XXI.
THE CARE OF INFANTS.
THE topic this chapter may well be prefaced by an extract from
Herbert Spencer on the treatment of offspring. He first supposes that
some future philosophic speculator, examining the course of education of
the present period, should find nothing relating to the training of
children, and that his natural inference would be that our schools were
all for monastic orders, who have no charge of infancy and childhood. He
then remarks, "Is it not an astonishing fact that, though on the
treatment of offspring depend their lives or deaths and their moral
welfare or ruin, yet not one word of instruction on the treatment of
offspring is ever given to those who will hereafter be parents? Is is
not monstrous that the fate of a new generation should be left to the
chances of unreasoning custom, or impulse, or fancy, joined with the
suggestions of ignorant nurses and the prejudiced counsel of
grandmothers?
"If a merchant should commence business without any knowledge of
arithmetic or book-keeping, we should exclaim at his folly and look for
diastrous consequences. Or if, without studying anatomy, a man set up as
a surgeon, we should wonder at his audacity and pity his patients. But
that parents should commence the difficult work of rearing children
without giving any attention to the principles, physical, moral or
intellectual, which ought to guide them, excites neither surprise at the
actors nor pity for the victims."
"To tens of thousands that are killed add hundreds of
thousands that survive with feeble constitutions, and millions not so
strong as they should be; and you will have some idea of the curse
inflicted on their offspring, by parents ignorant of the laws of life.
Do but consider for a moment that the regimen to which children are
subject is hourly telling upon them to their life-long injury or
benefit, and that there are twenty ways of going wrong to one way of
going right, and you will get some idea of the enormous mischief that is
almost everywhere inflicted by the thoughtless, hap-hazard system in
common use."
"When sons and daughters grow up sickly and feeble, parents commonly
regard the event as a visitation of Providence. They assume that these
evils come without cause, or that the cause is supernatural. Nothing of
the kind. In some cases causes are inherited, but in most cases foolish
management is the cause. Very generally parents themselves are
responsible for this pain, this debility, this depression, this misery.
They have undertaken to control the lives of their offspring, and with
cruel carelessness have neglected to learn those vital processes which
they are daily affecting by their commands and prohibitions. In utter
ignorance of the simplest physiological laws, they have been, year by
year, undermining the constitutions of their children, and so have
inflicted disease and premature death, not only on them but also on
their descendants.
"Equally great are the ignorance and consequent injury, when we turn
from the physical to the moral training. Consider the young, untaught
mother and her nursery legislation. A short time ago she was at school,
where her memory was crammed with words and names and dates, and her
reflective faculties scarcely in the slightest degree exercised--where
not one idea was given her respecting the methods of dealing with the
opening mind of childhood, and where her discipline did not in the least
fit her for thinking out methods of her own. The intervening
years have been spent in practicing music, fancy work, novel-reading and
party-going, no thought having been given to the grave responsibilities
of maternity, and scarcely any of that solid intellectual culture
obtained which would fit her for such responsibilities; and now see her
with an unfolding human character committed to her charge, see her
profoundly ignorant of the phenomena with which she has to deal,
undertaking to do that which can be done but imperfectly even with the
aid of the profoundest knowledge!"
In view of such considerations, every young lady ought to learn how
to take proper care of an infant; for, even if she is never to become
the responsible guardian of a nursery, she will often be in situations
where she can render benevolent aid to others, in this most fatiguing
and anxious duty.
The writer has known instances in which young ladies, who had been
trained by their mothers properly to perform this duty, were in some
cases the means of saving the lives of infants, and in others, of
relieving sick mothers from intolerable care and anguish by their
benevolent aid.
On this point, Dr. Combe remarks, "All women are not destined, in
the course of nature, to become mothers; but how very small is the
number of those who are unconnected, by family ties, friendship, or
sympathy, with the children of others! How very few are there, who, at
some time or other of their lives, would not find their usefulness and
happiness increased, by the possession of a kind of knowledge intimately
allied to their best feelings and affections! And how important is it,
to the mother herself, that her efforts should be seconded by
intelligent, instead of ignorant assistants!"
In order to be prepared for such benevolent ministries, every young
lady should improve the opportunity, whenever it is afforded her, for
learning how to wash, dress,
and tend a young infant; and whenever she meets with such a work as Dr.
Combe's, on the management of infants, she ought to read it, and
remember its contents.
It was the design of the author to fill this chapter chiefly with
extracts from various medical writers, giving some of the most important
directions on this subject; but finding these extracts too prolix for a
work of this kind, she has condensed them into a shorter compass. Some
are quoted verbatim, and some are abridged, from the most approved
writers on this subject.
