The Mother and Her Child

Usually we begin with number one on the second day; number two on the fourth day; number three at seven to ten days; but after that make the increase more slowly. A large infant with a strong digestion will bear a rather rapid increase and may be able to take number five by the time it is three or four weeks old. A child with a feeble digestion must go much slower and may not reach number five before it is three or four months old.

PEPTONIZED MILK

Another modification which at times may be ordered by your physician is peptonized milk. Since it is infrequent for the proteins of milk to be the cause of indigestion, peptonized milk has only a limited use, chiefly in cases of acute illness. The milk is peptonized in the following manner:

Place the peptonizing powder (it is procurable in tubes or tablets from the drug store) in a small amount of milk, and after being well dissolved, put into the bottle or pitcher with the plain or modified milk, after which the whole is shaken up together. The bottle is then put into a large pitcher containing water heated to about 110° F. or as warm as would bear the hand comfortably, and left for ten or twenty minutes (if the milk is to be partially peptonized). To completely peptonize the milk, two hours are required. Either of these formulas is only used on the advice of a physician.

BUTTERMILK

In many cases of chronic intestinal indigestion, buttermilk is used in place of the milk. It is prepared as follows: After the cream has been taken from the milk and it has been allowed to come to a boil, it is cooled to just blood heat. A buttermilk tablet, having first been dissolved in a teaspoonful of sterile water, is now stirred into the quart of warmed, skimmed milk and allowed to stand at room temperature for twenty-four hours at which time it should look like a smooth custard. With a sterile whip this is now beaten and is ready for the sugar and the boiled water which is added according to the written prescription from the doctor.

CONDENSED MILK

Under no circumstances should condensed milk be used as the sole food of the baby for more than one month. Children often gain upon it, but as a rule they have little resistance, and they are very prone to develop rickets and oftentimes scurvy; and, as noted elsewhere, orange juice should always be administered at least once during the twenty-four hours as long as condensed milk is used.

Of all the brands of condensed milk, those only should be selected which contain little or no cane sugar. Perhaps the "Peerless Brand" of evaporated milk is the most reliable and in the preparation of food from this evaporated milk the same amount of sugar, etc., should be added as we do in the preparation of "whole milk" or "top milk."

We do not in any way advise the use of condensed milk. Fresh milk should always be used where it is obtainable, but in traveling it sometimes has to be used. Holt says, "It should be diluted twelve times for an infant under one month and six to ten times for those who are older."

Malted milk is a preparation suitable in some cases where fresh cow's milk is not obtainable. Even better than condensed milk, this food will be found serviceable in traveling, or in instances where only very bad cow's milk is within reach.

SPECIAL FOODS

Most patent foods are made up of starches and various kinds of sugars, and some of them have dried milk or dried egg albumin added. Many flours under fanciful names are sold on the market today. For instance, one flour with a very fanciful name is simply the old fashioned "flour ball" that our great, great grandmothers made; and, by the way, perhaps there is no flour for which we are more grateful in the preparation of infant food than the flour ball which is prepared as follows: A pound of flour is tied tightly in a cheesecloth and is put into a kettle of boiling water which continues to boil for five or six hours, at the end of which time the cheesecloth is removed and the hard ball, possibly the size of an orange, is placed on a pie pan and allowed slowly to dry out in a low temperatured oven. At the end of two or three hours, the ball, having sufficiently dried, has formed itself into a thick outer peel which is removed, while the heart which is very hard and thoroughly dry, is now grated on a clean grater, and this flour has perhaps helped more specialists to serve more sick babies than any other form of starch known. It is used just as any other flour is used—wet up into a paste, made into a gruel, which is boiled for twenty minutes before it is added to the milk.

Whey is sometimes used in the preparation of sick babies' food and is prepared as follows:

The heavy proteins remain in the curd, and the protein that goes through with the whey is chiefly the lactalbumin.

A friend of ours who presides over a court of domestic relations in a large city, recently told us that he believed much trouble was caused in families—many divorces, occasioned, and many desertions provoked—because improperly fed babies were cross and irritable and so completely occupied the time of the mother, who, herself, knew nothing about mothercraft or the art of infant feeding. Consequently, the home was neglected and unhappy, quarreling abounded and failure, utter failure, resulted. The children were constantly cross, and so much of the mother's time was consumed in caring for these irritable, half-fed babies, that the home was disheveled, the meals never ready, the husband's home-coming was a dreaded occurrence, and he, endeavoring to seek rest and relaxation, usually sought for it in the poolroom or the saloon, with the usual climax which never fails to bring the time-honored results of debauch—despair and desertion.

