YOUR BABY E.B. LOWRX M.D. Class Book GqpghtN! COPYRIGHT DEPOSIT. YOUR BABY BY THE SAME AUTHOR HERSELF Talks with Women Concerning Themselves $1.00 HIMSELF Talks with Men Concerning Themselves $1.00 CONFIDENCES Talks with a Young Girl Concerning Herself 50 cts. TRUTHS Talks with a Boy Concerning Himself 50 cts. FALSE MODESTY 50 cts. TEACHING SEX HYGIENE 50 cts. THE HOME NURSE $1.00 YOUR BABY A Guide for Young Mothers BY EDITH B. LOWRY, M.D. Author of "Herself," "The Home Nurse, ' ' etc. CHICAGO FORBES & COMPANY 1915 COPYRIGHT, I9I5, BY FORBES AND COMPANY 7 1915 ©CI.A414657 PREFACE It is estimated that nearly half the babies born into this world die before they are a year old. Statistics prove that the great majority of these die of some intestinal trouble, that their deaths might have been prevented by proper care, especially in re- gard to feeding. The mothers of these babies could not be blamed for this lack of intelligent care, for they gave the best they knew how to give. The blame lies deeper, for the mothers never had received any training for their very important work of motherhood. In some countries every able-bodied man is re- quired to serve three years of military service. In this way the country hopes, in time of war, to be prepared with efficient men to protect its inhabitants and their homes. Some one has suggested that, to prepare for the protection of the future generation in time of peace, women should be required to pass through a period of training lasting just as long, but devoting themselves to the study of the care of children, hygiene and nursing. Even women who never become mothers themselves, in this way, PREFACE would learn the general principles of psychology, hygiene and the care of the sick, which they might make use of in any station of life. Medical certifi- cates regarding the capacity for marriage certainly are of more importance than those for military serv- ice. Many untrained individuals have wrong ideas concerning what constitutes proper care of children. They are liable to go to one of two extremes. Either they are over-indulgent or they are too severe. The one disregards all rules of hygiene and refuses to conform to any regulations " because the baby does not want it." The undeveloped child is al- lowed to eat and sleep when it pleases, to follow its own caprice in all matters without regard to the effect upon its health or without consideration for the remainder of the family. The other extremist is over-anxious concerning every detail of the child's life. The over-watched child is not allowed to drink one drop more than the rules prescribe. A variation of a few minutes in its hours of sleeping is watched with concern. The baby is wrapped and toasted and kept so like a hothouse flower that it does not develop any power of resistance. One of these extremes is as bad as the other. A great deal of judgment and common sense, with a foundation of knowledge, is necessary for the proper care of PREFACE babies. It sometimes is a matter of surprise that young mothers do not make more mistakes, con- sidering their lack of training and experience. In no other line of work do we throw such great re- sponsibilities upon the untrained worker. It is strange that in our great system of public education no provision is made to train girls for their great work in life. There is no reason why the proper care of babies should not be a required study in school. It certainly would be of much more prac- tical and economic benefit in later life than many of the subjects that now are required. The present-day mothers who realize how handi- capped they are by lack of knowledge of babies, should insist that their daughters do not suffer from the same lack. Whatever the mothers of the coun- try demand should be taught in the schools will be placed in the curriculum. But for those young mothers who have passed be- yond the school age before the needed changes in education have taken place, this little book is sent forth with the hope that it may aid many a young mother to bring up her child to its rightful heritage of health and happiness. CONTENTS PART I THE MOTHER IAPTER PAGE I The Well Born Child 17 Preparing for the child. — Heredity. — Prenatal influences. — The sex of the baby. II When Hopes Become Real 29 Symptoms of Pregnancy. — Probable date of labor. — Engaging the physician and nurse. III Painless Childbirth 34 Twilight Sleep. IV The Necessary Preparations 54 What to prepare for baby. — The maternity outfit. V Care of the Prospective Mother 62 Clothing. — Exercise and work. — The necessity of daily bathing. — Breasts and nipples. — Rest and sleep. — The teeth. — Diet. — The bowels. — Sewing for the baby. — Mental condition. VI Accidents and Incidents of Pregnancy ... 75 Nausea and vomiting. — Sleeplessness. — Fainting. — Constipation. — The kidneys. — Swelling of the legs and feet. — Irritability of the bladder. VII The Period of Labor 82 What to do when labor commences. — What to take to the hospital. — Child bed fever. — After care of the patient. CONTENTS CHAPTER PAGE VIII The Young Mother 91 General care. — Exercise for the mother. — The mother's rest. — Nursing the baby. — To increase the milk. — Bone forming diet. PART II THE BABY IX First Care of the Baby 107 The first thing to be done. — To prevent blindness. — Care of the mouth. — The cord. — The first bath. — Dressing the baby. X Weight, Growth and Development . . . .119 The weight of the baby. — What the baby knows when it is born. — What the baby learns the first year. — What the baby learns the second year. XI General Care of the Baby 129 The baby's tub bath. — Sex toilet. — Powdering the baby. — The baby's sleep. — The baby's rest. — Baby's bed. — Exercise for the baby. — Fresh air for the baby. — Care of the teeth. — Shoes for the baby. — The night clothes. — Diapers. — How long should baby wear bands. XII What, When and How to Feed the Baby . . 154 The best food for baby. — Modified milk. — Sugar in the baby's milk. — Supplementary feeding for the baby.— The older baby. — Selecting the baby's bottle and nipple. — Do not feed too much. — Care of the baby's bottle. — Water for the baby. — Teas and soothing syrups. — Beware of these baby killers. — Weaning the baby. — The older child. XIII Intestinal Disorders 176 Constipation. — Massage for constipation. — Sum- mer diarrhoea. — Colic. CONTENTS CHAPTER PAGE XIV Some Common Disorders 186 Jaundice of the new born. — Night terrors. — Bed wetting. — Spina bifida. — Thumb sucking habit. — Eczema. — Sleeplessness. — Birth marks. — Stuttering. — Ear ache. — Cross eyes. — ■ Holding breath spells. — Knock knees, pigeon toes. — Bow legs. XV Accidents and Diseases of Childhood . . .207 When baby has croup. — Colds. — Pneumonia. — Measles. — . Mumps. — Whooping cough. — Scar- let fever. — When baby becomes burned. — Be careful of drugs. — Look twice before giving any medicine. — Do not keep unlabeled bottles. XVI The Discipline of Children 227 How to spoil the baby. — The secret of discipline. — Suggestion during babyhood. — Training chil- dren while they sleep. — Habits of regularity. — Fear in children. PART I — THE MOTHER The bearing and training of a child Is woman's wisdom. Tennyson. YOUR BABY PART I — THE MOTHER CHAPTER I THE WELL BORN CHILD It is safe to say that until recently few people had any definite idea of what was meant by the science of eugenics. By some it was looked upon as a passing fad which soon would run its course and be forgotten. Recently, though, the real mean- ing of the word has been so brought to the attention of the general public that now nearly every one has some opinion on this vast subject. Sir Francis Galton, who coined the word " eu- genics," defined it as " the science which deals with all influences that improve the inborn qualities of the race." We know that farmers have found it necessary not only to attend to the growing plants but to select the seeds from which they are grown, 17 YOUR BABY and that stock raisers have found it necessary to give strict attention to breeding in order to improve the quality of the domestic animals. Considering these two facts, thinking people have come to the conclusion that it is necessary to give some thought to the conditions surrounding the birth of children. Every child lias a right to be well born, to have a birthright of good health, freedom from inherited taints and to be endowed with an unblemished brain and nervous system. Any one who deprives a child of this heritage should be treated as a criminal. Preparing for the Child The preparations for the birth of a child should commence several generations before its conception. As it is impossible for us to regulate the lives of our ancestors the best we can do is to commence with the present generation. Young men and women should be impressed with the fact that while so-called social position should not be of great weight in the selection of a mate, yet the mental and physical condition of the ancestors of the future husband or wife should be considered, for feeblemindedness and some diseases are transmis- sible by inheritance. One should investigate the 18 THE WELL BORN CHILD quality of the family into which he or she is marry- ing. Every child has a right to be well born. An un- desired child never should be brought into the world. An undesired child, or a child of parents who are not in good bodily or mental condition comes into the world with an inheritance that perhaps never is overcome. Heredity The question of heredity has received considerable attention during recent years. As a result, many of our old time theories have undergone a decided change. Many of the diseases that formerly were thought to be acquired through inheritance we now know to be contracted through lack of care or through association. The only inheritance is pos- sibly a tendency to a disease and a diminished power of resistance. It is a law of pathology that the dis- eases of the parents, who suffer from certain serious, chronic maladies, create in the offspring a condition of defective life shown in malformations or in al- tered nutrition. The hereditary influence of most diseases is shown in the transmission to the child of a defective body shown by feebleness or a diminished power of resisting disease. 19 YOUR BABY Tuberculosis, which once was considered hered- itary, now is known to be transmitted by a germ which may be found in the sputum or expectoration of the patient. It is not well for a person with tuberculosis to bear children, for the child of such a parent probably would inherit a weak constitution which would make it a ready prey to the disease. Then, if it were constantly associated with one who has tuberculosis, it probably would become a victim of the disease. There is one disease, known as one of the social .diseases, which is truly inherited. This disease. syphilis, may be inherited from either parent. In many cases the disease is transmitted by the father when the mother escapes infection. The inheritance seems to manifest itself chiefly in a disordered nutri- tion. Even during the first few months of develop- ment, this may be so effective as to destroy life. If life is not destroyed, the nutritional processes may be so affected that the pregnancy will result in the birth of a defective child. These children, perhaps fortunately, usually die during the first few months of their lives. Seldom do they live to maturity. Many children who seem to have escaped this in- herited trait really have not done so, but their in- heritance is not recognized. Some individuals with 20 THE WELL BORN CHILD defective generative organs owe this to a diseased parent. Others suffering from a chronic skin dis- order, and many afflicted with epilepsy or some brain malformation could trace their inheritance to the same source. Prenatal Influences Heredity is that law by which permanent and set- tled qualities of the parent, or of some remote an- cestors, reappear in the child. But other forces than heredity are at work, too, and these forces which modify heredity are called prenatal. The manner by which the influence is produced by the father is obscure but the seed seems stamped with the imprint of his temporary condition of mind or body so that these qualities also have a place in determining the character of the offspring. The children of drunken fathers often are degenerates. It is a well known fact that certain mental condi- tions influence the physical body. Fear has turned hair white and anger has caused apoplexy. If fear and anger have such disastrous effects on the human body, love and happiness may be expected to have just the opposite effects. The unborn child is nourished directly from the mother's blood. If the mother's mental condition 21 YOUR BABY can affect her own physical body, it is logical to ex- pect that her mental condition can affect that which is a part of her, namely her unborn child. A woman, who does not desire children and who, when she finds one is inevitable, rebels and, in her heart, longs for an accident to happen to it, certainly does not give the child an enviable impression. The ancient Greeks surrounded the prospective mother with beautiful paintings and statues so as to give a mental impression of beauty to the future genera- tion. They were noted as a beautiful race. The expectant mother should give her child all possible advantages of a good mental impression, and, during its prenatal life, the mother should think nothing but loving and wholesome thoughts. She should train her mind in habits that she wishes to impress upon the child. She should cul- tivate habits of system, she should cultivate a cor- rect taste and ear for music. Her surroundings should be artistic but simple. She should live as close to Nature as possible. The mother's own physical health cannot help but affect her child ; therefore the mother should take those measures that will promote the health of her body. In ancient Sparta the women exercised in the gymnasium in order to obtain the highest pos- THE WELL BORN CHILD sible bodily vigor in preparation for the function of motherhood. The Spartans were noted as a race of exceptionally strong men. But the mother should be careful not to take any violent exercise during the prenatal period. Swimming and walking are two of the best general exercises that can be taken. Housework, with the exception of the heavy lifting and scrubbing, is a valuable exercise. The expectant mother needs a large amount of fresh air, so she should plan to spend several hours a day in the open air. It is well for her to sleep out-of-doors, if pos- sible, otherwise she should sleep in a room with wide open windows. The influence of the health, occupations, desires and thoughts of the expectant mother upon her un- born child cannot be overestimated. At what period the greatest influence is exerted only can be a mat- ter of conjecture. Some who have given this matter considerable thought have decided that during the first three months of the embryo the laws for phys- ical perfection are especially in force. Students of embryology know that during this period there are the greatest structural changes and that by the end of this period the body is practically perfect, only waiting to be developed and strengthened. There- fore these scientists have deducted that it is the in- 23 YOUR BABY fiuence of the first three months that impresses fu- ture physical integrity, although this theory has not been proven. According to this the mother who is strong and well during the first three months of her pregnancy will produce a child well formed and full of endurance, while the overworked mother produces a child who is ever tired and who has little strength of resistance. Hence the expectant mother always should stop working before she has reached the point of fatigue. She never should become tired. The entire period of pregnancy should be a period of increased mental and physical vigor just as it was in primitive days. From the moment that pregnancy is suspected it is the bounden duty of every woman to take intelligent care of herself and to strive by every means in her power to secure for her baby its birthright of health. And it is the bounden duty of her husband to urge her to do so and to give her his intelligent care. As soon as she is aware of her condition, if she has not done so before, the expectant mother should go to her family physician and have a thorough physical examination and then proceed to correct any abnormal conditions. It is very common for young women who have stood long hours day after day in the school room, 24 THE WELL BORN CHILD store or office to have some displacement or inflam- mation of the uterus which seriously affects their general health. Every one of these disorders is liable to become accentuated during pregnancy if not corrected in the beginning. Not long ago I had occasion to examine a young wife who had exces- sive vomiting following conception. An examina- tion revealed considerable inflammation which re- sponded readily to proper treatment, and the young expectant mother soon found herself in much better health than she had been for a long time. It is much better to give some care to placing the body in per- fect health at the beginning of this period than it is to suffer from avoidable troubles for many months. The second three months of the unborn child are considered by some to be the period during which the mental capacity of the child is influenced ; there- fore during this period the mother should be mod- erately active intellectually. The last three months have been considered to be the moral prenatal period. A woman's enthusiasm during the entire nine months should be shared and appreciated by her hus- band. Probably the fact that it is not is the cause of the silence and misunderstanding in so many homes. The mental condition of both the father and 2 5 YOUR BABY mother some little time before conception also helps to determine the character of the offspring. The Sex of the Baby Statisticians tell us that the sexes are practically equal in number, taking the world as a whole. They sometimes advance this as proof that Nature ar- ranges matters quite as they should be, and that in- terference on our part is unnecessary. Some even go so far as to say that human interference on our part would be interference with God's plans. This reasoning, however, does not appeal to intelligent people. God or Nature, whichever one may choose to call it, has given us intelligence with which to over- come harmful natural laws, and it is our privi- lege as well as our duty, to use that intelligence to preserve harmony in any given condition, — in this of sex as well as in all others. God has given us laws of gravitation, laws of heat and cold, laws of health and disease, laws of pro- creation. Does a man, therefore, not try to sup- port his roof? Does he not artificially warm his house? Does he not bear upon disease the knowl- edge of medical science? Shall he then blindly obey the wild law of procreation, seeking to bring no light upon this one paramount law of life? It is 26 THE WELL BORN CHILD said that the great superfluity of female births in civilized countries is due to the inertia of the parents, through the unhygienic laws of our social life, and that this is true not only of human beings but also of domestic animals. This may not be correct, but cer- tainly there is some subtle reason for this inequality of the sexes, and if science should discover a way to adjust matters in such a manner as to bring about equality, it will be better for the world. There are a great many theories in regard to the determination of the sex of the baby. One is that the diet of the mother before conception has con- siderable influence. It is claimed that in times of plenty there are more girls than boys born. As proof of this it is instanced that following the Siege of Paris nearly all babies born were boys. Another example is that bees feed the larvae especially when they wish a queen bee. The time of the month at which conception takes place is considered by others to have an influence upon the sex of the offspring. If conception takes place soon after the cessation of menstruation, the child is more liable to be a girl, while if it takes place just before a menstrual period the child is liable to be a boy. Mental impressions are considered by some to 27 YOUR BABY have an influence in determining the sex. The ancient women gazed at statues of Hercules or of the God Apollo when they wished a male child. The Bible story of Jacob and the peeled rods placed before the sheep when they came to drink is given as another instance in proof of mental impression. The determination of the sex of the baby before birth is at most only a conjecture. There is no positive way in which one can predict whether the coming baby is a girl or a boy. We frequently hear that the size of the abdomen may be taken as a guide, but this is not true, for the size of the ab- domen varies with the amount of liquor amni (water in which the baby floats), the condition of the mus- cles, and with the number of offspring. Twins may account for an unusual size to the abdomen. By the aid of a stethoscope a physician can count the foetal heart beats and their rate is a fair guide to ascertaining sex, for boy babies, as a rule, have a slower pulse rate than girls. 