THE CARE OF INFANTS


XXI.

THE CARE OF INFANTS.


The topic of 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 it 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 disastrous 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
quantity 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 peculiarity irritable, (from teething,) it is of
paramount necessity to withhold all the nostrums which have been so
falsely 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 everything 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.