Advice to a Mother on the Management of Her Children

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Advice To A Mother

ON THE MANAGEMENT OF HER CHILDREN AND ON THE TREATMENT ON THE MOMENT OF SOME OF THEIR MORE PRESSING ILLNESSES AND ACCIDENTS

By

Pye Henry Chavasse,

FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND, FELLOW OF THE OBSTETRICAL SOCIETY OF LONDON, FORMERLY PRESIDENT OF QUEEN'S COLLEGE MEDICO-CHIRURGICAL SOCIETY, BIRMINGHAM.

"Lo, children and the fruit of the womb are an heritage and gift that cometh of the Lord."

Preface.

This Book has been translated into French, into German, into Polish, and into Tamil (one of the languages of India); it has been extensively published in America; and is well-known wherever the English language is spoken.

The Twelfth Edition--consisting of twenty thousand copies--being exhausted in less than three years, the THIRTEENTH EDITION is now published.

One or two fresh questions have been asked and answered, and two or three new paragraphs have I been added.

Pye Henry Chavasse.

214, HAGLEY ROAD, EDGBASTON, BIRMINGHAM, _June_, 1878.

Contents.

Part I--Infancy.

PRELIMINARY CONVERSATION ABLUTION MANAGEMENT OF THE NAVEL NAVEL RUPTURE--GROIN RUPTURE CLOTHING DIET VACCINATION AND RE-VACCINATION DENTITION EXERCISE SLEEP THE BLADDER AND THE BOWELS AILMENTS, DISEASE, ETC. CONCLUDING REMARKS ON INFANCY

Part II--Childhood

ABLUTION CLOTHING DIET THE NURSERY EXERCISE AMUSEMENTS EDUCATION SLEEP SECOND DENTITION DISEASE, ETC. WARM BATHS WARM EXTERNAL APPLICATIONS ACCIDENTS

Part III--Boyhood And Girlhood

ABLUTION, ETC. MANAGEMENT OF THE HAIR CLOTHING DIET AIR AND EXERCISE AMUSEMENTS EDUCATION HOUSEHOLD WORK FOR GIRLS CHOICE OF PROFESSION OR TRADE SLEEP ON THE TEETH AND GUMS PREVENTION OF DISEASE, ETC. CONCLUDING REMARKS INDEX

Advice To A Mother.

Part I.--Infancy

_Infant and suckling._--I. SAMUEL _A rose with all its sweetest leaves yet folded._--BYRON. _Man's breathing Miniature!_--COLERIDGE.

Preliminary Conversation

1. _I wish to consult you on many subjects appertaining to the management and the care of children; will you favour me with your advice and counsel_?

I shall be happy to accede to your request, and to give you the fruits of my experience in the clearest manner I am able, and in the simplest language I can command--freed from all technicalities. I will endeavour to guide you in the management of the health of your offspring;--I will describe to you the _symptoms_ of the diseases of children;--I will warn you of approaching danger, in order that you may promptly apply for medical assistance before disease has gained too firm a footing;--I will give you the _treatment_ on the moment; of some of their more pressing illnesses--when medical aid cannot at once be procured, and where delay may be death;--I will instruct you, in case of accidents, on the _immediate_ employment of remedies--where procrastination may be dangerous;--I will tell you how a sick child should be nursed, and how a sick-room ought to be managed;--I I will use my best energy to banish injurious practices from the nursery;--I will treat of the means to prevent disease where it be possible;--I will show you the way to preserve the health of the healthy,--and how to strengthen the delicate;--and will strive to make a medical man's task more agreeable to himself,--and more beneficial to his patient,--by dispelling errors and prejudices, and by proving the importance of your _strictly_ adhering to his rules. If I can accomplish any of these objects, I shall be amply repaid by the pleasing satisfaction that I have been of some little service to the rising generation.

2. _Then you consider it important that I should be made acquainted with, and be well informed upon, the subjects you have just named_?

Certainly! I deem it to be your imperative duty to _study_ the subjects well. The proper management of children is a vital question,--a mother's question,--and the most important that can be brought under the consideration of a parent; and, strange to say, it is one that has been more neglected than any other. How many mothers undertake--the responsible management of children without previous instruction, or without forethought; they undertake it, as though it may be learned either by intuition or by instinct, or by affection. The consequence is, that frequently they are in a sea of trouble and uncertainty, tossing about without either rule or compass; until, too often, their hopes and treasures are shipwrecked and lost.

The care and management, and consequently the health and future well-doing of the child, principally devolve upon the mother, "for it is the mother after all that has most to do with the making or marring of the man." [Footnote: _Good Words_, Dr W. Lindsay Alexander, March 1861.] Dr Guthrie justly remarks that--"Moses might have never been the man he was unless he had been nursed by his own mother. How many celebrated men have owed their greatness and their goodness to a mother's training!" Napoleon owed much to his mother. "'The fate of a child,' said Napoleon, 'is always the work of his mother;' and this extraordinary man took pleasure in repeating, that to his mother he owed his elevation. All history confirms this opinion..." The character of the mother influences the children more than that of the father, because it is more exposed to their daily, hourly observation.--_Woman's Mission_.

I am not overstating the importance of the subject in hand when I say, that a child is the most valuable treasure in the world, that "he is the precious gift of God," that he is the source of a mother's greatest and purest enjoyment, that he is the strongest bond of affection between her and her husband, and that

"A babe in a house is a well-spring of pleasure, A messenger of peace and love."--_Tupper_,

I have, in the writing of the following pages, had one object constantly in view--namely, health--

"That salt of life, which does to all a relish give, Its standing pleasure, and intrinsic wealth, The body's virtue, and the soul's good fortune--health."

If the following pages insist on the importance of one of a mother's duties more than another it is this,--_that the mother herself look well into everything appertaining to the management of her own child_.

Blessed is that mother among mothers of whom it can be said, that "she hath done what she could" for her child--for his welfare, for his happiness, for his health!

For if a mother hath not "done what she could for her child"--mentally, morally, and physically--woe betide the unfortunate little creature;--better had it been for him had he never been born!

Ablution

3. _Is a new-born infant, for the first time, to be washed in warm or in cold water_?

It is not an uncommon plan to use _cold_ water from the first, under the impression of its strengthening the child. This appears to be a cruel and barbarous practice, and is likely to have a contrary tendency. Moreover, it frequently produces either inflammation of the eyes, or stuffing of the nose, or inflammation of the lungs, or looseness of the bowels. Although I do not approve of _cold_ water, we ought not to run into an opposite extreme, as _hot_ water would weaken and enervate the babe, and thus would predispose him to disease. Luke warm _rain_ water will be the best to wash him with. This, if it be summer, should have its temperature gradually lowered, until it be quite cold, if it be winter, a _dash_ of warm water ought still to be added, to take oft the chill [Footnote: A nursery basin (Wedgwoode make is considered the best), holding either six or eight quarts of water, and which will be sufficiently large to hold the whole body of the child. The baton is generally fitted into a wooden frame which will raise it to a convenient height for the washing of the baby.] (By thermometer = 90 to 92 degrees.)

It will be necessary to use soap--Castile soap being the best for the purpose--it being less irritating to the skin than the ordinary soap. Care should be taken that it does not get into the eyes, as it may produce either inflammation or smarting of those organs.

If the skin be delicate, or if there be any excoriation or "breaking-out" on the skin, then glycerine soap, instead of the Castile soap, ought to be used.

4. _At what age do you recommend a mother to commence washing her infant either in the tub, or in the nursery basin_?

As soon as the navel string comes away [Footnote: Sir Charles Locock strongly recommends that an infant should be washed _in a tub_ from the very commencement. He says,--"All those that I superintend _begin_ with a tub."--_Letter to the Author_.] Do not be afraid of water,--and that in plenty,--as it is one of the best strengtheners to a child's constitution. How many infants suffer, for the want of water from excoriation!

5. _Which do you prefer--flannel or sponge--to wash a child with_?

A piece of flannel is, for the first part of the washing very useful--that is to say, to use with the soap, and to loosen the dirt and the perspiration; but for the finishing-up process, a sponge--a large sponge--is superior to flannel, to wash all away, and to complete the bathing. A sponge cleanses and gets into all the nooks, corners, and crevices of the skin. Besides, sponge, to finish up with, is softer and more agreeable to the tender skin of a babe than flannel. Moreover, a sponge holds more water than flannel, and thus enables you to stream the water more effectually over him. A large sponge will act Like a miniature shower bath, and will thus brace and strengthen him.

6. _To prevent a new-born babe from catching cold, is it necessary to wash his head with brandy_?

It is _not necessary_. The idea that it will prevent cold is erroneous, as the rapid evaporation of heat which the brandy causes is more likely to give than to prevent cold.

7. _Ought that tenacious, paste like substance, adhering to the skin of a new-born babe, to be washed off at the first dressing_?

It should, provided it be done with a soft sponge and with care. If there be any difficulty in removing the substance, gently rub it, by means of a flannel, [Footnote: Mrs Baines (who has written so much and so well on the Management of Children), in a _Letter_ to the Author, recommends flannel to be used in the _first_ washing of an infant, which flannel ought afterwards to be burned; and that the sponge should be only used to complete the process, to clear off what the flannel had already loosened. She also recommends that every child should have his own sponge, each of which should have a particular distinguishing mark upon it, as she considers the promiscuous use of the same sponge to be a frequent cause of _ophthalmia_ (inflammation of the eyes). The sponges cannot be kept too clean.] either with a little lard, or fresh butter, or sweet-oil. After the parts have been well smeared and gently rubbed with the lard, or oil, or butter, let all be washed off together, and be thoroughly cleansed away, by means of a sponge and soap and warm water, and then, to complete the process, gently put him in for a minute or two in his tub. If this paste like substance be allowed to remain on the skin, it might produce either an excoriation, or a "breaking-out" Besides, it is impossible, if that tenacious substance be allowed to remain on it, for the skin to perform its proper functions.

8. _Have you any general observations to make on the washing of a new-born infant_?

A babe ought, every morning of his life, to be thoroughly washed from head to foot, and this can only be properly done by putting him bodily either into a tub or into a bath, or into a large nursery basin, half filled with water. The head, before placing him in the bath, should be first wetted (but not dried), then immediately put him into the water, and, with a piece of flannel well soaked, cleanse his whole body, particularly his arm pits, between his thighs, his groins, and his hams, then take a large sponge in hand, and allow the water from it, well filled, to stream all over the body, particularly over his back and loins. Let this advice be well observed, and you will find the plan most strengthening to your child. The skin must, after every bath, be thoroughly but quickly dried with warm, dry, soft towels, first enveloping the child in one, and then gently absorbing the moisture with the towel, not roughly scrubbing and rubbing his tender skin as though a horse were being rubbed down.

The ears must, after each ablution, be carefully and well dried with a soft dry napkin, inattention to this advice has sometimes caused a gathering in the ear--a painful and distressing complaint, and at other times it has produced deafness.

Directly after the infant is dried, all the parts that are at all likely to be chafed ought to be well powdered. After he is well dried and powdered, the chest, the back, the bowels, and the limbs should be gently rubbed, taking care not to expose him unnecessarily during such friction.

He ought to be partially washed every evening, indeed it may be necessary to use a sponge and a little warm water frequently during the day, namely, each time after the bowels have been relieved. _Cleanliness is one of the grand incentives to health_, and therefore cannot be too strongly insisted upon. If more attention were paid to this subject, children would be more exempt from chafings, "breakings-out," and consequent suffering, than they at present are. After the second month, if the babe be delicate, the addition of two handfuls of table-salt to the water he is washed with in the morning will tend to brace and strengthen him.

