Tokology

What more helpless and dependent than the newborn infant! A human soul, with all the possibilities of life, yet of itself it cannot supply its slightest need.

No wonder that so great a wealth of maternal love is called forth in administering to such helplessness! No wonder that the mother’s heart is humbled at the greatness of her mission as special guardian of the little one! May divine love and wisdom aid and guide her!

The newborn babe has had a sleep, at least a rest. It has entered upon its new life, and all the functions of the body are well established.

The first thing in lending a helping hand to the little stranger is to give him a bath. This is done ordinarily by using soap and warm water. The vernix caseosa, a thick, white, unctuous material that usually covers the child, and is abundant in the axilla and groin, is much more easily and thoroughly removed by cleansing it entirely with some oily substance. For this purpose olive oil or lard can be used. It should be applied with a soft, worn piece of flannel, keeping the child well covered. When it is entirely clean, rub all over with a fresh piece of flannel, and the skin is left in a soft, smooth condition.

R. P. Harris, M. D., says: “As the vernix caseosa is readily miscible with pure lard, and can be easily removed by its means, the practice prevails with many obstetricians in the United States of ordering the infant well anointed, and then wiped from head to foot with soft rags, until all the vernix disappears, and the skin retains an oily trace, not enough to soil the clothing. By this means water is avoided, and with it much risk of taking cold; the skin is left much less sensitive, after the sudden change which it is made to endure at birth than when subject to soap and water.”

Dress the navel with absorbent antiseptic cotton. Put a piece three or four inches square on the left side of the abdomen, just above the navel, the remnant of the cord laid upon it, with its cut end pointing to the left, and upward—the cotton arranged to embrace the base of the cord, and another piece of cotton the same size placed over the cord, the whole kept in place by a soft flannel band. This is preferable to linen. It absorbs the secretion more readily, making less liability of an unpleasant odor. It is kept in place better, and the cord comes off much sooner. Can often be entirely removed the fourth day. There needs to be no grease or oil upon the cotton. After the separation of the cord, the navel should be dressed with a little simple cerate or cosmoline, and still use the absorbent cotton.

Any pouching of the navel can be relieved by using a thin slice of cork or a piece of thick pasteboard two inches in diameter. Wrap it with several thicknesses of linen and place it outside of the cotton, applying the bandage sufficiently snug to keep it in place.

The Clothing of the child should be soft, warm, light, loose, and easily adjusted. Superfluous garments should be avoided, and waistbands dispensed with.

Activity is so natural to child-life that it seems almost life itself. Months before it is born a babe is in ceaseless motion, and after birth it is never still during its waking hours. This activity is synchronous with its development and should be encouraged rather than hindered. A child’s dress, while it serves the purposes of warmth, protection and adornment, should in no way prevent this activity.

Only a few years since, the dress for all infants was cut low in the neck and with short sleeves. A sensible reform made it fashionable to protect the necks and arms of the little ones. It is equally as essential and is just as desirable a reform, that the dress should be so constructed that the natural activity of any part of the body is not hindered. To accomplish this the skirts must be shortened and all bands abolished. Is there any reason why a child’s clothes should be so long that they are a burden to him and an inconvenience to all who handle him?

Many mothers, noting their babies’ constant struggle for exercise, frequently uncover their feet in order to give them an opportunity to kick and stretch. It is not unusual, also, for them to get them out of long clothes by the time they are three months old.

One lady writes that she tried making her baby’s first clothes very short. They were only twenty-seven inches in the entire length, from the shoulder to the hem at the bottom. This experiment proved so satisfactory that she says she will never put long dresses on a child again. Not only was her baby so much more comfortable, but he was so much more easily handled that she felt repaid in the comfort it was to herself. Aside from this, there was no necessity of making short clothes for him until he walked, which was a saving in time and money.