28 CHAPTER II WHEN HOPES BECOME REAL The first question that occurs to the prospec- tive mother is what are the signs and symptoms, the natural accompaniments of her condition. Symptoms of Pregnancy Some of the symptoms of pregnancy are the sup- pression of the menses (monthlies) with morning sickness sometimes accompanied by nausea and vomiting at different periods of the day. Usually there is a darkening of the areola (brown ring sur- rounding the nipple). Later there will be an en- largement of the abdomen. There may be an in- ability of the bladder to retain the urine, and later a secretion of milk in the breasts. One of the more significant signs which occurs about the fourth or fifth month of pregnancy is "quickening" or the feeling of life. This usually is described as the sensation of fluttering. 29 YOUR BABY Probable Date of Labor The average duration of the period of waiting for the expectant mother is nine calendar or ten lunar months. To find the probable date of confinement, count back three months from the date of the close of the last menstrual period and to this date add seven days. For example, if the last menstrual period ended December seventh, we count back three months which gives us September seventh, then adding seven days we have September fourteenth as the probable date of confinement. With the first child, confinement may come a week or two early. When the date of the last period is not known, the best method is to reckon from the first time move- ment is felt, or from the period of quickening. This occurs about the seventeenth week, so if we count four and a half months from this date we are nearly correct. Of course the date obtained by either method is not absolutely correct but usually it is within a week of the exact date. Engaging the Physician and Nurse As soon as the expectant mother is aware of her condition she should engage the physician and nurse. It is well to consult with the former before engag- ing the latter, for the physician has a good oppor- 30 WHEN HOPES BECOME REAL tunity to be able to judge of the qualifications of the nurse. Many a nurse is excellent in certain classes of cases but unsatisfactory in others. The obstetric nurse needs to be especially fitted for this work; for she will have two patients instead of one, and it depends upon her to a great extent whether the care of the baby is to be a pleasure or a great burden to the young mother. The first ten days of a baby's life are the most important of its existence. During this ten days, habits are established that it will take months to change. If the baby is started right, its care will not be a burden. A baby can be so spoiled during this first ten days that it will de- mand almost constant attention day and night. If it is held in the arms very much during this time it will demand the same treatment later, but if dur- ing this time it is put to sleep, as it should be, in a separate bed and left undisturbed between feedings it becomes accustomed to these regular habits and the mother will find that the later care is much easier. During this first ten days, regular hours for feeding should be established and the baby should be trained to require little attention at night. The mother needs her rest at night in order to be strong enough to furnish good milk for her baby and give it the proper care. The thoroughly qualified ob- 3i YOUR BABY stetric nurse takes pride in establishing right habits for the baby and it is she who is largely responsible for the kind of habits formed by the baby. So it becomes very important to engage the right nurse for this very important period. Physicians, also, vary in their ability on these cases. Some physicians make a specialty of this obstetrical work, while others avoid it as much as possible because they prefer to give their energies to other lines of practice. So it is important for the expectant mother to inquire carefully in regard to the physician engaged for this event. At the first consultation, the physician should make a thorough examination to determine if there is any deformity, or any condition that needs cor- rection. At this time, also, he will give her general directions as to her care. From this time on she should report to the physician at least once a month so that he may keep a close watch of her general health. At each of these visits, she should take with her a specimen of urine to be examined. This urine should be the first that is passed in the morning and should be placed in a bottle that has been boiled previously. By an examination of the urine, the physician can determine the condition of the kidneys, which quite frequently are affected during this 32 WHEN HOPES BECOME REAL period. If he finds any deviation from the normal he can correct it before it has proceeded far enough to cause serious trouble. Many cases of eclampsia, or convulsions, might thus have been avoided. All during the nine months the expectant mother should consider her physician as her chief adviser. Whenever any question comes up that affects her health or the health of her child she should ask his advice rather than that of the various women in the neighborhood, many of whom, though well meaning, have entirely wrong ideas and may give the wrong advice. Just because a woman has had several children does not make her competent to ad- vise others, for she may have given her own children such improper care that several of them died or were sickly. Over half the deaths among babies are due to improper care. At any time that the mother notices any unusual occurrence or symptoms she should consult the physician at once. The office of a physician should be that of a trusted adviser, and during this period of a woman's life she should feel free to consult with him whenever she desires. There are many disturbances of the general health which may be cor- rected by a little care, perhaps only a regulation of the diet will be necessary. 33 CHAPTER III PAINLESS CHILDBIRTH Much of the pain and danger incident to child bearing can be prevented if the mother is given proper care both before and during labor. The early care seems to have been overlooked to a great extent. In these days of modern surgery and anti- septic measures it is possible to do many things that would have been hazardous a few years ago. In some cases of deformed pelvis where it would be impossible to give birth to a living child at full term, it is possible by the induction of premature labor or Cesarean section to save the child without added danger to the mother, yet these wonderful feats con- cern only a few women. The simple laws of hygiene are more important to the majority. Childbirth is a natural process and should be at- tended with little pain or danger. Yet many women are made invalids for life from lack of proper care both before and after this event. To get up im- 34 PAINLESS CHILDBIRTH mediately after labor may seem very wonderful. We wonder at, perhaps admire, the squaw who picks up her newly born babe and follows the trail. When we come to know more about these women we find no reason to emulate them. They are harmed by their customs. Many die. Practically all have permanent disorders. When we come to know all the facts, we find nothing left to commend except the stoicism with which they endure the harm resulting from their bad methods. The changes undergone by a woman during the weeks after labor are far reaching. Consider one — the abdominal muscles which have been stretched for months. In order that these muscles shall get back to where they were before, they must have care. A few days of planned exercises and care will ac- complish much. Work does not accomplish the purpose. Many women consider that the services of a physi- cian are needed only at the time of labor, yet this really is only a small part in comparison with the care needed before and after. The various " nat- ural " healers achieve their success in painless childbirth because of the fact that the expectant mother is prepared properly for the interesting event. 35 YOUR BABY Normal Childbirth Childbearing is a perfectly natural function of the female body and should, therefore, be performed as healthily and as easily as any other regular duty, but we cannot expect childbirth to be a normal or an easy feat if the body is feeble and lacking in tone any more than we would expect a machine to stand a great strain if it had been allowed to become rusty and weak in parts instead of being well oiled and kept in good repair. By some lack of logic that is precisely what we do. We demand that the doctors give us birth without pain instead of being willing to plan our lives so as to obtain the greatly desired conditions. We expect our bodies, the most wonderful of machines, to be ready for a great strain, as in child- birth, without giving them the proper attention. We neglect them from childbirth and then expect them to be in such good working order that they will respond to an exertion without pain. Just as reasonable would it be to expect a man who had neg- lected all physical training to be able to run a Mara- thon race without having any bad after effects. The whole tendency of modern industrialism is to place too heavy a burden on the nervous system of 36 PAINLESS CHILDBIRTH all classes, men and women alike. The most serious results are from the undue nervous strain from economic pressure which is placed on the growing girl at the period of adolescence when the child has to assume the burden of self-support and self-direc- tion that in many cases overtaxes her system and unfits her for future motherhood. During the period of development there are great changes taking place in the girl's system. This change and development requires considerable of the girl's strength and naturally influences her nervous system. This lessens the amount of energy that can be spared to outside interests. Seldom do we rec- ognize this fact. As a rule, too much work is re- quired in school at this age. The school duties should be lessened and the girl allowed to rest on the days when Nature requires an extra amount of energy. The girl at this age should not attempt as much work as a boy does. Her time at this period might be better occupied in learning the rudiments of housekeeping and homemaking. Then, when her body has become better developed, her strength can be spared and can be well used in the development of her mind. If the nervous strain too common at this age could be relieved we would have fewer in- 37 YOUR BABY valided women, less pain and trouble at childbirth, and a healthier and happier posterity. If a girl in the business world is entrusted with a delicate piece of machinery, she is taught the struc- ture, use and care of it. Why is it not just as im- portant that the girl who is entrusted with the care of delicate mechanism upon whose condition depends the health of the future generation be instructed re- garding the care of these organs? Instead she is left in absolute ignorance and then blamed if she mars them. A girl upon marriage is expected to learn many things by instinct. When she is en- trusted with the care of her first born she is ex- pected to know how to care for it. But does she ? In all affairs of business we consider well spent any time, energy or money that is used in gaining better or more modern methods. We do not say, " My father and grandfather did that way and they got along all right, so I guess their ways are good enough for me to follow." Yet babies can come by chance and be brought up by instinct in old-fash- ioned ways that leave a train of sightless eyes and mutilated women. Fortunately this is a woman's age, and women are awakening to the fact that they have been suffering unnecessarily; that many of their aches and pains 38 PAINLESS CHILDBIRTH were not due to Providence but to a lack of knowl- edge of the laws of hygiene and sanitation. Their experience in business, in the stores and offices, has taught them the necessity of preparation for any work. A large proportion of the lives of the majority of women is spent in homemaking and the bearing and rearing of children. It is more necessary that a woman be prepared for this, her life work, than that she be prepared for a temporary position in an office or school, a position which she seldom keeps for more than a few years, after which she takes up her real life work. A woman who tries to guide her household, educate her children, or take her proper place in society without adequate education along these lines is like a man who attempts to run his business blindfolded. The result is a partial, if not an absolute, failure instead of the success and hap- piness that should be the heritage of every woman. Compared with the school life of their grand- mothers, the training of the girls of the present age is entirely different, but the pendulum has swung a little too far. In our eagerness to train the girls for their part in the business life, we have been in- clined to neglect the training for the other part of life — that of homemaker and mother. 39 YOUR BABY The proper method of feeding babies is more im- portant for many girls to know than many of the things now taught in our public schools. The keep- ing of household accounts is the best of arithmetic for these girls. The care of their own bodies and a respect for themselves is necessary if we do not wish to see young girls painted and dressed as the demimonde, and nervous systems ruined for future motherhood. Every girl before leaving school should have some training for her future work of motherhood. The introduction of domestic science into the curriculum of the public schools is one of the great milestones of educational advancement. Correlated with the instruction in cooking, sewing and the general care of the home should come the care of those very important members of the home — the babies — and each girl should be taught the care of her own health so that she might be properly prepared for motherhood. A normal woman, who has not become imbued with false ideas and fears, desires children. She realizes that motherhood in its highest form is a privilege and not a curse. It is the woman who has been falsely educated who dreads motherhood. Re- cently I received a letter which shows the prevailing attitude of many girls. The writer says : 40 PAINLESS CHILDBIRTH " I am twenty-two years of age, but strange to say I am ignorant as far as the knowledge of the origin of life is concerned. I am a business girl drawing a good salary and have many friends. I am the oldest child of a large family of moderate means, and have been brought up under Christian principles and possess a goodly amount of common sense. I have no desire to be a married woman for a long time to come. I shudder on account of fear to think of becoming a mother. I hear so much of woman's pains and aches that I often think I would prefer to remain single all- my life, although I am perfectly healthy and a happy, cheerful girl. My mother is, and always will be, too busy to tell me about such matters, although I had a right to know long ago." This letter indicates that the writer has an abun- dance of common sense, but the pity is that she has become over-impressed with the possibilities of pain and never has been told the wonderful truths that would overcome fear. If love is the greatest thing in the world, fear and its companion worry certainly are the greatest curses of humanity. And the most piti ful part is that this fear and worry usually result from ignorance which a little instruction at the right time could dispel so easily. It is the unknown and 41 YOUR BABY misunderstood things that we fear. When any trouble actually comes, we find strength enough to meet it. Anyway the trouble usually is not half as bad in reality as it was in prospect. Young girls hear so much of the pains of childbirth that this fear overshadows the natural longings for motherhood. We are realizing more and more that preparation for the birth of a child commences several genera- tions before its conception, that the laws of heredity cannot be denied. However, as it is impossible for us to regulate the lives of our ancestors the best we can do is to commence with the present generation and determine to so train them that the following generation will have many of the advantages that we have missed. We will strive that the next gen- eration of mothers will not look forward to mother- hood with fear and trembling as an unknown danger for which they are not prepared either mentally or physically, but they will be so taught that painless childbirth will be their rightful heritage — the result of preparation. Twilight Sleep Although physicians for many years have tried to teach that agonizing pain was not necessarily an accompaniment of childbirth, that a great deal could 42 PAINLESS CHILDBIRTH. be done by science and right living to alleviate this condition, yet it is only since the furore of " Twi- light Sleep," as exploited by two or three magazines, that women generally have been giving much atten- tion to the subject that so deeply concerns them. " Twilight Sleep " was reintroduced to the public in such a manner as to have every appearance of a paid- for invitation to wealthy women to go to Frei- burg. The article even stated that women delivered by the " Twilight " method gave birth to healthier babies — that the children were better looking, grew faster and were stronger. This nonsense in itself branded the whole article as unscientific. It would have failed to interest any physician or well in- formed individual were it not for the harm to the public generally that usually results from such an article. The public, on reading this article, naturally in- ferred that this method was something new; as a matter of fact the suggestion for the use of scopo- lamine and morphine was made over twelve years before this article was written and was put to a thorough test in this country as well as in Germany. While not altogether obsolete, it has been greatly modified in hospitals and practically discarded in general practice, for the drugs used in producing twi- 43 YOUR BABY light sleep carry inherent dangers which have not been thoroughly eliminated even in Freiburg. The majority of physicians agree that the general re-employment of this twice discarded method would result in repetition of the bad experiences of those times. Practiced by especially trained ob- stetricians, in a specially equipped maternity hospital, with an abundance of trained assistants and nurses, the dangers to mother and child may be reduced to bring them to a point where one may well consider the advantages and disadvantages to more nearly balance each other. Even under these circumstances one will have to reckon with a certain toll of infants' deaths and injured mothers. For general use — especially in the home — the drugs are contra-indi- cated. The history of the method is of interest. Stein- buchel first published a paper in 1902, telling of his experiences. He began with small doses of mor- phine and scopolamine and had no unfavorable re- sults. Following his work, many physicians used repeated doses of morphine, as well as scopolamine — sometimes excessively large doses. Serious re- sults followed, particularly the death of the in- fant. The method in the clinic at Freiburg is substan- 44 PAINLESS CHILDBIRTH tially as follows : The patient is given a dose of a preparation of morphine known as narcophia, which is stated to be a double salt of morphine and narcotin, containing about 30 per-cent of morphine alkaloid. It is claimed to be a scientific substitute for opium and that it has advantages over morphine, specifically that it is less liable to produce disturbances of the respiration or nausea. These claims have not been fully confirmed. Scopolamine is a drug which produces loss of memory. It has its own dangers, as small doses sometimes produce very serious results. There may follow great disturbance of the nervous system or of the heart or lungs. As it is impossible to predict when such disturbances will arise, they cannot be guarded against. Following the first dose of narcopin and sco- polamine the patient is given repeated doses of scopolamine alone. The object aimed at is to make the woman forget her pains, although she may know of them at the time. In order to test her mental condition, she is shown some object. After an in- terval of about half an hour, the same object is again shown her, and if she remembers having seen it before, an additional dose of scopolamine is given. 