With regard to the best powder to dust an infant with, there is nothing better for general use than starch--the old fashioned starch _made of wheaten flour_--reduced by means of a pestle and mortar to a fine powder, or Violet Powder, which is nothing more than finely powdered starch scented, and which may be procured of any respectable chemist. Some others are in the habit of using white lead, but as this is a poison, it ought _on no account_ to be resorted to.

9. _If the parts about the groin and fundament be excoriated, what is then the best application_?

After sponging the parts with tepid _rain water_, holding him over his tub, and allowing the water from a well filled sponge to stream over the parts, and then drying them with a soft napkin (not rubbing, but gently dabbing with the napkin), there is nothing better than dusting the parts frequently with finely powdered Native Carbonate of Zinc-Calamine Powder. The best way of using this powder is, tying up a little of it in a piece of muslin, and then gently dabbing the parts with it.

Remember excoriations are generally owing to the want of water,--to the want of an abundance of water. An infant who is every morning well soused and well swilled with water seldom suffers either from excoriations, or from any other of the numerous skin diseases. Cleanliness, then, is the grand preventative of, and the best remedy for excoriations. Naaman the Syrian was ordered "to wash and be clean," and he was healed, "and his flesh came again like unto the flesh of a little child and he was clean." This was, of course, a miracle; but how often does water, without any special intervention, act miraculously both in preventing and in curing skin diseases!

An infant's clothes, napkins especially, ought never to be washed with soda; the washing of napkins with soda is apt to produce excoriations and breakings-out. "As washerwomen often deny that they use soda, it can be easily detected by simply soaking a clean white napkin in fresh water and then tasting the water; if it be brackish and salt, soda has been employed." [Footnote: Communicated by Sir Charles Locock to the Author.]

10. _Who is the proper person to wash and dress the babe_?

The monthly nurse, as long as she is in attendance; but afterwards the mother, unless she should happen to have an experienced, sensible, thoughtful nurse, which, unfortunately, is seldom the case. [Footnote: "The Princess of Wales might have been seen on Thursday taking an airing in a brougham in Hyde Park with her baby--the future King of England--on her lap, without a nurse, and accompanied only by Mrs Brace. The Princess seems a very pattern of mothers, and it is whispered among the ladies of the Court that every evening the mother of this young gentleman may be seen in a flannel dress, in order that she may properly wash and put on baby's night clothes, and see him safely in bed. It is a pretty subject for a picture."--_Pall Mall Gazette_.]

11. _What is the best kind of apron for a mother, or for a nurse, to wear, while washing the infant_?

Flannel--a good, thick, soft flannel, usually called bathcoating--apron, made long and full, and which of course ought to be well dried every time before it is used.

12. _Perhaps you will kindly recapitulate, and give me further advice on the subject of the ablution of my babe_.

Let him by all means, then, as soon as the navel-string has separated from the body, be bathed either in his tub, or in his bath, or in his large nursery-basin, for if he is to be strong and hearty, in the water every morning he must go. The water ought to be slightly warmer than new milk. It us dangerous for him to remain for a long period in his bath, this, of course, holds good in a ten fold degree if the child have either a cold or pain in his bowels. Take care that, immediately after he comes out of his tub, he is well dried with warm towels. It is well to let him have his bath the first thing in the morning, and before he has been put to the breast, let him be washed before he has his breakfast, it will refresh him and give him an appetite. Besides, he ought to have his morning ablution on an empty stomach, or it may interfere with digestion, and might produce sickness and pain. In putting him in his tub, let his head be the first part washed. We all know, that in bathing in the sea, now much better we can bear the water if we first wet our head, if we do not do so, we feel shivering and starved and miserable. Let there be no dawdling in the washing, let it be quickly over. When he is thoroughly dried with warm _dry_ towels, let him be well rubbed with the warm hand of the mother or of the nurse. As I previously recommended, while drying him and while rubbing him, let him repose and kick and stretch either on the warm flannel apron, or else on a small blanket placed on the lap. One bathing in the tub, and that in the morning, is sufficient, and better than night and morning. During the day, as I before observed, he may, after the action either of his bowels or of his bladder, require several spongings of lukewarm water, _for cleanliness is a grand incentive to health and comeliness_.

Remember it is absolutely necessary to every child from his earliest babyhood to have a bath, to be immersed every morning of his life in the water. This advice, unless in cases of severe illness, admits of no exception. Water to the body--to the whole body--is a necessity of life, of health, and of happiness, it wards off disease, it brace? the nerves, it hardens the frame, it is the finest tonic in the world. Oh, if every mother would follow to the very letter this counsel how much misery, how much ill-health might then be averted!

Management Of The Navel.

13. _Should the navel-string be wrapped in SINGED rag_?

There is nothing better than a piece of fine old linen rag, _unsinged_; when singed, it frequently irritates the infant's skin.

14. _How ought the navel-string to be wrapped in the rag_?

Take a piece of soft linen rag, about three inches wide and four inches long, and wrap it neatly round the navel string, in the same manner you would around a cut finger, and then, to keep on the rag, tie it with a few rounds of whity-brown thread. The navel-string thus covered should, pointing upwards, be placed on the belly of the child, and must be secured in its place by means of a flannel belly-band.

15. _If after the navel-string has been secured, bleeding should (in the absence of the medical man) occur, how must it be restrained_?

The nurse or the attendant ought immediately to take off the rag, and tightly, with a ligature composed of four or five whity-brown threads, retie the navel-string; and to make assurance doubly sure, after once tying it, she should pass the threads a second time around the navel-string, and tie it again; and after carefully ascertaining that it no longer bleeds, fasten it up in the rag as before. Bleeding of the navel-string rarely occurs, yet, if it should do so--the medical man not being at hand--the child's after-health, or even his life, may, if the above directions be not adopted, be endangered.

16. _When does the navel-string separate from the child_?

From five days to a week after birth; in some cases not until ten days or a fortnight, or even, in rare cases, not until three weeks.

17. _If the navel-string does not at the end of a week came away, ought any means to be used to cause the separation_?

Certainly not, it ought always to be allowed to drop off, which, when in a fit state, it will readily do. Meddling with the navel string has frequently cost the babe a great deal of suffering, and in some cases even his life.

18. _The navel is sometimes a little sore, after the navel-string comes away, what ought then to be done_?

A little simple cerate should be spread on lint, and be applied every morning to the part affected, and a white-bread poultice, every night, until it is quite healed.

Navel Rupture--Groin Rupture.

19. _What are the causes of a rupture of the navel? What ought to be done? Can it be cured_?

(1) A rupture of the navel is sometimes occasioned by a meddlesome nurse. She is very anxious to cause the navel-string to separate from the infant's body, more especially when it is longer in coming away than usual. She, therefore, before it is in a fit state to drop off, forces it away. (2) The rapture, at another time, is occasioned by the child incessantly crying. A mother, then, should always bear in mind, that a rupture of the navel is often caused by much crying, and that it occasions much crying, indeed, it is a frequent cause of incessant crying. A child, therefore, who, without any assignable cause, is constantly crying, should have his navel carefully examined.

A rupture of the navel ought always to be treated early--the earlier the better. Ruptures of the navel can only be _cured_ in infancy and in childhood. If it be allowed to run on until adult age, a _cure_ is impossible. Palliative means can then only be adopted.

The best treatment is a Burgundy pitch plaster, spread on a soft piece of wash leather, about the size of the top of a tumbler, with a properly-adjusted pad (made from the plaster) fastened on the centre of the plaster, which will effectually keep up the rupture, and in a few weeks will cure it. It will be necessary, from time to time, to renew the plaster until the cure be effected. These plasters will be found both more efficacious and pleasant than either truss or bandage; which latter appliances sometimes gall, and do more harm than they do good.

20. _If an infant have a groin-rupture (an inguinal rupture), can that also be cured_?

Certainly, if, soon after birth, it be properly attended to. Consult a medical man, and he will supply you with a well-fitting truss, _which will eventually cure him_. If the truss be properly made (under the direction of an experienced surgeon) by a skilful surgical-instrument maker, a beautiful, nicely-fitting truss will be supplied, which will take the proper and exact curve of the lower part of the infant's belly, and will thus keep on without using any under-strap whatever--a great desideratum, as these under-straps are so constantly wetted and soiled as to endanger the patient constantly catching cold. But if this under-strap is to be superseded, the truss must be made exactly to fit the child--to fit him like a ribbon; which is a difficult thing to accomplish unless it be fashioned by a skilful workman. It is only lately that these trusses have been made without under-straps. Formerly the under-straps were indispensable necessaries.

These groin-ruptures require great attention and supervision, as the rupture (the bowel) must, before putting on the truss be cautiously and thoroughly returned into the belly; and much care should be used to prevent the chafing and galling of the tender skin of the babe, which an ill-fitting truss would be sure to occasion. But if care and skill be bestowed on the case, a perfect cure might in due time be ensured. The truss must not be discontinued, until a _perfect_ cure be effected.

Let me strongly urge you to see that my advice is carried out to the very letter, as a groin-rupture can only be _cured_ in infancy and in childhood. If it be allowed to ran on, unattended to, until adult age, he will be obliged to wear a truss _all his life_, which would be a great annoyance and a perpetual irritation to him.

Clothing.

21. _Is it necessary to have a flannel cap in readiness to put on as soon as the babe is born_?

Sir Charles Locock considers that a flannel cap is _not_ necessary, and asserts that all his best nurses have long discarded flannel caps. Sir Charles states that since the discontinuance of flannel caps infants have not been more liable to inflammation of the eyes. Such authority is, in my opinion, conclusive. My advice, therefore, to you is, discontinue by all means the use of flannel caps.

22. _What kind of a belly-band do you recommend--a flannel or a calico one_?

I prefer flannel, for two reasons--first, on account of its keeping the child's bowels comfortably warm; and secondly, because of its not chilling him (and thus endangering cold, &c.) when he wets himself. The belly-band ought to be moderately, but not tightly applied, as, if tightly applied, it would interfere with the necessary movement of the bowels.

23. _When should the belly-band be discontinued_?

When the child is two or three months old. The best way of leaving it off is to tear a strip off daily for a few mornings, and then to leave it off altogether. "Nurses who take charge of an infant when the monthly nurse leaves, are frequently in the habit of at once leaving off the belly-band, which often leads to ruptures when the child cries or strains. It is far wiser to retain it too long than too short a time; and when a child catches whooping-cough, whilst still very young, it is safer to resume the belly-band." [Footnote: Communicated by Sir Charles Locock to the Author.]

24. _Have you any remarks to make on the clothing of on infant_?

A babe's clothing ought to be light, warm, loose, and free from pins. (1.) _It should be light_, without being too airy. Many infant's clothes are both too long and too cumbersome. It is really painful to see how some poor little babies are weighed down with a weight of clothes. They may be said to "bear the burden," and that a heavy one, from the very commencement of their lives! How absurd, too, the practice of making them wear _long_ clothes. Clothes to cover a child's feet, and even a little beyond, may be desirable; but for clothes, when the infant is carried about, to reach to the ground, is foolish and cruel in the extreme. I have seen a delicate baby almost ready to faint under the infliction. (2.) _It should be warm_, without being too warm. The parts that ought to be kept warm are the chest, the bowels, and the feet. If the infant be delicate, especially if he be subject to inflammation of the lungs, he ought to wear a fine flannel, instead of his usual shirts, which should be changed as frequently. (3.) _The dress should be loose_, so as to prevent any pressure upon the blood-vessels, which would otherwise impede the circulation, and thus hinder a proper development of the parts. It ought to be loose about the chest and waist, so that the lungs and the heart may have free play. It should be loose about the stomach, so that digestion may not be impeded; it ought to be loose about the bowels, in order that the spiral motion of the intestines may not be interfered with--hence the importance of putting on a belly-band moderately slack; it should be loose about the sleeves, so that the blood may course, without let or hindrance, through the arteries and veins; it ought to be loose, then, everywhere, for nature delights in freedom from restraint, and will resent, sooner or later, any interference. Oh, that a mother would take common sense, and not custom, as her guide! (4.) _As few pins_ should be used in the dressing of a baby as possible. Inattention to this advice has caused many a little sufferer to be thrown into convulsions.

