Again, in case of a severe illness occurring during the first nine months of a child’s life, what a comfort either the mother’s or the wet-nurse’s milk is to him! it often determines whether he shall live or die.
But if a wet-nurse cannot fill the place of a mother, then, asses’ milk will be found the best substitute, as it approaches nearer, in composition, than any other animal’s, to human milk; but it is both difficult and expensive to obtain. The next best substitute is goats’ milk. Either the one or the other ought to be milked fresh and fresh, as it is wanted, and should be given by means of a feeding-bottle.
Asses’ milk is more suitable for delicate infants, and goats’ milk for those who are strong.
If neither asses’ milk nor goats’ milk can be procured, then the following from the very commencement should be given:
Liebig, the great chemist, asserts that a small quantity of table salt to the food is essential to the health of children. The milk itself ought not to be heated over the fire, but should, as above directed, be warmed by the water; it must, morning and evening, be had fresh and fresh. It now and then happens that if the milk be not boiled, the motions of an infant are offensive; when such is the case let the milk be boiled, but not otherwise. The milk and water should be of the same temperature as the mother’s milk, that is to say, at about ninety to ninety-five degrees Fahrenheit. It ought to be given by means of a feeding-bottle, and care must be taken to scald the bottle out twice a day, for if attention be not paid to this point the delicate stomach of an infant is soon disordered. As he grows older the milk should be gradually increased, and the water decreased, until nearly all milk be given.
There will, in many cases, be quite sufficient nourishment in the above; I have known some robust infants brought up on it alone. But if it should not agree with the child, or if there should not be sufficient nourishment in it, then the food recommended in answer to No. 34 question ought to be given, with this only difference—a little new milk must from the beginning be added, and should be gradually increased, until nearly all milk be used.
The milk, as a general rule, ought to be unboiled; but if it purge violently, or if it cause offensive motions—which it sometimes does—then it must be boiled. The moment the milk boils up it should be taken off the fire.
Food ought, for the first month, to be given about every two hours; for the second month, about every three hours; lengthening the space of time as the baby advances in age. A mother must be careful not to over-feed a child, as over-feeding is a prolific source of disease.
Let it be thoroughly understood, and let there be no mistake about it, that a babe, during the first nine months of his life, MUST have—it is absolutely necessary for his very existence—milk of some kind, as the staple and principal article of his diet, either mother’s, or wet-nurse’s, or asses’, or goat’s, or cow’s own milk.
37. How would you choose a wet-nurse?
I would inquire particularly into the state of her health; whether she be of a healthy family, or a consumptive habit, or if she or any of her family have labored under “king’s evil;” ascertaining if there be any seams or swellings about her neck; any eruptions or blotches upon her skin; if she has a plentiful breast of milk, and if it be of good quality (which may readily be ascertained by milking a little into a glass. “It should be thin, and of a bluish-white color, sweet to the taste, and when allowed to stand should throw up a considerable quantity of cream.”—Maunsell and Evertson on the Diseases of Children.) If she has good nipples, sufficiently long for the baby to hold; that they be not sore; and if her own child be of the same or nearly of the same age as the one you wish her to nurse. Ascertain whether she menstruates during suckling; if she does, the milk is not so good and nourishing, and you had better decline taking her. Sir Charles Locock considers that a woman who menstruates during lactation is objectionable as a wet-nurse, and “that as a mother with her first child is more liable to that objection, that a second or a third child’s mother is more eligible than a first.”—Letter to the Author. Assure yourself that her own babe is strong and healthy, and that he is free from a sore mouth and from a “breaking-out” of the skin. Indeed, if it be possible to procure such a wet-nurse, she ought to be from the country, of ruddy complexion, of clear skin, and of between twenty and five-and-twenty years of age, as the milk will then be fresh, pure, and nourishing.
I consider it to be of great importance that the infant of the wet-nurse should be, as nearly as possible, of the same age as your own, as the milk varies in quality according to the age of the child. For instance, during the commencement of suckling, the milk is thick and creamy, similar to the biestings of a cow, which, if given to a babe of a few months old, would cause derangement of the stomach and bowels. After the first few days, the appearance of the milk changes; it becomes of a bluish-white color, and contains less nourishment. The milk gradually becomes more and more nourishing as the infant becomes older and requires more support.