45 YOUR BABY A natural inference obtained from reading maga- zine literature which has recently appeared on the subject is that the physician who withholds this method from his labor cases is negligent of his pa- tient's rights. The facts are that the method has been thoroughly investigated over a long period of time and has been found wanting because of the dangers connected with it. These dangers are re- lated particularly to the direct action of the drugs on the mother and child. At a recent meeting of the Chicago Medical So- ciety, one well known obstetrician reported that of ten cases he saw at Freiburg, instruments were re- quired in five; the birth pains were weakened and birth prolonged in all, while the infants were born in a narcotic slumber and suffocated to a degree. In only two of the ten cases did he consider the method a success. Later he visited the famous hos- pitals of Berlin, Vienna, Munich and Heidelberg, and in all these was told that this method had been tried and discarded. The best American obstetri- cians agree that in the past results with this treat- ment have not been satisfactory. More recently the revival of the Freiburg method has led another magazine to enter the field by bring- ing forth a method originating in Paris involving 46 PAINLESS CHILDBIRTH the use of a drug known as detoxicated morphine, whatever that may be. The editor of the publication states that his method is not the Freiburg method, which is a dangerous one that can be " administered properly only in hospitals, and its use in general practice should, and probably will, be forbidden by law," but is a method for every physician to use in the home. The author of the article slightly corrects this statement by saying, " The new drug was almost, but not absolutely poisonous," and that " in certain cases, there is an effect upon the child. The infants born are, in the proportion of one to three, voiceless " (not breathing), but their lives may be restored by the physician producing artificial respiration. It is needless to explain that to physicians many of the statements contained in these articles are ridiculous. The time may come, when, as a result of clinical investigation cautiously conducted, a harmless agent with which to lessen or abolish altogether the pains of labor may be secured, but in the opinion of prac- tically every scientific obstetrician that time has not arrived yet. A great deal of harm always is done when writers try to give to the public new methods that have not 47 YOUR BABY received the endorsement of the medical profession. It ever is a case of " a little learning is a dangerous thing." These people who send broadcast theories that have not been proven, only succeed in benefiting the quacks who wax fat by exploiting the public. Two instances in recent years should serve to cau- tion the thinking public. The Freidman cure for tuberculosis was given widely spread notoriety, and scientific physicians were condemned for not giving their unqualified endorsement to this remedy. They were accused of jealousy, while, as a matter of fact, they were trying to protect the gullible public. As a result of the ill-advised publicity many people spent their entire fortunes for that which gave no real benefit. About this same time " 606 " was given so much publicity that many quack advertising men special- ists waxed prosperous. In the majority of cases an inert or dangerous substitute was passed off on the victims. So it is with this much-lauded twilight sleep. There is a grain of truth mixed with much unwar- rantable publicity. It is possible in a well con- ducted hospital, with trained nurses and physicians in constant attendance, to use drugs and methods which would be impracticable and dangerous under 48 PAINLESS CHILDBIRTH less favorable conditions. American physicians for years have been working with the end in view of producing a method of painless childbirth. To a great extent their labors have been rewarded when the patient is able and willing to place herself under favorable conditions. It is becoming more and more customary for women to go to a hospital to be confined. Those who have been once, always return when the next occasion arrives. A modifica- tion of the methods that have been exploited in the magazines has been in use in many of the best hos- pitals in America for a number of years. In a great many cases, childbirth under these conditions has become practically painless, while at the same time there is no added danger to the patient. In fact, in a well equipped hospital, the danger always is les- sened, for there everything is provided for emer- gencies no matter how great or small. The methods of painless childbirth that have been so widely advertised, or their modifications that have been found practicable, are essentially hospital methods. They would be dangerous in the home under less skilled guidance. For many years chloroform has proven a great blessing to humanity. When given by a skilled physician there is very little danger, but if the same 49 YOUR BABY amount were given by a layman death probably would occur. No physician, while giving chloro- form, would think of leaving his patient even for a minute. In the same manner, the drugs given to produce painless childbirth are a blessing when given under conditions in which the patient never is without con- stant attention from skilled physicians or nurses. These same drugs, however, would be very danger- ous if given in the home on the average country or small town case. Under such circumstances, a trained nurse is not the rule, while the average pa- tient would not be willing or able to pay the physi- cian sufficient fee so that he could afford to give her his undivided time for even eight hours. Besides, in the home the arrangements and surroundings are not such as are necessary in this method. It would seem, then, that painless childbirth were a possibility only for those so situated that they were able to go to a first class hospital which is prepared for this class of cases. Such is not abso- lutely the truth, for physicians have not neglected the needs of the women not so fortunately situated. The modern well trained obstetrician has many methods at his command. There is no one method 50 PAINLESS CHILDBIRTH of caring for a woman in labor any more than there is any one method of treating a person with any given disease, as typhoid. There is no specific treatment for typhoid fever ; even the diet of a typhoid patient must vary accord- ing to conditions. The same is true of pneumonia; what will benefit one pneumonia patient may injure another. More is required of a physician than a diagnosis of a disease by name only. If it were otherwise, doctors would not be necessary, for the majority of people can tell a case of whooping cough, of measles, of typhoid fever, and of other common diseases. The doctor is supposed to treat, not a name, but the individual patient and the par- ticular conditions in that patient. So there is no best treatment for a woman in confinement, but what is best for each patient must be settled first by determining the actual conditions in the individual. Not all methods are useful in every case, for every case is a law unto itself. The drug or method, which would bring excellent results in a selected case, might do absolute harm in an- other in which the conditions were different. Only by a thorough examination can the trained obstetri- cian decide what method to use in a special case. 5i YOUR BABY One of the more recent drugs is pituitary extract. In many cases of feeble pains, one dose of this drug will bring almost wonderful results and hasten labor considerable. However, a great deal of judgment must be exercised, for any agent powerful enough to help also is powerful enough to harm. Under certain conditions where dilatation is not complete this drug might even cause enough harm to rupture the uterus. In the same manner and for nearly the same conditions, quinine has been used for many years. This also is of great benefit in some cases, but useless and harmful in others. In some cases ether or chloroform is given to relieve the pains, but even these must be given with caution by an experienced physician or the sleep produced may be forever. At the present time, the best advice that it seems one can give women generally, is to go to a hospital if possible. If not, select the physician in whom you have most faith and who is experienced in this class of cases, then allow him to use his best judgment as to which method is feasible for your case. You may rest assured that the modern American physi- cian is as far advanced in useful and harmless methods as any physician of any other country, and American physicians are constantly on the lookout 52 PAINLESS CHILDBIRTH for any new method that might be of benefit to their patients, but they do not exploit untried and ques- tionable remedies or methods. They do not take chances or gamble on the lives of the patients who entrust their welfare to them. 53 CHAPTER IV THE NECESSARY PREPARATIONS What to Prepare for Baby. The question troubling many a young and inexperienced mother is " What shall I prepare in anticipation of the com- ing of the little stranger?" Many young wives have no one near to advise them and so at the time of confinement the physician and nurse find that many necessary articles are missing among the little clothes prepared. Simplicity should be the keynote of a baby's out- fit and but few articles are necessary. In this day of factory-made clothing it is possible to purchase a complete outfit ready-made for a reasonable sum. Of course much more may be spent on fine French embroidery and delicate laces but these are not neces- sary. However, the majority of young mothers pre- fer to have the clothes made at home and with a good set of patterns any one who is acquainted with the rudiments of dressmaking or who has the faculty 54 THE NECESSARY PREPARATIONS of following instructions exactly will have no trouble in preparing the clothing. A complete set of pat- terns for the baby's outfit can be purchased for twenty-five cents. For a simple outfit the following will be adequate : Three soft, white wool, or cotton and wool shirts. The latter are more desirable, for they are not as liable to shrink. These may be obtained in several weights but usually the medium weight is best. The smallest size seldom is desirable as it is outgrown too soon and should baby prove especially large it may be too small at first. Three abdominal bands made of soft, white flan- nel about eight inches wide and eighteen inches long will be needed. A half a yard of flannel cut in three strips lengthwise will make these bands. They should not be hemmed but the edges may be notched. If they are hemmed they are liable to make a crease in the baby's skin when pinned tightly. Three white flannel skirts should be provided. These take the place of the pinning blanket and should be made on a band that is about four inches wide. Better even than these are the knit " Ger- trudes " that fasten on the shoulder. No other petticoat is necessary although some mothers prefer to have a white cotton skirt which may be trimmed 55 YOUR BABY with lace or embroidery. The habit of loading the baby with unnecessary clothing has passed out of fashion and the more simple and less cumbersome the outfit the better. Six white cotton slips or dresses should be pro- vided. These seem more appropriate for a baby if made simply. The neck and sleeves may be finished with some dainty edging but elaborate trimmings are out of place. The dresses should be provided with buttons and buttonholes, or tapes, as pins are liable to become unfastened. The dresses should be made large enough to allow for a large baby. Three kimonos made of white outing flannel are very useful. As they fasten in front, they are con- venient to be worn the first few days of a baby's life. After that, they may be used for night dresses. Those who prefer nightgowns of a standard pattern should provide three. About two dozen diapers should be provided. One cannot have too many of these. They may be made of bird's-eye linen, canton flannel or any other absorbent material that is not too heavy. A rub- ber diaper is useful to be worn when the baby is out for a ride or on special occasions but it should not be worn long at a time. Besides these, there should be provided two small 56 THE NECESSARY PREPARATIONS blankets or shawls in which to wrap the baby. One is not sufficient as it is liable to become soiled and must be changed. The two blankets should be of the same weight. The baby also will need a bonnet and coat or cape for out-of-door wear. Shoes and stockings are not necessary and not desirable until the baby is old enough to kick the clothing off. ■ A card each of small, medium and large safety pins will be needed unless one uses the Vanta pin- less garments which give excellent satisfaction. Five cents' worth of boric acid crystals for making a wash for the baby's eyes and mouth, four ounces of olive oil for the baby's baths and a box of good talcum powder should be in readiness. It is well to have the outfit practically complete at least two months before the expected time so that an emer- gency will not find one unprepared. The Maternity Outfit Besides the clothes for the baby, there are nu- merous things that should be gotten in readiness in anticipation of the expected event. Some supply houses now make maternity packages which include the things that will be needed at labor and the days following. However, the majority of women find it necessary to plan their own supplies. It is well to 57 YOUR BABY gather all the necessary articles in one place some weeks before the requisite time. To have them all together in one drawer or box so that they can be found when needed is the best plan. Sometimes they are necessary an entire month before the ex- pected time so it is well to be prepared for emer- gencies. In the box should be placed about four clean sheets, six towels, an extra nightgown for the mother, two wash cloths, a bar of castile or other pure soap, a rubber sheet, sanitary pads or gauze and cotton, abdominal binders, a bottle of antiseptic, besides all the articles given in the list as required for the baby. A rubber sheet about a yard square should be provided. Table oilcloth will do, but it is not as soft and is more liable to form wrinkles and crack than is rubber sheeting. The latter can be pro- cured from fifty cents to a dollar a yard. It is used to protect the bed at the time of labor. Later it can be used on the baby's bed. Two dozen sanitary pads should be provided. These may be made of any clean white cloth but a convenient plan is to buy a five yard package of sterile gauze and a pound roll of absorbent cot- ton. A piece of cotton of the desired size is 58 THE NECESSARY PREPARATIONS wrapped in one thickness of gauze. These pads are convenient as they may be burned after use. There will be enough of the cotton left to be used in cleans- ing the baby's eyes and for other purposes. Two abdominal binders for the mother will be needed. A yard and a half of muslin torn in two lengthwise makes very satisfactory binders. It is not even necessary to hem these. It is a good plan to have an extra piece of muslin on hand that may be used for breast binders if necessary. These are not needed in all cases but in others are indispensable. The breast binder should be about four feet long and eight inches wide. The ends should be split in two for a foot and a half, leaving the middle por- tion whole for the back. The lower end from each side is fastened to the upper one of the opposite side crossing in front of the breasts. This method leaves the nipples free, but gives pressure on the sides of the breast where it is needed. A card of large safety pins should be with the binders. Some good antiseptic, as a two ounce bottle of lysol, should be provided. This is used to make an antiseptic solution for an external douche for the mother. Five cents' worth of boric acid crystals will be needed to make a solution for cleansing the baby's 59 YOUR BABY eyes and mouth and the mother's nipples. Small pieces of absorbent cotton or gauze may be used for this. Each piece should be destroyed after use. The same piece never should be used to cleanse both eyes. In anticipation of an emergency, as the birth of the baby before the arrival of the doctor, a pair of scissors, a piece of silk tape and a small bottle of al- cohol should be handy. After birth, the cord should be tied in two places, the first one about an inch and a half from the body and the next one a couple of inches further away. It is necessary that the cord be tied tightly to prevent bleeding after it is cut, The cord is severed between the two ligatures. The cut end of the cord then should be wiped with a piece of cotton dipped in alcohol. Alcohol not only is an antiseptic but it is an astringent and helps to cause the cord to dry quickly. The navel should be covered with a piece of sterile gauze. In the absence of this, a piece of freshly scorched linen may be used. Every home should be supplied with a bed pan and a fountain syringe. These are quite necessary in nearly all cases of illness and are required es- pecially during the period following confinement. 60 THE NECESSARY PREPARATIONS The Nursery This should be a large well-ventilated room to which the sun gains entrance part of the day. There should be no plumbing in the room, no drying of clothes, including diapers, no cooking of food and no gas burning at night. The furnishings should be simple so the room can be cleaned easily. The temperature should be about 68° F. during the day. A pan of water should be kept on the heater to pro- vide moisture, especially if the room is heated by steam or hot air. 6l CHAPTER V CARE OF THE PROSPECTIVE MOTHER Clothing. All clothing should fit loosely but comfortably. Garments for maternity wear have been greatly improved during the last few years. The time has gone by when the prospective mother appeared several months in a " wrapper." Modern maternity dresses have a much different appearance and are just as comfortable and healthful. The undergarments should be warm. For the majority of women, wool is desirable except during the hot weather. A union suit usually is more com- fortable than separate garments as it does away with an extra band around the waist. Ordinary corsets should not be worn as they are liable to give undue pressure where it is harmful. Most of the reliable corset firms now make special maternity corsets which are not injurious and in many cases are extremely desirable as they sup- port the abdomen. If every woman could lead a simple, out-of-door life there would be no need of any woman wearing 62 CARE OF THE PROSPECTIVE MOTHER corsets, for the muscles would be strong enough to support the body without aid, but in these days of so-called civilization when we must of necessity live under more or less artificial conditions and the ma- jority do not have sufficient exercise to keep the muscles in good condition, almost every woman needs the aid of well fitting corsets. Of course, the woman who is accustomed to going without a corset should continue to do so, but the one who always has worn corsets will be more comfortable with some support. Whatever style of corset is worn, there should be no pressure downward, but the corset should be so fashioned that it will give an upward support to the abdomen. Usually these maternity corsets lace on both sides so that they may be regu- lated to the increased size of the abdomen. Tight garters, or round garters, should not be worn as they impede the circulation. During pregnancy, the pressure of the enlarging womb on the blood vessels of the lower extremities is liable to produce varicose veins, and this tendency is increased if there is any impediment to the circulation, as from tight gar- ters or any tight clothing. The stockings should be suspended from the shoulders. The expectant mother who is troubled with varicose veins or swell- ing of the lower limbs will be benefited by an ab- 63 YOUR BABY dominal supporter which will relieve the pressure on the blood vessels. High heeled shoes are an abomination to the prospective mother, for they increase the danger of falling. Her shoes, preferably, are low heeled with medium weight soles and broad toes. Care should be taken to avoid damp feet by wearing either heavy shoes or rubbers when out of doors if the walks are at all damp. Quite often it is necessary to wear shoes one or two sizes larger than usual. Exercise and Work Even up to the day of confinement a woman should take some exercise unless there is a positive reason against it. Violent exercise should be avoided, as well as heavy lifting and high reaching. Ordinary housework is excellent exercise and does not have any bad effect upon the expectant mother. Aside from this, she needs out-of-door exercise every day. Walking and swimming are two good exercises during this period, as they strengthen the muscles of the back and abdomen especially. Overwork should be avoided, for it has a dis- astrous effect upon both mother and child. If the mother's strength is exhausted by overwork, the child does not receive proper nourishment and the 64 CARE OF THE PROSPECTIVE MOTHER mother has not the necessary reserve energy to carry her well through labor. The Necessity of Daily Bathing All during the period of pregnancy the kidneys have added work to do and it is of great importance that they be kept in good condition. Drinking plenty of water during the day will aid in keeping them in good condition as the water flushes out the kidneys, which may be called the sewers of the body. Another way to aid the kidneys is by having some other organ do part of their work of throwing off the waste of the body. The bowels aid in this work and if they are kept free the kidneys are relieved of some of their work. The skin is another excretory organ of the body. It constantly is throwing off waste through the tiny pores. If these pores become clogged it is natural that the skin will not be able to do so much work and consequently this neglected part is thrown back- on the kidneys. The reason, then, for frequent bathing is seen readily. By the use of a daily bath the pores of the skin are kept open and if this bathing be followed by a brisk rubbing the skin is exercised and kept in better condition. 