The generality of mothers use no pins in the dressing of their children; they tack every part that requires fastening with a needle and thread. They do not even use pins to fasten the baby's diapers. They make the diapers with loops and tapes, and thus altogether supersede the use of pins in the dressing of an infant. The plan is a good one, takes very little extra time, and deserves to be universally adopted. If pins be used for the diapers, they ought to be the Patent Safety Pins.

25. _Is there any necessity for a nurse being particular in airing an infant's clothes before they are put on? If she were less particular, would it not make him more hardy_?

A nurse cannot be too particular on this head. A babe's clothes ought to be well aired the day before they are put on, as they should _not_ be put on warm from the fire. It is well, where it can be done, to let him have clean clothes daily. Where this cannot be afforded, the clothes, as soon as they are taken off at night, ought to be well aired, so as to free them from the perspiration, and that they may be ready to put on the following morning. It is truly nonsensical to endeavour to harden a child, or any one else, by putting on damp clothes!

26. _What is your opinion of caps for an infant_?

The head ought to be kept cool; caps, therefore, are unnecessary. If caps be used at all, they should only be worn for the first month in summer, or for the first two or three months in winter. If a babe take to caps, it requires care in leaving them off, or he will catch cold. When you are about discontinuing them, put a thinner and a thinner one on, every time they are changed, until you leave them off altogether.

But remember, my opinion is, that a child is better _without_ caps; they only heat his head, cause undue perspiration, and thus make him more liable to catch cold.

If a babe does not wear a cap in the day, it is not at all necessary that he should wear one at night. He will sleep more comfortably without one, and it will be better for his health. Moreover, night-caps injure both the thickness and beauty of the hair.

27. _Have you any remarks to make on the clothing of an infant, when, in the winter time, he is sent out for exercise_?

Be sure that he is well wrapped up. He ought to have under his cloak a knitted worsted spencer, which should button behind, and if the weather be very cold, a shawl over all, and, provided it be dry above, and the wind be not in the east or in the north-east, he may then brave the weather. He will then come from his walk refreshed and strengthened, for cold air is an invigorating tonic. In a subsequent Conversation I will indicate the proper age at which a child should be first sent out to take exercise in the open air.

28. _At what age ought an infant "to be shortened?"_

This, of course, will depend upon the season. In the summer, the right time "for shortening a babe," as it is called, is at the end of two months, in the winter, at the end of three months. But if the right time for "shortening" a child should happen to be in the spring, let it be deferred until the end of May. The English springs are very trying and treacherous, and sometimes, in April the weather is almost as cold, and the wind as biting as in winter. It is treacherous, for the sun is hot, and the wind, which is at this time of the year frequently easterly, is keen and cutting I should far prefer "to shorten" a child in the winter than in the early spring.

Diet

29. _Are you an advocate for putting a baby to the breast soon after birth, or for waiting, as many do, until the third day_?

The infant ought to be put to the bosom soon after birth, the interest, both of the mother and of the child demands it. It will be advisable to wait three or four hours, that the mother may recover from her fatigue, and, then, the babe must be put to the breast. If this be done, he will generally take the nipple with avidity.

It might be said, at so early a period that there is no milk in the bosom; but such is not usually the case. There generally is a _little_ from the very beginning, which acts on the baby's bowels like a dose of purgative medicine, and appears to be intended by nature to cleanse the system. But, provided there be no milk at first, the very act of sucking not only gives the child a notion, but, at the same time, causes a draught (as it is usually called) in the breast, and enables the milk to flow easily.

Of course, if there be no milk in the bosom--the babe having been applied once or twice to determine the fact--then you must wait for a few hours before applying him again to the nipple, that is to say, until the milk be secreted.

An infant, who, for two or three days, is kept from the breast, and who is fed upon gruel, generally becomes feeble, and frequently, at the end of that time, will not take the nipple at all. Besides, there is a thick cream (similar to the biestings of a cow), which, if not drawn out by the child, may cause inflammation and gathering of the bosom, and, consequently, great suffering to the mother. Moreover, placing him _early_ to the breast, moderates the severity of the mother's after pains, and lessens the risk of her flooding. A new-born babe must _not_ have gruel given to him, as it disorders the bowels, causes a disinclination to suck, and thus makes him feeble.

30. _If an infant show any disinclination to suck, or if he appear unable to apply his tongue to the nipple, what ought to be done_?

Immediately call the attention of the medical man to the fact, in order that he may ascertain whether he be tongue-tied. If he be, the simple operation of dividing the bridle of the tongue will remedy the defect, and will cause him to take the nipple with ease and comfort.

31. _Provided there be not milk AT FIRST, what ought then to be done_?

Wait with patience; the child (if the mother have no milk) will not, for at least twelve hours, require artificial food. In the generality of instances, then, artificial food is not at all necessary; but if it should be needed, one-third of new milk and two-thirds of warm water, slightly sweetened with loaf sugar (or with brown sugar, if the babe's bowels have not been opened), should be given, in small quantities at a time, every four hours, until the milk be secreted, and then it must be discontinued. The infant ought to be put to the nipple every four hours, but not oftener, until he be able to find nourishment.

If after the application of the child for a few times, he is unable to find nourishment, then it will be necessary to wait until the milk be secreted. As soon as it is secreted, he must be applied with great regularity, _alternately_ to each breast.

I say _alternately_ to each breast. _This is most important advice_. Sometimes a child, for some inexplicable reason, prefers one breast to the other, and the mother, to save a little contention, concedes the point, and allows him to have his own way. And what is frequently the consequence?--a gathered breast!

We frequently hear of a babe having no notion of sucking. This "no notion" may generally be traced to bad management, to stuffing him with food, and thus giving him a disinclination to take the nipple at all.

32. _How often should a mother suckle her infant_?

A mother generally suckles her baby too often, having him almost constantly at the breast. This practice is injurious both to parent and to child. The stomach requires repose as much as any other part of the body; and how can it have if it be constantly loaded with breast-milk? For the first month, he ought to be suckled, about every hour and a half; for the second month, every two hours,--gradually increasing, as he becomes older, the distance of time between, until at length he has it about every four hours.

If a baby were suckled at stated periods, he would only look for the bosom at those times, and be satisfied. A mother is frequently in the habit of giving the child the breast every time he cries, regardless of the cause. The cause too frequently is that he has been too often suckled--his stomach has been overloaded, the little fellow is consequently in pain, and he gives utterance to it by cries. How absurd is such a practice! We may as well endeavour to put out a fire by feeding it with fuel. An infant ought to be accustomed to regularity in everything, in times for sucking, for sleeping, &c. No children thrive so well as those who are thus early taught.

33. _Where the mother is MODERATELY strong, do you advise that the infant should have any other food than the breast_?

Artificial food must not, for the first five or six months, be given, if the parent be _moderately_ strong, of course, if she be feeble, a _little_ food will be necessary. Many delicate women enjoy better health whilst ambling than at any other period of their lives.

It may be well, where artificial food, in addition to the mother's own milk, is needed, and before giving any farinaceous food whatever (for farinaceous food until a child is six or seven months old is injurious), to give, through a feeding bottle, every night and morning, in addition to the mother's breast of milk, the following _Milk-Water-and Sugar-of Milk Food_--

Fresh milk, from ONE cow, Warm water, of each a quarter of a pint, Sugar of milk one tea spoonful

The sugar of milk should first be dissolved in the warm water, and then the fresh milk _unboiled_ should be mixed with it. The sweetening of the above food with sugar-of-milk, instead of with lump sugar, makes the food more to resemble the mother's own milk. The infant will not, probably, at first take more than half of the above quantity at a time, even if he does so much as that but still the above are the proper proportions, and as he grows older, he will require the whole of it at a meal.

34. _What food, when a babe is six or seven months old, is the best substitute for a mother's milk?_

The food that suits one infant will not agree with another. (1) The one that I have found the most generally useful, is made as follows--Boil the crumb of bread for two hours in water, taking particular care that it does not burn, then add only a _little_ lump-sugar (or _brown_ sugar, if the bowels be costive), to make it palatable. When he is six or seven months old, mix a little new milk--the milk of ONE cow--with it gradually as he becomes older, increasing the quantity until it be nearly all milk, there being only enough water to boil the bread, the milk should be poured boiling hot on the bread. Sometimes the two milks--the mother's and the cow's milk--do not agree, when such is the case, let the milk be left out, both in this and in the foods following, and let the food be made with water, instead of with milk and water. In other respects, until the child is weaned, let it be made as above directed, when he is weaned, good fresh cow's milk MUST, as previously recommended, be used. (2) Or cut thin slices of bread into a basin, cover the bread with _cold_ water, place it in an oven for two hours to bake, take it out, beat the bread up with a fork, and then slightly sweeten it. This is an excellent food. (3) If the above should not agree with the infant (although, if properly made, they almost invariably do), "tous les-mois" may be given. [Footnote: "Tous les mois" is the starch obtained from the tuberous roots of various species of _canna_, and is imported from the West Indies. It is very similar to arrow root. I suppose it is called "tous les-mois," as it is good to be eaten all the year round.](4) Or Robb's Biscuits, as it is "among the best bread compounds made out of wheat-flour, and is almost always readily digested."--_Routh_.

(5) Another good food is the following--Take about a pound of flour put it in a cloth, tie it up tightly, place it a saucepanful of water, and let it boil for four or five hours, then take it out, peel off the outer rind, and the inside will be found quite dry, which grate. (6) Another way of preparing an infant's food, is to bake flour--biscuit flour--in a slow oven, until it be of a light fawn colour. Baked flour ought after it is baked, to be reduced, by means of a rolling pin, to a fine powder, and should then be kept in a covered tin, ready for use. (7) An excellent food for a baby is baked crumbs of bread. The manner of preparing it is as follows--Crumb some bread on a plate, put it a little distance from the fire to dry. When dry, rub the crumbs in a mortar, and reduce them to a fine powder, then pass them through a sieve. Having done which, put the crumbs of bread into a slow oven, and let them bake until they be of a light fawn colour. A small quantity either of the boiled, or of the baked flour, or of the baked crumb of bread, ought to be made into food, in the same way as gruel is made, and should then be slightly sweetened, according to the state of the bowels, either with lump or with brown sugar.