In the beginning of this book we paid our respects to the present-day educational system which does not provide an adequate compulsory course in which all women could be given at least a working knowledge of home making and the care and feeding of the babies; so that statement need not be repeated in this chapter. But we wish to add, in passing, that ignorance is the basis and the foundation of more unhappy homes, broken promises, panicky divorces, and shattered hopes, as well as of more deaths during the first year of infancy, than any other cause. And in speaking of its relationship to babycraft, we believe that ignorance concerning normal stools, how many times a day the bowels should move; how much a baby's stomach holds; how often he should be fed, etc.—I say it is ignorance of these essential details that lies at the bottom of many problems which come up during the first year, particularly the "feeding problem."

INFANT WELFARE

In the city of Chicago at the time of this writing, the Infant Welfare Association maintains over twenty separate stations where meetings are held for mothers, where lectures are delivered on the care and feeding of babies. Babies are brought to these stations week in and week out; they are weighed and measured and, if bottle-fed, nurses are sent to the homes to teach the mother how properly to modify the milk in accordance with the physician's orders. The health authorities of our city also maintain several such stations where mothers and babies may have this efficient help. A corps of nurses are employed to carry out the instructions and to follow up the mothers and the babies in their homes, and thus the death rate has been greatly reduced, not only in our city but in all such cities where baby stations have been instituted. In a certain ward in Philadelphia the death rate was reduced forty-four per cent in one year after the baby stations were established.

CHOOSING A FORMULA

There are three classes of infants who require weak-milk mixtures to begin with: namely, the baby who has been previously nursed and whose mother's milk has utterly failed; the baby just weaned; and the infant whose power to digest is low. If these children were six months old, and the formula best suited to them is unknown, we must begin with a formula suited to a two- or three-month-old child and quickly work up to the six-month formula, which may often be accomplished within two or three days.

THE BOTTLE-FED BABY

When a baby is getting on well with his food, he should show the following characteristics: He should have a good appetite; should have no vomiting or gas; he should cry but little; and he should sleep quietly and restfully. His bowels should move once or twice in twenty-four hours. His stool should be a pasty homogeneous mass. He should possess a clear skin and good color. He should show some gain each week—from four to eight ounces—and he should also show mental development.

As long as a baby appears happy and gains from four to eight ounces a week and seems comfortable and well satisfied, the feeding mixture should not be changed or increased.

MAKE CHANGES GRADUALLY

In our experience with the artificial feeding of infants, we have come to look upon the practice of gradually changing the food formula as the most important element in successful baby feeding.

We recall one mother in the suburbs who came to us with her baby who had been feeding on a certain proprietary food. She declared that it "just couldn't take cow's milk." She admitted "it was not doing well," and so she would like to have help. The baby was old enough, had it been normal, to have been taking whole milk for some time. We recall our having the mother prepare the proprietary food just as she had been used to preparing it, and each day we had her throw away one-half ounce and put in one-half ounce of whole milk, this mixture she fed the baby for two days.

The next time, we had her take out one ounce of the mixture and put in one ounce of whole milk, which we fed the baby for three successive days; and then one and one-half ounces were substituted which was fed to the baby for four days; and thus we carefully, slowly, and gradually withdrew the proprietary food and substituted fresh, certified cow's milk. It took us a month to complete the change, but we are glad to add that it was done without in the least disturbing the child.

Now, had the change been made abruptly—in a day or two, or three days—the baby would probably have been completely upset, while both the mother and the doctor would have been greatly discouraged. Many mothers and even some physicians have jumped from one baby food to another baby food; they have tried this and they have tried that, until the poor child, having been the victim of a number of such dietetic experiments, finally succumbed.

We cannot urge too strongly the fact that, as a rule, whenever a change is made from one food to another, it should be done gradually, unless it be the change of a single element such as that of a very high per cent of cream found in top milk mixtures, when it seems to be a troublesome element in the milk. No bad effects will follow the quick change to skimmed milk with added sugar, starches, etc; but in changing from a proprietary food to a milk mixture, the change should always be made gradually, the quantity of the new food being increased gradually. Milk should be increased by quarter (1/4) ounce additions, and it should not be increased more than one ounce in one week; while the mixture should not be increased as long as the baby is gaining satisfactorily. A wise mother and an experienced physician can usually see at a glance when a child is doing well—by the color and consistency of the stools, the child's appetite, his sleep, and his general disposition.

