Better babies and their care

The ushering of a new life into the world is an event so momentous and fraught with such wonderful possibilities for both mother and child that it should be planned with every possible precaution. No item of preparation, however trifling, should be left to the last moment. The mother should be able to find relief in the thought that all things are in readiness for the safety and comfort of herself and her child.

The doctor who will be in attendance should be chosen early in the period of pregnancy and consulted whenever the expectant mother feels any anxiety about herself. In this matter the wishes of the woman should be supreme, for her dread of confinement will be greatly lessened if she feels confidence in her physician. I have known women to become extremely nervous because, for reasons of expediency, they were forced to accept the services of a physician desired by husband or family. No one has a right to dictate in this matter to her who must pass through the ordeal of labor. If the woman prefers the family physician to the obstetrician recommended to her husband by friends, relatives, or neighbors, her wishes should be respected. Or if, on the other hand, she decides in favor of the obstetrician instead of the family doctor, there should be no interference. The faith which casts out fear, that indefinable sense of security which she feels in her chosen physician, supports her through the hours of confinement.

During the months of pregnancy the physician thus consulted will follow the changes in his patient and study particularly her nervous condition.

The nurse chosen should also be congenial to the expectant mother, who will depend upon her for assistance and comfort in the last trying hours before actual confinement. The engagement with the nurse should be so made as to insure her freedom to answer the call at least a week in advance. It is poor economy to let a nurse work on another case up to the last moment. Better to pay for a week of idleness and be in command of her services. To prevent misunderstanding, the date on which her pay is to begin, irrespective of the actual date of confinement, should be named definitely.

A few weeks before the date on which the confinement is expected the nurse should come to the house and make herself thoroughly familiar with the plan of the rooms, the water supply, closets, etc. There is nothing more trying for the expectant mother than to have a nurse arrive at the last moment, asking questions and locating needed articles, when she should be rendering service.

When the woman is confined in her own home, the nurse is engaged to remain at least two weeks after the baby is born, and three or four weeks, if the family purse will permit.

In cities the custom of going to a hospital for confinement is growing steadily. It is recognized that the hospital is cheaper, safer and more convenient. The sanitation is perfect, danger from infection is practically nil, and there are expert nurses and house physicians at hand should an emergency arise. It is cheaper because the hospital equipment is at the command of all patients; while, in the home, individual equipment must be bought outright. Moreover, if labor is normal, a special nurse is not required at the hospital, but the patient is cared for by the ward or corridor nurse.

There are women, however, for whom the hospital holds a terror which doctor, husband and friends cannot eradicate. Other women have a deep sentiment or home instinct. They do not want to be taken from the familiar environment of their family. When the question has been placed before the woman in every possible light, and she elects to remain at home, undue pressure should not be brought to bear upon her. The result to her nervous and mental condition may be quite serious.

The room in which the mother will be confined at home should be the most comfortable, cheerful, and the best ventilated room in the house. If there is any room which has an open fireplace, this should be selected, as it improves the ventilation and makes the room cheerful. Two sets of shades, light and dark, should be provided; but heavy hangings, upholstered furniture and dusty carpets should be removed. Small, clean rugs on the floor, and simple, light furniture, which can be easily moved about, are preferable.

A strong single or three-quarter bed is better than the double size, and it should be so placed that it can be reached from all sides by the nurse and doctor. If it is possible to rent a high iron bed, such as is used in hospitals, the work of the doctor and nurse will be lightened. If this cannot be done, a bed of ordinary height can be raised on four strong blocks of wood.

There should be an ample supply of old soft night-dresses, either open all the way down the front or, better still, open in the back and tied at the neck with tapes. For the mother’s convalescence there should be, especially in cold weather, dainty short negligées or dressing-sacques in softly tinted silk and wool, albatross, or outing flannel.

For the home confinement the following equipment should be purchased under the direction of doctor or nurse:

The ergot and chloroform need not be provided by the city mother, with the drugstore close at hand, but for the suburban or country mother their presence in the house, if the doctor is summoned hastily and there is no drugstore near by, may save confusion and perhaps futile errand running. Neither drug is to be used without the permission of the doctor, for, if chloroform is administered too soon, it may hinder the progress of labor. If given in too large a quantity it increases the possibilities of hemorrhage.

The gauze, cotton-batting and absorbent cotton are used for dressings for the bed. These may be made by the mother or the nurse. They must then be sterilized and put in an air-tight box or drawer until needed. With great care they may be sterilized by dry heat in the oven, but as there is danger from scorching, steam is more satisfactory. The most convenient way is to utilize a washboiler, one-fourth full of water. The dressings are laid, first in loose cheese-cloth bags, then in a hammock-shaped strip of muslin attached by either end to the handles of the boiler. The hammock should be swung high enough in the boiler so that it does not actually touch the water. The lid is fastened on tight and the steaming goes on for an hour. The dressings are then dried in the sun or in the oven. In the latter case great care must be taken or they will be scorched.