(8) Baked flour sometimes produces constipation, when such is the case, Mr. Appleton, of Budleigh Salterton, Devon, wisely recommends a mixture of baked flour, and prepared oatmeal, [Footnote: If there is any difficulty in obtaining _prepared_ oatmeal, Robinson's Scotch Oatmeal will answer equally as well.] in the proportion of two of the former and one of the latter. He says--"To avoid the constipating effects, I have always had mixed, before baking, one part of prepared oatmeal with two parts of flour, this compound I have found both nourishing, and regulating to the bowels. One table-spoonful of it, mixed with a quarter of a pint of milk, or milk and water, when well boiled, flavoured and sweetened with white sugar, produces a thick, nourishing, and delicious food for infants or invalids." He goes on to remark--"I know of no food, after repeated trials, that can be so strongly recommended by the profession to all mothers in the rearing of their infants, without or with the aid of the breasts, at the same time relieving them of much draining and dragging whilst nursing with an insufficiency of milk, as baked flour and oatmeal." [Footnote: _British Medical Journal_, Dec 18, 1858]

(9) A ninth food may be made with "Farinaceous Food for Infants, prepared by Hards of Dartford". If Hard's Farinaceous food produces costiveness--as it sometimes does--let it be mixed either with equal parts or with one third of Robinson's Scotch Oatmeal. The mixture of the two together makes a splendid food for a baby. (10) A tenth, and an excellent one, may be made with rusks, boiled for an hour in water, which ought then to be well beaten up, by means of a fork, and slightly sweetened with lump sugar. Great care should be taken to select good rusks, as few articles vary so much in quality. (11) An eleventh is--the top crust of a baker's loaf, boiled for an hour in water, and then moderately sweetened with lump sugar. If, at any time, the child's bowels should be costive, _raw_ must be substituted for _lump_ sugar. (12) Another capital food for an infant is that made by Lemann's Biscuit Powder. [Footnote: Lemann's Biscuit Powder cannot be too strongly recommended--It is of the finest quality, and may be obtained of Lemann, Threadneedle Street, London. An extended and an extensive experience confirms me still more in the good opinion I have of this food.] (13) Or, Brown and Polson's Patent Corn Flour will be found suitable. Francatelli, the Queen's cook, in his recent valuable work, gives the following formula for making it--"To one dessert-spoonful of Brown and Polson, mixed with a wineglassful of cold water, add half a pint of boiling water, stir over the fire for five minutes, sweeten lightly, and feed the baby, but if the infant is being brought up by the hand, this food should then be mixed with milk--not otherwise." (14) A fourteenth is Neaves' Farinaceous Food for Infants, which is a really good article of diet for a babe, it is not so binding to the bowels as many of the farinaceous foods are, which is a great recommendation.

(15) The following is a good and nourishing food for a baby:--Soak for an hour, some _best_ rice in cold water; strain, and add fresh water to the rice; then let it simmer till it will pulp through a sieve; put the pulp and the water in a saucepan, with a lump or two of sugar, and again let it simmer for a quarter of an hour; a portion of this should be mixed with one-third of fresh milk, so as to make it of the consistence of good cream. This is an excellent food for weak bowels.

When the baby is six or seven months old, new milk should be added to any of the above articles of food, in a similar way to that recommended for boiled bread.

(16.) For a delicate infant, lentil powder, better known as Du Barry's "Ravalenta Arabica," is invaluable. It ought to be made into food, with new milk, in the same way that arrow-root is made, and should be moderately sweetened with loaf-sugar. Whatever food is selected ought to be given by means of a nursing bottle.

If a child's bowels be relaxed and weak, or if the motions be offensive, the milk _must_ be boiled, but not otherwise. The following (17) is a good food when an infant's bowels are weak and relaxed:--"Into five large spoonfuls of the purest water, rub smooth one dessert-spoonful of fine flour. Set over the fire five spoonfuls of new milk, and put two bits of sugar into it; the moment it boils, pour it into the flour and water, and stir it over a slow fire twenty minutes."

Where there is much emaciation, I have found (18) genuine arrow-root [Footnote: Genuine arrow-root, of first-rate quality, and at a reasonable price, may be obtained of H. M. Plumbe, arrow-root merchant, 8 Alie Place. Great Alie Street. Aldgate, London, E.] a very valuable article of food for an infant, as it contains a great deal of starch, which starch helps to form fat and to evolve caloric (heat)--both of which a poor emaciated chilly child stands so much in need of. It must be made with equal parts of water and of good fresh milk, and ought to be slightly sweetened with loaf sugar; a small pinch of table salt should be added to it.

Arrow-root will not, as milk will, give bone and muscle; but it will give--what is very needful to a delicate child--fat and warmth. Arrow-root, as it is principally composed of starch, comes under the same category as cream, butter, sugar, oil, and fat. Arrowroot, then, should always be given with new milk (mixed with one-half of water); it will then fulfil, to perfection, the exigencies of nourishing, of warming, and fattening the child's body.

New milk, composed in due proportions as it is, of cream and of skim milk--the very acme of perfection--is the only food, _which of itself alone,_ will nourish and warm and fatten. It is, for a child, _par excellence,_ the food of foods!

Arrow-root, and all other farinaceous foods are, for a child, only supplemental to milk--new milk being, for the young, the staple food of all other kinds of foods whatever.

But bear in mind, _and let there be no mistake about it,_ that farinaceous food, be it what it may, until the child be six or seven months old, until, indeed, he _begin_ to cut his teeth, is not suitable for a child; until then, _The Milk-water-salt-and-sugar Food_ (see page 29) is usually, if he be a dry-nursed child, the best artificial food for him.

I have given you a large and well-tried infant's dietary to chose from, as it is sometimes difficult to fix on one that will suit; but, remember, if you find one of the above to agree, keep to it, as a babe requires a simplicity in food--a child a greater variety.

Let me, in this place, insist upon the necessity of great care and attention being observed in the preparation of any of the above articles of diet. A babe's stomach is very delicate, and will revolt at either ill-made, or lumpy, or burnt food. Great care ought to be observed as to the cleanliness of the cooking utensils. The above directions require the strict supervision of the mother.

Broths have been recommended, but, for my own part, I think that, for a _young_ infant, they are objectionable; they are apt to turn acid on the stomach, and to cause flatulence and sickness, they, sometimes, disorder the bowels and induce griping and purging.

Whatever artificial food is used ought to be given by means of a bottle, not only as it is a more natural way than any other of feeding a baby, as it causes him to suck as though he were drawing it from the mother's breasts, but as the act of sucking causes the salivary glands to press out their contents, which materially assist digestion. Moreover, it seems to satisfy and comfort him more than it otherwise would do.

One of the best, if not _the best_ feeding bottle I have yet seen, is that made by Morgan Brothers, 21 Bow Lane, London. It is called "The Anglo-French Feeding Bottle" S Maw, of 11 Aldersgate Street, London, has also brought out an excellent one--"The Fountain Infant's Feeding Bottle" Another good one is "Mather's Infant's Feeding Bottle" Either of these three will answer the purpose admirably. I cannot speak in terms too highly of these valuable inventions.

The food ought to be of the consistence of good cream, and should be made fresh and fresh. It ought to be given milk warm. Attention must be paid to the cleanliness of the vessel, and care should be taken that the milk be that of ONE cow, [Footnote: I consider it to be of immense importance to the infant, that the milk be had from ONE cow. A writer in the _Medical Times and Gazette_ speaking on this subject, makes the following sensible remarks--"I do not know if a practice common among French ladies when they do not nurse, has obtained the attention among ourselves which it seems to me to deserve. When the infant is to be fed with cow milk that from various cows is submitted to examination by the medical man and if possible, tried on some child, and when the milk of any cow has been chosen, no other milk is ever suffered to enter the child's lips for a French lady would as soon offer to her infant's mouth the breasts of half a dozen wet-nurses in the day, as mix together the milk of various cows, which must differ, even as the animals themselves, in its constituent qualities. Great attention is also paid to the pasture, or other food of the cow thus appropriated."] and that it be new and of good quality, for if not it will turn acid and sour, and disorder the stomach, and will thus cause either flatulence or looseness of the bowels, or perhaps convulsions. The only way to be sure of having it from _one_ cow, is (if you have not a cow of your own), to have the milk from a _respectable_ cow keeper, and to have it brought to your house in a can of your own (the London milk cans being the best for the purpose). The better plan is to have two cans, and to have the milk fresh and fresh every night and morning. The cans, after each time of using, ought to be scalded out, and, once a week the can should be filled with _cold_ water, and the water should be allowed to remain in it until the can be again required.

Very little sugar should be used in the food, as much sugar weakens the digestion. A small pinch of table-salt ought to be added to whatever food is given, as "the best savour is salt." Salt is most wholesome--it strengthens and assists digestion, prevents the formation of worms, and, in small quantities, may with advantage be given (if artificial food be used) to the youngest baby.

35. _Where it is found to be absolutely necessary to give an infant artificial food_ WHILST SUCKLING, _how often ought he to be fed_?

Not oftener than twice during the twenty four hours, and then only in _small_ quantities at a time, as the stomach requires rest, and at the same time, can manage to digest a little food better than it can a great deal. Let me again urge upon you the importance, if it be at all practicable, of keeping the child _entirely_ to the breast for the first five or six months of his existence. Remember there is no _real_ substitute for a mother's milk, there is no food so well adapted to his stomach, there is no diet equal to it in developing muscle, in making bone, or in producing that beautiful plump rounded contour of the limbs, there is nothing like a mother's milk _alone_ in making a child contented and happy, in laying the foundation of a healthy constitution, in preparing the body for a long life, in giving him tone to resist disease, or in causing him to cut his teeth easily and well, in short, _the mothers milk is the greatest temporal blessing an infant can possess_.

As a general rule, therefore, when the child and the mother are tolerably strong, he is better _without artificial_ food until he have attained the age of three or four months, then, it will usually be necessary to feed him with _The Milk-water-and-sugar-of milk Food_ (see p 19) twice a day, so as gradually to prepare him to be weaned (if possible) at the end of nine months. The food mentioned in the foregoing Conversation will, when he is six or seven months old, be the best for him.

36. _When the mother is not able to suckle her infant herself, what ought to be done_?

It must first be ascertained, _beyond all doubt_, that a mother is not able to suckle her own child Many delicate ladies do suckle their infants with advantage, not only to their offspring, but to themselves. "I will maintain," says Steele, "that the mother grows stronger by it, and will have her health better than she would have otherwise She will find it the greatest cure, and preservative for the vapours [nervousness] and future miscarriages, much beyond any other remedy whatsoever Her children will be like giants, whereas otherwise they are but living shadows, and like unripe fruit, and certainly if a woman is strong enough to bring forth a child, she is beyond all doubt strong enough to nurse it afterwards."

Many mothers are never so well as when they are nursing, besides, suckling prevents a lady from becoming pregnant so frequently as she otherwise would. This, if she be delicate, is an important consideration, and more especially if she be subject to miscarry. The effects of miscarriage are far more weakening than those of suckling.

A hireling, let her be ever so well inclined, can never have the affection and unceasing assiduity of a mother, and, therefore, cannot perform the duties of suckling with equal advantage to the baby.

The number of children who die under five years of age is enormous--many of them from the want of the mother's milk. There is a regular "parental baby-slaughter"--"a massacre of the innocents"-- constantly going on in England, in consequence of infants being thus deprived of their proper nutriment and just dues! The mortality from this cause is frightful, chiefly occurring among rich people who are either too grand, or, from luxury, too delicate to perform such duties; poor married women, as a rule, nurse their own children, and, in consequence reap their reward.

If it be ascertained, _past all doubt_, that a mother cannot suckle her child, then, if the circumstances of the parents will allow--and they ought to strain a point to accomplish it--a healthy wet-nurse should be procured, as, of course, the food which nature has supplied is far, very far superior to any invented by art. Never bring up a baby, then, if you can possibly avoid it, on _artificial_ food. Remember, as I proved in a former Conversation, there is in early infancy no _real_ substitute for either a mother's or a wet-nurse's milk. It is impossible to imitate the admirable and subtle chemistry of nature. The law of nature is, that a baby, for the first few months of his existence, shall be brought up by the breast, and nature's law cannot be broken with impunity. [Footnote: For further reasons why artificial food is not desirable, at an early period of infancy, see answer to 35th question, page 26.] It will be imperatively necessary then--

"To give to nature what is nature's due."