COMMON MISTAKES IN FORMULAS

First and foremost, we believe a great mistake is often made in using too heavy cream mixtures; babies as a rule do not stand the use of too high a percentage of cream. Formulas that call for whole milk should contain four per cent fat or cream; and while babies often gain rapidly on the higher percentage of cream found in a rich Jersey milk, nevertheless, sooner or later serious disturbances of digestion usually occur. Herd milk is, therefore, better for the babies because in the "whole milk" of the herd of Holsteins we have only about four per cent fat.

Another common mistake is too heavy feeding at the time of an attack of indigestion; even the usual feeding may be too heavy during this time of indisposition. It is not at all uncommon for us to dilute baby's food to one-third its strength at the time of an acute illness.

Still another trouble maker is dirt—dirt on the dish-towel, dirt on the nipple, dirt in the milk, dirt on the mother's hands. Dirt is an ever present evil and an endless trouble maker, as evidenced by stool disturbances, indigestion, fretful days, and sleepless nights. A dirty refrigerator is another factor which has been responsible for much illness and distress.

Indigestion is often brought on because a nurse, caretaker, or possibly the mother, not wishing to go down to the refrigerator in the middle of the night, brings up the food early in the evening and allows it to become warm—to remain in a thermos bottle—and we are sure that had they been able to see the enormous multiplication of germs because of this warm temperature, they would never have given occasion for such an increase in bacteria just to save themselves a trifle of inconvenience.

Still another common mistake is to use one formula too long; a feeding mixture which was good for four or possibly six weeks, must be changed as the child grows older and his requirements become greater. Let the weight, stools, general disposition and sleep of the child be your guides, and with these in mind errors in feeding can be quickly detected and minor mistakes speedily rectified.

SYMPTOMS OF DISSATISFACTION

Some of the pointed questions which are put to a young mother who brings her child into the office of the baby specialist, are the following:

Does the baby seem satisfied after his feeding?
Does he suck his fist?
How much does he gain each week in weight?
Does he sleep well?
Does the baby vomit?
What do his bowel movements look like?
Will you please send a stool to the office?

With the intelligent answers to these questions—after knowing the birth weight and the age of the child and its general nervous disposition—the physician can formulate some conclusion as to the babe's general condition and can usually find a feeding formula that will make him grow.

Vomiting, restlessness, sleeplessness and the condition of the bowels, are the telltales which indicate whether or not the food is being assimilated; and the stools may vary all the way from hard bullet-like lumps to a green diarrhea.

Babies do not thrive well in large institutions where the food is so often made up in a wholesale manner, for the simple reason that the food elements are not suited to the need of each individual baby. Some infants are unable to digest raw milk, and for them sterilized or boiled milk should be tried; others require a fat-free mixture such as skimmed milk, while still others may need buttermilk for a short time. Babies require individual care, particularly in their food, and the good or bad results are plainly shown in the stools, weight, sleep, etc.

FLATULENCE

Flatulence is an excessive formation of gas in the stomach and bowels leading to distension of the abdomen and the belching of gas, and often the bringing up of a sour, pungent, watery fluid.

Flatulence is seen in infants suffering from intestinal indigestion and the food is nearly always at fault. This condition is the result of the faulty digestion of the sugar and starches—particularly the starch—which should be immediately reduced. In such conditions the addition of a slight amount of some alkaline (such as soda, magnesia or lime water) to the food often produces good results. Great patience must be exercised with a child that suffers from flatulence, for immediate improvement can hardly be expected; time is required for the restoration of good digestion.

VOMITING

Vomiting is perhaps more often the result of over feeding or too frequent feeding than anything else. A healthy, breast-fed baby may now and then regurgitate a bit, but it simply spills over because it is too full. We do not refer to this as vomiting, we refer to the belching up or vomiting of very sour or acrid milk which leaves a sour odor on the clothing. This can all usually be rectified by lengthening the intervals from two to three hours and preventing bolting of food by getting a nipple whose hole is not so large. Too much cream in the food will also sometimes cause vomiting.