A new-born child requires the following garments:

A Shirt and Band Combined: This should be made of soft flannel or knitted wool. If of flannel, turn hems but once, and cross-stitch down smoothly. Finish the neck and arm’s eye with a button-hole stitch, using silk or worsted. Lay a fold in back of shirt, to make it fit the child, and stitch down smoothly and lap in front and fasten as if it were a band. The shirt has this advantage over the ordinary band, that it cannot wrinkle up if the napkin is pinned to it as it should be. One-half yard of thirty-six inch flannel will make four shirts. This garment is worn mainly to keep the dressing upon the navel in place, and can be discarded when that necessity no longer exists.

Foot blanket: Made of flannel, twenty-seven inches square, and hemmed on three sides. Lay a double box-plait in the center of fourth (or upper) side, stitch down one inch, and face the same width, with a strip of cotton, cut bias. Fasten over the diaper with a small safety-pin. This garment protects other clothing and wraps the feet up nicely until the child is large enough to wear socks. If the weather is cold woolen socks are advisable from the first. However, it is not absolutely necessary, and some mothers dispense with it altogether.

A Flannel Skirt: Is made with long sleeves, and is cut from the same pattern as a night-dress or day-slip. Fine, all-wool flannel is generally used for this skirt, but I would recommend the use of the eider-down flannel, which is also so desirable for baby cloaks. The outside dress can be made as a Mother Hubbard, or slip, and where taste inclines, it may be of finest material and exquisite embroidery. Besides the diaper, the flannel skirt and slip are all the clothes a young baby actually requires. The skirt should be put inside of the dress and the two put on the child at the same time.

Thus an infant may be dressed in less than five minutes, instead of the long, tedious process of the customary dress.

Once clothing a baby in this simple fashion, one would never be inclined to again adopt the long full skirts, the bands and pins, that are a torture to infants and trying to the patience of the mother.

The same general principle may be followed for a child’s wardrobe until he is put into drawers; then these require to be attached to a light waist without sleeves.

The first few months the child’s feet are most comfortable in crocheted socks. The first shoes may be made like moccasins, of broadcloth or chamois skin. A lady in Cincinnati makes many of the latter for the trade, supporting her children and an invalid husband by their sale.

These directions for infants’ clothing are so simple that many may think they are not worth following, but when we see the little ones bandaged and burdened as we do, is it not time to make a protest that will reach every mother? A child’s dress should always serve the purposes of protection and warmth without any hindrance to its activity and development.

Habits of cleanliness can be taught every child. The clumsy diaper can be dispensed with by the time it is three or four months old. Let the mother practice holding out her baby immediately after nursing it, and it will easily be taught to urinate at this time, and also to have a passage from the bowels at a stated time in the morning and evening. The actual comfort secured to mother and child through this habit, more than repays for the labor and patience in securing it. Teach your children to be cleanly. A dirty child is a mother’s disgrace. When a child begins to creep and walk, the diaper (necessarily large and bulky) has to be pinned too tightly for comfort and health, in order to keep it in place.

A bath may be given to the child every day or every other day. By the time it is two months old, it can be put into a bath daily. Should remain in the water not more than five minutes. The temperature should not exceed 90°, and it is quite as well to accustom the child to a lower temperature gradually. Don’t trust the hand to determine the heat. Always have a thermometer. Do not bathe a child immediately after nursing. Avoid the use of soap. A child’s skin is naturally oily, and should be preserved so.

NURSING.

The newborn infant needs no artificial food. It should be put to the breast whenever it shows an inclination. The true mother will delight in the privilege of nursing her child, and will allow nothing but the most entire inability to prevent the exercise of this maternal office.

The mother’s milk is the natural food, and nothing can fully take its place. Every means should be used to secure and maintain this natural nutriment before resorting to artificial food. The nursing process, by sympathetic action, assists in restoring the uterus to normal conditions. A few years since everybody supposed the baby must be fed artificially the first two days of its life, that there was a break in nature’s provision for its sustenance. The consequence was the poor little victim was dosed with all sorts of slops, catnip tea, panada, gruel, cracker water, cream tea, etc., etc. Remember, it needs nothing but the secretion that is in the breast, which is laxative at first, and removes the meconium from the bowels. If for any reason the mother has not milk for her child, or is separated from it, the best substitute is a wet nurse, whose babe should be near the same age. The nurse should be well and strong, having abundant and nourishing milk.