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, when wanted, and should be given by means of a feeding-bottle. Asses' milk is more suitable for a _delicate_ infant, and goats' milk for a _strong_ one.

If neither asses' milk nor goats' milk can be procured, then the following _Milk-water-salt-and-sugar Food_, from the very commencement, should be given; and as I was the author of the formula, [Footnote: It first appeared in print in the 4th edition of _Advice to a Mother_, 1852.] I beg to designate it as--_Rye Chavasse's Milk Food_:--

New milk, the produce of ONE _healthy_ cow; Warm water, of each, equal parts; Table salt, a few grains--a small pinch; Lump sugar, a sufficient quantity, to slightly sweeten it.

The milk itself ought not to be heated over the fire, [Footnote: 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.] but should, as above directed, be warmed by the water; it must, morning and evening, be had fresh and fresh. The milk and water should be of the same temperature as the mother's milk, that is to say, at about ninety degrees Fahrenheit. It ought to be given by means of either Morgan's, or Maw's, or Mather's feeding-bottle, [Footnote: See answer to Question 24, page 24.] 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. The milk should, as he grows older, be gradually increased and the water decreased, until two-thirds of milk and one-third of water be used; but remember, that either _much_ or _little_ water must _always_ be given with the milk.

The above is my old form, and which I have for many years used with great success. Where the above food does not agree (and no food except a healthy mother's own milk does _invariably_ agree) I occasionally substitute sugar-of milt for the lump sugar, in the proportion of a tea spoonful of sugar-of milk to every half pint of food.

If your child bring up his food, and if the ejected matter be sour-smelling, I should advise you to leave out the sugar-of milk altogether, and simply to let the child live, for a few days, on milk and water alone, the milk being of _one_ cow, and in the proportion of two-thirds to one-third of _warm_ water--not _hot_ water, the milk should not be scalded with _hot_ water, as it injures its properties, besides, it is only necessary to give the child his food with the chill just off. The above food, where the stomach is disordered, is an admirable one, and will often set the child to rights without giving him any medicine whatever. Moreover, there is plenty of nourishment in it to make the babe thrive, for after all it is the milk that is the important ingredient in all the foods of infants, they can live on it, and on it alone, and thrive amazingly.

Mothers sometimes say to me, that farinaceous food makes their babes flatulent, and that my food (_Pye Chavasse's Milk Food_) has not that effect.

The reason of farinaceous food making babes, until they have _commenced_ cutting their teeth, "windy" is, that the starch of the farinaceous food (and all farinaceous foods contain more or less of starch) is not digested, and is not, as it ought to be, converted by the saliva into sugar [Footnote: See Pye Chavasse's _Counsel to a Mother_, 3d edition.] hence "wind" is generated, and pain and convulsions often follow in the train.

The great desideratum, in devising an infant's formula for food, is to make it, until he be nine months old, to resemble as much as possible, a mother's own milk, and which my formula, as nearly as is practicable, does resemble hence its success and popularity.

As soon as a child begins to cut his teeth the case is altered, and _farinaceous food, with milk and with water_, becomes an absolute necessity.

I wish, then, to call your especial attention to the following-facts, for they are facts--Farinaceous foods, _of all kinds_, before a child _commences_ cutting his teeth (which is when he is about six or seven months old) are worse than useless--they are, positively, injurious, they are, during the early period of infant life, perfectly indigestible, and may bring on--which they frequently do-- convulsions. A babe fed on farinaceous food alone would certainly die of starvation, for, "up to six or seven months of age, infants have not the power of digesting farinaceous or fibrinous substances"--Dr Letheby on _Food_.

A babe's salivary glands, until he be six or seven months old, does not secrete its proper fluid--namely, ptyalin, and consequently the starch of the farinaceous food--and all farinaceous food contains starch--is not converted into dextrine and grape-sugar, and is, therefore, perfectly indigestible and useless--nay, injurious to an infant, and may bring on pain and convulsions, and even death, hence, the giving of farinaceous food, until a child be six or seven months old, is one and the principal cause of the frightful infant mortality at the present time existing in England, and which is a disgrace to any civilized land!

In passing, allow me to urge you never to stuff a babe--never to overload his little stomach with food, it is far more desirable to give him a little not enough, than to give him a little too much. Many a poor child has been, like a young bird, killed with stuffing. If a child be at the breast, and at the breast alone, there is no fear of his taking too much, but if he be brought up on artificial food, there is great fear of his over loading his stomach. Stuffing a child brings on vomiting and bowel-complaints, and a host of other diseases which now it would be tedious to enumerate. Let me, then, urge you on no account, to over load the stomach of a little child.

There will, then, in many cases, be quite sufficient nourishment in the above. I have known some robust infants brought up on it, and on it along, without a particle of farinaceous food, or of any other food, in any shape or form whatever. 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, wet-nurse's, or asses', or goats', or cow's 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, of a consumptive habit, or if she or any of her family have laboured 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 [Footnote: "It should be thin, and of a bluish-white colour, sweet to the taste, and when allowed to stand, should throw up a considerable quantity of cream,"--_Maxell and Evenson on the Diseases of Children_.] (which may readily be ascertained by milking a little into a glass); 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 menstruate during suckling; if she does, the milk is not so good and nourishing, and you had better decline taking her. [Footnote: 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 third child's mother is more eligible than a first"--_Letter to the Author_.] Assure yourself that her own babe is strong and healthy that he be 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, an 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 colour, 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 really 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, or not, in his mouth.

Very feeble new-born babes sometimes cannot take the bosom, be the nipples and the breasts ever so good, and although Maw's nipple-shield and glass tube had been tried. In such a case, cow's milk-water-sugar-and-salt, as recommended at page 29, must be given in small quantities at a time--from two to four tea-spoonfuls--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 tea-spoonfuls, 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 tea-spoonfuls 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 broccoli, 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 and 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 mouths, 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, endeavour to procure one of a mild, calm, and placid disposition. [Footnote: "'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 labouring 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 [Footnote: The previous boiling of the milk will prevent the warmth of the bed turning the milk sour, which it otherwise would do.]--in the bed, so as to give a little to him in lieu of the breast. The warmth of the body will keep the milk of a proper temperature, and will supersede the use of lamps, of candle-frames, and of other troublesome contrivances.

42. _While a mother is weaning her infant, and after she have weaned him, what ought to be his diet_?

Any one of the foods recommended in answer to question 34.

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 five or six 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, [Footnote: For the first five or six 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_.] suffer severely.

Care in feeding, then, is the grand preventative 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 cow's 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:--

"Things sweet to taste, prove in digestion sour."

_Shakspeare._

If a babe'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, _raw_ sugar ought to be substituted for lump sugar, as _raw_ 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.

Vaccination And Re-Vaccination.

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 _re-vaccinated_,--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 be known only 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 re-vaccinated_?

I decidedly do: it would be an excellent plan for _every_ person, once every seven years to be re-vaccinated, and even oftener, if small-pox be rife in the neighbourhood. 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 be 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 civilised 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 re-vaccinated once every seven years, or even, oftener, if there was an epidemic of small-pox in the neighbourhood.

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 ten-fold 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 he 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 neighbourhood, 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." [Footnote: Communicated by Sir Charles Locock to the Author.]

51. _Do you consider that 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 have 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."--_Dendy_. 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 neighbourhood, 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, 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 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 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 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 comfort and relief.

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."-- _Gregory_.

Dentition

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:--

"YORK.--Marry, they say my uncle grew so fast, That he could gnaw a crust at two hours old. 'Twas full two years ere I could get a tooth, Grandam, this would have been a biting jest."

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 incissors [cutting teeth], then the upper front, then the _upper_ two lateral incissors, 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." [Footnote: Sir Charles Locock in a _Letter_ to the Author.] Then the first grinders, in the lower jaw, afterwards 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 the 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 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 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 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 [Footnote: For the precautions to be used in putting a child into a warm bath, see the answer to question on "Warm Baths."] of 98 degrees Fahrenheit. If a thermometer be not at hand, [Footnote: No family, where there are young children, should be without Fahrenheit's thermometer.] 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 table-spoonful of salt, of one of oil, and a tea-cupful 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.

It may be well, for the comfort of a mother, to state that a child in convulsions is perfectly insensible to all pain whatever; indeed, a return to consciousness speedily puts convulsions to the rout.

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 assist 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 contended 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 heartily commend to your favourable 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 have 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,--

"Perhaps it's as well to keep children from plums, And from pears in the season, and sucking their thumbs." [Footnote: _Ingoldsby Legends_.]

My reply is,--

P'rhaps 'tis as well to keep children from pears; The pain they might cause, is oft follow'd by tears; 'Tis certainly well to keep them from plums; But certainly not from sucking their thumbs! If a babe suck his thumb 'Tis an ease to his gum; A comfort; a boon; a calmer of grief; A friend in his need--affording relief; A solace; a good; a soother of pain; A composer to sleep; a charm; and a gain.

'Tis handy, at once, to his sweet mouth to glide; When done with, drops gently down by his side; 'Tis fix'd, like an anchor, while the babe sleeps. And the mother, with joy, her still vigil keeps.

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 ware house.

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 fruit, _raw_ apples or pears, ought to be carefully avoided, as they not only disorder the stomach and the bowels,--causing convulsions, gripings, &c.,--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, &c.; the _lungs_, producing congestion, inflammation, cough, &c.; the _stomach_, exciting sickness, flatulence, acidity, &c,; 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; [Footnote: 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.] 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, &c.; 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 Abbot's _Mother of Home_, wherein the author proves the great importance of _early_ training.

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 flashed. His head is heavy and hot. He is sometimes convulsed. [Footnote: 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 gum with the finger, with a little "soothing syrup," as recommended by Sir Charles Locock, [Footnote: Soothing syrup--Some of them probably contain opiates, but a perfectly safe and useful one is a little Nitrate of Potass in syrup of Roses--one scruple to half an ounce.--_Communicated by Sir Charles Locock to the Author._ This 'soothing syrup' is not intended to be given us a mixture but to be used as an application to rub the gums with. It may be well to state that it is a perfectly harmless remedy even if a little of it were swallowed by mistake.] a tepid bath of about 92 degrees Fahrenheit, every night at bed time, attention to diet and to bowels, fresh air and exercise. 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. [Footnote: I should put this in capitals, it is so important and is 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, is there 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 labouring 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.

Exercise.

74. _Do you recommend exercise in the open air for a baby? and if so, how soon after birth_?

I am a great advocate for his having exercise in the open air. "The infant in arms makes known its desire for fresh air, by restlessness, it cries, for it cannot speak its wants, is taken abroad and is quiet."

The age at which he ought to commence taking exercise will, of course, depend upon the season and upon the weather. If it be summer, and the weather be fine, he should he carried in the open air, a week or a fortnight after birth, but if it be winter, he ought not on any account to be taken out under the month, and not even then, unless the weather be mild for the season, and it be the middle of the day. At the end of two months he should breathe the open air more frequently. And after the expiration of three months, he ought to be carried out _every day_, even if it be wet under foot, provided it be fine above, and the wind be neither in an easterly nor in a north-easterly direction. By doing so we shall make him strong and hearty, and give the skin that mottled appearance which is so characteristic of health. He must, of course, be well clothed.