Too frequent feeding at night is another cause of vomiting. When the stomach is full, the failure to lay the baby down quietly, as is so often seen in those homes where bouncing and jolting are practiced, may also result in vomiting.

Vomiting may be the first sign of many acute illnesses such as scarlet fever, measles, pneumonia, whooping cough, etc.

The treatment for acute vomiting is simple. All foods should be withheld—nothing but plain, sweetened water should be administered, while it is often advisable to give a dose of castor oil. A physician should be called at once if the vomiting continues, and not until the vomiting has entirely ceased for a number of hours and water is easily retained, should food be given, and even then it should be begun on very weak mixtures.

OVER-FEEDING

The size of the child's stomach should be the guide to the quantity of food given, and attention is called to the table given in a previous chapter. All food taken in excess of his needs lies in his stomach and intestines only to ferment and cause wind and colic. The symptoms of over-feeding are restlessness, sleeplessness, stationary weight (or loss in weight), and oftentimes these very symptoms are interpreted by the mother as sufficient evidence that the baby needs more food; and so the reader can see the terrible havoc which is soon wrought where such ignorance reigns.

WEIGHT

The weighing time should immediately follow a bowel movement and just before a feeding time; then, and only then, we have the real weight of baby, as a retained bowel movement may often add from four to five ounces to the child's weight. There should be a careful record of each weighing, for there may develop a great difference if different members of the family endeavor to keep the weight in their minds. The normal baby should gain four to eight ounces a week up to six months, and from then on the weekly gain is from two to four ounces; in other words, by six months the baby should double his birth weight and at the end of a year his weight should be three times the birth weight. A stationary or diminishing weight demands careful attention; a good doctor should be called at once. Likewise, a very rapid increase in weight is not to be desired, as we do not want a fat baby, but we do desire a well-proportioned and alert baby, and, as someone has said, it is better to have little or no gain during the excessive heat than to upset the digestion by over-feeding, designed to keep the baby gaining.

In weighing, usually the outside garments are removed, leaving on a shirt, band, diaper, and stockings with the necessary pins; the little fellow thus protected is placed into the weighing basket and at each successive weighing, these same clothes or others just like them are always included in the weight, and it should be so reported to the physician.

THE STOOLS

In the chapter "Baby's Early Care," the first stools were described in detail, and there we learned that the dark, tarry, meconium stools are quickly changed within a week to the normal canary-yellow stool, having the odor of sour milk.

The bottle-fed babies' stools differ somewhat in appearance; they are thicker and a lighter color, but should always be homogeneous if the food is well digested. They do not have nearly the number of bowel movements each day that the breast-fed baby does. If a bottle-fed baby's bowels move once a day and he seems perfectly well otherwise, we are satisfied. And curds (white lumps), or mucus (sedimentary, slimy phlegm), indicate that the food is not well digested.

BOTTLE FEEDING AND CONSTIPATION

A bottle baby may be constipated because the proteins are too high, the fat too high, the food of an insufficient quantity or quality, or the milk have been boiled, while weak babies really may lack the muscular power to produce a bowel movement. With the help of your physician endeavor to arrive at the cause of the constipation, and, if the baby is two or three months old, from one to two teaspoons of unsweetened prune juice may be administered. Milk of magnesia may be added to the food (leaving out the lime water), or a gluten suppository may be used.

The change from milk sugar to malt sugar has helped many infants; while the giving of orange juice (after six months) is very beneficial in many cases. A small amount of sweet oil may be injected into the rectum which will lubricate the hard lumps and thus favor comfortable evacuation. The periodicity of the bowel movement (at definite times each day) is a matter of great importance. Immediately after a meal, if the child is old enough, he should be placed on the toilet chair. A bit of cotton, well anointed with vaseline and inserted into the rectum just before meals, will often aid in producing a bowel movement shortly after the meal has been taken.

Abdominal massage should be administered in all instances of constipation, beginning with light movements and gradually increasing, with well-oiled hands.

DIARRHOEA

Diarrhoea usually accompanies acute intestinal indigestion and is so often associated with the common disorders of infancy that we refer the reader to the chapter "Common Disorders of Infancy." Dark stools should always be saved for the physician to observe, as they frequently contain blood. Stools full of air bubbles with pungent sour odor show fermentation; in which cases the starches should be reduced, if not entirely taken away from the food mixtures. Green stools mean putrefaction from filth-germs; a thorough cleansing of the bowel should be immediately followed by a reduction in the strength of the food and the boiling of the milk.