The best artificial food is cream reduced and sweetened with sugar of milk. Analysis show that the human milk contains more cream and sugar and less casein than the milk of animals. The reduced cream, sweetened, closely approximates human milk. The difference in the quality of cream presents a great difficulty. No rule can be given for its reduction. Most nurses leave it too rich, and the child’s system is soon deranged.

To obviate this difficulty, let new milk stand from four to six hours, take the top off, reduce one-half with hot water; to one pint add one teaspoonful of sugar of milk and one grain of phosphate of lime. When the child is from three to five months old, oatmeal, barley or bran gruel can be added.

Children have not sufficient secretion of saliva to convert starch into sugar. Therefore never use arrowroot or corn starch; these do not digest in the stomach, and intestinal derangement is likely to follow. Bran or barley gruel furnishes phosphates, which are essential to stimulate digestion.

Microscopical examination of the artificial foods prepared and sold for infants, proves many of them deficient in gluten and too abundant in starch to make them desirable nutriment. The following extract from “Playfair’s Midwifery” explains the

“Causes of mortality in hand-fed children.—Much of the mortality following hand-feeding may be traced to unsuitable food. Among the poorer classes especially there is a prevalent notion that milk alone is insufficient, and hence the almost universal custom of administering various farinaceous foods, such as corn-flour or arrowroot, even from the earliest period. Many of these consist of starch alone, and are therefore absolutely unsuited for forming the staple of diet, on account of the total absence of nitrogenous elements. Independently of this, it has been shown that the saliva of infants has not at first the digestive action on starch that it subsequently acquires, and this affords a further explanation of its so constantly producing intestinal derangement. Reason, as well as experience, abundantly proves that the object to be aimed at in hand-feeding is to imitate as nearly as possible the food which nature supplies for the newborn child, and therefore the obvious course is to use milk from some animal, so treated as to make it resemble human milk as nearly as may be.

“Artificial human milk.—An admirable plan of treating cow’s milk, so as to reduce it to almost absolute chemical identity with human milk has been devised by Professor Frankland, to whom I am indebted for permission to insert the receipt. I have followed this method in many cases, and find it far superior to the usual one, as it produces an exact and uniform compound. With a little practice nurses can employ it with no more trouble than the ordinary mixing of cow’s milk with water and sugar. The following extracts from Dr. Frankland’s work will explain the principles on which the preparation of the artificial human milk is founded: ‘The rearing of infants, who can not be supplied with their natural food, is notoriously difficult and uncertain, owing chiefly to the great difference in the chemical composition of human milk and cow’s milk. The latter is much richer in casein, and poorer in milk-sugar than the former, whilst asses’ milk, which is sometimes used for feeding infants, is too poor in casein and butter, although the proportion of sugar is nearly the same as in human milk. The relation of the three kinds of milk to each other are clearly seen from the following analytical numbers, which express the percentage amounts of the different constituents:

These numbers show that by the removal of one-third of the casein from cow’s milk, and the addition of about one-third more milk-sugar, a liquid is obtained which closely approaches human milk in composition, the percentage amounts of the four chief constituents being as follows:

The following is the mode of preparing the milk: Allow one-third of a pint of new milk to stand for about twelve hours, remove the cream and add to it two-thirds of a pint of new milk, as fresh from the cow as possible. Into the one-third of a pint of blue milk left after the abstraction of the cream, put a piece of rennet about one inch square. Set the vessel in warm water, until the milk is fully curdled, an operation requiring from five to fifteen minutes, according to the activity of the rennet, which should be removed as soon as the curdling commences, and put into an egg cup for use on subsequent occasions, as it may be employed daily for a month or two. Break up the curd repeatedly, and carefully separate the whole of the whey, which should then be rapidly heated to boiling in a small tin pan placed over a spirit or gas lamp. During the heating a further quantity of casein, technically called ‘fleetings,’ separates, and must be removed by straining through muslin. Now dissolve 110 grains of powdered sugar of milk in the hot whey, and mix it with the two-thirds of a pint of new milk, to which the cream from the other third of a pint was added, as already described. The artificial milk should be used within twelve hours of its preparation, and it is almost needless to add that all the vessels employed in its manufacture and administration should be kept scrupulously clean.