I cannot help expressing my disapprobation of the practice of smothering up an infant's face with a handkerchief, with a veil or with any other covering, when he is taken out into the air. If his face be so muffled up, he may as well remain at home, as under such circumstances, it is impossible for him to receive any benefit from the invigorating effects of the fresh air.

75. _Can you devise any method to induce a babe himself to take exercise_?

He must be encouraged to use muscular exertion, and, for this purpose, he ought to be frequently laid either upon a rug, or carpet, or the floor. He will then stretch his limbs and kick about with perfect glee. It is a pretty sight, to see a little fellow kicking and sprawling on the floor. He crows with delight and thoroughly enjoys himself. It strengthens his back, it enables him to stretch his limbs, and to use his muscles, and is one of the best kinds of exercise a very young child can take. While going through his performances his diaper, if he wear one, should be unfastened, in order that he might go through his exercises untrammelled. By adopting the above plan, the babe quietly enjoys himself--his brain is not over excited by it; this is an important consideration, for both mothers and nurses are apt to rouse, and excite very young children to their manifest detriment. A babe requires rest, and not excitement. How wrong it is, then, for either a mother or a nurse to be exciting and rousing a new born babe. It is most injurious and weakening to his brain. In the early period of his existence his time ought to be almost entirely spent in sleeping and in sucking!

76. _Do you approve of tossing an infant much about_?

I have seen, a child tossed nearly to the ceiling! Can anything be more cruel or absurd! Violent tossing of a young babe ought never to be allowed, it only frightens him, and has been known to bring on convulsions. He should be gently moved up and down (not tossed), such exercises causes a proper circulation of the blood, promotes digestion, and soothes to sleep. He must always be kept quiet immediately after taking the breast, if he be tossed _directly_ afterwards, it interferes with his digestion, and is likely to produce sickness.

Sleep

77. _Ought the infant's sleeping apartment to be kept warm_?

The lying-in room is generally kept too warm, its heat being, in many instances, more that of an oven than of a room. Such a place is most unhealthy, and is fraught with danger both to the mother and the baby. We are not, of course, to run into an opposite extreme, but are to keep the chamber at a moderate and comfortable temperature. The door ought occasionally to be left ajar, in order the more effectually to change the air and thus to make it more pure and sweet.

A new born babe, then, ought to be kept comfortably warm, but not very warm. It is folly in the extreme to attempt to harden a very young child either by allowing him, in the winter time, to be in a bedroom without a fire, or by dipping him in _cold_ water, or by keeping him with scant clothing on his bed. The temperature of a bedroom, in the winter time, should be, as nearly as possible, at 60 deg. Fahr. Although the room should be comfortably warm, it ought from time to time to be properly ventilated. An unventilated room soon becomes foul, and, therefore, unhealthy. How many in this world, both children and adults, are "poisoned with their own breaths!"

An infant should not be allowed to look at the glare either of a fire or of a lighted candle, as the glare tends to weaken the sight, and sometimes brings on an inflammation of the eyes. In speaking to, and in noticing a baby, you ought always to stand _before_, and not _behind_ him, or it might make him squint.

78. _Ought a babe to lie alone from the first_?

Certainly not: at first--say, for the first few months--he requires the warmth of another person's body, especially in the winter; but care must be taken not to overlay him, as many infants, from carelessness in this particular, have lost their lives. After the first few months he had better lie alone, on a horse-hair mattress.

79. _Do you approve of rocking an infant to sleep_?

I do not. If the rules of health be observed, he will sleep both soundly and sweetly without rocking; if they be not, the rocking might cause him to fall into a feverish, disturbed slumber, but not into a refreshing, calm sleep. Besides, if you once take to that habit, he will not go to sleep without it.

80. _Then don't you approve of a rocking-chair, and of rockers to the cradle_?

Certainly not: a rocking-chair, or rockers to the cradle, may be useful to a lazy nurse or mother, and may induce a child to sleep, but that restlessly, when he does not need sleep, or when he is wet and uncomfortable, and requires "changing;" but will not cause him to have that sweet and gentle and exquisite slumber so characteristic of a baby who has no artificial appliances to make him sleep. No! rockers are perfectly unnecessary, and the sooner they are banished the nursery the better will it be for the infant community. I do not know a more wearisome and monotonous sound than the everlasting rockings to and fro in some nurseries, they are often accompanied by a dolorous lullaby from the nurse, which adds much to the misery and depressing influence of the performance.

81. _While the infant is asleep, do you advise the head of the crib to be covered with a handkerchief, to shade his eyes from the light, and, if it be summer time, to keep off the flies_?

If the head of the crib be covered, the babe cannot breathe freely, the air within the crib becomes contaminated, and thus the lungs cannot properly perform their functions. If his sleep is to be refreshing, he must breathe pure air. I do not even approve of a head to a crib. A child is frequently allowed to sleep on a bed with the curtains drawn completely close, as though it were dangerous for a breath of air to blow upon him [Footnote: I have somewhere read that if a cage containing a canary, be suspended at night within a bed where a person is sleeping, and the curtains be drawn closely around, that the bird will, in the morning, in all probability, be found dead!] This practice is most injurious. An infant must have the full benefit of the air of the room, indeed, the bed room door ought to be frequently left ajar, so that the air of the apartment may be changed, taking care, of course, not to expose him to a draught. If the flies, while he is asleep, annoy him, let a net veil be thrown over his face, as he can readily breathe through net, but not through a handkerchief.

82. _Have you any suggestions to offer as to the way a babe should be dressed when he is put down to sleep_?

Whenever he be put down to sleep, be more than usually particular that his dress be loose in every part, be careful that there be neither strings nor bands, to cramp him. Let him, then, during repose, be more than ordinarily free and unrestrained--

"If, whilst in cradled rest your infant sleeps. Your watchful eyes unceasing vigil keeps Lest cramping bonds his pliant limbs constrain, And cause defects that manhood may retain."

83. _Is it a good sign for a young child to sleep much_?

A babe who sleeps a great deal thrives much more than one who does not. I have known many children, who were born [Footnote: It may be interesting to a mother to know the average weight of new born infants. There is a paper on the subject in the _Medical Circular_ (April 10, 1861) and which has been abridged in _Braithwaite's Retrospect of Medicine_ (July and December 1861). The following are extracts--"Dr. E. von Siebold presents a table of the weights of 3000 infants (1586 male and 1414 female) weighed immediately after birth. From this table (for which we have not space) it results that by far the greater number of the children, 2215 weighed between 6 and 8 lbs. From 5 3/4 to 6 lbs. the number rose from 99 to 268, and from 8 to 8 1/4 lbs. they fell from 226 to 67, and never rose again at any weight to 100. From 8 3/4 to 9 1/2 lbs. they sank from 61 to 8, rising however at 9 1/2 lbs. to 21. Only six weighed 10 lbs., one 10 3/4 lbs. and two 11 lbs. The author has never but once met with a child weighing 11 lbs. The most frequent weight in the 3000 was 7 lbs, numbering 426. It is a remarkable fact, that until the weight of 7 lbs the female infants exceeded the males in number, the latter thenceforward predominating.

From these statements, and those of various other authors here quoted, the conclusion may be drawn that the normal weight of a mature new born infant is not less than six nor more than 8 lbs., the average weight being 6 1/2 or 7 lbs., the smaller number referring to female and the higher to male infants."] small and delicate, but who slept the greatest part of their time, become strong and healthy. On the other hand, I have known those who were born large and strong, yet who slept but little, become weak and unhealthy.

The common practice of a nurse allowing a baby to sleep upon her lap is a bad one, and ought never to be countenanced. He sleeps cooler, more comfortably, and soundly in his crib.

The younger an infant is the more he generally sleeps, so that during the early months he is seldom awake, and then only to take the breast.

84. _How is it that much sleep causes a young child to thrive so well_?

If there be pain in any part of the body, or if any of the functions be not properly performed, he sleeps but little. On the contrary, if there be exemption from pain, and if there be a due performance of all the functions, he sleeps a great deal, and thus the body becomes refreshed and invigorated.

85. _As much sleep is of such advantage, if an infant sleep but little, would you advise composing medicine to be given to him_?

Certainly not. The practice of giving composing medicine to a young child cannot he too strongly reprobated. If he does not sleep enough, the mother ought to ascertain if the bowels be in a proper state, whether they be sufficiently opened, that the motions be of a good colour--namely, a bright yellow, inclining to orange colour--and free from slime or from bad smell. An occasional dose of rhubarb and magnesia is frequently the best composing medicine he can take.

86. _We often hear of coroner's inquests upon infants who have been found dead in bed--accidentally overlaid what is usually the cause_?

Suffocation, produced either by ignorance, or by carelessness. From _ignorance_ in mothers, in their not knowing the common laws of life, and the vital importance of free and unrestricted respiration, not only when babies are up and about, but when they are in bed and asleep. From _carelessness_, in their allowing young and thoughtless servants to have the charge of infants at night, more especially as young girls are usually heavy sleepers, and are thus too much overpowered with sleep to attend to their necessary duties.

A foolish mother sometimes goes to sleep while allowing her child to continue sucking. The unconscious babe, after a tune, looses the nipple, and buries his head in the bed-clothes. She awakes in the morning, finding, to her horror, a corpse by her side, with his nose flattened, and a frothy fluid, tinged with, blood, exuding from his lips. A mother ought, therefore, never to go to sleep until her child have finished sucking.

_The following are a few rules to prevent an infant from being accidentally overlaid_--(1.) Let your baby while asleep have plenty of room in the bed. (2.) Do not allow him to be too near to you; or if he he unavoidably near you (from the small size of the bed), let his face be turned to the opposite side. (3.) Let him lie fairly either on his side, or on his back. (4.) Be careful to ascertain that his mouth be not covered with the bed-clothes; and, (5.) Do not smother his face with clothes, as a plentiful supply of pure air is as necessary when he is awake, or even more so, than when he is asleep. (6.) Never let him lie low in the bed. (7.) Let there be _no_ pillow near the one his head is resting on, lest he roll to it, and thus bury his head in it Remember, a young child has neither the strength nor the sense to get out of danger; and, if he unfortunately either turn on his face, or bury his head in a pillow that is near, the chances are that he will be suffocated, more especially as these accidents usually occur at night, when the mother, or the nurse, is fast asleep. (8.) Never intrust him at night to a young and thoughtless servant.

The Bladder And The Bowels Of An Infant.

87. _Have you any hints to offer respecting the bowels and the bladder of an infant during the first three months of his existence_?

A mother ought daily to satisfy herself as to the state of the bladder and the bowels of her child. She herself should inspect the motions, and see that they are of a proper colour (bright-yellow, inclining to orange), and consistence (that of thick gruel), that they are neither slimy, nor curdled, nor green; if they should be either the one or the other, it is a proof that she herself has, in all probability, been imprudent in her diet, and that it will be necessary for the future that she be more careful both in what she eats and in what she drinks.

She ought, moreover, to satisfy herself that the urine does not smell strongly, that it does not stain the diapers, and that he makes a sufficient quantity.

A frequent cause of a child crying is, he is wet, and uncomfortable, and wants drying and changing, and the only way he has of informing his mother of the fact is by crying lustily, and thus telling her in most expressive language of her thoughtlessness and carelessness.

88. _How soon may an infant dispense with diapers_?