In preparing an outfit for the baby, it should be borne in mind that this is an age of simplicity in dressing children; also that a baby outgrows its first clothes very quickly. The essentials for the new-born baby are:

Soft material should be used for making the baby’s garments and neither lace nor embroidery should be employed around the necks and sleeves of the little slips, as they may chafe the tender skin and cause eczema. Cleanliness is the one demand for the baby until it has passed safely through the first month of its life, when the mother may give more attention to its raiment.

In this day when cotton materials are highly mercerized and bleached, it is safest to wash the little garments made from them before they are worn by the new-born baby with its delicate skin. Diapers in particular should be washed, and dried, but not ironed. The necks of dresses or slips should be loose and tied with tape; buttons or fancy pins may cause discomfort to the baby.

Every woman knows that efficiency in all branches of home-making depends largely on having the proper tools. This is true in the nursery as well as in the kitchen. There is no more delightful occupation for the last two months before confinement than fitting up a nursery for the little guest. A modern nursery equipped with all the up-to-date appliances is not within the purse or even the house limitations of many mothers, but there is no reason why the new baby should not have its own corner in the house whether this be an entire room or just one end of “mother’s room.”

The expectant mother with a modern house, plenty of rooms, electric light, and running water, at her command, has half of the problem solved for her. She will choose for the nursery a room opening off her own, and convenient to the bathroom. This need not be large, but it should be well ventilated, and, if possible, have a southern exposure in order that it may be flooded with air and sunshine. The walls should be painted, not papered, and the floor should be of hard wood or stained pine, never carpeted. A few rugs that can be washed or cleaned will be sufficient floor covering. It is better not to have a stationary washstand in this room, because, unless the plumbing is above suspicion, the pipes may breed germs.

There are two ways of providing against draughts: one of these is the use of a screen that can be placed around the baby’s bed; the other is a wooden board, about five or six inches high, and long enough to fit the window when the lower sash is raised. The upper sash can then be dropped to let the impure air out, and the clean, pure air will enter the room between the upper and lower sashes.

The windows should have both light and dark shades. Babies stare at the light, and, especially during the first few weeks after birth, the nursery should be kept dark, or at least with only a dim light. The custom of hanging an old shawl or dark curtain over the window is not sanitary. At no time should the young baby’s eyes be exposed to a strong light, either artificial light or sunlight. The crib should be so placed that the baby looks away from the light, not toward it. Protecting the baby’s eyes from glare may mean guarding it from defective vision.

Except for very cold weather an open fireplace is the best possible method of heating the room. When there is no fireplace, hot water heating is best for the nursery; as it is for the entire house. When steam or hot air is used, a pan of water, changed daily, should always be kept in the room to relieve dryness in the atmosphere. Air-tight coal stoves, gas or oil stoves should never be used in the nursery.

For the first week or so after the baby’s birth the nursery should be kept at a temperature of 70° F. by day and 64° F. by night. As the child grows older, the temperature may gradually be reduced at night.

Electric lighting is the best for the nursery. If this is not a part of the equipment of the house, neither gas nor an oil lamp should be allowed to burn in the room at night; a candle or wax night light should be at hand. These can be bought at any house-furnishing store.

It is very important that the nursery should be fitted with screens to keep out flies and mosquitoes. Mosquitoes carry malaria, and the foot of a fly brings germs from the street, garbage and trash piles far beyond the limits of the most sanitary nursery. The nursery should furnish the baby’s first protection from contagious diseases. It must be a veritable haven of safety. Therefore, no household work of any kind should be done in the room, such as washing or drying the baby’s clothes. The floors and the furniture should be wiped daily with damp cloths. A dry cloth or feather duster should never be used to scatter dust around the room.

Very important are the bath equipment, fully described in Chapter VIII, “Cleanliness and Health,” and the baby’s toilet basket. The latter is most sanitary when made of wicker, plain or enameled, and fitted with celluloid or ivorine boxes. Swiss lining, with lace-trimmed pockets and bows, soon soils and catches dust and germs.

The equipment of the nursery should include a crib of enameled iron, a low table, a screen, a closet or chest for the baby’s clothing and supplies, a small clothes-rack, a pair of scales, and a low chair—a rocker without arms if the mother prefers it. If these are all painted white, they give the room a very sanitary appearance.

The crib should be supplied with springs, mattress—preferably of hair—a piece of India-rubber sheeting, and several cotton pads which can be washed, half a dozen cotton sheets, a pair of light woolen blankets—woven especially for cribs, or made from old blankets on hand, carefully washed and bound, or wide flannel by the yard finished with binding ribbon. The quilt should be of eider-down or a light-weight cotton-batting, covered with silk or silkaline. If the bed clothing is heavy, the baby will perspire and take cold more easily. A small hair pillow is better than feathers, and the pillow-slip should not be embroidered. It is far better to start the baby early in life sleeping without any pillow at all. A hot-water bottle or bag, covered with flannel, should always be at hand for warming the baby’s cold feet.