REGULATION OF THE STOOLS

At a certain time each day the napkin should be removed and the child should be held out over a small jar. It is surprising to note how quickly and readily the little fellow cooperates. Diaper experiences may be limited to much less than a year if the mother has patience enough and the baby has the normal intelligence to enter into this regulation regime. We recall one caretaker who complained bitterly because the child under her care constantly wet his diaper; so the caretaker was instructed to keep a daily schedule of the baby's actions for five days; and, to her surprise, she discovered that the baby urinated about the same time each day. A regularity was also noted concerning the bowel movements.

The variations in the time of the urinations were only fifteen or twenty minutes, so nearly did the kidneys act at the same time each day. The caretaker was instructed to remove the diaper and hold the baby out at the earliest occurrence on the daily schedule, and, to the astonishment of the entire family, no further accidents occurred, and the child soon acquired the habit of letting them understand when he was about to wet his diaper. Bowel movements may be regulated more easily than the urination. After the child is about a year old, very few accidents should occur.

MIXED FEEDING

In many instances, and particularly if the infant is under six months of age, and where he has had to have additional feeding from the bottle—under such circumstances the breast milk may be continued as "partial feeding," at least until the baby has reached his ninth or tenth month, at which time it may be wholly discontinued.

At each nursing time the baby empties both breasts, and the amount he draws may readily be estimated by carefully weighing him before and after each nursing. By referring to the directions in a previous chapter, the quantity of food needed for his size and age may be determined; while the deficit is made up from a bottle of milk containing properly modified cow's milk.

If the mother's health admits, or if the breasts continue to secrete a partial meal for the babe, mixed feeding should be continued until after the ninth or tenth month, when it can gradually be reduced from four or five times each day to once or twice a day, until it is finally omitted altogether. In the meantime, the baby is gradually getting stronger food and at eleven or twelve months the little fellow is able to subsist and thrive upon whole milk.

INFANT FEEDING PUZZLES

It is very difficult to explain how some babies thrive on some certain food while others grow thin and speedily go into a decline on the same régime. The hereditary tendencies and predispositions undoubtedly have a great deal to do with such puzzling cases.

Again, sometimes a slight variation in technic or some other trifling error in connection with the preparation of the baby's food, may be more or less responsible for the variation in the results obtained. No two mothers will prepare food exactly alike even when both are following the same printed directions and these slight discrepancies are enough to upset some delicately balanced baby.

On the other hand, some babies are born with such strong digestive powers and such a powerful constitution that they are easily able to survive almost any and all blunders as regards artificial feeding, while at the same time they also manifest the ability to surmount a score of other obstacles which the combined ignorance and carelessness of their parents or caretakers unknowingly place in the pathway of early life which these little folks must tread.

The fact that so many babies do so well on such unscientific feeding only serves to demonstrate the old law of "the survival of the fittest"—they are born in the world with an enormous endowment of "survival qualities"—and in many cases the little fellows thrive and grow no matter how atrociously they are fed.

There may be other factors in the explanation of why some babies do so well on such poor care, but heredity is the chief explanation, while adaptation is the other. If the little fellows can survive for a few weeks or a few months, the human machine possesses marvelous powers of adaptation, and we find here the explanation why many a neglected baby pulls through.

INFANT FOODS

Rickets and scurvy have so often followed the prolonged use of the so-called "infant foods" which have flooded the market for the past decade, that intelligent physicians unanimously agree that they are injurious and quite unfit for continued use in the feeding of infants. If they are prescribed to replace milk during an acute illness, or at other times when the fats and proteins should be withheld for a short period, both the physician and the mother should be in the possession of definite and exact knowledge as to just what they do and do not contain. To provide such knowledge, we present the analysis (Holt) of some of the more commonly used infant foods.

1. The Milk Foods. Nestle's Food is perhaps the most widely known. The others closely resembling it in composition are the Anglo-Swiss, the Franco-Swiss, the American-Swiss, and Gerber's Food. These foods are essentially sweetened, condensed milk evaporated to dryness, with the addition of some form of flour which has been dextrinized; they all contain a large proportion of unchanged starch.