A babe of three months and upwards, ought to be held out, at least, a dozen times during the twenty-four hours; if such a plan were adopted, diapers might at the end of three months be dispensed with--a great _desideratum_-and he would be inducted into clean habits--a blessing to himself, and a comfort to all around, and a great saving of dresses and of furniture. "Teach your children to be clean. A dirty child is the mother's disgrace," [Footnote: Hints on Household Management, By Mrs C. L. Balfour.] Truer words were never written,--A DIRTY CHILD IS THE MOTHER'S DISGRACE.

Ailments, Disease, Etc.

89. _A new born babe frequently has a collection of mucus in the air passages, causing him to wheeze: is it a dangerous symptom_?

No, not if it occur _immediately_ after birth; as soon as the bowels have been opened, it generally leaves him, or even before, if he give a good cry, which as soon as he is born he usually does. If there be any mucus either within or about the mouth, impeding breathing, it must with a soft handkerchief be removed.

90. _Is it advisable, as soon as an infant is born, to give him medicine_?

It is now proved that the giving of medicine to a babe _immediately_ after birth is unnecessary, nay, that it is hurtful--that is, provided he be early put to the breast, as the mother's _first_ milk is generally sufficient to open the bowels. Sir Charles Locock [Footnote: In a _Letter_ to the Author.] makes the following sensible remarks on this subject:--"I used to limit any aperient to a new-born infant to those which had not the first milk, and who had wet nurses, whose milk was, of course, some weeks old, but for many years I have never allowed any aperient at all to any new born infant, and I am satisfied it is the safest and the wisest plan."

The advice of Sir Charles Locock--_to give no aperient to a new-born infant_--is most valuable, and ought to be strictly followed. By adopting his recommendation, much after misery might be averted. If a new born babe's bowels be costive, rather than give him an aperient, try the effect of a little moist sugar, dissolved in a little water, that is to say, dissolve half a tea-spoonful of pure unadulterated _raw_ sugar in a tea-spoonful of warm water and administer it to him, if in four hours it should not operate, repeat the dose. Butter and raw sugar is a popular remedy, and is sometimes used by a nurse to open the bowels of a new born babe, and where there is costiveness, answers the purpose exceedingly well, and is far superior to castor oil. Try by all means to do, if possible, without a particle of opening medicine. If you once begin to give aperients, you will have frequently to repeat them. Opening physic leads to opening physic, until at length his stomach and bowels will become a physic shop! Let me, then, emphatically say, avoid, if possible, giving a new born babe a drop or a gram of opening medicine. If from the first you refrain from giving an aperient, he seldom requires one afterwards. It is the _first_ step, in this as in all other things, that is so important to take.

If a new-born babe have _not_ for twelve hours made water, the medical man ought to be informed of it, in order that he may inquire into the matter, and apply the proper remedies. Be particular in attending to these directions, or evil consequences will inevitably ensue.

91. _Some persons say, that new-born female infants have milk in their bosoms, and that it is necessary to squeeze them, and apply plasters to disperse the milk_.

The idea of there being real milk in a baby's breast is doubtful, the squeezing of the bosom is barbarous, and the application of plasters is useless. "Without actually saying," says Sir Charles Locock, "there is milk secreted in the breasts of infants, there is undoubtedly not rarely considerable swelling of the breasts both in _female_ and _male_ infants, and on squeezing them a serous fluid oozes out. I agree with you that the nurses should never be allowed to squeeze them, but be ordered to leave them alone." [Footnote: _Letter_ to the Author.]

92. _Have the goodness to mention the SLIGHT ailments which are not of sufficient importance to demand the assistance of a medical man_?

I deem it well to make the distinction between _serious_ and _slight_ ailments, I am addressing a mother. With regard to serious ailments, I do not think myself justified, except in certain _urgent_ cases, in instructing a parent to deal with them. It might be well to make a mother acquainted with the _symptoms_, but not with the _treatment_, in order that she might lose no time in calling in medical aid. This I hope to have the pleasure of doing in future Conversations.

_Serious diseases, with a few exceptions_, and which I will indicate in subsequent Conversations, ought never to be treated by a parent, not even in the _early_ stages, for it is in the early stages that the most good can generally be done. It is utterly impossible for any one who is not trained to the medical profession to understand a _serious_ disease in all its bearings, and thereby to treat it satisfactorily.

There are some exceptions to these remarks. It will be seen in future Conversations that Sir CHARLES LOCOCK considers that a mother ought to be made acquainted with the _treatment_ of _some_ of the more _serious_ diseases, where delay in obtaining _immediate_ medical assistance might be death. I bow to his superior judgment, and have supplied the deficiency in subsequent Conversations.

The ailments and the diseases of infants, such as may, in the absence of the doctor, be treated by a parent, are the following:--Chafings, Convulsions, Costivenesa, Flatulence, Gripings, Hiccup, Looseness of the Bowels (Diarrhoea), Dysentery, Nettle-rash, Red-gum, Stuffing of the Nose, Sickness, Thrush. In all these complaints I will tell you--_What to do_, and--_What NOT to do_.

93. _What are the causes and the treatment of Chafing_?

The want of water: inattention and want of cleanliness are the usual causes of chafing.

_What to do._--The chafed parts ought to be well and thoroughly sponged with tepid _rain_ water--allowing the water from a well-filled sponge to stream over them,--and, afterwards, they should be thoroughly, but tenderly, dried with a soft towel, and then be dusted, either with finely-powdered starch, made of wheaten flour, or with Violet Powder, or with finely-powdered Native Carbonate of Zinc, or they should be bathed with finely-powdered Fuller's-earth and tepid water.

If, in a few days, the parts be not healed discontinue the above treatment, and use the following application:--Beat up well together the whites of two eggs, then add, drop by drop, two table-spoonfuls of brandy. When well mixed, put it into a bottle and cork it up. Before using it let the excoriated parts be gently bathed with luke-warm rain water, and, with a soft napkin, be tenderly dried; then, by means of a camel's hair brush, apply the above liniment, having first shaken the bottle. But bear in mind, after all that can be said and done, _that there is nothing in these cases like water_--there is nothing like keeping the parts clean, and the only way of thoroughly effecting this object is _by putting him every morning INTO his tub_.

_What NOT to do_.--Do not apply white lead, as it is a poison. Do not be afraid of using _plenty_ of water, as cleanliness is one of the most important items of the treatment.

94. _What are the causes of Convulsions of an infant_?

Stuffing him, in the early months of his existence, _with food_, the mother having plenty of breast milk the while, the constant physicking of child by his own mother, teething, hooping-cough, when attacking a very young baby.

I never knew a case of convulsions occur--say for the first four months--(except in very young infants labouring under hooping-cough), where children lived on the breast-milk alone, and where they were _not_ frequently quacked by their mothers.

For the treatment of the convulsions from teething, see page 46.

_What to do_ in a case of convulsions which has been caused by feeding an infant either with too much or with _artificial_ food. Give him, every ten minutes, a tea-spoonful of ipecacuanha wine, until free vomiting be excited then put him into a warm bath (see Warm Baths), and when he comes out of it administer to him a tea-spoonful of castor oil, and repeat it every four hours, until the bowels be well opened.

_What NOT to do_--Do not for at least a month after the fit, give him artificial food, but keep him entirely to the breast. Do not apply leeches to the head.

_What to do in a case of convulsions from hooping cough_--There is nothing better than dashing cold water on the face, and immersing him in a warm bath of 98 degrees Fahr. If he be about his teeth, and they be plaguing him, let the gums be both freely and frequently lanced. Convulsions seldom occur in hooping-cough, unless the child be either very young or exceedingly delicate. Convulsions attending an attack of hooping-cough make it a _serious_ complication, and requires the assiduous and skilful attention of a judicious medical man.

_What NOT to do in such a case_--Do not apply leeches, the babe requires additional strength, and not to be robbed of it, and do not attempt to treat the case yourself.

95. _What are the best remedies for the Costiveness of an infant_?

I strongly object to the frequent administration of opening medicine, as the repetition of it increases the mischief to a tenfold degree.

_What to do_.--If a babe, after the first few months, were held out, and if, at regular intervals, he were put upon his chair, costiveness would not so much prevail. It is wonderful how soon the bowels, in the generality of cases, by this simple plan, may be brought into a regular state. Besides, it inducts an infant into clean habits, I know many careful mothers who have accustomed their children, after the first three months, to do without diapers altogether. It causes at first a little trouble, but that trouble is amply repaid by the good consequences that ensue; among which must be named the dispensing with such encumbrances as diapers. Diapers frequently chafe, irritate, and gall the tender skin of a baby. But they cannot of course, at an early age be dispensed with, unless a mother have great judgment, sense, tact, and perseverance, to bring her little charge into the habit of having his bowels relieved and his bladder emptied every time he is either held out or put upon his chair.

Before giving an infant a particle of aperient medicine, try, if the bowels are costive, the effect of a little _raw_ sugar and water, either half a tea-spoonful of raw sugar dissolved in a tea-spoonful or two of water, or give him, out of your fingers, half a tea-spoonful of raw sugar to eat. I mean by _raw_ sugar, not the white, but the pure and unadulterated sugar, and which you can only procure from a respectable grocer. If you are wise, you will defer as long as you can giving an aperient. If you once begin, and continue it for a while, opening medicine becomes a dire necessity, and then woe betide the poor unfortunate child. Or, give a third of a tea-spoonful of honey, early in the morning, occasionally. Or administer a warm water enema--a tablespoonful, or more, by means of a 2 oz. India Rubber Enema Bottle.

_What NOT to do_.--There are two preparations of mercury I wish to warn you against administering of your own accord, viz.--(1) Calomel, and a milder preparation called (2) Grey-powder (mercury with chalk). It is a common practice in this country to give calomel, on account of the readiness with which it can be administered it being small in quantity, and nearly tasteless. Grey powder also, is, with many mothers, a favourite in the nursery. It is a medicine of immense power--either for good or for evil, in certain cases it is very valuable, but in others, and in the great majority, it is very detrimental. This practice, then, of a mother giving mercury, whether in the form either of calomel or of grey powder, cannot be too strongly reprobated, as the frequent administration either of the one or of the other weakens the body, predisposes it to cold, and frequently excites king's-evil--a disease too common in this country. Calomel and grey-powder, then, ought never to be administered unless ordered by a medical man.

Syrup of buckthorn and jalap are also frequently given, but they are griping medicines for a baby, and ought to be banished from the nursery.

The frequent repetition of opening medicines, then, in any shape or form, very much interferes with digestion, they must, therefore, be given as seldom as possible.

Let me, at the risk of wearying you, again urge the importance of your avoiding, as much as possible, giving a babe purgative medicines. They irritate beyond measure the tender bowels of an infant, and only make him more costive afterwards, they interfere with his digestion, and are liable to give him cold. A mother who is always, of her own accord, quacking her child with opening physic, is laying up for her unfortunate offspring a debilitated constitution--a miserable existence.

For further information on this important subject see the 3d edition of _Counsel to a Mother (being the companion volume of Advice to a Mother)_, on the great importance of desisting from irritating, from injuring, and from making still more costive, the obstinate bowels of a costive child,--by the administration of opening medicine,--however gentle and well-selected the aperients might be. Oh, that the above advice could be heard, and be acted upon, through the length and the breadth of the land, how much misery and mischief would then be averted!

96. _Are there any means of preventing the Costiveness of an infant_?

If greater care were paid to the rules of health, such as attention to diet, exercise in the open air, thorough ablution of the _whole_ body--more especially when he is being washed--causing the water, from a large and well-filled sponge, to stream over the lower part of his bowels; the regular habit of causing him, at stated periods, to be held out, whether he want or not, that he may solicit a stool. If all these rules were observed, costiveness would not so frequently prevail, and one of the miseries of the nursery would be done away with.