Many mothers cannot provide either a separate room or the modern equipment described; but a resourceful woman will supply admirable substitutes. If she can do no better, she will arrange one corner of her own bedroom for the baby. To make this sanitary she will follow the general plan of a bare floor, painted walls, and even sacrifice her ruffled curtains to the health of her baby. The baby’s corner can be separated from the rest of the room by screens. A screen may be made from an ordinary clothes-horse, enameled white, and covered with heavy dotted Swiss or silkaline, which can be taken off and washed.

If the white enameled crib is beyond the family purse, there are several substitutes which can be placed on an ordinary table with the legs cut off a few inches. One woman whom I met at a contest had found an old kitchen table in the attic. Her husband first cut off the legs evenly and then inserted casters, painting the whole white. On this she placed an ordinary marketing basket, with the handle sawed off. This, too, was painted with white enamel. In it she laid a hair pillow, cut down to the size of the basket, and then added the usual protecting piece of rubber cloth, sheets, and bedding. This basket was closely woven, and when the paint filled all the cracks, it made a snug little bed. If an open-work basket or an ordinary laundry basket is used, it may be draped on the outside with plain muslin, fastened with thumb tacks so that it can easily be removed and washed. Decorating the basket with frills of dotted Swiss over paper-muslin or silesia may give very attractive results, but it is not sanitary.

Another substitute for a crib is an ordinary packing box, which can be bought from any grocer or shoe dealer, scrubbed, dried and then painted white inside and out, and covered with muslin attached with thumb tacks.

If a feather pillow, instead of hair, must be used, it should be completely covered with rubber cloth or ordinary table oilcloth, because the feathers are heating and should be separated from the baby by the rubber.

If a good-sized basket or box is chosen, the baby can sleep in this until it is several months old.

On the day of baby’s birth, his clothes-rack and toilet basket, a low chair, and a table with basin should be placed near the fireplace, stove, or radiator. On the clothes-rack hang the first garments he will wear. On the chair hang an outing flannel or soft woolen apron for the nurse, and the soft shawl or blanket in which the little newcomer will be wrapped directly after birth. The toilet basket should contain the following supplies:

Every item mentioned in these preparations for the baby’s birth is important, as it bears directly upon sanitation, the comfort of the mother, and the safety of the child. This is no hour in which to take chances through false economy or procrastination.

Directly after the child is born and the navel cord has been tied, either the nurse or doctor should give attention to the baby’s eyes. Science has proved that a large proportion of blindness is preventable, if prompt care is given to the eyes of new-born children. Hundreds of children are blind from birth through infection which might have been prevented.

The eyes of the new-born baby are generally closed and covered with mucus. This should be washed off very gently with absorbent cotton dipped in boracic acid solution, starting at the nose and wiping outward, without opening the lids. To remove any chance of infection which leads to blindness, or ophthalmia neonatorum, as it is known to the medical profession, the nurse then applies a few drops of antiseptic solution, provided by the physician. For this purpose she uses a medicine dropper. So successful has been this treatment in reducing the percentage of blindness at birth, that many health boards, notably in New York, demand such precautions of physicians and midwives.

If for any reason the treatment is not given, the mother will do well to watch the baby’s eyes for such symptoms as redness, swollen lids, and a slight discharge oozing from under the lids. If these symptoms appear, the parents should insist upon summoning a physician, for at this time prompt treatment may save the child’s sight. Neglect may result in total blindness or, at best, permanently impaired vision.

The baby’s eyes should be washed daily with boracic acid solution, the cotton or gauze used for this purpose being destroyed and never used a second time.

Next, the baby’s skin should receive the nurse’s attention. Before it is bathed, the entire surface of the body should be covered with olive oil or vaseline; after this process, the baby may be wrapped warmly in a blanket and tucked into a safe corner, while the nurse turns her attention to the mother. The baby need not be bathed until the mother has been made comfortable.

By this time the olive oil or vaseline has softened the cheese-like substance which encrusts the skin of the new-born baby. The nurse fills the basin or tub with water, which registers 100 degrees F., if a bath thermometer is used, or which will feel comfortably warm when she thrusts her bare elbow into the water. Making a soft suds with Castile or Ivory soap, the nurse then lathers the entire body, taking great care not to get soap in the baby’s eyes. The soap is rinsed off with gauze or old linen and clear water, and the flesh is patted dry with old soft towels which have been warmed. The tender skin must never be rubbed. Talcum powder is then applied, and the baby is ready to be dressed in flannel binder, shirt, soft diaper, flannel skirt and outing flannel wrapper.

As the little body is indescribably tender and sensitive at this time, the nurse must handle it with exquisite care, always supporting the head and back and protecting it from draughts; she must be very careful not to let a strong light strike the eyes. If the baby is normally healthy and has been made comfortable, it now falls sound asleep. This is nature’s way of permitting the mother to recuperate before nursing the baby for the first time. When the baby wakens, the mother will have regained her strength in that amazing way which is appreciated only by those who have watched her pass from the ordeal of labor into the joys of maternity as through a miracle. The baby should be given the breast when it awakens from its first sleep, and if there is any flow of milk whatever, no artificial food should be supplied. Thus does the baby start aright its splendid progress toward a normal, healthy childhood.