In selecting a wet-nurse for a very small and feeble babe, you must carefully ascertain that the nipples of the wet-nurse are good and soft, and yet not very large: if they be very large, the child’s mouth being very small, he may not be able to hold them. You must note, too, whether the milk flows readily from the nipple into the child’s mouth; if it does not, he may not have strength to draw it, and he would soon die of starvation. The only way of ascertaining whether the infant actually draws the milk from the nipple, can be done by examining the mouth of the child immediately after his taking the breast, and seeing for yourself whether there be actually milk in his mouth.
Very feeble new-born babes sometimes cannot take the bosom, be the nipples and the breasts ever so good. In such a case, cow’s milk and water, sugar and salt, as recommended at page 45, must be given in small quantities at a time—from two to four teaspoonfuls—but frequently; if the child be awake, every hour or every half hour, both night and day, until he be able to take the breast. If, then, a puny, feeble babe is only able to take but little at a time, and that little by teaspoonfuls, he must have little and often, in order that “many a little might make a mickle.”
I have known many puny, delicate children who had not strength to hold the nipple in their mouths, but who could take milk and water (as above recommended) by teaspoonfuls only at a time, with steady perseverance, and giving it every half hour or hour (according to the quantity swallowed), at length be able to take the breast, and eventually become strong and hearty children; but such cases require unwearied watching, perseverance, and care. Bear in mind, then, that the smaller the quantity of the milk and water given at a time, the oftener must it be administered, as, of course, the babe must have a certain quantity of food to sustain life.
38. What ought to be the diet either of a wet-nurse, or of a mother who is suckling?
It is a common practice to cram a wet-nurse with food, and to give her strong ale to drink, to make good nourishment and plentiful milk! This practice is absurd; for it either, by making the nurse feverish, makes the milk more sparing than usual, or it causes the milk to be gross and unwholesome. On the other hand, we must not run into an opposite extreme. The mother, or the wet-nurse, by using those means most conducive to her own health, will best advance the interest of her little charge.
A wet-nurse ought to live somewhat in the following way: Let her for breakfast have black tea, with one or two slices of cold meat, if her appetite demand it, but not otherwise. It is customary for a wet-nurse to make a hearty luncheon; of this I do not approve. If she feel either faint or low at eleven o’clock, let her have either a tumbler of porter, or of mild fresh ale, with a piece of dry toast soaked in it. She ought not to dine later than half-past one or two o’clock; she should eat, for dinner, either mutton or beef, with either mealy potatoes, or asparagus, or French beans, or secale, or turnips, or brocoli, or cauliflower, and stale bread. Rich pastry, soups, gravies, high-seasoned dishes, salted meats, greens, and cabbage must one and all be carefully avoided, as they only tend to disorder the stomach, and thus to deteriorate the milk.
It is a common remark, that “a mother who is suckling may eat anything.” I do not agree with this opinion. Can impure or improper food make pure and proper milk, or can impure or improper milk make good blood for an infant, and thus good health?
The wet-nurse ought to take with her dinner a moderate quantity of either sound porter, or of mild (but not old or strong) ale. Tea should be taken at half-past five or six o’clock; supper at nine, which should consist either of a slice or two of cold meat, or of cheese if she prefer it, with half a pint of porter or of mild ale; occasionally, a basin of gruel may with advantage be substituted. Hot and late suppers are prejudicial to the mother or to the wet-nurse, and, consequently, to the child. The wet-nurse ought to be in bed every night by ten o’clock.
It might be said that I have been too minute and particular in my rules for a wet-nurse; but when it is considered of what importance good milk is to the well-doing of an infant, in making him strong and robust, not only now, but as he grows up to manhood, I shall, I trust, be excused for my prolixity.
39. Have you any more hints to offer with regard to the management of a wet-nurse?
A wet-nurse is frequently allowed to remain in bed until a late hour in the morning, and during the day to continue in the house, as if she were a fixture! How is it possible that any one, under such treatment, can continue healthy?
A wet-nurse ought to rise early, and, if the weather and season will permit, take a walk, which will give her an appetite for breakfast and will make a good meal for her little charge. This, of course, cannot, during the winter months, be done; but even then, she ought, some part of the day, to take every opportunity of walking out; indeed, in the summer time she should live half the day in the open air.
She ought strictly to avoid crowded rooms; her mind should be kept calm and unruffled, as nothing disorders the milk so much as passion and other violent emotions of the mind; a fretful temper is very injurious, on which account you should, in choosing your wet-nurse, endeavor to procure one of a mild, calm, and placid disposition.