2. The Liebig or Malted Foods. Mellin's Food may be taken as a type of the class. Others which resemble it more or less closely are Liebig's, Horlick's Food, Hawley's Food, malted milk, and cereal milk. Mellin's food is composed principally (eighty per cent) of soluble carbohydrates. They are derived from malted wheat and barley flour, and are composed chiefly of a mixture of dextrins, dextrose, and maltose.

3. The Farinaceous Foods. These are Imperial Granum, Ridge's Food, Hubbell's Prepared Wheat, and Robinson's Patent Barley. The first consists of wheat flour previously prepared by baking, by which a small proportion of the starch—from one to six per cent—has been converted into sugar.

In chemical composition these four foods are very similar to each other, consisting mainly of unchanged starch which forms from seventy-five to eighty per cent of their solid constituents.

4. Miscellaneous Foods. Under this head may be mentioned Carnrick's Soluble Food and Eskay's Food.

The composition of the foods mentioned is given in the accompanying table.

¹ Chiefly Lactose.     ² Largely Maltose.

From earliest girlhood, women have loved their dolls, and one of the greatest joys connected with the adored experience was the make-believe bath and the dressing of the make-believe baby; so now, when we are the happy possessors of real live dolls, we should go about the task with the same lightheartedness of a score of years ago when we hugged, kissed, bathed, and dressed our dolls. There is one big advantage now, the doll won't break; but, we sigh as we stop to think, we can't stick pins into it as we all did into the sawdust bodies of our dolls those years and years ago.

THE FIRST WEEK

In the chapter on "Baby's Early Care," this subject was fully discussed and we only wish to repeat, in passing, that before baby's bath or toilet is undertaken the hands of the mother, nurse, or caretaker must be scrupulously clean. And while the first day's bath usually consists of sweet oil, albolene, or benzoated lard, if the new baby happens to come during the very warm days of July or August and the oil seems to irritate the soft downy skin, as it often does during those hot days, a simple sponge bath may be substituted. The cord dressing remains as the doctor left it, and if there be any interference, let it be subject to his orders.

The cord usually drops off, and the abdomen is entirely healed by the seventh to the tenth day, after which time baby is daily sponged for another week. And now we will describe in detail the simplest, easiest manner of administering an oil bath or a sponge bath.

GIVING THE BATH

A large pillow or a folded soft comfort is placed on a table in a warm room—temperature not below 75 F. On baby's tray near by, and within reaching distance, are the boracic acid solution in a small cup, a medicine dropper, the warm saucer of oil, the toothpick applicators (made by twisting cotton about one end, making sure the sharp end of the pick is well protected), a glass jar of small cotton balls made from sterile absorbent cotton, the castile soap, talcum powder, needle and thread. A vessel of warm water, several old, soft, warmed towels and the clean garments required, complete the layout.

Into the warm, soft blanket on the pillow or comfort we place the partially undressed baby, for the binder, diaper, and socks are not removed until the head-and-face toilet is completed.

The top of the head, behind the ears, the folds of the neck, and the armpits are now gently but thoroughly rubbed with oil, which is then all rubbed off with a soft linen towel. The eyes next receive two or three drops of the boracic acid solution, put in by the aid of the medicine dropper, while, with a separate piece of cotton, the surplus solution is wiped off each eye, rubbing from the nose outward.

Then with the applicator made by wrapping cotton about the end of a toothpick, oil is put into each nostril, all the time exercising the utmost care not to harm the tender mucous membrane. The ears are also carefully cleansed with a squeezed-out dip of boracic acid on the applicator.

Unless there is an inflammation present in the mouth, and the physician in attendance has ordered mouth swabbing, do not touch it; for much harm is done the mucous membrane of the baby's mouth by the forceful manner in which much of the swabbing is done. The face and head are then washed with warm water; very little soap is needed and, when used, must be most thoroughly rinsed off.

THE SECOND WEEK

And now during the second week, we proceed to sponge the baby's body; the hands are washed with soap and rinsed, and, only those who have performed this feat know just how tightly they hold shut their little fists. These hands must be relaxed, and all the lint, dirt, and perspiration be thoroughly washed away. The arms, shoulders, chest, and back are then sponged. All the time the nurse or caretaker is standing while carrying out this most pleasant task. At any time she may quickly cover the babe and stop for this or that with no inconvenience to herself or the child.

