, dries the mucous membrane of the nose, and the air passages, leaving them susceptible to infection.

In Chapter II, when describing a sanitary nursery, I mentioned the importance of having a pan of water on the radiator, or the register if the house is heated by furnace. All this heat should be turned off at night, so that the child may sleep in a cool room. This means that he must be warmly dressed; and his bed covers should be carefully adjusted, and should be plentiful, though light in weight. In this connection it may be mentioned that insufficient clothing and excessive clothing are equally apt to cause colds. The child whose hands and feet are cold and whose lips are blue is not sufficiently clad. The child who perspires from heavy clothing in the house will take cold when he goes out into the air. In country houses, in particular, a baby should never be carried from one warm room to another through a cold hall, unless he is carefully wrapped in a shawl.

Neither should a baby be allowed to play on the floor in a draught. He should be laid on the bed and surrounded by pillows if he is active; or some resourceful member of the family can build him a little pen raised two or three feet from the floor on legs, and covered with a pad. This should have a padded fence around it so that the baby will not roll out. Another reason why the baby may contract a cold if allowed to play on the floor is the fact that he will find there the germs which come with dust.

And, finally, the baby’s nose or mouth should never be wiped with a handkerchief used by adults or by other children. Handkerchiefs are the very best carriers of germs.

When a small baby has a cold in the head his discomfort can be relieved by dropping a little melted vaseline or albolene into the nose with a medicine dropper. Vaseline may also be rubbed on the outside of the nostrils. In an older child relief can be secured by using warm boric acid—one teaspoonful to a pint of water—with a nasal atomizer.

Generally a cathartic, like castor-oil or calomel, will help to work off a cold. It is not wise, however, to make any violent change in the baby’s daily habits. He should not be loaded down with heavy clothing. Irritating flannels should not be wrapped around his chest; nor should the room be overheated, or the supply of fresh air shut off. None of these things will relieve a cold. They will make the child more uncomfortable.

If fever develops and the child does not throw off the cold a physician should be summoned.

If the throat is sore no time should be lost in sending for a physician, for the mother cannot tell the difference between tonsilitis and diphtheria. If the doctor announces the trouble diphtheria, insist on antitoxin immediately. This wonderful remedy has passed the experimental stage: it is saving thousands of lives every year.

A sharp, dry cough, wheezing or purring in the chest, is also a dangerous symptom, and may mean bronchitis. Send for a physician at once; and, until the doctor arrives, the child should be kept in bed, the room should be warm, the temperature moist. If a considerable time must pass before the doctor will arrive it is safe to apply a mustard plaster across the bronchial tubes.

Be very careful in mixing this plaster, because the child’s skin is very tender and easily burned. Mix one part of English mustard with five or six parts of flour, and sufficient warm water to make a thin paste. Have ready a piece of old muslin or linen cut square and twice as large as the chest of the child; spread the mustard paste in the center and fold up the four corners so as to close tightly; rub the baby’s chest lightly with sweet-oil or melted vaseline to prevent blistering; lay the mustard plaster on the chest and cover it with a piece of flannel, which should be wound around the child like a bandage. Lift the corner of the plaster, from time to time, to make sure that it is not burning the flesh. In ten or fifteen minutes the skin will be slightly reddened, then remove the plaster; pat the skin dry with old linen; and cover the little patient carefully.

The old-fashioned remedy of equal parts of camphorated oil and spirits of turpentine may be applied with a warm hand, and the chest carefully covered with soft flannel, or silk and wool. Great care must be taken that the chest is not bared after these remedies have been applied, for they make the little patient more prone to chill.

If the cough is troublesome, until the arrival of the doctor, give him doses of liquid peptonoids with creosote every two hours, as follows:

If the attack is light it may be broken up before the doctor arrives; but it is never safe for the mother to treat symptoms of bronchitis without the advice of a physician as soon as he can be secured.

When a child shows a tendency to take cold at almost regular intervals, and the mother feels sure that this is not due to the temperature of the nursery, ill-chosen clothes or general anemia, she may well suspect adenoids. For many generations the baby who had “snuffles” and breathed with his mouth open quite generally developed an ugly case of chronic catarrh, which clung to him for life. To-day catarrh is rapidly disappearing, because it has been traced to adenoids, which can be removed.

Adenoids are a grapelike formation of tissue which grows back of the palate in the passage leading from the nose to the throat. The air must pass through this passageway when the mouth is closed. If the passageway is filled with the adenoid growth there can be no breathing through the nose, and the mouth remains open, waking and sleeping.

Among the evils which spring from adenoids are deafness, a deformed jaw, restlessness, general debility, loss of appetite, defective speech, persistent colds, and arrested mental development. Frequently children pronounced defective in the public schools are found to be suffering with adenoids. When the adenoids are removed the child slowly but surely makes progress in his studies.