“The child is poisoned.”
“Poisoned! by whom?”
“By you. You have been fretting.”
“Nay, indeed, mother. How can I help fretting?”
“Don’t tell me, Margaret. A nursing mother has no business to fret. She must turn her mind away from her grief to the comfort that lies in her lap. Know you not that the child pines if the mother vexes herself?”—The Cloister and the Hearth. By Charles Reade.
A wet-nurse ought never to be allowed to dose her little charge either with Godfrey’s Cordial, or with Dalby’s Carminative, or with Syrup of White Poppies, or with medicine of any kind whatever. Let her thoroughly understand this, and let there be no mistake in the matter. Do not, for one moment, allow your children’s health to be tampered and trifled with. A baby’s health is too precious to be doctored, to be experimented upon, and to be ruined by an ignorant person.
40. Have the goodness to state at what age a child ought to be weaned?
This, of course, must depend both upon the strength of the child and upon the health of the parent; on an average, nine months is the proper time. If the mother be delicate it may be found necessary to wean the infant at six months; or if he be weak, or laboring under any disease, it may be well to continue suckling him for twelve months; but after that time the breast will do him more harm than good, and will, moreover, injure the mother’s health, and may, if she be so predisposed, excite consumption.
41. How would you recommend a mother to act when she weans her child?
She ought, as the word signifies, do it gradually—that is to say, she should, by degrees, give him less and less of the breast, and more and more of artificial food; at length she must only suckle him at night; and lastly, it would be well for the mother either to send him away, or to leave him at home, and, for a few days, to go away herself.
A good plan is, for the nurse-maid to have a half-pint bottle of new milk—which has been previously boiled—in the bed, so as to give a little to him in lieu of the breast. The previous boiling of the milk will prevent the warmth of the bed turning the milk sour, which it would otherwise do. The warmth of the body will keep the milk of a proper temperature, and will supersede the use of lamps, of candle-frames, and other troublesome contrivances.
42. While a mother is weaning her infant, and after she has weaned him, what ought to be his diet?
Any one of the foods recommended in answer to question 34, page 36.
43. If a child be suffering severely from “wind,” is there any objection to the addition of a small quantity either of gin or of peppermint to his food to disperse it?
It is a murderous practice to add either gin or peppermint of the shops (which is oil of peppermint dissolved in spirits) to his food. Many children have, by such a practice, been made puny and delicate, and have gradually dropped into an untimely grave. An infant who is kept, for the first three or four months, entirely to the breast—more especially if the mother be careful in her own diet—seldom suffers from “wind;” those, on the contrary, who have much or improper food, suffer severely. For the first three or four months never, if you can possibly avoid it, give artificial food to an infant who is sucking. There is nothing, in the generality of cases, that agrees, for the first few months, like the mother’s milk alone.
Care in feeding, then, is the grand preventive of “wind;” but if, notwithstanding all your precautions, the child be troubled with flatulence, the remedies recommended under the head of Flatulence will generally answer the purpose.
44. Have you any remarks to make on sugar for sweetening a baby’s food?
A small quantity of sugar in an infant’s food is requisite, sugar being nourishing and fattening, and making cows’ milk to resemble somewhat in its properties human milk; but, bear in mind, it must be used sparingly. Much sugar cloys the stomach, weakens the digestion, produces acidity, sour belchings, and wind.
If a baby’s bowels be either regular or relaxed, lump sugar is the best for the purpose of sweetening his food; if his bowels are inclined to be costive, brown sugar ought to be substituted for lump sugar, as brown sugar acts on a young babe as an aperient, and, in the generality of cases, is far preferable to physicking him with opening medicine. An infant’s bowels, whenever it be practicable (and it generally is), ought to be regulated by a judicious dietary rather than by physic.
45. Are you an advocate for vaccination?
Certainly. I consider it to be one of the greatest blessings ever conferred upon mankind. Small-pox, before vaccination was adopted, ravaged the country like a plague, and carried off thousands annually; and those who did escape with their lives were frequently made loathsome and disgusting objects by it. Even inoculation (which is cutting for the small-pox) was attended with danger—more especially to the unprotected—as it caused the disease to spread like wildfire, and thus it carried off immense numbers.
Vaccination is one and an important cause of our increasing population; small-pox, in olden times, decimated the country.