65 YOUR BABY A cool sponge bath in the morning is refreshing and acts as a tonic not only to the skin but to the entire body as well. A warm bath at night for cleansing purposes is desirable. The bath should not be so hot that there is danger of it inducing fainting, neither is it desirable to remain in the bath too long as the effect is too relaxing. Salt added to the bath water acts as a tonic, and makes the bath more refreshing. If there is an irritation of the skin, common baking soda added to the bath is sooth- ing. During the last few months of this period, a daily application of pure olive oil to the abdomen, breasts and vulva will place the skin in a good condition and prevent cracking to a considerable extent. Vaginal douches should not be taken except upon the advice of the attending physician, but usually one or two a week are beneficial. The water should not be too hot nor used for more than a few mo- ments at a time. In some cases the vaginal secre- tion is so irritating as to produce pruritis or inflam- mation of the genitals. This usually can be re- lieved by a douche of warm water containing a little baking soda, but if it is severe the physician should be consulted. 66 CARE OF THE PROSPECTIVE MOTHER Breasts and Nipples For a couple of months before the termination of this period, the breasts and nipples should be bathed daily with a mild soap and warm water, dried gently and then massaged with pure olive oil or cocoa but- ter. All massage should be given gently in a cir- cular movement. This treatment will tend to in- crease the amount of milk secreted and also to place the nipples in a condition so that they will not crack or fissure readily. If the nipples are retracted, they should be drawn out gently several times a day for several months before labor is expected. Rest and Sleep The prospective mother needs plenty of rest and sleep. Only by an abundance of these can she place her nervous system in a stable condition. She should provide for at least eight hours sleep at night, besides a nap during the day. The usual marital relations are distasteful to many women at this time and under such circumstances should be discontinued. In most cases it is better that the husband and wife should sleep in separate beds. These relations always should be discontinued during what would be the regular menstrual periods, 67 YOUR BABY for they are liable to bring about an abortion at this time. Many educators claim that if the marital relations were discontinued during the entire period of pregnancy, the child would profit accordingly. However, this seems to be a question that must, of necessity, be left to the individuals, but in fair- ness to the woman who is bearing the burden at this time she should be allowed to decide this ques- tion. The Teeth There is an old saying " for every child a tooth," but this is not necessarily the truth. There seems to be an increased acidity to the secretions of the mouth during this period so, in order to preserve the teeth, the mouth should be rinsed several times a day with a mild alkaline solution, as a half a teaspoonful of baking soda to a glass of water. Milk of magnesia also is excellent for this purpose. If the teeth com- mence to decay they should not be neglected, for fear of more serious results. Many women are afraid to go to a dentist at this period and so neglect their teeth until they have a bad abscess or neuralgia. This should not be the case. The teeth should be given attention at the first appearance of any decay. The dentist can put in a temporary filling which 68 CARE OF THE PROSPECTIVE MOTHER will preserve the tooth and not involve any strain on the woman. The teeth should be well brushed at least twice a day, while the mouth wash must be used many times for the best results. Diet The question of diet is an important consideration. There is a popular superstition that the expectant mother needs an unusual amount of food, that she must eat for two. This is not the truth. Many births are rendered much more painful because of the effect of overeating during this period. The mother does not need more than her ordinary amount of food and this should be regulated to meet the vari- ous conditions. Another popular fallacy is that the prospective mother should not be denied anything that she craves because it might " mark " the child. This also is untrue, unless the woman has so little control over herself that she allows her mind con- tinually to dwell on the one thought. She should satisfy her cravings within reason, but she should not indulge in an excess of any food. The peculiar desires of prospective mothers are innumerable. They usually do not indicate any special need of her system but, if they are reasonable, they may be allowed. 69 YOUR BABY The diet for the prospective mother should be nourishing but non-stimulating and should be con- sidered from two standpoints, — its effect upon the mother and its effect upon the child. The pain of labor is caused chiefly by the necessity of the on- coming head forcing its way through the birth canal, which it must dilate. Anything that would tend to make the head large or the birth canal more rigid naturally would tend to make childbirth more pain- ful. A number of years ago a pamphlet was published in London giving the results of living on fruits dur- ing the period before the birth of the baby. The author adopted the idea that all foods that con- tributed to the foundation of bony matter served to prolong labor and endangered the life of both mother and babe. Be that as it may, the easiest birth I ever witnessed was with a woman who told me she lived the last two months almost entirely on apples. In a number of instances I have observed that women who ate little meat and much fruit the last two or three months of pregnancy had very easy labors. Starchy and fat-forming foods con- tribute to make the muscles of the mother less pliable. A vegetarian and salt free diet has been highly recommended as ideal for the prospective 70 CARE OF THE PROSPECTIVE MOTHER mother. Fruits will keep the bowels in good condi- tion, so there will be no need of laxatives, while fruits also have a beneficial effect upon the kidneys. Poultry, fish or eggs, vegetables, such grains as rice, tapioca and sago, tea or milk in moderation, and nutritive broths may be given. The Bowels Many expectant mothers suffer more or less from constipation during this period. This is due chiefly to the pressure of the enlarging uterus upon the intestines. It is liable to become more marked dur- ing the latter months. However, it is very impor- tant that the bowels should move freely at least once a day during the entire period. Whenever possible this should be accomplished by the use of laxative foods rather than by any of the usual methods. Many of the common laxative pills contain drugs which would be harmful. The expectant mother never should take any drugs except on the advice of her physician as some of the remedies that would be beneficial at other periods of life are dangerous at this period. Among the laxative foods that may be eaten freely during this period are fresh fruits, such as apples, apricots, pears, peaches, oranges, grapes, 71 YOUR BABY grape fruit, figs and pineapples. One or another of these are available at almost every season of the year. Cooked fruits, such as prunes, also are beneficial. Coarse breads and cookies, as those made from gra- ham, bran or oatmeal, stimulate the intestines and in- crease their activity. If molasses is used instead of sugar for sweetening the bread or cookies they will have a more laxative effect. Fresh vegetables, especially if eaten with an olive oil dressing, have a laxative effect. In many cases it is necessary to avoid the use of certain vegetables, as cabbage and baked beans, that are hard to digest. The juice of half a lemon in a cup of water before breakfast is agreeable and beneficial to many. If these simple measures do not regulate the bowels the physician should be consulted. An enema is beneficial as an occasional measure but should not be used regularly as its tendency is to paralyze the muscles of the rectum so that they become incapable of doing their work unaided. Sewing for the Baby Most mothers look forward with pleasure to pre- paring the clothing for the expected baby. They even may spend hours stitching at the machine and more hours sewing on lace. This is all right if the 72 CARE OF THE PROSPECTIVE MOTHER mother does not spend all her leisure in this occupa- tion. However, some mothers neglect the necessary out-of-door exercise in order to have more time to spend in preparation of dainty garments. In this case the entire preparations are for the bodily cov- erings of the child while at the same time the mother is neglecting to prepare to give him health and a good disposition. The latter only come as the result of proper attention to the hygiene of living, — plenty of sleep, out-of-door exercise, proper diet and free- dom from care and worry. Mental Condition During the period before the birth of her child, many a woman is inclined to be despondent and ir- ritable. She should try to overcome this condition for the sake of both her child and herself. If there is a special cause for the cross feeling, as overwork, this should be removed. It is better to neglect the household duties, to revert entirely to the simple life, than to have the prospective mother over-burdened. If the mother is unhappy and overworked this has a disastrous effect upon the child, for it does not de- rive sufficient nourishment. A mother should school herself to be cheerful dur- ing this period. She should not read any horror 73 YOUR BABY stories or medical books or anything that will tend to morbid thoughts. If there is a blue day, she should read an entertaining story or go to see a jolly friend until the blueness has flown away. Despond- ency sometimes is caused by indigestion, therefore this should be taken into account and corrected. Late hours and excitement are not advisable for the prospective mother. She should not attend crowded gatherings nor appear on a crowded street- car. The more quiet and peaceful her life, the bet- ter will be the condition of her nervous system. 74 CHAPTER VI ACCIDENTS AND INCIDENTS OF PREGNANCY Nausea and Vomiting, usually called morning sickness because occurring upon rising, is common during pregnancy. It usually commences two or three weeks after the beginning of the period and may be the first symptom noticed. However, some women do not have this disagreeable symptom dur- ing the entire time. In the majority of cases it disappears after the first three months but with some it continues during the entire period. In such a case, it usually indicates some disorder that should be corrected. Sometimes a few simple things will relieve this disorder. Every day take some exercise in the open air. Sleep with the windows open at night. Eat only light, easily digested food. A light breakfast in bed half an hour before rising has been found to be beneficial in many cases. Even a glass of hot milk taken at this time may be sufficient. With some the nausea continues during the day 75 YOUR BABY and they find themselves unable to take sufficient food. An old-fashioned remedy for this condition is pop-corn. This may be eaten (without butter) at various times during the day and usually can be retained when other food cannot. Pop-corn tea also may be taken. A hot water bag or a mustard plaster to the abdomen sometimes relieves. If the vomiting is so severe that the woman is be- coming weakened a physician should be consulted without delay. In a great many cases, local treat- ment to correct a displacement of the womb or to relieve inflammation of the cervix may be indicated. Sleeplessness This is a symptom of disordered health and should not be neglected. A warm bath before retiring, fol- lowed by a gentle massage, especially along the spine will, by relaxing the nerves and muscles, produce good results in many cases. A hot bath, by drawing the blood away from the brain, often will be bene- ficial. A glass of hot milk or cocoa taken just be- fore retiring often will have the same effect. If the sleeplessness is the result of indigestion, a plain diet will relieve. Sleeping upon a hard bed or without a pillow sometimes produces the desired effect. Always have plenty of fresh air in the room. Keep 76 ACCIDENTS OF PREGNANCY the mind free from the cares of the day. If they will intrude, crowd them out by repeating some soothing sentence as " There is no reason why I should not sleep, therefore I shall sleep. My body is relaxed, my mind is at peace, sleep is coming. I am getting sleepy. I am about to sleep." Never take any sleeping powders except upon the advice of a physician. The majority contain morphine, ace- tanalid or some other harmful drug. Fainting Should fainting occur the physician should be sent for at once. In the meantime the patient should be laid with the head low, the clothing loosened and plenty of fresh air should be admitted. Water may be sprinkled upon the face or aromatic spirits of ammonia be held near the nose. Constipation A regular daily action of the bowels is necessary to health. Constipation often may be relieved by drinking a glass of cold water upon rising, at in- tervals during the day and upon retiring. Fruit at breakfast or figs taken after meals often will re- lieve a tendency to constipation. Regularity in go- ing to the toilet is one of the most important meas- 77 YOUR BABY ures in treating constipation. Laxatives or cathar- tics should not be taken except upon the advice of a physician, for some laxatives contain drugs which might cause contractions of the uterus and so bring on an abortion. The Kidneys It is of the greatest importance that these organs should perform their functions properly. Drinking plenty of water during the day will help to keep them in good condition. Upon any diminution in the amount of urine passed or any swelling of the feet and ankles a physician should be consulted as these may indicate a serious kidney lesion. By making an examination of a specimen of urine the physician will be able to tell the condition of the kidneys. When sending a specimen take a four ounce bottle, thoroughly cleanse it by boiling, fill it with some of the urjne first voided in the morning, cork tightly with a new cork and send at once. Swelling of the Legs and Feet Swelling of the legs and feet is very common dur- ing the latter months of pregnancy. Usually it is worse towards evening. There may or may not be other symptoms accompanying thi9 swelling. If 78 ACCIDENTS OF PREGNANCY there are no other symptoms, as headache or a feeling of depression, the condition probably is not serious. Quite frequently the swelling is accompanied by en- largement of the blood vessels (varicose veins). The swelling may be so great as to cause the patient considerable discomfort and still not be a serious condition. However, the swelling may indicate a serious disorder of the kidneys, so it is best in all cases to have the urine examined so as to be cer- tain of the condition of the kidneys. An expectant mother who is having this disorder should save a portion of the first urine that is passed in the morn- ing, put it in a clean bottle, which holds about four ounces, and send or take it to the physician who has charge of her case. The kidneys are so liable to be affected during this period and such serious results, as eclampsia (convulsions), may result if the con- dition is not remedied that it is not wise to take any risks even though the patient feels fairly well. In a great many cases the swelling and varicose condition are due to pressure of the enlarging uterus upon the blood vessels of the lower limbs so that the blood is unable to return to the heart. In such a case much can be done by a few simple measures. The patient should keep off her feet as much as possible and whenever she is sitting should elevate 79 YOUR BABY her feet and limbs. It is better if her feet are higher than her hips. Even at night it may be well to elevate the feet. Many women obtain relief from wearing an elastic abdominal binder, or even one of cotton cloth. By the use of such a binder the pelvic contents are lifted and the pressure on the blood ves- sels going to the limbs is relieved so that the blood may flow more freely. The clothing should be loose, especially that about the lower limbs. Tight stockings or round elastics should be avoided. It quite frequently is necessary for the expectant mother to wear shoes several sizes larger or wider than she ordinarily wears. These always should have a broad heel. Massage of the limbs with alcohol or some other astringent tonic is beneficial. The movement always should be towards the heart so as to help to empty the engorged blood vessels. Bathing with cold water sometimes gives relief. With this also the movements should be towards the heart. Irritability of the Bladder Disturbances of the function of the bladder often are present during this period. They are caused by pressure of the enlarging uterus upon the bladder. 80 ACCIDENTS OF PREGNANCY As a result, there is a frequent desire to urinate although the amount passed at each time is small. Although this disorder is annoying, yet it is not serious and usually passes away after a few weeks when the position of the uterus is changed. Sometimes the irritation may be relieved by changing the position of the body or by assuming the knee-chest position for a few minutes morning and night. To assume this position the patient kneels on the bed and then bends forward until the chest touches the bed. The thighs should be at right angles with the bed. This allows the pelvic and abdominal organs to drop towards the upper part of the body cavity and so relieves the pressure on the bladder. This position also may give relief in swelling of the limbs or in varicose condition. Frequent periods of rest in the recumbent position aid greatly in avoiding these disorders. If an ex- pectant mother would lie down for five minutes at the end of every hour she would be greatly bene- fited. These short, but frequent, resting periods are productive of more good than are one or two long periods of rest during the day. Whenever the ex- pectant mother is resting she should make it a rule to elevate her lower limbs. CHAPTER VII the period of labor What to Do When Labor Commences. As soon as labor pains begin, the physician should be notified. His services may not be required for sev- eral hours but if he knows that he is to be needed soon he will arrange his other work so as to be free when the time arrives. While awaiting his arrival, the mother should pre- pare herself by taking a cleansing bath and an enema. The enema is necessary in order to empty the lower bowel. If this is emptied thoroughly it will make the progress of labor easier, for if the rectum is full it presses on the vagina and gives less room for the descent of the child. A full bladder and a full rec- tum frequently retard labor considerably. From the beginning of labor pains the patient should not go to an out-of-door toilet because there is danger of a precipitate labor, that is, the baby may be born very quickly. Instances are not uncommon of babies being born in public toilets, on the street car and in other public places. These instances caution 82 THE PERIOD OF LABOR us that the expectant mother should not go far from home during the last couple of weeks before labor is expected. The patient may be dressed in her nightgown and white stockings. Over this she may wear a kimono until near time for labor to be terminated. The hair should be parted down the center and braided in two braids. This makes it convenient to be combed in bed during the next week or ten days. A kettle of water should be boiled and allowed to cool so as to provide cold sterile water. Another kettleful should be boiled and kept hot. The bed should be prepared by putting on first the under sheet, then the rubber sheet, which should be pinned at all four corners. Over this a folded sheet, called a draw sheet, should be placed. The latter may be changed easily at any time without disturb- ing the patient much. A second rubber sheet and a second draw sheet may be placed on top of the first ones and these can be removed when labor is terminated leaving a clean draw sheet in place. In the absence of a rubber sheet several thicknesses of newspaper may be used. Everything necessary for the baby's first bath, one suit of clothes, and the articles required for the mother should be placed in a convenient place. Be- 83 YOUR BABY sides these, there should be two hand basins, a nail brush and plenty of clean towels in the room. What to Take to the Hospital It is becoming customary for an expectant mother to go to a hospital instead of being confined at home. For