The mother who finds her baby breathing through the mouth should have his throat examined immediately. Even the small nursing baby that seems to choke and sputter when nursing may be suffering from this dangerous growth. The only cure for adenoids is their complete removal. This can be done any time after the baby passes its third month.

Next to adenoids as a menace to the baby’s health come enlarged tonsils. We all know how certain children are subject to sore throats, with high temperature, followed by extreme lassitude and debility. This is tonsilitis, caused in ninety-nine cases out of a hundred by enlarged tonsils. These can be operated on without any danger to the small patient, with little pain, and at comparatively small cost. Enlarged tonsils form a fine lodging-place for germs, especially those of diphtheria.

In considering cold of any sort, bear in mind that the baby cannot tell you where he feels pain. Irregular and unnatural breathing, coughs of all kinds, together with fever, should give the inexperienced mother reason for quick action. She should lose no time in sending for a physician. I recall, when one of my children was wheezing and coughing sharply, that I supposed it was an incipient case of croup. I undertook to treat it as I had treated cases of croup in my other children; but without results. I sent for the family physician, only to learn that my baby was in an advanced stage of capillary bronchitis. His life was saved only by prompt action and the faithful attendance of our family doctor.

Pneumonia may develop just as suddenly in a child, and it is therefore advisable to have the physician make a stethoscopic examination of the little patient.

Croup will be treated as a nursery emergency in Chapter XIV.

A baby can be made ill and fretful by skin eruptions. The most common of these is prickly heat, which looks like small red pimples and blisters. These seem to be crowded together, but, nevertheless, each remains separate. The baby suffers from severe itching and a tingling or burning sensation.

At many contests I have heard mothers resent the fact that their babies were penalized or marked down for prickly heat.

“Why,” the mother would exclaim, “all babies have prickly heat!”

All babies should not have prickly heat. It is a proof that the mother is not as careful of her baby as she should be. It is due to clothing that is too heavy, too hot, or too rough; anything that will overheat the tender skin. Remove the cause of trouble. Dress the baby lightly and loosely, and give him bicarbonate of soda baths—allowing a tablespoonful of ordinary baking soda, not washing soda, to a gallon of water. Pat the skin dry, and powder the little body freely with talcum powder and boric acid mixed—allow two teaspoonfuls of the boric acid to one ounce of powder. You can get the talcum powder in one-ounce boxes, or can have it measured by your druggist.

If the eruption does not yield to the bicarbonate of soda bath try sponging the skin with vinegar and water—that is, in the summer. The eruption may be partly due to wool in the underwear. Change it for muslin or linen shirts, and have the knitted belly-band over that, not next to the skin.

Eczema is a far more serious eruption. It is marked by inflammation and great itching. The skin seems to thicken; it becomes moist and shows fissures from which a serum oozes and forms crusts. It is most commonly found on the face and scalp, but it may also be found in the folds of the skin at various parts of the baby’s anatomy. It may spread or it may be confined to only a small area. In either case the child suffers great discomfort and is bound to be fretful and wretched.

As eczema generally springs from lack of attention to the diet and hygiene, it is not found among children cared for in an intelligent way. When it does make its appearance the mother and doctor must set themselves to the task of changing the baby’s diet. In the meantime, some relief may be given by the treatment of the skin. Water baths must not be given, but a sweet-oil rub is used for cleansing purposes. Ointments will not cure and they give little relief. One of the best recommended by physicians is Lassar’s Paste, which can be bought at any drugstore.

Eczema may be recognized but it cannot be treated successfully by the mother. She must send at once for the family physician and place the child under his care.

Chafing, which results from uncleanliness in handling the diapers, is not dangerous, but it is most irritating to the child and is responsible for much crying and fretfulness in the nursery. This inflammation appears most frequently between the buttocks, on the thighs, and in the folds of the groin. The mother should look to the cause: neglect to change the diapers promptly; washing the diapers with strong soap or washing-powders; lack of rinsing. The cure consists of changing the diapers promptly and washing them promptly and carefully. Relief is given by dusting the affected parts with talcum powder and boric acid powder, as for prickly heat.

If any eruption does not yield promptly to change of diet or clothing, and the simple remedies suggested, send for your physician. Never take chances on skin diseases.

While attending Better Babies Contests I have been amazed at the careless way in which comparatively intelligent mothers discuss worms and their treatment with patent medicines.