46. But vaccination does not always protect a child from small-pox?
I grant you that it does not always protect him, neither does inoculation; but when he is vaccinated, if he take the infection, he is seldom pitted, and very rarely dies, and the disease assumes a comparatively mild form. There are a few, very few fatal cases recorded after vaccination, and these may be considered as only exceptions to the general rule; and, possibly some of these may be traced to the arm, when the child was vaccinated, not having taken proper effect.
If children and adults were revaccinated,—say every seven years after the first vaccination,—depend upon it, even these rare cases would not occur, and in a short time small-pox would only be known by name.
47. Do you consider it, then, the imperative duty of a mother in every case to have, after the lapse of every seven years, her children revaccinated?
I decidedly do; it would be an excellent plan for every person, once every seven years, to be revaccinated, and even oftener, if small-pox be rife in the neighborhood. Vaccination, however frequently performed, can never do the slightest harm, and might do inestimable good. Small-pox is both a pest and a disgrace, and ought to be constantly fought and battled with until it is banished (which it may readily be) the kingdom.
I say that small-pox is a pest; it is worse than the plague, for if not kept in subjection it is more general—sparing neither young nor old, rich nor poor, and commits greater ravages than the plague ever did. Small-pox is a disgrace; it is a disgrace to any civilized land, as there is no necessity for its presence: if cow-pox were properly and frequently performed, small-pox would be unknown. Cow-pox is a weapon to conquer small-pox, and to drive it ignominiously from the field.
My firm belief then is, that if every person were, every seven years, duly and properly vaccinated, small-pox might be utterly exterminated; but as long as there are such lax notions on the subject, and such gross negligence, the disease will always be rampant, for the poison of small-pox never slumbers nor sleeps, but requires the utmost diligence to eradicate it. The great Dr. Jenner, the discoverer of cow-pox as a preventative of small-pox, strongly advocated the absolute necessity of every person being revaccinated once every seven years, or even oftener, if there was an epidemic of small-pox in the neighborhood.
48. Are you not likely to catch not only the cow-pox, but any other disease that the child has from whom the matter is taken?
The same objection holds good in cutting for small-pox (inoculation)—only in a tenfold degree—small-pox being such a disgusting complaint. Inoculated small-pox frequently produced and left behind inveterate “breakings-out,” scars, cicatrices, and indentations of the skin, sore eyes, blindness, loss of eyelashes, scrofula, deafness—indeed, a long catalogue of loathsome diseases. A medical man, of course, will be careful to take the cow-pox matter from a healthy child.
49. Would it not be well to take the matter direct from the cow?
If a doctor be careful—which, of course, he will be—to take the matter from a healthy child, and from a well-formed vesicle, I consider it better than taking it direct from the cow, for the following reasons: The cow-pox lymph, taken direct from the cow, produces much more violent symptoms than after it has passed through several persons; indeed, in some cases, it has produced effects as severe as cutting for the small-pox; besides, it has caused, in many cases, violent inflammation and even sloughing of the arm. There are also several kinds of spurious cow-pox to which the cow is subject, and which would be likely to be mistaken for the real lymph. Again, if even the genuine matter were not taken from the cow exactly at the proper time, it would be deprived of its protecting power.
50. At what age do you recommend an infant to be first vaccinated?
When he is two months old, as the sooner he is protected the better. Moreover, the older he is the greater will be the difficulty in making him submit to the operation, and in preventing his arm from being rubbed, thus endangering the breaking of the vesicles, and thereby interfering with its effects. If small-pox be prevalent in the neighborhood, he may, with perfect safety, be vaccinated at the month’s end; indeed, if the small-pox be near at hand, he must be vaccinated, regardless of his age and regardless of everything else, for small-pox spares neither the young nor the old, and if a new-born babe should unfortunately catch the disease, he will most likely die, as at his tender age he would not have strength to battle with such a formidable enemy. “A case in the General Lying-in-Hospital, Lambeth, of small-pox occurred in a woman a few days after her admission and the birth of her child. Her own child was vaccinated when only four days old, and all the other infants in the house, varying from one day to a fortnight and more. All took the vaccination; and the woman’s own child, which suckled her and slept with her; and all escaped the small-pox.” Communicated by Sir Charles Locock to the author.
51. Do you consider that the taking of matter from a child’s arm weakens the effect of vaccination on the system?
Certainly not, provided it has taken effect in more than one place. The arm is frequently much inflamed, and vaccinating other children from it abates the inflammation, and thus affords relief. It is always well to leave one vesicle undisturbed?