"Nearly one half of the deaths, occurring during the first two years
of existence, are ascribable to mismanagement, and to errors in diet. At
birth, the stomach is feeble, and as yet unaccustomed to food; its
cravings are consequently easily satisfied, and frequently renewed.At
that early age, there ought to be no fixed time for giving nourishment.
The stomach can not be thus satisfied.The active call of the infant is a
sign, which needs never be mistaken."
"But care must be taken to determine between the crying of pain or
uneasiness, and the call for food; and the practice of giving an infant
food, to stop its cries, is often the means of increasing its
sufferings. After a child has satisfied its hunger, from two to four
hours should intervene before another supply is given."
"At birth, the stomach and bowels, never having been used, contain a
quantitiy of mucous secretion, which requires to be removed. To effect
this, Nature has rendered the first portions of the mother's milk
purposely watery and laxative. Nurses, however, distrusting Nature,
often hasten to administer some active purgative; and the consequence
often is, irritation in the stomach and bowels, not easily subdued." It
is only where the child is deprived of its mother's milk, as the first
food, that some gentle laxative should be given.
"It is a common mistake, to suppose that because a woman
is nursing, she ought to live very fully, and to add an allowance of
wine, porter, or other fermented liquor, to her usual diet. The only
result of this plan is, to cause an unnatural fullness in the system,
which places the nurse on the brink of disease, and retards rather than
increases the food of the infant. More will be gained by the observance
of the ordinary laws of health, than by any foolish deviation, founded
on ignorance."
There is no point on which medical men so emphatically lift the
voice of warning as in reference to administering medicines to infants.
It is so difficult to discover what is the matter with an infant, its
frame is so delicate and so susceptible, and slight causes have such a
powerful influence, that it requires the utmost skill and judgment to
ascertain what would be proper medicines, and the proper quantity to be
given.
Says Dr. Combe, "That there are cases in which active means must be
promptly used to save the child, is perfectly true. But it is not less
certain that these are cases of which no mother or nurse ought to
attempt the treatment. As a general rule, where the child is well
managed, medicine, of any kind, is very rarely required; and if disease
were more generally regarded in its true light, not as something thrust
into the system, which requires to be expelled by force, but as an
aberration from a natural mode of action, produced by some external
cause, we should be in less haste to attack it by medicine, and more
watchful in its prevention. Accordingly, where a constant demand for
medicine exists in a nursery, the mother may rest assured that there is
something essentially wrong in the treatment of her children."
"Much havoc is made among infants, by the abuse of calomel and other
medicines, which procure momentary relief but end by producing incurable
disease; and it has often excited my astonishment, to see how recklessly
remedies of this kind are had recourse to, on the most trifling
occasions, by mothers and nurses, who would be horrified if they knew
the nature of the power they are wielding, and the extent of injury they
are inflicting."
Instead, then, of depending on medicine for the preservation of the
health and life of an infant, the following precautions and preventives
should be adopted.
"Take particular care of the food
of an infant. If it is nourished by the mother, her own diet should be
simple, nourishing, and temperate. If the child be brought up 'by hand,'
the milk of a new-milch cow, mixed with one third
water, and sweetened a little with
white sugar, should be
the only food given, until the teeth come. This is more suitable than
any preparations of flour or arrowroot, the
nourishment of which is too highly concentrated. Never give a child
bread, cake, or
meat, before the teeth appear.
If the food appear to distress the child after eating, first ascertain
if the milk be really from a new-milch cow, as it may
otherwise be too old. Learn, also, whether the cow lives on proper food.
Cows that are fed on still-slops,
as is often the case in cities, furnish milk which is very
unhealthful."
Be sure and keep a good supply of pure and fresh air in the nursery.
On this point, Dr. Bell remarks, respecting rooms constructed without
fireplaces and without doors or windows to let in pure air from without,
"The sufferings of children of feeble constitutions are increased beyond
measure, by such lodgings as these. An action, brought by the
commonwealth, ought to lie against those persons who build houses for
sale or rent, in which rooms are so constructed as not to allow of free
ventilation; and a writ of lunacy taken out against those who, with the
commonsense experience which all have on this head, should spend any
portion of their time, still more, should sleep, in rooms thus nearly
air-tight."
After it is a month or two old, take an infant out to walk, or ride,
in a little wagon, every fair and warm day;
but be very careful that its feet, and every part of its body, are kept
warm; and be sure that its eyes are well protected from the light. Weak
eyes, and sometimes blindness, are caused by neglecting this precaution.