Young babies, either nursing or bottle-fed, are seldom subject to worms. They more often attack older children, especially country children who drink well water. The symptoms are bad breath, gritting the teeth in the sleep, irritation of the nostrils, which makes the child pick at his nose, loss of appetite, anemia, headache, and dizziness. Many of these symptoms often come from ordinary indigestion. The only way to decide what really lies behind the symptoms is to have the stools examined. The worms themselves will not be found in the stools, but the eggs can be detected by the aid of a microscope.

The most common form of worms is the thread-worm, which looks like small broken pieces of white thread, from one-third to one-half inch long. The roundworm and tapeworm are rarely found.

No mother should attempt to treat this trouble, either before or after she has learned that the child has worms. She must never administer patent medicines, but must turn her child over to the care of a physician, who will prescribe medicine.

Rickets is one of the most serious ailments which attack the young baby. It is not an acute but a chronic disease due to malnutrition. It overtakes the baby gradually, between six months and two years, and seems to strike chiefly at the bones. The first symptoms are fretfulness, sleeplessness, pallor, and sweating of the head. The child threatened with rickets wears off the hair at the back of the head, in its restlessness, and its pillow is always wet from perspiration. Gradually the abdomen becomes enlarged and out of proportion to the child’s other measurements. The teething is delayed, and the baby cannot sit up or walk as early as a normal child should. The little baby is usually constipated and suffers from general intestinal trouble. It is subject to colds, and it may have convulsions. If the condition is neglected the mother suddenly discovers that the child looks deformed. Some of the bones become enlarged; the chest is barrel-shaped; and when the baby begins to walk he is bow-legged because the bones are so soft.

If the child survives the illness it is often so deformed that it is marked for life. If the disease is discovered and treated promptly the child becomes strong and outgrows most of the defects.

Rickets is generally caused by improper feeding, by proprietary foods without the needed amount of fresh milk, or by fresh milk and foods that do not contain enough fat or cream. The prolonged use of boiled or sterilized milk, also, will cause rickets.

The cure lies with the diet, which should be changed immediately, under the direction of a physician, who will generally stop all proprietary, condensed, and boiled milk, and give whole milk, modified to suit the baby’s age. After the child has passed the first year the physician will order fresh eggs, beef juice, broths, and, possibly, cod-liver oil in emulsion. The little invalid must sleep in a well-aired room and be kept out of doors whenever the weather is pleasant.

Scurvy is another disease which can be traced to the use of proprietary foods without fresh milk, sterilized, pasteurized, or boiled milk, and it generally attacks a child between the seventh and tenth month. Among the symptoms are these:

Baby cries when handled; when the diaper is being changed; or, in severe cases, when any one touches the bed or bedding. The knee and ankle joints swell and are very tender, but they are not hot to the touch nor inflamed. The baby suffering from scurvy will generally lie on his back with the knees slightly drawn up and held far apart. If he has teeth the gums will swell and turn purple in color, or bleed easily. In some cases there is also bleeding from the nose and from the bowels. A physician should be called at once; but the real treatment is in the hands of the mother, who will give her baby fresh cow’s milk properly modified, and strained orange juice or thin apple-sauce once a day.

If the child has passed his first year when attacked by scurvy, he may have potatoes, mashed very fine and beaten light with milk, and other fresh vegetables, cooked very tender and pressed through a vegetable sieve. All this treatment must be given under the direction of the family physician.

There are certain ailments which no mother should neglect or attempt to treat. One of these is swollen glands behind and under the jaw and below the ear. These may be due to the presence of infectious diseases, to decayed teeth, enlarged tonsils, malnutrition, or marasmus. They may indicate tuberculosis. Sometimes the growth is gradual; sometimes they appear quite suddenly and disappear without making any great trouble. Occasionally they require incision to let out the pus. This is a simple operation, and recovery is almost always complete in a young child.

For retention of urine give the child a hot bath, raising the temperature from 100° to 105° F. If this does not have the desired effect put the child in bed and lay a compress over the region of the bladder. If the child is still unable to pass urine and there is inflammation of the parts, or a slight yellow discharge, a physician should be summoned.

Vaccination is still a mooted question among persons who argue that smallpox is now so rare that vaccination is unnecessary. This is a mistaken idea. Smallpox is rare because vaccination is commonly practiced. The healthy, normal baby should be vaccinated when he is about six months of age, and subsequently once in five years. If at any period between these dates he is exposed to the disease, he should be vaccinated immediately. Parents who object to compulsory vaccination in the schools can avoid this by having their children vaccinated at home by the family physician. If the latter is conscientious in selecting the vaccine, and the wound is kept clean until it is healed, there is absolutely no danger from infection of any kind. Occasionally one hears of a case where vaccination has been followed by some form of poisoning. This can almost invariably be traced to carelessness in the care of the wound, not to the quality of the vaccine used.