Any babe can be fed from the first with a spoon, and in a few weeks it will drink from a cup or glass. When it seems necessary to use the nursing bottle the utmost care should be taken to keep it clean and sweet. Two bottles should be used alternately. The one not in use should be thoroughly rinsed, and then laid (without the nipple) in an earthen or granite dish, containing a solution of common soda. Let it remain there until needed, then rinse it well, and you may feel that it is in good condition. Cleanse the nipple by hand. Do not use the rubber tube.

A young babe should not be fed more frequently than once in two hours, and by the time it is three months old once in three hours is preferable. Most children, when four or five months old, can be taught to sleep all night without nursing. Nothing deranges a child’s digestion more than irregular and constant nursing. I have seen a mother give her child the breast five times during a half-hour’s conversation. It is unreasonable to suppose that a child is hungry every time it nestles and frets. Consider the time since it has nursed, and look for other causes of uneasiness before giving it the breast.

A babe should be weaned when it is from twelve to eighteen months old. The exact time depends largely upon its development, and also upon the mother’s condition. Begin weaning by omitting nursing once a day for several days, then twice a day, and so on. In this way the little one is weaned almost, or quite unconsciously, is never for a minute unhappy, and the mother is saved great anxiety and worry. Before weaning and some time after, it should be fed upon oatmeal, barley meal, wheat meal, graham bread and milk, wheatlet, etc. The digestive organs are not in a condition for a mixed diet until the teeth are developed, and, as has been indicated above, the saliva is not yet an efficient aid for digesting starchy food. Many a case of summer complaint, convulsions, etc., is due to the meat, pie and cake upon which the child has been fed.

Meat-fed children are cross, irritable and quarrelsome. Some three years since a kind, conscientious mother said: “The greatest trial of my life is that my children quarrel so with each other. I cannot understand the reason. Nothing they do annoys me so much, and by teaching, persuasion or punishment I have been unable to change their habit.”

Hoping to give her aid, I asked many questions—among other things in regard to diet. She told me they were great meat eaters; her husband and brother must have it three times a day, and the children often ate scarcely anything else. I told her the story of the bear that was kept at the museum in Giessen; when fed on bread only it was quiet and tractable—even children could play with it with impunity—but a few days’ feeding upon meat would make it ferocious, quarrelsome and dangerous.

She agreed to try the experiment upon her children. I counseled her, as her husband did not dine at home, to make a special dinner for the children. Instead of giving them scraps of cold meat, pies and cake, etc., make them milk toast, tiny graham or corn meal gems, cracked wheat or wheatlet moulded in small cups with fruit sauce, fruit puddings, etc. Spare no pains in making it attractive and palatable. Decorate the table with fruit and flowers, and make the occasions frequent when their own holiday presents of china should be used. Follow this with a light lunch at night, of simple, farinaceous food before the ordinary family dinner. In this way they would be tempted with the meat only at breakfast, and even then, fresh fish, fish balls, omelets, etc., might often be made to supplant the platter of steak or ham.

This lady entered into the plan heartily, and was more than amply paid. In less than a month she could see a difference in the habits of her children, and a year later she testified that it would hardly be recognized as the same family. The children were cheerful, playful, gleeful, and full of spirit—but in place of fretfulness and quarrels, were kind, benevolent and considerate to each other. They were also more than ordinarily exempt from acute attacks of fevers and inflammation.