52. If the infant has any “breaking-out” upon the skin, ought that to be a reason for deferring the vaccination?
It should, as two skin diseases cannot well go on together; hence the cow-pox might not take, or, if it did, might not have its proper effect in preventing small-pox. “It is essential that the vaccine bud or germ have a congenial soil, uncontaminated by another poison, which, like a weed, might choke its healthy growth.” The moment the skin be free from the breaking-out, he must be vaccinated. A trifling skin affection, like red gum, unless it be severe, ought not, at the proper age, to prevent vaccination. If small-pox be rife in the neighborhood, the child must be vaccinated, regardless of any “breaking-out” on the skin.
53. Does vaccination make a child poorly?
At about the fifth day after vaccination, and for three or four days, he is generally a little feverish; the mouth is slightly hot, and he delights to have the nipple in his mouth. He does not rest so well at night; he is rather cross and irritable; and, sometimes, has a slight bowel complaint. The arm, about the ninth or tenth day, is usually much inflamed—that is to say, it is, for an inch or two or more around the vesicles, red, hot, and swollen, and continues in this state for a day or two, at the end of which time the inflammation gradually subsides. It might be well to state that the above slight symptoms are desirable, as it proves that the vaccination has had a proper effect on his system, and that, consequently, he is more likely to be thoroughly protected from any risk of catching small-pox.
54. Do you approve, either during or after vaccination, of giving medicine, more especially if he be a little feverish?
No; as it would be likely to work off some of its effects, and thus would rob the cow-pox of its efficacy on the system. I do not like to interfere with vaccination in any way whatever (except, at the proper time, to take a little matter from the arm), but to allow the pock to have full power upon his constitution.
What do you give the medicine for? If the matter that is put into the arm be healthy, what need is there of physic? And if the matter be not of a good quality, I am quite sure that no physic will make it so! Look, therefore, at the case in whatever way you like, physic after vaccination is not necessary; but, on the contrary, hurtful. If the vaccination produce a slight feverish attack it will, without the administration of a particle of medicine, subside in two or three days.
55. Have you any directions to give respecting the arm AFTER vaccination?
The only precaution necessary, is to take care that the arm be not rubbed; otherwise the vesicles may be prematurely broken, and the efficacy of the vaccination may be lessened. The sleeve, in vaccination, ought to be large and soft, and should not be tied up. The tying up of a sleeve makes it hard, and is much more likely to rub the vesicles than if it were put on in the usual way.
56. If the arm, AFTER vaccination, be much inflamed, what ought to be done?
Smear frequently, by means of a feather or a camel’s-hair brush, a little cream on the inflamed part. This simple remedy will afford great relief and comfort.
57. Have the goodness to describe the proper appearance, after the falling off of the scab, of the arm?
It might be well to remark that the scabs ought always to be allowed to fall off of themselves. They must not, on any account, be picked or meddled with. With regard to the proper appearance of the arm after the falling off of the scab, “a perfect vaccine scar should be of small size, circular, and marked with radiations and indentations.”
58. At what time does dentition commence?
The period at which it commences is uncertain. It may, as a rule, be said that a babe begins to cut his teeth at seven months old. Some have cut teeth at three months; indeed, there are instances on record of infants having been born with teeth. King Richard the Third is said to have been an example. Shakspeare notices it thus:
When a babe is born with teeth they generally drop out. On the other hand, teething in some children does not commence until they are a year and a half or two years old, and, in rare cases, not until they are three years old. There are cases recorded of adults who have never cut any teeth. An instance of the kind came under my own observation.
Dentition has been known to occur in old age. A case is recorded by M. Carre, in the Gazette Medicale de Paris (Sept. 15, 1860), of an old lady, aged eighty-five, who cut several teeth after attaining that age!
59. What is the number of the FIRST set of teeth, and in what order do they generally appear?
The first or temporary set consists of twenty. The first set of teeth are usually cut in pairs. “I may say that nearly invariably the order is—1st, the lower front incisors [cutting-teeth], then the upper front, then the upper two lateral incisors, and that not uncommonly a double tooth is cut before the two lower laterals; but at all events the lower laterals come 7th and 8th, and not 5th and 6th, as nearly all books on the subject testify.” [Sir Charles Locock, in a Letter to the Author.] Then the first grinders in the lower jaw, afterward the first upper grinders, then the lower corner pointed or canine teeth, after which the upper corner or eye-teeth, then the second grinders in the lower jaw, and lastly, the second grinders of the upper jaw. They do not, of course, always appear in this rotation. Nothing is more uncertain than the order of teething. A child seldom cuts his second grinders until after he is two years old. He is usually, from the time they first appear, two years in cutting his first set of teeth. As a rule, therefore, a child of two years old has sixteen, and one of two years and a half old, twenty teeth.