several reasons this is a desirable course. Among others, it lessens the work of preparing for the event. Then, too, it does not disturb the family nor upset the household arrangements. But most important is the fact that in the hospital everything is convenient and ready for any emergency. The decision as to which hospital must be in- fluenced by the individual circumstances. Nearly every general hospital has special apartments for mothers and their babies. The care is similar in all. It is well to choose a hospital that is convenient to the physician's residence, if possible, so that he will be within reach should any emergency arise. The price of the room varies with different hospitals, therefore this matter must be taken into considera- tion in many cases. After the decision as to the hospital comes the problem of what to take. This varies with the hos- pital. It would be wise for the expectant mother to call at the hospital and make her arrangements 84 THE PERIOD OF LABOR several weeks before she expects to enter as a patient. At this time she can see the rooms and have an understanding as to the rate. Also she can talk with the superintendent or head nurse, who will give her a list of the things she should bring with her. Hospitals vary so much in their rules that no list could be given that would suit all cases. Some hospitals have their own gowns and require all patients to wear the hospital gowns, while others keep only a few gowns for emergency and operative work and desire the patient to bring her own gowns. In the latter case, she should have at least two gowns at a time. This allows a change and the soiled one can be taken home to be laundered and a fresh one brought in its place. Usually the patient's family are expected to attend to the laundering of the gowns, as they are liable to become mixed if sent with the hospital laundry. Only a few baby clothes should be taken, for the reason that they sometimes are lost or mixed with others. Three shirts, three bands, three pinning blankets, three kimonos, one dozen diapers and a soft blanket are sufficient if some member of the family will bring a fresh suit each day to replace the soiled ones. Besides the clothes, the mother will need to take 85 YOUR BABY her own toilet articles, especially a comb, brash and tooth brush. Aside from these, other things are not necessary and should not be carried along. It is not desirable for the patient to take any jewelry or other valuables with her as the hospital cannot be respon- sible for their loss unless they are left in the office in the care of the superintendent or nurse in charge. Childbed Fever In former times there were many deaths following confinement from so-called childbed fever. That this was due to carelessness never was suspected, but recent discoveries of the germ theories of disease have proven that this fever is due to disease germs which enter the womb during or following labor. These germs might be upon dirty carpets, on the floors or walls of a room, in soiled bed clothing, in utensils and vessels that are not surgically clean, in unboiled water or on the hands of the attendants. Recent progress has proven that if the doctor and attending nurse are surgically clean there is little danger of childbed fever. This is one great reason for not employing an ignorant midwife who does not understand surgical cleanliness, and why only the best care obtainable should be given a woman during confinement. Good care is as necessary at this time 86 THE PERIOD OF LABOR as it is in a surgical operation, and the modern physicians insist that the lying-in room should be as clean as the operating room of a hospital. Quite frequently it is impossible to take all the necessary precautions at the home and therefore it is becoming- more and more common to go to the hospital. However, if one is to remain at home, the sick room should be given a thorough cleansing before confinement. Everything to be used about the bed should be strictly clean. Formerly it was a custom to use an old quilt to protect the bed and quite fre- quently this was the real cause of childbed fever, for the quilt contained disease germs. Now, in place of a quilt we use a rubber sheet and have all the other bed clothing freshly washed or sterile. The nurse should wear a cotton gown that can be washed, as woolen skirts often carry disease germs. All cloths that are to be used about the patient should be freshly washed and ironed and then baked in the oven or steamed for two hours. It is better to take extra precautions than to run any risk of in- fection. After Care of the Patient The period after confinement is very important for the young mother, for upon her care during 87 YOUR BABY this period depends to a great extent the condition of her future health. Under the present condition of living it seems best for her to remain in bed for a period of ten days after the birth of her baby. This allows time for the parts to assume nearly their normal positions before there is any strain put upon them. If the mother gets up before the end of this period the womb is liable to become displaced be- cause of its weight and because the muscles and liga- ments, which have been on a strain for several months, require time to resume their normal length and elasticity. As soon as labor is terminated, the mother should be made comfortable. Soiled linen should be re- placed by clean, the binder and pad applied and the mother left in a comfortable position. It is probable that she will drop to sleep and rest for several hours. It is not necessary for the mother to lie in one position, as on her back, unless she should flow ex- cessively. The wide binder pinned very snugly around the abdomen will give a feeling of comfort and also help to support the overstretched muscles and aid them in resuming their normal condition. In pinning this binder one should pin from below upward. The flow will be rather profuse for two or three THE PERIOD OF LABOR days, then gradually decrease and will cease before the end of the ten days. Any excessive flow or failure of cessation should be reported to the physi- cian as it may indicate that shreds or clots have re- mained in the womb and must be removed. The patient should be given an external douche every morning and after each urination. A pitcher is filled with warm sterile water (water that has been boiled) to which has been added a few drops of lysol or other antiseptic. A bed pan is placed un- der the patient and this solution poured over the external parts. A vaginal douche should not be given except by direction from the attending physi- cian. The bowels should be kept free during this period. The patient should not be allowed to sit up, but should use a bed pan. On account of her reclining position it frequently is necessary to give an enema to start the bowels. It is customary to give one dose of castor oil the day after confinement. If the patient has not urinated by the end of twenty- four hours it may be necessary to have her catheterized. Before this is done, however, it is well to try the effect of an external douche which may relax the parts so that the urine will flow naturally. Sometimes a hot drink will have the same effect. 89 YOUR BABY In other cases the sound of running water brings the desired results. As soon as she wishes after labor, the patient may be given a drink of hot tea or milk. The diet for the first twenty-four hours should be liquid or semi-solid, after that it should be light with little or no meat, and no acid vegetables or fruit. Toast, poached eggs, custards, broths and milk are excellent. By the time the mother is able to be around she may resume her normal diet except to watch that she eats nothing that has a bad effect upon the milk. The marital relations should not be resumed for at least a month after confinement, as they cause a more or less congestion of the parts which might result in inflammation at this time. 90 CHAPTER VIII THE YOUNG MOTHER After the Baby Comes the mother should take especial care of her health, not only for her own sake but for the sake of her baby. A mother who is not well, or who is overworked cannot nourish her baby properly. If she is half sick she cannot expect that her milk will be nourishing. It is im- portant for the young mother to remain in bed for the first ten days after the birth of her baby; for it takes that long for the muscles to regain enough elasticity to be able to hold the womb in position. However, the womb does not entirely regain its natural size for about three months, so the mother should be especially careful during this period. If she returns to her work too early or does much heavy lifting, the womb is liable to become inflamed and fall out of place. On account of its increased size it is heavier than normal during this period and much easier displaced, not only because of the extra weight but because the muscles that hold it in place have not entirely regained their natural elasticity 9i YOUR BABY after being on a stretch before the baby came. The young mother should lie down and rest for a few minutes several times a day. It is a good plan for her to take the knee-chest position for a few mo- ments every night. To do this, she kneels on the bed and bends forward until the chest touches the bed, the thighs being at right angles with the bed. This position allows the womb to drop back to its natural position if it has become displaced during the day. If the parts have become torn during labor they should be repaired early, for every unrepaired tear weakens the supports to the womb and predisposes to inflammation and displacements. Exercise for the Mother Too many young mothers become so absorbed in the care of their babies that they neglect the simple things so essential to their own health and happi- ness. Fresh air and exercise are indispensable to the health of every woman. Both are classed with the luxuries in many a mother's life, whereas they should be looked upon as necessities. Every mother should make it a point to spend at least half an hour a day in the open air and another 92 THE YOUNG MOTHER half hour doing something for her own pleasure. If her work is a drudgery she cannot accomplish as much in a given time as she could if it were not so. A half hour's rest or change will give a woman added energy so that she can attack her mountain of housework with increased zeal. Exercise and fresh air are essential for the health of the baby also. A mother, who is tired out and suffering from oxygen starvation, cannot give her child the same care that she could if she were in a fit condition. Any one who is worn out with sleepless nights cannot expect her brain to perform the same work that it would if it had been rested. The mother's work is never done, and it seems as though there were no time for exercise or pleasure. She cannot find a stopping place where she can leave her work for a few minutes. This is one of the cases where one must " make time." Drop the work, if necessary in the midst of the ironing. It is much better that a family should wear a few un-ironed clothes than that the mother should be- come worn out, nervous and cross from overwork. As a child grows older it remembers and appreciates the happy moments spent with mother playing some simple game much more than it appreciates ruffles and embroidery correctly starched and ironed. The 93 YOUR BABY mother who holds her children's love and confidence is not the one who makes a drudge of herself that her children may appear in clothes better than their neighbors, but it is the one who finds time to go for a half hour's walk in the woods with the chil- dren, talking with them about the wonders of na- ture. It is the one who finds time for a game of blind man's buff. Begin while the baby is young by making it a rule to spend an hour a day playing with the child, out of doors if the weather permits. It is in these hours of unrestrained freedom that the mother learns her child's nature, its longings and aspirations. The mother who is a chum to her children, who enters into their play and interests, not only keeps herself young but is the one best be- loved by the children. The mother needs to keep her mind active by reading books in order to be able to interest her children and hold their respect. Remember that the mother's condition, both of mind and body, will affect her child. Worry, an- ger, illness or overwork on the mother's part are as harmful as improper food or lack of cleanliness. The Mother's Rest Recently I talked with a young mother who was in a very nervous state, chiefly from lack of rest. 94 THE YOUNG MOTHER Her baby, who was about three weeks old, was an exceptionally healthy child yet she had allowed him to be a constant care. Inquiring about her habits I found she had permitted the baby to nurse nearly all night. As a result, she had very little sleep and the baby's stomach was becoming upset. Not only was the frequent nursing harmful for the baby but the milk, which is affected easily by the mother's condition, was not agreeing with him. The mother was young and inexperienced. She had no mother to advise her and so had been taking the advice of well meaning neighbors, who, although with the kindest intentions, had been giving her the wrong advice. As a result, she had been dosing her baby with various teas and syrups. Naturally, no good results were obtained as the cause of the trouble had not been removed and the baby was growing more colicky and the mother more nervous and worn out. The mother was advised to stop all teas and to feed the baby every three hours by the clock, except that between ten at night and six in the morning, it should have only one feeding. If the baby seemed to want to be fed between regular times, she was to give a little warm water but nothing else. She followed this regular routine with the result that within a few days the baby awakened at regular 95 YOUR BABY hours to be fed and had forgotten all about its colic. The mother had her night's rest without being dis- turbed every few minutes and had become rested and had lost her nervousness. It does not pay for the mother to get too tired and worn out from lack of rest, for if she does the milk is affected, the baby's stomach is upset and it becomes cross and fretful and requires twice as much care as it would if the mother were in a rested state. If every mother would make it a point to feed her baby regularly by the clock, she would find she had plenty of time for other work and it would be done at regular times. It is a good plan for the mother to establish the habit of lying down on the bed with the baby when she is feeding it. This gives her the necessary rest, for a mother with a young baby needs considerable rest in order to regain her strength. Between meals, the baby should require very little attention and certainly should not be held during this time. If the mother does not have regular hours for feeding the baby but feeds it only when it cries, she may have to stop in the midst of some important work in order to feed and soothe it for fifteen or twenty minutes. She never will be able to plan her work, for she does not know what time, if any, 96 THE YOUNG MOTHER she will be free from holding the baby. The more a baby is held the more it wants to be and it is not slow in making its wants known. Nursing the Baby It is very rare that a mother cannot nurse her baby if she is given the proper care both before and after the arrival of the baby. A great many babies really have been killed by well-meaning but ignorant old women of the " Sairy Gamp " type who think they can improve upon Nature and who by their advice cause the young mother to believe that her milk is not good for the baby, but that some other prepared food is much superior. Mother's milk is infinitely superior to any other kind of food and the majority of women can nurse their babies if they have not been discouraged by interfering friends and if they are well nourished. One great item to be considered in the nursing of the baby is the mother's mental condition. Any- thing that unfavorably affects either her mental or physical condition, as her nutrition, her digestion or her bowel movements, injuriously affects her milk and so hurts the baby. The mother who would have good milk for her baby must avoid unnecessary worry, excitement, fa- 97 YOUR BABY tigue or exertion. It is not a good plan for her to go to many public places where she becomes weary or excited. The more quiet and peaceful her life can be, the better will the milk be. The question of diet is one that bothers many a young mother. As a general rule the nursing mother can eat anything that agrees with her except those foods that are highly spiced, indigestible or very acid. The mother must remember that any- thing which she eats is liable to affect the milk, and the condition of the baby's bowels and digestion is the best guide to her own diet. If the baby's bowels are too loose or the baby has gas or colic the mother should consider what her diet has been for the last two days and usually she will be able to find some article of diet that will account for the baby's con- dition. One mother brought her baby to me be- cause it was having colic and crying continually. The mother insisted that she had not eaten anything that could have affected the baby. She especially said that she had not eaten fruit. However, she was asked to give a list of everything she had eaten for three days and then I found that she had eaten a great deal of watermelon and green corn. Nat- urally it was not hard to decide what was the cause 98 THE YOUNG MOTHER of the baby's trouble. Ripe tomatoes also should be avoided by the nursing mother. The mother should drink sparingly of tea and coffee and avoid all beer and alcoholic stimulants. Remember that a taste for alcoholic drinks may be formed by the baby if the mother indulges in some of these mild alcoholic tonics while nursing the baby. The baby's system becomes accustomed to the stimulation and craves it in later life. The nursing mother should exercise moderately in the open air and sleep with the windows open at all seasons of the year. Fresh air is one of the best tonics for any one and is needed especially by the young mother. The bowels should be kept free. If the mother is constipated this will affect the milk and the baby will be constipated. The milk can be made more laxative by the addition of fats to the diet of the mother. Nursing the baby regularly and not too often also tends to increase the amount of milk. If the baby is allowed to nurse at frequent and irregular times the breasts are kept drained constantly and the baby never has enough to satisfy him. The baby never should be nursed simply because he cries and certainly should not be allowed to tug at the breast 99 YOUR BABY constantly at night. Such a procedure keeps the mother awake and drains all her vitality. If the mother does not have sufficient rest it is impossible for her to have enough milk for the baby. The baby never should be weaned on the advice of neighbors. If the mother does not think she has sufficient milk for the baby she should consult her physician at once and have this corrected. In a great many cases a baby's life has been lost simply because the young but ignorant mother changed the food a number of times on the advice of different so-called friends. The best friend to the young mother is the one who does not try to advise her in regard to her baby's diet. This should be left to the physician who understands such matters. The best guide as to the milk agreeing with the baby is the steady (even if slow) increase in weight. To Increase the Milk Every true mother desires to nurse her baby. By doing this she gives it a better start in life, and lessens the danger of intestinal troubles which cause the death of nearly half the babies before they are a year old. In some cases the mother does not seem to have a sufficient quantity of milk. In a great many cases this may be overcome by care before the roo THE YOUNG MOTHER birth of the baby and by careful dieting afterwards. For the last three months before the expected arrival of the baby, the breasts may be massaged daily with warm olive oil. This should be done with a circular movement. The breasts never should be pinched as this is liable to cause inflammation. If the nipples are retracted they should be pulled out gently once or twice a day for the last six weeks before labor. Bathing them with alcohol will tend to harden them, and this followed by an oil massage will place them in a good condition so that they will not be so liable to become sore and cracked when the baby commences to nurse. If the nipples are much retracted it is well to apply a breast pump once or twice a day during this period. This also tends to increase the supply of milk secreted. After the arrival of the baby and for a few days before its expected arrival the mother should regu- late her diet so as to increase the amount of liquid. She should drink plenty of milk, cocoa, malted milk and other liquids. Broths and soups are excellent. The mother should not limit the taking of this fluid to the regular meal times but should make it a rule to drink a cupful every two hours during the day and one cupful at night when she awakens