Keep the head of an infant cool, never allowing too warm bonnets, nor
permitting it to sink into soft pillows when asleep. Keeping an infant's
head too warm very much increases nervous irritability; and this is the
reason why medical men forbid the use of caps for infants. But the head
of an infant should, especially while sleeping, be protected from
draughts of air, and from getting cold.
Be very careful of the skin of an infant, as nothing tends so
effectually to prevent disease. For this end, it should be washed all
over every morning, and then gentle friction should be applied with the
hand, to the back, stomach, bowels and limbs. The head should be
thoroughly washed every day, and then brushed with a soft hair-brush, or
combed with a fine comb. If, by neglect, dirt accumulates under the
hair, apply with the finger the yolk of an egg, and then the fine comb
will remove it all, without any trouble.
Dress the infant so that it will be always warm, but not so as to
cause perspiration. Be sure and keep its feet
always warm; and for this often
warm them at a fire, and use long dresses. Keep the neck and arms
covered. For this purpose, wrappers, open in front, made high in the
neck, with long sleeves, to put on over the frock, are now very
fashionable.
It is better for both mother and child, that it should not sleep on
the mother's arm at night, unless the weather be extremely cold. This
practice keeps the child too warm, and leads it to seek food too
frequently. A child should ordinarily take nourishment but twice in the
night. A crib beside the mother, with plenty of warm and light covering,
is best for the child; but the mother must be sure that it is always
kept warm.
Never cover a child's head, so that it will inhale the air of its
own lungs. In very warm weather, especially in cities, great pains
should be taken to find fresh and cool air by rides and sailing. Walks
in a public square in the cool of the morning, and frequent excursions
in ferry or steamboats, would often save a long bill for medical
attendance. In hot nights, the windows should be kept open, and the
infant laid on a mattress, or on folded blankets. A bit of straw
matting, laid over a feather bed and covered with the under sheet, makes
a very cool bed for an infant.
Cool bathing, in hot weather, is very useful; but the water should
be very little cooler than the skin of the child. When the constitution
is delicate, the water should be slightly warmed. Simply sponging the
body freely in a tub, answers the same purpose as a regular bath. In
very warm weather, this should be done two or three times a day, always
waiting two or three hours after food has been given.
"When the stomach is peculiarily irritable, (from teething,) it is
of paramount necessity to withhold all the nostrums which have been so
falsly lauded as 'sovereign cures for
cholera infantum.' The true restoratives for a child threatened
with disease are cool air, cool bathing, and
cool drinks of simple water, in addition to
proper food, at stated
intervals."
In many cases, change of air from sea to mountain or the reverse,
has an immediate healthful influence and is superior to every other
treatment. Do not take the advice of mothers who tell of this, that, and
the other thing which have proved excellent remedies in their
experience. Children have different constitutions, and there are
multitudes of different causes for their sickness; and what might cure
one child, might kill another, which
appeared to have the same complaint. A mother should go on the
general rule of giving an infant very little medicine, and then only by
the direction of a discreet and experienced physician. And there are
cases, when, according to the views of the
most distinguished and competent practitioners, physicians themselves
are much too free in using medicines, instead of adopting preventive
measures.
Do not allow a child to form such habits that it will not be quiet
unless tended and amused. A healthy child should be accustomed to lie or
sit in its cradle much of the time; but it should occasionally be taken
up and tossed, or carried about for exercise and amusement. An infant
should be encouraged to creep,
as an exercise very strengthening and useful. If the mother fears the
soiling of its nice dresses, she can keep a long slip or apron which
will entirely cover the dress, and can be removed when the child is
taken in the arms. A child should not be allowed, when quite young, to
bear its weight on its feet very long at a time, as this tends to weaken
and distort the limbs.
Many mothers, with a little painstaking, succeed in putting their
infants into their cradle while awake, at regular hours for sleep; and
induce regularity in other habits, which saves much trouble. During this
training process a child may cry, at first, a great deal; but for a
healthy child, this use of the lungs does no harm and tends rather to
strengthen than to injure them, unless it becomes exceedingly violent. A
child who is trained to lie or sit and amuse itself, is happier than one
who is carried and tended a great deal, and thus rendered restless and
uneasy when not so indulged.
The most critical period in the life of an infant is that of
dentition or teething, especially at the early stages. An adult has
thirty-two teeth, but young children have only twenty, which gradually
loosen and are followed by the permanent teeth. When the child has ten
teeth on each jaw, all that are added are the permanent set, which
should be carefully preserved; this caution is needful, as sometimes
decay in the first double teeth of the second set are supposed to be of
the transient set, and are so neglected, or are removed instead of being
preserved by plugging.