60. If an infant be either feverish or irritable, or otherwise poorly, and if the gums be hot, swollen, and tender, are you an advocate for their being lanced?
Certainly; by doing so he will, in the generality of instances, be almost instantly relieved.
61. But it has been stated that lancing the gums hardens them?
This is a mistake—it has a contrary effect. It is a well-known fact that a part which has been divided gives way much more readily than one which has not been cut. Again, the tooth is bound down by a tight membrane, which, if not released by lancing, frequently brings on convulsions. If the symptoms be urgent, it may be necessary from time to time to repeat the lancing.
It would, of course, be the height of folly to lance the gums unless they be hot and swollen, and unless the tooth or the teeth be near at hand. It is not to be considered a panacea for every baby’s ill, although, in those cases where the lancing of the gums is indicated, the beneficial effect is sometimes almost magical.
62. How ought the lancing of a child’s gums to be performed?
The proper person, of course, to lance his gums is a medical man. But, if perchance you should be miles away and be out of the reach of one, it would be well for you to know how the operation ought to be performed. Well, then, let him lie on the nurse’s lap upon his back, and let the nurse take hold of his hands, in order that he may not interfere with the operation.
Then, if it be the upper gum that requires lancing, you ought to go to the head of the child, looking over, as it were, and into his mouth, and should steady the gum with the index finger of your left hand; then you should take hold of the gum-lancet with your right hand—holding it as if it were a table-knife at dinner—and cut firmly along the inflamed and swollen gum and down to the tooth, until the edge of the gum-lancet grates on the tooth. Each incision ought to extend along the ridge of the gum to about the extent of each expected tooth.
If it be the lower gum that requires lancing, you must go to the side of the child, and should steady the outside of the jaw with the fingers of the left hand, and the gum with the left thumb, and then you should perform the operation as before directed.
Although the lancing of the gums, to make it intelligible to a non-professional person, requires a long description, it is, in point of fact, a simple affair, is soon performed, and gives but little pain.
63. If teething cause convulsions, what ought to be done?
The first thing to be done (after sending for a medical man) is to freely dash cold water upon the face, and to sponge the head with cold water, and as soon as warm water can be procured, to put him into a warm bath of 98 degrees Fahrenheit. For the precautions to be used in putting a child into a warm bath, see the answer to question on “Warm baths.”
No family where there are young children, should be without Fahrenheit’s thermometer. If a thermometer be not at hand, you must plunge your own elbow into the water: a comfortable heat for your elbow will be the proper heat for the infant. He must remain in the bath for a quarter of an hour, or until the fit be at an end. The body must, after coming out of the bath, be wiped with warm and dry and coarse towels; he ought then to be placed in a warm blanket. The gums must be lanced, and cold water should be applied to the head. An enema, composed of table salt, of olive oil, and warm oatmeal gruel—in the proportion of one tablespoonful of salt, of one of oil, and a teacupful of gruel—ought then to be administered, and should, until the bowels have been well opened, be repeated every quarter of an hour; as soon as he comes to himself a dose of aperient medicine ought to be given.
64. A nurse is in the habit of giving a child who is teething either coral or ivory to bite—do you approve of the plan?
I think it a bad practice to give him any hard, unyielding substance, as it tends to harden the gums, and by so doing causes the teeth to come through with greater difficulty. I have found softer substances, such as either a piece of wax-taper, or an india-rubber ring, or a piece of the best bridle-leather, or a crust of bread, of great service. If a piece of crust be given as a gum-stick, he must, while biting it, be well watched, or by accident he might loosen a large piece of it, which might choke him. The pressure of any of these excites a more rapid absorption of the gum, and thus causes the tooth to come through more easily and quickly.