for the night feeding. An old recipe is to boil two table- IOI YOUR BABY spoonfuls of yellow corn meal with one quart of water for half an hour. Add salt and flavor and drink an entire quart each day. Bone Forming Diet Frequently physicians advise nursing mothers to eat bone forming foods, but this direction is not of much value unless the mother has been instructed as to what are the bone forming foods. Bones are formed by the deposit of mineral salts in cartilage or gristle. If one examines the end of the breast bone of a young chicken she will find that it is not bone but cartilage or gristle. As the chicken grows older, mineral salts are deposited in this cartilage and gradually it becomes true bone. The same process takes place in the body of a child. When the baby is born many of its bones are not true bones but really are cartilage, which, although tough, is bent easily. Gradually mineral matter is deposited in the cartilage and the bones become harder and less flexi- ble. It is on account of the flexibility of its bones that a baby should not be allowed to bear its weight on its feet when very young, for the bones of the legs are soft and easily bent out of place. At the time the mineral matter is being deposited in the bones it also is being deposited to make teeth. THE YOUNG MOTHER The first teeth really commence to form several weeks before the birth of the baby, although they do not become fully developed until some time after. If the baby does not obtain sufficient mineral salts in its food, its legs are liable to become bowed when it commences to walk. Other bones, also, are liable to be bent out of shape. Then, too, the teeth are not well formed and are liable to be soft so that they decay early. Therefore it is necessary for the young baby to obtain mineral matter in its food. When the baby is breast fed the mother must so regulate her diet as to give this necessary mineral. Common salt is one of the most important mineral ingredients of food. Some vegetables are natu- rally rich in this mineral while others, as potatoes, are lacking and require it to be added in order to make them palatable. Among the foods rich in salt may be mentioned corn, peas, Lima beans, stewed fruits, spinach, onions, peaches, pears, celery, to- matoes, Brussels sprouts, apples and cranberries. However, the nursing mother must be careful about eating some of the more acid of these, as tomatoes, because they may cause the baby to have colic. The bottle fed baby has mineral added to its food in the form of lime water. In some instances it is necessary to feed the baby upon condensed milk. 103 YOUR BABY It has been found that these babies, although they thrive well, lack bone salts. They do not sit alone or walk as early as do breast fed babies. Their teeth are liable to be poorer. Much of this can be overcome by adding small quantities of lime water to each feeding. Sometimes a very little salt is added to the diet of the bottle fed baby for this same reason. The nursing mother or the expectant mother often complains that her teeth are decaying easily or that they do not seem as strong as pre- viously. Much of this trouble can be avoided by the use of soda, lime water or magnesia in the mouth wash. Milk of magnesia makes a pleasant mouth wash for the mother. This also is one of the best laxatives for the nursing mother to take if one is needed. 104 PART II — THE BABY Anything that touches the life of children, that deals with the beginning of life, cannot help being hopeful. It is a joy to do something that shall not only touch the present but shall reach forward to the future. Phillips Brooks. PART II — THE BABY CHAPTER IX FIRST CARE OF THE BABY To the inexperienced mother the care of a young baby appears to be such a vague and unin- telligible affair that it seems almost impossible that she ever would become proficient in the art. The bathing, the feeding, even the dressing become, in prospect, tasks of Herculean size. Yet there are a few simple rules which if followed solve the major- ity of the problems. The First Thing to Be Done As soon as a baby is born, the eyes and mouth should be wiped carefully with pieces of gauze or soft cloth that has been soaked in a solution of boric acid. To Prevent Blindness The cleansing of the eyes is especially important, for it is estimated that about thirty per-cent of the 107 YOUR BABY blindness in the world has been caused by neglect of the eyes of the new born babe. In every institu- tion for the blind there are many inmates who are regarded as having been " born blind." In almost every instance the eyes were perfect at birth but, during the passage of the head through the birth canal, some disease germs which had been lying in ambush entered the eyes of the babe and, as they were not routed at once, began their ruinous work of destroying the eyesight. The most disastrous germs are those of one of the so-called " social diseases," which are so very powerful and work so quickly that the sight can be destroyed entirely in a few days, and there is no hope of it being re- stored. Since scientific men have discovered the cause of ophthalmia neonatorium, or birth infection of the eyes, every reputable physician takes precautions to avoid an opportunity for these germs to even com- mence their calamitous work. As soon as a baby is born the modern physician washes its eyes thor- oughly with a solution of boric acid. In addition to this some physicians put a drop of a two per-cent solution of silver nitrate into each eye. By these precautions all germs that possibly may have en- tered the eyes are either washed out or destroyed 1 08 FIRST CARE OF THE BABY without any danger to the eyes. The eyesight is so valuable that we would consider any one very negli- gent who would overlook this simple precaution. In some states, this negligence is regarded as a crime and treated accordingly. These destroying germs may enter the eyes at other periods of life than at birth, for they are so widely distributed that they may be encountered al- most anywhere. They may be carried from one person to another by the use of a common towel, wash-cloth or other article. It is on this account that public towels are being banished from the most progressive and enlightened states. In order to avoid any possibility of infection after birth the baby's eyes should be cleansed with a solu- tion of boric acid at least once a day. Small pieces of gauze should be used and then burned. The same piece never should be used for both eyes as disease germs from one eye might be carried to the other. Should any symptoms of inflammation, such as redness or a discharge, appear, this fact should be reported to the physician at once so that he may direct the proper treatment. It is not safe to allow any " sore eyes " to be neglected, for even a day's delay may mean permanent blindness in some cases. 109 YOUR BABY If by any accident or neglect the baby's eyes have been infected at birth, the fact will be manifested in a few days by a redness and puffiness of the upper eyelid, together with a discharge of pus. If heroic measures are taken at once, the eyes may yet be saved. One important part of the treatment is the cleansing of the eyes thoroughly every hour of the day and night. This requires constant attention and it is better for the baby to be under the care of a trained nurse either at home or in a hospital. Babies' eyes are liable to become a little " sore " at times. At the first sign of any inflammation the eyes should be bathed with the boric acid solution about every hour. It is a good plan to use a medi- cine dropper and put one or two drops of the solu- tion into each eye every one or two hours. This will cleanse them more thoroughly than can be done with a cloth. Sometimes when a baby awakens in the morning its eyes will be found glued together with dis- charges caused by a cold. In such a case, the mother should lay a cloth wet with a warm solution of boric acid over the eyes until the discharge is softened. Then it may be bathed away carefully. Do not use any force or the eye might be injured or the eyelashes torn out. The eyes should be no FIRST CARE OF THE BABY bathed several times a day as long as there is any discharge. If the eyes become much inflamed at any time, or if a slight inflammation does not yield to treatment readily, a physician should be consulted without loss of time, for the baby's eyes are too precious to be neglected. Think what it would mean for the child to have to go through life blind as a result of its mother's neglect! Care of the Mouth The cleansing of the mouth at birth is important, for there may be an accumulation of mucus in the mouth which will be drawn down into the lungs when the baby breathes and so cause pneumonia. In many cases it is necessary and desirable to hold the baby's head downward while a few quick pats are given on the back. This effectually dislodges any mucus that may have accumulated in the throat. If the baby does not breathe well when the eyes and mouth have been cleansed, it should be held face downward supported by one hand of the nurse while the back is patted quickly with the other. If it still does not breathe, a little cold water should be sprinkled on it. In some cases it is necessary to place the baby in a warm bath while at the same in YOUR BABY time its face is sprinkled with cold water. In still other cases it is necessary to perform artificial res- piration for a time. Strict attention should be given to the baby until it is breathing regularly. In normal cases it is best to be certain that the baby is breathing well before severing the cord, but if the baby requires much attention, the cord must be tied first. The Cord When the pulsation in the cord has ceased, it should be tied in two places about an inch and a half apart. The first ligature should be about an inch and a half from the baby's body. The cord is cut between the two ligatures. The tying should be done carefully so that the baby may not bleed to death. A piece of narrow tape that has been boiled is better than a round cord. The severed end of the cord should be wiped with a cloth wet in alco- hol, dusted with boric powder and covered with a piece of sterile gauze. In the absence of regular sterile gauze, a piece of clean white cloth heated to scorching may be used. It is very important to keep the cord dry so that it will drop off early. Vase- line or oil never should be applied to the cord. 112 FIRST CARE OF THE BABY When the cord remains constantly moist an applica- tion of alcohol will help to improve the condition, and no other care is necessary. The cord should come off about the fifth day. Then the navel should be cleansed daily and dusted with boric powder. After the cord has been severed, the baby should be wrapped in a warm blanket and laid on its right side until the nurse has time to give the bath. Be- fore birth there is an opening between the two sides of the heart which should close after birth. If this opening, or valve, does not close, a " blue baby " will result. Such a child is weak and seldom lives very long. The closure of the valve is assisted by having the baby lie on its right side. The First Bath The first bath of the modern baby usually is an oil rub or cleansing. Olive oil or fresh lard is warmed slightly, then rubbed over the entire body. When this is removed by wiping with a soft cloth it will leave the skin clean and free from the white cheesy material so frequently found on the body of a new born babe. This white cheesy substance is called vernix caseosa and covers the entire body during the seventh and eighth months of fcetal life. 113 YOUR BABY It usually disappears during the last month so that by the time the baby is born only occasional parti- cles are seen. These sometimes are difficult to re- move with soap and water, but are removed readily with the olive oil. In giving the first bath especial care should be given to all creases, the axilla, the groin, and the genitals. The latter should be ex- amined carefully at this time to see that there is no imperfection which would prevent their natural use. Babies have been born without any external opening to the rectum. For the first few days of its life the baby should be oiled every morning. The eyes and mouth should be cleaned thoroughly with boric acid solu- tion. Every time the diaper is changed, the but- tocks should be sponged with warm water, or water and a little pure soap. The parts should be dried well and powdered with a good talcum powder. All the little creases on the neck and under the arms should be well powdered after the bath. When the baby is undressed at night a gentle rubbing followed by powder will rest the little muscles. By the time the baby is a week or ten days old, it may be given a tub bath every morning unless the baby is poorly nourished. In such a case the oil bath had better be continued for a time. 114 FIRST CARE OF THE BABY Dressing the Baby An abdominal band made of soft, white flannel about eight inches wide and eighteen inches long is then fastened snugly around the baby's abdomen to hold the dressing in place on the cord and to keep the abdomen warm. This band also helps prevent rupture before the muscles surrounding the navel have grown together. In preparing the baby's out- fit, a half yard of flannel cut in strips lengthwise makes three or four of these bands. The bands should not be hemmed as the hem would be liable to cause a crease on the tender skin. The bands may be notched on the edges. A medium weight wool shirt, or cotton and wool, should be worn by the new baby no matter what the weather. In buying the first shirts three will be sufficient as they are outgrown so quickly. The second size is better than the very smallest for the same reason. About two dozen diapers are needed in a baby's outfit. These should be made of some soft ab- sorbent material, as bird's-eye linen or canton flan- nel. They should be about two feet square and hemmed on the raw edges. At least three pinning blankets of soft white flan- nel, made with a four-inch band and open all the "5 . YOUR BABY way down the front, will be needed. It is not well to burden the new baby with too many clothes, therefore besides those mentioned it is customary to add only a kimono of white outing flannel. Three of these will be necessary. A little later, an extra petticoat and a white slip instead of the ki- mono may be used, but at first it is well not to have any unnecessary clothes or any that require much handling of the baby. When dressed, the baby should be wrapped in a warm blanket with a light covering over its head and laid in a warm place on its right side. It probably will go to sleep and not awaken for several hours. After the bath the baby may be given one or two teaspoonsful of warm water which will help cleanse the throat and also will fill the tiny stomach. Sugar should not be added to the water as it is liable to ferment and cause colic. Aside from the water, no diet should be given the baby except the mother's milk. The various teas recommended by the fond neighbors are unnecessary and frequently prove harmful. A new baby usually is deluged with presents by the adoring relatives and friends. Among these are many that are useful while others are useless. One of the most appreciated but least seldom provided is 116 FIRST CARE OF THE BABY a small-sized hot water-bottle. One young mother said recently that this was the most used of all her baby's gifts. In order to keep the baby good na- tured and to avoid colic, its feet must be kept warm at all times. This makes a hot water bag almost a necessity. Many cross and colicky babies would be reformed if provided with a hot water-bottle for their feet. The weaker the baby the more it becomes impor- tant to prevent heat loss. To keep the baby thor- oughly warm, to prevent chilling at any time, and to keep the supply of air pure are important points to be watched. When urination is delayed, try a warm sitz bath, and give the baby plenty of warm water to drink. When the baby has difficulty in nursing, the appli- cation of a hot fomentation to the breast over the nipple, before each nursing, will help to lessen the trouble by bringing the milk to the surface. A few drops of warm water on the nipple will cause the baby to take hold more quickly. The baby must not be given a " soother " or nipple before it has learned to suckle the breast, as this may cause it to refuse to nurse. A great deal can be learned of the child's condi- tion by carefully observing the stools. The normal 117 YOUR BABY stool in the new born is dark green for two - or three days, gradually becoming brown. The change from brown to yellow is gradual and by the end of the first week the stool should be golden yellow. When a baby is not getting sufficient food the color of the stools will remain brownish rather than yellow. Registering the Baby's Birth The importance of registering the birth of a baby should be more widely realized. These records are essential in settling questions of heredity, legitimacy, the age of consent, the right to work and the right to vote, property rights and other rights. In many localities the physicians send the record to the proper authorities. However, parents always should see that this has been attended to properly. 118 CHAPTER X WEIGHT, GROWTH AND DEVELOPMENT The Weight of the Baby. The average weight of the new born baby is seven and a third pounds, while many healthy babies weigh less than this. Frequently, we hear of twelve and fourteen pound babies but these stories seldom are true. The little scales used in weighing babies can be regulated so that the apparent weight is several pounds more than the correct weight. So many parents seem disappointed if the baby does not weigh at least eight pounds that the friend or accommodating doc- tor or nurse often " stretches " the weight As a rule, boy babies weigh more than girl babies but this is not invariable. The size of the baby varies with the weight of the parents. Giants naturally would have larger children than Lillipu- tians. The child's weight varies also with the health of the parents, especially that of the mother. A woman who is overworked or run down from excessive childbearing cannot expect to have as healthy a child as she would have under normal con- no. YOUR BABY ditions. The age of the mother has some effect upon the size of the child. If she is very young or old the child is liable to be small. The best age for childbearing is from twenty- four to thirty- four. Before the former age a woman has not reached her full development. The first few days after birth a baby loses weight. Then it begins to gain, so that by the time it is ten days old it weighs about the same as it did at birth. If the baby is well, the gain will be slow but certain from that time on. The average gain is about an ounce a day for the first two months. Babies gain in weight most rapidly the first three months. From the sixth to the ninth months the gain is slower. The average baby will weigh about fourteen pounds at five months and twenty-one pounds at the end of the first year. Babies fed upon artificial food do not show the same gain the first week. Such a baby usually loses the first three days, then the weight remains sta- tionary for nearly two weeks. This is due to the effort of the system to become accustomed to the new food. Frequently, this failure to gain weight alarms the parents, who may as a consequence make a change in the food, which change only lengthens the period of stationary weight. WEIGHT, GROWTH AND DEVELOPMENT The weight of the infant is the best means we have of judging the nutrition of the baby. Although the weight should not be taken as the only guide to a baby's condition, yet, it is of so much impor- tance that it is of great advantage to have it weighed regularly. For the first six months, the baby should be weighed weekly; for the next six months, bi-weekly weighing is sufficient ; during the second year, it is well to weigh the baby once a month. Perfect health the first year goes with the steady gain in weight. A child may not gain as rapidly as the average but the gain should be steady, otherwise the cause should be investigated. In many cases the baby's weight remains stationary for a period be- tween the seventh and tenth months when the baby is teething. This should not cause any alarm if the baby is well and happy. What the Baby Knows When It Is Born In the New York Lying-in Hospital, investiga- tions have been carried on to determine the extent of the knowledge possessed by the new born babe. From these studies, it has been concluded that a baby at birth is sensible to light and darkness. The optic nerve is ready to receive impressions even be- 121 YOUR BABY fore birth. Probably the first impression it receives after birth is that of light as distinguished from darkness. Aside from this, the baby has no use of its eyes for a number of weeks. It has some sense of hearing as shown by the fact that some children react to sound the first day of their lives. Some cry out as in pain at a sharp sound. However, there seems to be no ability to distinguish sounds except by their pitch and in- tensity. Words are meaningless to the new baby. Even the sound of its mother's voice is no different from that of others. There also is reason to believe that the new born babe has a sense of touch, a sense of motion and of position. Before it is twenty-four hours old, it makes known its preference in regard to position and place. It will lie quietly on a warm soft pillow while it will cry if laid on a hard chair. It also early manifests a desire for motion, and if its father humors this he might as well begin training for night walks, for the baby will not lie quietly if it can com- pel its father to walk the floor with it. Thirst is experienced the first day, but real hun- ger seldom appears for several days, as shown by the fact that for the first three days of its life a baby will be satisfied with a water diet. This seems WEIGHT, GROWTH AND DEVELOPMENT to be in compliance with Nature's provisions, for usually the real milk does not appear in the mother's breasts until the third day. Before this time, there is a secretion which acts as a laxative for the baby. The young baby frequently suffers from thirst the first few days of its life as shown by the fact that many new babies cry and are restless without any apparent cause. A little warm water usually causes the baby to become quiet at once. Then it prob- ably will drop to sleep and remain asleep for sev- eral hours. Many mothers who do not understand this thirst of the new baby and who are un- able to discover any cause for its restlessness begin the harmful practice of giving soothing syrup or some kind of " tea." A drink of water would have the desired effect without the harmful results. In a few cases it is necessary to feed the baby if there is a rise of temperature known as inanition fever, but in such a case the physician will direct the feed- ing. There is good reason to believe that a new born child comes into the world with a shadowy remem- brance of several experiences. The child's body readily transmits sound and it must have had an impression of the sound of its mother's heart beat. 123 YOUR BABY The sense of touch must be developed in fcetal life during its movements. What a Baby Learns the First Year Usually we do not consider that a baby of one year of age has a great deal of knowledge, but, when we compare its knowledge with that which it had at birth, we find it has made considerable advancement during the year. At birth, it has no control of any muscles. Its movements are purposeless and futile. If it has any thought of what it would like to do, it has no power of accomplishment. Before it can make the most simple of controlled movements, every individual muscle concerned must be educated and trained to do the will of its owner. At first the little head, when unsupported, wobbles piteously. After a while the baby learns to control the muscles that support the head so, by the time it is a year old, it can maintain its head in any desired position. The early movements of the hands are futile, but, after a while, the baby learns to reach toward any- thing it desires. Later it learns to grasp an object and make use of its thumb in opposition to its fingers. 