After the thorough drying of baby's upper body, a bit of talcum is put under the arms, in the folds of neck, etc., and the shirt is slipped on. Next the band, diaper, and stockings are removed and after first oiling the groin and the folds of the thighs and the buttocks, the same sponging, drying, and powdering is done here as on the upper body.

The band is now applied, and sewed on. The diaper, stockings, booties, and—if a winter baby—the skirt and outing flannel gown (for babies should wear only night dresses for the first two or three weeks) are now slipped over the feet and drawn upward, and baby is ready for nursing or for his nap.

TEMPERATURE OF BATHS

First few weeks, 100 F.; early infancy, 98 F.; after six months, 97 F., cooling down to 90 F.

A wooden bath thermometer may be purchased for twenty-five cents and it should be in every home where babies are bathed. In the absence of a thermometer do not depend upon the hand to determine temperature. Thrust the bared elbow into the water and if it is just comfortable—neither hot or cool—it is probably about the correct temperature for baby. Do not shock the baby by dashes of cold water, for, while it may amuse an onlooker, it unnecessarily frightens your child, and, subconsciously, he learns to dread his bath.

THE BATHING PLACE

If the bathroom is warm—temperature 75 F.—that is the most logical place for the bath, provided baby has his own tub. Place a couple of strong slats several inches wide across the big tub, six inches apart, and on this place the baby's tub. Of course, care must be exercised to prevent slipping by means of properly fitted cleats on the under surface of the slats. The mother should always stand to bathe her baby and the small tub should be placed at such a height that she neither has to stoop nor bend. Thus the bathing of the baby becomes a pleasure instead of a "job" or an "irksome task."

If the bathroom is not warm then the kitchen table or a small table pulled up near the stove is a place par excellence for the dip.

Many boils seen on young baby's tender skin have been traced to the careless use of the family tub to bathe the baby in. Not until the child is two or three years of age, when his skin has become more toughened, should he be allowed to use the family tub.

FREQUENCY OF BATHS

To begin with, we never bathe either a baby or an adult immediately after a full meal. From one hour to one and one half hours should intervene.

The frequency of baths depends somewhat upon the season of the year, the vitality of the child, and the warmth of the home.

We have seen many infants who were bathed too often. The vitality expended upon the necessary reaction following a tub bath was too much for the little fellow; the daily bath was stopped and a semi-weekly bath substituted, much to the gain of the child. Of course in this instance the hands, face, and buttocks received a daily sponging.

The oil bath may be administered daily. In robust children the tub bath may be a daily affair; while in pale, anemic little folks, the tub bath is perhaps better given twice a week. In hot summer days a sponge bath may be given many times a day.

BEST HOUR FOR BATHING

Again this depends upon several factors; the warmth of the house or apartment, the vitality of the child, and the kind of bath to be administered.

An oil bath may be given any time—often it may be administered entirely under the bed clothes, only care must be taken to keep oil from the blankets.

Many of our mothers prefer to give the tub bath at five o'clock in the afternoon, when the house is thoroughly warm, and the child is thereby prepared for the long night's sleep. Before dressing in the morning an oil bath or rub may be given in such cases.

If the forenoon is selected as the time for bathing the child, then an hour just before the mid forenoon meal is the best. In either event, be regular about it—do it at the same time every day. Let the caretaker attend to her many duties, and, as far as possible, mothers, bathe your baby yourself. The folds of the skin, the creases in the neck, the clenched fists, must all receive particular care, and no one in all the world will ever care as you—the mother—cares.

SOAP AND WATER

Select a soap free from irritants and excess of alkalis. There are few kinds that equal the old-fashioned, white castile soap our grandmothers used.

Very hard water which makes the skin rough and sore may be improved by boiling, but if possible substitute rain water for it. A flannel bag tied over the faucet and changed each day will help to clarify muddy water, provided the stream flows gently through it.

ROUTINE OF THE TUB BATH

Just as we directed the nurse or caretaker to stand while the oil rub or sponge bath was given, so we admonish the mother to stand while the tub bath is given. First, get everything in readiness for the bath as directed for the oil bath, and then the baby's tub setting on the securely cleated slats placed across the top of the family tub may be filled with water by means of a hose attached to the faucet. The temperature should be 100 F. when baby is dipped in to be rinsed.