65. Have you any objection to my baby, when he is cutting his teeth, sucking his thumb?
Certainly not; the thumb is the best gum-stick in the world—it is convenient, it is handy (in every sense of the word), it is of the right size, and of the proper consistence—neither too hard nor too soft; there is no danger, as of some artificial gum-sticks, of its being swallowed, and thus of its choking the child. The sucking of the thumb causes the salivary glands to pour out their contents, and thus not only to moisten the dry mouth, but assists the digestion; the pressure of the thumb eases, while the teeth are “breeding,” the pain and irritation of the gums, and helps, when the teeth are sufficiently advanced, to bring them through the gums. Sucking of the thumb will often make a cross infant contented and happy, and will frequently induce a restless babe to fall into a sweet refreshing sleep. Truly may the thumb be called a baby’s comfort. By all means, then, let your child suck his thumb whenever he likes, and as long as he chooses to do so.
There is a charming, bewitching little picture of a babe sucking his thumb in Kingsley’s Water Babies, which I cordially commend to your favorable notice and study.
66. But if an infant be allowed to suck his thumb, will it not be likely to become a habit, and stick to him for years—until, indeed, he become a big boy?
After he has cut the whole of his first set of teeth, that is to say, when he is about two years and a half old, he might, if it be likely to become a habit, be readily cured by the following method, namely, by making a paste of aloes and water and smearing it upon his thumb. One or two dressings will suffice, as after just tasting the bitter aloes he will take a disgust to his former enjoyment, and the habit will at once be broken.
Many persons, I know, have an objection to children sucking their thumbs, as, for instance—
My reply is—
67. A child who is teething dribbles, and thereby wets his chest, which frequently causes him to catch cold; what had better be done?
Have in readiness to put on several flannel dribbling-bibs, so that they may be changed as often as they become wet; or, if he dribble very much, the oiled silk dribbling-bibs, instead of the flannel ones, may be used, and which may be procured at any baby-linen warehouse.
68. Do you approve of giving a child, during teething, much fruit?
No; unless it be a few ripe strawberries or raspberries, or a roasted apple, or the juice of five or six grapes—taking care that he does not swallow either the seeds or the skin—or the insides of ripe gooseberries, or an orange. Such fruits, if the bowels be in a costive state, will be particularly useful.
All stone fruits, raw apples, or pears ought to be carefully avoided, as they not only disorder the stomach and the bowels—causing convulsions, gripings, etc.—but they have the effect of weakening the bowels, and thus of engendering worms.
69. Is a child, during teething, more subject to disease, and if so, to what complaints, and in what manner may they be prevented?
The teeth are a fruitful source of suffering and of disease, and are with truth styled “our first and our last plagues.” Dentition is the most important period of a child’s life, and is the exciting cause of many infantile diseases; during this period, therefore, he requires constant and careful watching. When we consider how the teeth elongate and enlarge in his gums, pressing on the nerves and on the surrounding parts, and thus how frequently they produce pain, irritation, and inflammation; when we further contemplate what sympathy there is in the nervous system, and how susceptible the young are to pain, no surprise can be felt at the immense disturbance and the consequent suffering and danger frequently experienced by children while cutting their first set of teeth.
The complaints or the diseases induced by dentition are numberless, affecting almost every organ of the body,—the brain, occasioning convulsions, water on the brain, etc.; the lungs, producing congestion, inflammation, cough, etc.; the stomach, exciting sickness, flatulence, acidity, etc.; the bowels, inducing griping, at one time costiveness, and at another time purging; the skin, causing “breakings-out.”
To prevent these diseases, means ought to be used to invigorate a child’s constitution by plain, wholesome food, as recommended under the article of diet; by exercise and fresh air; by allowing him, weather permitting, to be out of doors a great part of every day; by lancing the gums when they get red, hot, and swollen; by attention to the bowels, and if he suffer more than usual, by keeping them rather in a relaxed state by any simple aperient, such as either castor oil or magnesia and rhubarb, etc.; and, let me add, by attention to his temper. Many children are made feverish and ill by petting and spoiling them. On this subject I cannot do better than refer you to an excellent little work entitled Abbott’s Mother at Home, wherein the author proves the great importance of early training. The young of animals seldom suffer from cutting their teeth—and what is the reason? Because they live in the open air and take plenty of exercise, while children are frequently cooped up in close rooms and are not allowed the free use of their limbs. The value of fresh air is well exemplified in the Registrar-General’s Report for 1843: he says that in 1,000,000 deaths from all diseases, 616 occur in the town from teething, while 120 only take place in the country from the same cause.