124 WEIGHT, GROWTH AND DEVELOPMENT The eyes, at first, are able to distinguish only- daylight from darkness. Then they learn to distin- guish objects and to follow moving bodies. Before long, the mother's face becomes distinct from the others in general. During the first year the baby has learned to taste and now will manifest any dislike. He has learned the odor of certain things. He has learned to dis- tinguish sounds and knows the sound of his mother's footsteps. He can tell a glass of water from other objects. In his efforts to reach some desired object, he one day finds to his amazement that he can move towards the object. Evidently the sensation is a pleasant one, for he tries it again and again. Before long he is able to propel himself in whichever direc- tion he wishes to go. Before he could creep he has had to educate the muscles of his arms and legs, as well as those of his back. Not only this, he has learned a sense of direction and a consciousness of the presence of a desired object. Besides these wonderful accomplishments, the baby, during this first year, has been forming habits that will remain with him all during life. He either has established habits of regularity in eating, bathing and sleeping or he has formed irregular 125 YOUR BABY habits that will be a drawback to him in later years. By this time, he understands if his parents are firm in their discipline or if he will be able to sway them by crying or exhibiting other evidences of an uncontrolled temper. A baby never is too young to be taught the meaning of " yes " and " no." The great secret of discipline is reliability, the faculty of remaining unchangeable. The mother must be truthful to her child if she would train him correctly. What the Baby Learns the Second Year During the second year of his life, the amount of knowledge acquired by the child is quite notice- able. First he learns to stand by his mother's knee, then he finds that he can walk by the aid of a chair or other support. After a time, he discovers that he can stand without touching anything and finally gains confidence enough to attempt a few steps alone. If an adult feels timid about trying to bal- ance himself on a bicycle, how much more timid must a child feel about trying to balance himself upon his own wobbling legs. The first words spoken by a baby usually are " da, da " or " ma, ma." He probably has no con- ception of the meaning of what he is saying but simply is trying to imitate the sounds that have been 126 WEIGHT, GROWTH AND DEVELOPMENT repeated to him many times. A mental impression finally has been made so that he is enabled to dis- tinguish these syllables from others. Although it is some time before he attempts to formulate any other sounds, yet all the time he is acquiring a store of knowledge and is learning words that he will repeat later. By the time a baby is two years of age, he will have a fair knowledge of the meaning of com- mon words so that he is able to understand the mean- ing of nearly all that is said to him. He also will have acquired a speaking knowledge of enough words to enable him to make his wants known. True, his remarks are very concise, but they are to the point. One word usually takes the place of an entire sentence. " Dink ! " might be interpreted to mean, " I would like a drink of water." " Mik ! " usually means " I would like some milk." " Bonnie, byby " means " I would like my bonnet so that I can go out of doors for a walk." Besides learning the meaning of words the baby has learned to recognize other sounds, as the sound of a street car on the track, of a wagon on the street, or of a whistle. Also he has learned to distinguish colors and has formed a basis for kindergarten work. He has gained control of his hands so that he is able to feed himself without many accidents. 127 YOUR BABY He, perhaps, has learned to make marks with a pencil and to cut paper into pieces. Indeed, if a child of this age has been under the guidance of one who understands kindergarten methods of teaching- children, there practically is no limit to the amount of knowledge that can be acquired by such a small person in the short time he has lived. During the second year he has acquired a set of teeth and a knowledge of their use. 128 CHAPTER XI GENERAL CARE OF THE BABY The Baby's Tub Bath. After the baby is a week or ten days old and the cord has dropped off it should be given a tub bath every day. For sev- eral reasons, this is preferable to the sponge bath. It can be done more quickly and thoroughly and the baby is not so liable to take cold. The room should be warm; an open fire is desirable. The water should be comfortably warm but not hot. It is well to lay a bath towel in the bottom of the tub and put only a small amount of water in at first so as not to frighten the baby. If a baby is plunged immediately into a tub of water, it becomes startled and may never enjoy a tub bath ; while if the water is added gradually, the baby's attention in the mean- time being attracted to something else, it soon learns to enjoy its morning dip. The eyes should be cleansed first with absorbent cotton dipped in boric acid solution. Squeeze a drop into each eye. The ears, mouth and nose then should be cleansed with (2 9 YOUR BABY an applicator dipped in boric acid solution. An applicator is made by twisting a small tuft of ab- sorbent cotton upon the end of a wooden toothpick in such a way as to make a rounded pad. If made correctly the cotton will not slip off readily. Be careful not to injure the ears. It is better to ask your physician to show you just how to cleanse the ears correctly. The baby's bath should be given as nearly as pos- sible at the same hour each day at least an hour after feeding. For the first few weeks the temperature should be about ioo° F. After a few weeks it may be lowered gradually. It is well to use a bath thermometer. At first the dura- tion of the bath should be only about three min- utes. Later it may be five minutes. Besides the regular daily bath the lower part of the body should be sponged after each bowel movement. Only pure, unscented soap should be used. If the baby is in- clined to have eczema or chapping, oatmeal bags may be substituted for the soap. An older child who does not want to take a bath may be taught to enjoy it by having some toy added to the bath, such as one of the floating animals that may be purchased as low as five cents apiece. It is much better to coax a child with some toy than to 130 GENERAL CARE OF THE BABY compel him by force and against his will. In train- ing a child one never should attempt to " break " his will but rather should endeavor to guide it in right channels. Strong willed (not stubborn) peo- ple make the best citizens. Many a child has been made stubborn by attempts to coerce him into sub- mission. For the first few months of its life, the baby should be allowed to stay in the bath only a few min- utes and then taken out and dried quickly. As it grows older and stronger it should be allowed to play in the water for about fifteen minutes, as the skin absorbs some water which is beneficial to the system. Besides this, the water relaxes the muscles and aids in overcoming many wrong conditions. Muscles that have been contracted by disease will be benefited by the warm bath. Ordinarily we think of a bath as a cleansing agent only. There probably is no other health producing agent so imperfectly understood. The daily bath, besides being essential to cleanliness and daintiness, is necessary to health. The skin is supplied with in- numerable small pores which have an important function to perform. Some of the glands pour an oil onto the skin which keeps it lubricated while others throw off some of the waste material from I3 1 YOUR BABY the body. Every minute, waste is being produced in the body in the same manner that ashes constantly are being made by a fire. If the ashes are not car- ried away the stove becomes clogged and the fire can- not burn. In the same manner, if the waste ma- terial of the body is not carried away, the various organs become clogged and cannot do their work. The pores of the skin must be kept open so that some of this waste material may pass away through the skin. Sex Toilet At the time of the daily bath, attention should be given to the external generative organs. With a boy, the foreskin should be retracted every day and the parts cleansed of all secretions. If it is impossible to retract the foreskin so as to expose the entire glans, the boy probably needs circum- cision. This should be done during the first year of life, for after that time the irritation from re- tained secretions is liable to cause various nervous disorders and to effect the general health of the child. Even girls sometimes need a similar operation if the clitoris is covered, or hooded. An irritation of the external generative organs is liable to cause the child to form a habit of self -abuse. 132 GENERAL CARE OF THE BABY In some instances female babies have a slight whitish discharge for a few days, and even may have a bloody discharge resembling the menses. This is nothing alarming and needs no treatment except to cleanse the parts twice a day with ab- sorbent cotton dipped in a warm boric acid solution. Powdering the Baby If the skin could be dried thoroughly after each bath, powder would not be necessary. However, there usually remains some dampness especially in the creases and folds. A mild pure powder applied to these parts and removed daily by the bath often pre- vents chafing. In some cases it is better to use vaseline or castor oil on the buttocks if there is much chafing. In a few cases the chafing is due to the food, when the baby is bottle fed, and it becomes necessary to make a change. The Baby's Sleep Twenty hours out of every twenty-four are re- quired for sleep by the very young baby. He should sleep nearly all the time except when he is being bathed and fed. A baby six months old should spend at least sixteen hours in sleep, and after that until the child reaches the school age, one-half the 133 YOUR BABY twenty- four hours should be devoted to sleep. Many babies become nervous, and this nervousness results in various troubles, as indigestion, all be- cause the baby does not have enough sleep. Even the smallest of babies should be provided with a separate bed, although this bed may be only a clothes-basket with a pillow for a mattress. In one year in Des Moines, Iowa, it was reported that ninety babies were found dead in bed with their mothers, in most cases they were suffocated by being rolled upon in their sleep. In England this acci- dent occurred so frequently that it became legally known as " over-lying " and is punished by law. Aside from this danger the baby who sleeps with a grown person is liable not to receive sufficient fresh air. Some mothers complain that the baby is cold when it sleeps alone. This can be remedied by a padded basket which keeps away drafts. The white iron cribs are sanitary but not very cozy for the small baby who arrives in cold weather. One way the bed can be made warmer is to place several thick- nesses of paper between the mattress and the springs and by throwing a blanket over the head of the bed. The latter is desirable as no good ever came from having a draft on the baby's head. Plenty of fresh 134 GENERAL CARE OF THE BABY air and drafts are two entirely different things. The former is necessary and desirable but the latter is unnecessary and harmful. The Baby's Rest The hours of rest and sleep for a young baby are as important as its diet. The very young baby should sleep practically all the time except while being bathed and fed. There is no danger of it sleeping too much if it is awakened at regular hours for feeding. One of the most important measures to insure a strong nervous system is plenty of sleep. From birth, the young baby should have a separate bed for the sake of both mother and child. If they sleep together one is liable to disturb the sleep of the other. If the baby is near the mother there is an in- clination to feed it too often, and the mother's sleep is disturbed frequently. Recently one young mother told me that she had been in the habit of allowing the baby to sleep with the nipple in its mouth all night. As a result, the baby had colic, the mother had very little sleep and was tired out. Her condi- tion naturally affected the baby and both were cross. A separate bed was provided for the baby and im- provement was seen at once. 135 YOUR BABY A baby may be " spoiled " the first two weeks of its life, or during this time habits of regularity may be established that will make the care of the baby much easier. It takes a baby only a few days to learn if it will be taken up and rocked every time it cries. If this is done in the beginning, the mother establishes a tyranny from which she will have hard work to escape and that will make her life a burden and her baby a care instead of a blessing. It seems rather hard at first to awaken a baby from a sound sleep just because the clock says it is time for feed- ing. Yet this seeming cruelty really is a kindness, not only to the baby but to all concerned. If the baby is awakened regularly for the first few months, it soon becomes accustomed to the habit. If fed at regular hours it is not as liable to have indigestion and colic as otherwise, the mother is enabled to plan her time and does not become so worn out by the constant demands upon her. During the summer the baby should sleep out of doors during the day, and at all seasons of the year a window should be opened in the baby's sleeping room. The baby should be well protected so as not to become cold. After the baby is old enough to move about, it is better that the regular night gowns should be discarded for sleeping suits made with feet 136 GENERAL CARE OF THE BABY so that there is no danger of the baby's feet becom- ing entirely exposed. By the time the baby is six months old it will lie awake several hours during the day and by proper training the mother may arrange these hours to suit her convenience. She should begin early to train the baby to have a nap from eleven to twelve when she is most liable to be busy. It then may have its luncheon and be ready for an afternoon of play. The baby should be quiet for the night by six o'clock. Too many families have a habit of allowing members of the family to play with the baby during the even- ing, tossing it and otherwise exciting it. This should not be allowed. Baby is not a plaything to be tossed about at the convenience of its elders. Its welfare should be the first consideration. After the baby is a year old it should not be put to bed for an hour after the evening meal, but this meal should be so arranged that the bedtime will not be later than seven o'clock. This is a good bed- time to keep until the child is about six years old. Then it may be allowed to sit up until eight o'clock and this latter time should be the regular bedtime until the child is at least ten years of age. The evening meal for children should be light, and only quiet games indulged in afterwards. The habit of 137 YOUR BABY allowing children to sit up until ten and eleven o'clock is very wrong, for this does not allow the child sufficient sleep. Many nervous children would overcome this condition if they had an earlier bed- time hour. If possible, children should sleep in separate rooms as they are liable to keep each other awake by talking if they are in the same room. The daily nap for a child should be continued until he enters school. Even then, if it can be ar- ranged to have him lie down for a few minutes after school, his nervous system will be greatly benefited. Nervous children are helped by lying quietly in a darkened room for a few minutes several times a day. Even five minute rest periods will work won- ders. Mental poise and self-control both are greatly benefited by these periods of absolute rest. Baby's Bed The most convenient bed for the baby is the bassi- net. This may be as simple or as elaborate as de- sired. A very good one may be made from an oval clothes-basket which should be about three feet long. The sides may be covered with dainty white material and trimmed according to the taste of the mother. The inside should be padded and fitted with a re- movable mattress. A rather large pillow will an- 138 GENERAL CARE OF THE BABY swer at first, although later a hair mattress is more desirable, especially in the summer time. Blankets are better than comforters as they may be washed easily. The dainty comforters soon lose their beauty. If a pillow for the head is used, it should be very small and usually it is more desirable that the baby should sleep without a pillow. Over the mattress should be a rubber sheet, or, preferably one of stork sheeting. This will keep the mattress clean and dry. The rubber sheet should be covered with a blanket and sheet as it is not desirable that the baby should lie directly on the rubber. The bassinet should not be allowed to stand on the floor as there is danger of drafts. It may be placed on one or two chairs and then can be moved easily. At night, it may be close to the mother's bed so that she can attend to the baby without get- ting out of bed. After the baby is about eight months old the basket will become too small and the baby be in danger of falling out if left alone. A white iron bed with adjustable sides is very convenient for the older baby. The old-fashioned cradle seldom is used, for although we love to think of the mother rocking her babe in the cradle, yet the cradle doomed mother to many weary hours of rocking. Recently, too, we '39 YOUR BABY have decided that the constant rocking disturbed the nervous system of the baby and really kept sleep away for some time. It has been found that babies go to sleep more quickly if trained to lie quietly on the bed. But this training must commence from birth, for if a baby is rocked to sleep a few times it will demand it ever after. The young baby should be held and handled very little. After it has been fed, it should be laid on its side in a cool, darkened room and left alone. The mother should not sit near unless she wants to be compelled to do this all the time, for a baby soon becomes accustomed to