Some mothers are frequently dosing their poor unfortunate babes either with magnesia to cool them, or with castor oil to heal their bowels! Oh, the folly of such practices! The frequent repetition of magnesia, instead of cooling an infant, makes him feverish and irritable. The constant administration of castor oil, instead of healing the bowels, wounds them beyond measure. No! it would be a blessed thing if a babe could be brought up without giving ham a particle of opening medicine; his bowels would then act naturally and well: but then, as I have just now remarked, a mother, must be particular in attending to Nature's medicines--to fresh air, to exercise, to diet, to thorough ablution, &c. Until that time comes, poor unfortunate babies must be, occasionally, dosed with an aperient.

97. _What are the causes of, and remedies for, Flatulence_?

Flatulence most frequently occurs in those infants who live on _artificial_ food, especially if they be over-fed. I therefore beg to refer you to the precautions I have given, when speaking of the importance of keeping a child for the first five or six months _entirely_ to the breast; and, if that be not practicable, of the times of feeding, and of the _best_ kinds of artificial food, and of those which are least likely to cause "wind."

_What to do._--Notwithstanding these precautions, if the babe should still suffer, "One of the best and safest remedies for flatulence is Sal volatile,--a tea-spoonful of a solution of one drachm to an ounce and a half of water" [Footnote: Sir Charles Locock, in a _Letter_ to the Author Since Sir Charles did me the honour of sending me, for publication, the above prescription for flatulence, a new "British Pharmacopoeia" has been published in which the sal volatile is much increased in strength it is therefore necessary to lessen the sal volatile in the above prescription one half--that is to say, a tea spoonful of the solution of _half_ a drachm to an ounce and a half of water.] Or, a little dill or aniseed may be added to the food--half a tea-spoonful of dill water Or, take twelve drops of oil of dill, and two lumps of sugar, rub them well in a mortar together, then add, drop by drop, three table-spoonfuls of spring water, let it be preserved in a bottle for use. A tea-spoonful of this, first shaking the vial, may be added to each quantity of food. Or, three tea-spoonfuls of bruised caraway-seeds may be boiled for ten minutes in a tea-cupful of water, and then strained. One or two tea-spoonfuls of the caraway tea may be added to each quantity of his food, or a dose of rhubarb and magnesia may occasionally be given.

Opodeldoc, or warm olive oil, well rubbed, for a quarter of an hour at a time, by means of the warm hand, over the bowels, will frequently give relief. Turning the child over on his bowels, so that they may press on the nurses' lap, will often afford great comfort. A warm bath (where he is suffering severely) generally gives _immediate_ ease in flatulence, it acts as a fomentation to the bowels. But after all, a dose of mild aperient medicine, when the babe is suffering severely, is often the best remedy for "wind."

Remember, at all times, prevention, whenever it be--and how frequently it is--possible, is better than cure.

_What NOT to do_--"Godfrey's Cordial," "Infants' Preservative," and "Dalby's Carminative," are sometimes given in flatulence, but as most of these quack medicines contain, in one form or another, either opium or poppy, and as opium and poppy are both dangerous remedies for children, ALL quack medicines must be banished the nursery.

Syrup of poppies is another remedy which is often given by a nurse to afford relief for flatulence; but let me urge upon you the importance for banishing it from the nursery. It has (when given by unprofessional persons) caused the untimely end of thousands of children. The medical journals and the newspapers teem with cases of deaths from mothers incautiously giving syrup of poppies to ease pain and to procure sleep.

98. _What are the symptoms, the causes, and the treatment of "Gripings" of an infant_?

_The symptoms._--The child draws up his legs; screams violently; if put to the nipple to comfort him, he turns away from it and cries bitterly; he strains, as though he were having a stool; if he have a motion, it will be slimy, curdled, and perhaps green. If, in addition to the above symptoms, he pass a large quantity of watery fluid from his bowels, the case becomes one of _watery gripes_, and requires the immediate attention of a doctor.

The _causes_ of "gripings" or "gripes" may proceed either from the infant or from the mother. If from the child, it is generally owing either to improper food or to over-feeding; if from the mother, it may be traced to her having taken either greens, or port, or tart beer, or sour porter, or pickles, or drastic purgatives.

_What to do._--The _treatment_, of course, must depend upon the cause. If it arise from over-feeding, I would advise a dose of castor oil to be given, and warm fomentations to be applied to the bowels, and the mother, or the nurse, to be more careful for the future. If it proceed from improper food, a dose or two of magnesia and rhubarb in a little dill water, made palatable with simple syrup. [Footnote:

Take of--Powdered Turkey Rhubarb, half a scruple; Carbonate of Magnesia, one scruple; Simple Syrup, three drachms; Dill Water, eight drachms;

Make a Mixture, One or two tea-spoonfuls (according to the age of the child) to be taken every four boors, until relief be obtained--first shaking the bottle.) If it arise from a mother's imprudence in eating trash, or from her taking violent medicine, a warm bath, a warm bath, indeed, let the cause of "griping" be what it may, usually affords instant relief.

Another excellent remedy is the following--Soak a piece of new flannel, folded into two or three thicknesses, in warm water, wring it tolerably dry, and apply as hot as the child can comfortably bear it to the bowels, then wrap him in a warm, dry blanket, and keep him, for at least half an hour, enveloped in it. Under the above treatment, he will generally soon fall into a sweet sleep, and awake quite refreshed.

_What NOT to do_--Do not give opiates, astringents, chalk, or any quack medicine whatever.

If a child suffer from a mother's folly in her eating improper food, it will be cruel in the extreme for him a _second_ time to be tormented from the same cause.

99. _What occasions Hiccup, and what is its treatment_?

Hiccup is of such a trifling nature as hardly to require interference. It may generally be traced to over feeding. Should it be severe, four or five grains of calcined magnesia, with a little syrup and aniseed water, and attention to feeding are all that will be necessary.

100. _Will you describe the symptoms of Infantile Diarrhoea_?

Infantile diarrhoea, or _cholera infantum_, is one of the most frequent and serious of infantile diseases, and carries off, during the year, more children than any other complaint whatever a knowledge of the symptoms, therefore, is quite necessary for a mother to know, in order that she may, at the proper tune, call in efficient medical aid.

It will be well, before describing the symptoms, to tell you how many motions a young infant ought to have a day, their colour, consistence, and smell. Well, then, he should have from three to six motions in the twenty four hours, the colour ought to be a bright yellow, inclining to orange, the consistence should be that of thick gruel; indeed, his motion, if healthy, ought to be somewhat of the colour (but a little more orange-tinted) and of the consistence of mustard made for the table; it should be nearly, if not quite, devoid of smell; it ought to have a faint and peculiar, but not a strong disagreeable odour. If it have a strong and disagreeable smell, the child is not well, and the case should be investigated, more especially if there be either curds or lumps in the motions; these latter symptoms denote that the food has not been properly digested.

Now, suppose a child should have a slight bowel complaint--that is to say, that he has six or eight motions during the twenty-four hours,--and that the stools are of a thinner consistence than what I have described,--provided, at the same time, that he be not griped, that he have no pain, and have not lost his desire for the breast:--What ought to be done?_Nothing_. A slight looseness of the bowels should _never_ be interfered with,--it is often an effort of nature to relieve itself of some vitiated motion that wanted a vent--or to act as a diversion, by relieving the irritation of the gums. Even if he be not cutting his teeth, he may be "breeding" them--that is to say, the teeth may be forming in his gums, and may cause almost as much, irritation as though he were actually cutting them. Hence, you see the immense good a slight "looseness of the bowels" may cause. I think that I have now proved to you the danger of interfering in such a case, and that I have shown you, the folly and the mischief of at once giving astringents--such as Godfrey's Cordial, Dalby's Carminative, &c.--to relieve a _slight_ relaxation.

A moderate "looseness of the bowels," then, is often a safety-valve, and you may, with as much propriety, close the safety-valve of a steam engine, as stop a moderate "looseness of the bowels!"

Now, if the infant, instead of having from three to six motions, should have more than double the latter number; if they be more watery; if they become slimy and green, or green in part and curdled; if they should have an unpleasant smell; if he be sick, cross, restless, fidgety, and poorly; if every time he have a motion he be griped and in pain, we should then say that he is labouring under Diarrhoea; then, it will be necessary to give a little medicine, which I will indicate in a subsequent Conversation.

Should there be both blood and slime mixed with the stool, the case becomes more serious; still, with proper care, relief can generally be quickly obtained. If the evacuations--instead of being stool--are merely blood and slime, and the child strain frequently and violently, endeavouring thus, but in vain, to relieve himself, crying at each effort, the case assumes the character of Dysentery. [Footnote: See Symptoms and Treatment of Dysentery.]

If there be a mixture of blood, slime, and stool from the bowels, the case would be called Dysenteric-diarrhoea. The latter case requires great skill and judgment on the part of a medical men, and great attention and implicit obedience from the mother and the nurse. I merely mention these diseases in order to warn you of their importance, and of the necessity of strictly attending to a doctor's orders.

101. _What are the causes of Diarrhoea--"Looseness of the bowels?"_

Improper food; overfeeding; teething; cold; the mother's milk from various causes disagreeing, namely, from her being out of health, from her eating unsuitable food, from her taking improper and drastic purgatives, or from her suckling her child when she is pregnant. Of course, if any of these causes are in operation, they ought, if possible, to be remedied, or medicine to the babe will be of little avail.

102. _What is the treatment of Diarrhoea_?

_What to do._--If the case be _slight_, and has lasted two or three days (do not interfere by giving medicine at first), and if the cause, as it probably is, be some acidity or vitiated stool that wants a vent, and thus endeavours to obtain one by purging, the best treatment is, to assist nature by giving either a dose of castor oil, or a moderate one of rhubarb and magnesia, [Footnote: For a rhubarb and magnesia mixture prescription, see page 71 (_note_).] and thus to work off the enemy. After the enemy has been worked off, either by the castor oil, or by the magnesia and rhubarb, the purging will, in all probability, cease; but if the relaxation still continue, that is to say, for three or four days--then, if medical advice cannot be procured, the following mixture should be given:--

Take of--Aromatic Powder of Chalk and Opium, ten grains; Oil of Dill, five drops; Simple Syrup, three drachms; Water, nine drachms;

Make a Mixture, [Footnote: Let the mixture be made by a chemist.] Half a tea-spoonful to be given to an infant of six months and under, and one tea-spoonful to a child above that age, every four hours--first shaking the bottle.

If the babe be at the breast, he ought, for a few days, to be kept _entirely_ to it. The mother should be most particular in her own diet.

_What NOT to do._--The mother must neither take greens, nor cabbage, nor raw fruit, nor pastry, nor beer; indeed, while the diarrhoea of her babe continues, she had better abstain from wine, as well as from fermented liquors. The child, if at the breast, ought _not_, while the diarrhoea continues, to have any artificial food. He must neither be dosed with grey-powder (a favourite, but highly improper Remedy, in these cases), nor with any quack medicines, such as Dalby's Carminative or Godfrey's Cordial.

103. _What are the symptoms of Dysentery_?

Dysentery frequently arises from a neglected diarrhoea. It is more dangerous than diarrhoea, as it is of an inflammatory character; and as, unfortunately, it frequently attacks a delicate child, requires skilful handling; hence the care and experience required in treating a case of dysentery.

Well, then, what are the symptoms? The infant, in all probability, has had an attack of diarrhoea--bowel complaint as it is called--for several days; he having had a dozen or two of motions