70. Have the goodness to describe the symptoms and the treatment of Painful Dentition.
Painful dentition may be divided into two forms—(1.) the Mild; and (2.) the Severe. In the mild form the child is peevish and fretful, and puts his fingers, and everything within reach, to his mouth; he likes to have his gums rubbed, and takes the breast with avidity; indeed, it seems a greater comfort to him than ever. There is generally a considerable flow of saliva, and he has frequently a more loose state of bowels than is his wont.
Now, with regard to the more severe form of painful dentition: The gums are red, swollen, and hot, and he cannot, without expressing pain, bear to have them touched; hence, if he be at the breast, he is constantly loosing the nipple. There is dryness of the mouth, although before there had been a great flow of saliva. He is feverish, restless, and starts in his sleep. His face is flushed. His head is heavy and hot. He is sometimes convulsed. (See answer to Question 63.) He is frequently violently griped and purged, and suffers severely from flatulence. He is predisposed to many and severe diseases.
The treatment of the mild form consists of friction of the gums with the finger; with a little “soothing syrup,” as recommended by Sir Charles Locock; a tepid bath of about 92 degrees Fahrenheit, every night at bedtime; attention to diet and bowels; fresh air and exercise. “‘Soothing Syrup.’ Some of them probably contain opiates, but a perfectly safe and useful one is a little nitrate of potassa in syrup of roses—one scruple to half an ounce.”—Communicated by Sir Charles Locock to the Author. For the mild form, the above plan will usually be all that is required. If he dribble and the bowels be relaxed, so much the better; the flow of saliva and the increased action of the bowels afford relief, and therefore must not be interfered with. In the mild form lancing of the gums is not desirable. The gums ought not to be lanced unless the teeth be near at hand, and unless the gums be red, hot, and swollen.
In the severe form a medical man should be consulted early, as more energetic remedies will be demanded; that is to say, the gums will require to be freely lanced, warm baths to be used, and medicines to be given, to ward off mischief from the head, from the chest, and from the stomach.
If you are living in the town and your baby suffers much from teething, take him into the country. It is wonderful what change of air to the country will often do, in relieving a child who is painfully cutting his teeth. The number of deaths in London from teething is frightful; it is in the country comparatively trifling.
71. Should an infant be purged during teething, or indeed, during any other time, do you approve of either absorbent or astringent medicines to restrain it?
Certainly not. I should look upon the relaxation as an effort of nature to relieve itself. A child is never purged without a cause; that cause, in the generality of instances, is the presence of either some undigested food, or acidity, or depraved motions that want a vent.
The better plan is, in such a case, to give a dose of aperient medicine, such as either castor oil or magnesia and rhubarb, and thus work it off. If we lock up the bowels, we confine the enemy, and thus produce mischief. [“I should put this in capitals, it is so important and so often mistaken.”—C. Locock.] If he be purged more than usual, attention should be paid to the diet—if it be absolutely necessary to give him artificial food while suckling—and care must be taken not to overload the stomach.
72. A child is subject to a slight cough during dentition—called by nurses “tooth-cough”—which a parent would not consider of sufficient importance to consult a doctor about; pray tell me if there is any objection to a mother giving her child a small quantity either of syrup of white poppies or of paregoric to ease it?
A cough is an effort of nature to bring up any secretion from the lining membrane of the lungs, or from the bronchial tubes, hence it ought not to be interfered with. I have known the administration of syrup of white poppies, or of paregoric, to stop the cough, and thereby to prevent the expulsion of the phlegm, and thus to produce either inflammation of the lungs or bronchitis. Moreover, both paregoric and syrup of white poppies are, for a young child, dangerous medicines (unless administered by a judicious medical man), and ought never to be given by a mother.
In the month of April, 1844, I was sent for in great haste to an infant, aged seventeen months, who was laboring under convulsions and extreme drowsiness, from the injudicious administration of paregoric, which had been given to him to ease a cough. By the prompt administration of an emetic he was saved.
73. A child who is teething is subject to a “breaking-out,” more especially behind the ears—which is most disfiguring, and frequently very annoying; what would you recommend?
I would apply no external application to cure it, as I should look upon it as an effort of the constitution to relieve itself; and should expect, if the “breaking-out” were repelled, that either convulsions, or bronchitis, or inflammation of the lungs, or water on the brain would be the consequence.
The only plan I should adopt would be, to be more careful in his diet: to give him less meat (if he be old enough to eat animal food), and to give him, once or twice a week, a few doses of mild aperient medicine; and, if the irritation from the “breaking-out” be great, to bathe it occasionally either with a little warm milk and water, or with rose water.