When the first teeth rise so as to press against the gums, there is
always more or less inflammation, causing nervous fretfulness, and the
impulse to put every thing into the mouth. Usually there is disturbed
sleep, a slight fever, and greater flow of saliva; this is often
relieved by letting the child have ice to bite, tied in a rag.
Sometimes the disorder of the mouth extends to the whole system. In
difficult teething, one symptom is the jerking back of the head when
taking the breath, as if in pain, owing to the extreme soreness of the
gums. This is, in extreme cases, attended with increased saliva and a
gummy secretion in the corners of the eyes, itching of the nose, redness
of cheeks, rash, convulsive twitching of lips and the muscles generally,
fever, constipation, and sometimes by a diarrhea, which last is
favorable if slight; difficulty of breathing, dilation of the pupils of
the eyes, restless motion and moaning; and finally, if not relieved,
convulsions and death. The most effective relief is gained by lancing
the gums. Every woman, and especially every mother, should know the time
and order in which the infant teeth come, and, when any of the above
symptoms appear, should examine the mouth, and if a gum is swollen and
inflamed, should either have a physician lance it, or if this can not be
done, should perform the operation herself. A sharp pen-knife and steady
hand making incision to touch the rising tooth will cause no more pain
than a simple scratch of the gum, and usually will give speedy relief.
The temporary teeth should not be removed until the new ones appear,
as it injures the jaw and coming teeth; but as soon as a new tooth is
seen pressing upward, the temporary tooth should be removed, or the new
tooth will come out of its proper place. If there is not room where the
new tooth appears, the next temporary tooth must be taken out. Great
mischief has been done by removing the first teeth before the second
appear, thus making a contraction of the jaw.
Most trouble with the teeth of young children comes from neglect to
use the brush to remove the tartar that accumulates near the gum,
causing disease and decay. This disease is sometimes called
scurvy, and is shown by an
accumulation around the teeth and by inflamed gums that bleed easily.
Removal of the tartar by a dentist and cleaning the teeth after every
meal with a brush will usually cure this evil which causes loosening of
the teeth and a bad breath.
Much injury is often done to teeth by using improper tooth-powder.
Powdered chalk sifted through muslin is approved by all
dentists, and should be used once every day. The tooth-brush should be
used after every meal, and floss silk pressed between the teeth to
remove food lodged there. This method will usually save the teeth from
decay till old age.
When an infant seems ill during the period of dentition, the
following directions from an experienced physician may be of service. It
is now an accepted principle of all the medical world that fevers are to
be reduced by cold applications; but an infant demands careful and
judicious treatment in this direction; some have extremely sensitive
nerves, and cold is painful. For such, tepid sponging should be used
near a fire, and the coldness increased gradually. The sensations of the
child should be the guide. Usually, but not always, children that are
healthy will learn by degrees to prefer cold water, and
then it may safely be used.
When an infant becomes feverish, wrapping its body in a towel wrung
out in warm or tepid water, and then keeping it warm in a
woolen blanket, is a very safe and soothing remedy.
In case of constipation this preparation of food is useful:
One table-spoonful of unbolted flour wet with
cold water. Add one pint of hot water, and boil
twenty minutes. Add when taken up, one pint of milk. If the
stomach seems
delicate and irritable, strain out the bran, but in most cases retain
it.
In case of diarrhea, walk with the child in arms a great deal in the
open air, and give it rice-water to drink.
The warmth and vital influences of the nurse are very important, and
make this mode of exercise both more soothing and more efficacious,
especially in the open air, the infant being warmly clad.
In case of feverishness from teething or from any other cause, wrap
the infant in a towel wrung out in tepid water and then
wrap it in a woolen blanket. The water may be cooler
according as the child is older and stronger. The evaporation of the
water draws off the heat, while the moisture soothes the
nerves, and usually the child will fall into a quiet sleep. As soon as
it becomes restless, change the wet towel and proceed as before.
The leading physicians of Europe and of this country, in all cases
of fevers, use water to reduce them, by this and other
modes of application. This method is more soothing than any other, and
is as effective for adults as for infants.
Some of the most distinguished physicians of New-York who have
examined this chapter give their full approval of the advice given. If
there is still distrust as to this mode of using water to reduce fevers,
it will be advantageous to read an address on the use of cold
applications in fevers, delivered by Dr. William Neftel, before the
New-York Academy of Medicine, published in the
New-York Medical Record for
November, 1868: this can be obtained by inclosing twenty cents to the
editor, with the post-office address of the applicant.
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