having his mother near and will require her pres- ence at all hours. After the baby has been laid in his bed he should not be taken up again even though he does cry. The mother should investigate to see that he is in a comfortable position, that his clothes are dry and no pins disturbing him. She may give him a drink of water, then she should gently but firmly give him to understand that he will not be taken up. It is bet- ter for her to leave the room, for if she is near he may cry for her. The first baby usually is spoiled and the mother finds his care a burden. After a few more children have been added to the family she finds that the baby 140 GENERAL CARE OF THE BABY is just as healthy and even happier with less atten- tion. It is an injustice to all concerned to allow a baby to acquire the habit of being walked to sleep by either father or mother. Exercise for the Baby Exercise is an important measure in the promo- tion of health. From time immemorial physicians and others competent to advise have insisted upon exercise as essential to the growth and health of the body. The ancient Romans and Spartans laid es- pecial stress upon the value of exercise for both mother and babe. Baby needs exercise but he does not need violent exercise any more than he needs a hearty meal of beef-steak and potatoes. The one would be as in- jurious as the other. It is no uncommon sight upon entering a home in the evening to see father " playing with the baby," bouncing him up and down, jolting him on his knee and in innumerable other ways tending to overstimu- late the excitable and unstable nervous system of the immature child. The effect of such a course can be demonstrated, in a manner, by the parent himself if he will go through a series of violent ex- ercises, such as running, jumping and laughing 141 YOUR BABY heartily in the late evening hours. After that, he should go to bed immediately and try to calm him- self for a quiet sleep. Impossible! you say, and yet that is exactly what is expected of the baby. Among the chief requirements for the growth of the baby are plenty of rest and quiet, intermingled with a moderate amount of gentle exercise. For the greater part of the day, a young baby should lie in its bed. For the first few weeks it receives sufficient exercise by the movements at the regular periods for bathing and feeding. When the baby is given its morning bath the little body should be rubbed gently so as to exercise the tired muscles. That this rub- bing is appreciated and restful is shown by the fact that the baby always sleeps the best after a bath. An olive oil rub at night will do wonders in pro- moting the growth of the baby. Rub up the arms to the body using a firm regular stroke. Then place the hands flat on opposite sides of the arm and gently roll the muscles between the hands. Work in this manner the entire length of the arm. The legs then should be rubbed in the same manner. Then work down over the chest using the tips of the fingers only. Fix the fingers firmly on the surface and move the muscles with a rotary move- 142 GENERAL CARE OF THE BABY ment. Do not allow the fingers to slip over the surface but lift them and move them from place to place. Massage the abdomen in the same manner, only start at the lower right hand side and work upward as far as the navel, then work across to the left side and down on that side. This massage will do won- ders for the constipated baby. Turn the baby over on his abdomen and massage his back. Rub with the palm of the hand from the head downward along the spine and then over the sides. Then use the rotary movement all over the back. Finish with a few regular strokes. Then turn the baby over on his back and play with him a few minutes. Let him pull on your hand and try to raise his body. You will be astonished how quickly he gains in strength. After the baby is a few weeks old, he exercises his own muscles by kicking, reaching and crowing. Every little cry he makes exercises the lungs. For this reason it is not harmful for a baby to cry a mod- erate amount every day. Of course, violent crying should be avoided if possible as there always is dan- ger from overstrain. When the baby is a few weeks old it begins to throw its arms and legs about. Then it should be allowed to lie on its back when awake 143 YOUR BABY and exercise as it desires. The clothing should be arranged so as not to interfere with its free move- ments. There is no more perfect picture of health than that of a growing baby lying on its back, kick- ing and crowing contentedly. An occasional word from its mother or other companion helps to keep it happy, for babies may be lonesome as well as older people. However, it is not necessary to take the baby up in order to talk to it. As a rule babies are handled too much. The baby should be taken up and its position changed every time it is fed, but between times it seldom should be held. Fresh Air for the Baby An abundance of fresh air is as necessary for the health of the baby as is plenty of sleep and nourish- ing food. With the exception of a very few stormy days, the baby should be taken out of doors every day. Besides this, it must have plenty of fresh air in the living and sleeping rooms. There is no dan- ger of having too much fresh air. In too many homes cold weather and necessary fires mean stuffy rooms. How common it is to see an entire family huddled around a stove in the evening — all breath- ing and rebreathing the foul air. The old expres- sion, " trying to heat the whole outdoors," has been 144 GENERAL CARE OF THE BABY so impressed upon their minds that, by trying to keep all the heat in they keep all the fresh air out. Some houses never are well ventilated during the winter months. The only fresh air that gains entrance is the small quantity that rushes in whenever a door is opened to allow some person to pass in or out. The effect of this lack of ventilation is seen in the pale, drawn faces of the family. Mother's face becomes wrinkled and drawn, not with old age but with oxygen starvation. You may put all the fuel in the universe into the stove but if you do not open up the drafts and pro- vide some fresh air laden with oxygen, the fire will not burn brightly and no benefit will be derived from the wood or coal. If just a little air is allowed to enter, the fire may smoulder and consume the coal but the family will not derive much benefit. In this way the body is like a stove. You may stuff it with fuel (food) but if you do not provide fresh air half the benefit is wasted. The fresh air schools that have been established in several of the larger cities are a striking illustra- tion of this. Weak, puny children that never could survive a term spent in an ordinary school room be- gin to thrive almost immediately after entering the out-of-door schools. In these schools, the children 145 YOUR BABY are practically out-of-doors all day, being protected only from the storms and severe winds. They wear warm wraps all the time, even while studying in their seats. At frequent intervals they play games or have other light exercises. In some of the modern hospitals, there are out- of-door living rooms for some of the patients. It is a common occurrence to see babies sleeping peacefully in some sheltered nook of the porch dur- ing even the coldest winter days. Not only is it a fact that these babies do not take cold from this treatment, but they thrive wonderfully and begin to take on flesh. All this tends to prove what educators are trying to impress upon the public — that people, as a rule, would be much healthier and happier if they lived in the open air the greater part of the time. Care of the Teeth The care of the baby's teeth is very important, for upon the care given at this time depends, to a great extent, the condition of the teeth during adult life. The first teeth commence to form about four months before the birth of the baby and, during the early months of its life, they are deriving their 146 GENERAL CARE OF THE BABY strength from the food taken by the baby. For this reason, the food of the young baby should be of such a nature that it will give proper nourishment to the teeth. As everything the mother eats affects the milk, she should regulate her diet so as to eat con- siderable bone-forming material. Bottle fed babies should have their diet regulated to provide this important element. So often is this neglected that bottle fed babies usually have poorer teeth than do babies fed upon mother's milk. The baby's gums and mouth should be kept in a healthy condition by cleansing the mouth thoroughly several times a day with a boric acid solution. The ideal way is to cleanse it both before and after every meal. This prevents any milk remaining in the mouth to become sour and fermented. " Sore mouths " of infants usually denote lack of care, al- though sometimes this condition is due to indiges- tion. From the first appearance of the teeth they should be cleansed regularly several times a day and espe- cially at night. If the child has been accustomed from infancy to the cleansing of the teeth, the habit naturally will cling as he grows older. As the first teeth erupt they should be watched that they appear in their proper positions. Should 147 YOUR BABY one come in crooked, it should be straightened, for a crooked first tooth usually means a crooked second tooth. With some children the teeth begin to decay very early. In such a case the teeth should be filled with a temporary filling. If they are not filled it will be necessary to have them extracted before the proper time and this may mean that the second teeth will not appear in their proper positions. The teeth are set in sockets but not so firmly but that one will crowd over into a vacant place. Besides detracting from the appearance of a person, crooked teeth are more liable to decay than straight teeth. Then, too, crooked teeth cannot do as good work in cutting and grinding the food as can straight, evenly meeting teeth. If the teeth are not able to do their work properly, the stomach will suffer in consequence, so that crooked or decayed teeth may be the real cause of indigestion. After the teeth have erupted, children should not be fed entirely upon soft food as they need exercise of the teeth to promote their efficiency. There are twenty teeth in the first set. The two lower central teeth usually are the first to make their appearance when the baby is five to nine months old. 148 GENERAL CARE OF THE BABY Between the eighth and twelfth months the four upper teeth are cut. Then the other two lower and the four front double teeth come between the twelfth and eighteenth months. The four canine appear during the last half of the second year. Of these, the upper ones are commonly known as the eye teeth and the lower ones the stomach teeth. During the third year the four back double teeth complete the first set. At one year of age the average baby has six teeth, at one and a half years it has twelve teeth, at two years sixteen, and at two and a half years twenty. Teething is liable to be later in bottle fed babies than in breast fed, and also is delayed on account of illness of the child. There is no necessity of a baby being sickly at the teething period. Nearly all bad symptoms at teething are due to indigestion or to faulty feeding. It seldom should be necessary to have the gums lanced if they have not been hardened by " teeth- ing rings." It is not necessary or wise to give a baby any hard object upon which to bite during this period as this tends to harden the gums in the same manner as calluses are formed by irritation. The teeth should be examined by a competent 149 YOUR BABY dentist about every six months in order to have any cavities filled before they become so large that extraction of the tooth is necessary. Never wait for a tooth to ache ! Shoes for the Baby For the first few months of its life the baby does not need shoes unless there is a tendency to have cold feet. In such a case, warm knitted booties should be worn. These are the only shoes that should be worn until the baby is old enough to stand on its feet. If other shoes are worn before this time, they are liable to cramp the foot and cause it to grow out of shape. There is no use in bur- dening a baby with unnecessary clothing. As soon as a baby begins to stand on its feet it should have soft kid shoes with thin soles and no heels. These should be broad at the toe and con- form to the shape of the feet. For this reason there should be " lefts " and " rights." If the baby wears a shoe that does not fit, the tender muscles and bones are drawn out of shape. The shoe should be a little longer than the foot so as not to crowd the toes. It should fit at the heel and around the ankle, otherwise the foot may turn in the shoe and a sprain result. It is not uncom- 150 GENERAL CARE OF THE BABY mon for babies to suffer with sprained ankles as a result of wearing shoes that do not fit their feet. Laced shoes are better than buttoned ones as they can be adjusted to the feet better. When the child begins to run about, the shoes may be a little heavier with thicker soles. There should be no heels on the shoes until the baby is about three years old, then it should wear " spring heels " until it is seven or eight years of age. With small children, as well as with grown peo- ple, the shoes should be adapted to the weather. I have seen small children all bundled up in furs trod- ding along on a cold pavement with thin soled shoes which rendered little protection from the cold. " Baby catches cold every time he goes out for a walk ! " is the cry of the unthinking mother. More children contract colds and pneumonia because their feet are not clad properly than they do from wearing thin coats. It is much more necessary to protect the feet than to wrap the throat in furs. Almost as injurious and much more uncomfort- able to the child are the hot pavements during the summer days. The heat goes right through the little thin soles and poor baby suffers with his blistered feet. 151 YOUR BABY The Night Clothes The baby's night clothes should consist of a flan- nel shirt and band, a diaper and an outing flannel night gown. It probably is unnecessary to say that the shirt worn at night should not be the same as that worn during the day. The baby should be given a complete change of clothing night and morn- ing. The gown should reach several inches below the feet and be tied at the bottom with a draw string. A hot water bottle should be placed in the bed, not touching the baby but near enough so that heat is supplied If the baby is placed in a cold bed, it requires some time to get the bed warm and the baby loses all the extra heat. In bitter cold weather cotton blankets are better than sheets and if the baby is inclined to throw off the covers, a shawl or light blanket should be pinned around the shoulders, or a loose knit jacket may be worn over the gown. Diapers A baby's diapers always should be clean and dry. They never should be merely dried and used a sec- ond time. They should be washed and rinsed in boiling water and always dried thoroughly before they are used. There should be no soda or bluing used in the water and the soap must be rinsed out 152 GENERAL CARE OF THE BABY thoroughly after each washing, otherwise the dried particles of soap will chafe the child's tender skin. Toilet powder should be used very sparingly, if at all, as too much powder clogs the pores of the skin and does more harm than good. Common pins never should be used about the baby. A child may be trained to be regular in the move- ments of his bowels and by the third month he may be taught to use the chamber or chair for his move- ments if he is taken up immediately upon waking. The Baby's Bands A baby's bands should not be taken off until he has finished teething. Day and night, winter and summer, the baby should have flannel (not outing flannel) about his abdomen. He is far less likely to have summer complaint if he wears bands. After the first few months it is better to get the knitted ones with shoulder straps as these require no pins and there is no danger of them being too tight. For the first few months, the bands should be fastened snugly (not tight) so as to prevent rup- ture of the umbilicus. 53 CHAPTER XII WHAT, WHEN AND HOW TO FEED THE BABY That two million babies have died in the United States during the last ten years, that the majority of these died from preventable diseases and that nearly one-half died from some gastro-intestinal (so-called stomach and bowel) trouble is the alarm- ing and awful fact that we must admit. In some parts of the country, one-half the babies die before they are twelve months old. The ma- jority of these die because they are not given the proper care. The mothers do the best they know how, but they never have been taught how to care for babies. It is a strange fact that we have con- sidered it necessary for a girl to receive instruction before she is able to read, write or perform various other feats. We do not expect her to be able to do any of these by instinct, but have found it neces- sary to instruct her carefully. Yet we have con- sidered that she should know by instinct how to care for babies, which certainly is a more important 154 FEEDING THE BABY study than any given in the ordinary school. Of all the changes needed in this country one of the most important is the establishment in every school of a course for the instruction of girls in the science of motherhood. The feeding of infants is one of the most impor- tant problems with which every young mother has to deal. There seems to be a superstition among certain classes of people that a baby should not be refused anything which it apparently desires. As a consequence, many babies are fed upon bread, potatoes and even cabbage and turnips. All of these are as indigestible to a young baby as leather would be to an adult. A baby's stomach is a very delicate organ and is not capable of digesting any but the most simple of food. If it were best that the baby should have meat and vegetables the first year of its life, Nature would have provided teeth at birth. Such is not the case, young babies are not provided with teeth and, consequently, should be given only such food as does not necessitate the use of teeth. The Best Food for a Baby Naturally the best food for a young baby is mother's milk. Unfortunately, however, there are 155 YOUR BABY many babies that, for various reasons, must be brought up on artificial food. As there are few deaths among breast fed babies in comparison with the number among babies fed upon other food, it is the duty of every mother to nurse her baby unless there is a positive reason against it. Among these reasons may be disease of the mother, as tuber- culosis, or a lack of sufficient milk. The latter con- dition, however, frequently can be remedied by proper care of the mother. Attention should be given to the breasts before confinement and to the diet of the nursing mother. The mother who self- ishly refuses to nurse her baby because of social aspirations or similar reasons cannot be condemned in too strong terms. By her selfishness she is jeop- ardizing the life of her child. In those cases in which it is necessary to use arti- ficial food this should be as nearly like mother's milk as possible. If it is possible to obtain a good dairy milk, this, properly modified, makes the best food as it can be regulated to suit the individual child. There is so much difference in babies that it is im- possible to make any set rule as to the amount or richness of the food to be given to a baby. Usually milk from a herd of cattle is better than that from a single cow as it varies less from day to day. 156 FEEDING THE BABY Milk from Jersey or Guernsey cattle frequently is too rich for a baby. Milk from a Holstein herd probably is the best. The milk should be obtained fresh every day and enough prepared to last twenty- four hours. Top Milk Method Until very recently top milk has been considered better than whole milk. To obtain this, allow a quart of milk to stand in a quart measure or vessel of similar shape for about four hours. Then dip off the top third. This should be done accu- rately so that the milk will be of the same richness from day to day. It cannot be poured off accu- rately. There are little dippers made for this pur- pose which measure the milk correctly. The pur- chase of one not only will save a great deal of trouble and annoyance but will insure better milk for the baby. For a new baby, take two ounces (by measure) of top milk, one ounce of lime water, one even table- spoonful of sugar of milk and seventeen ounces of boiled water. Of this mixture about one and a half ounces should be given at a feeding. This food should be poured into the feeding bottles at once, just enough in each bottle for one feeding. 157 YOUR BABY This will make it necessary to have about six or eight bottles for a small baby. The bottles should be stoppered with a little absorbent cotton and placed on ice or in a cool cellar until needed. Remember that milk absorbs odors and do not place it near onions or other vegetables of pronounced odor. When it is time to feed the baby, one bottle should be heated by being placed in a pan of hot water. The other bottles should remain undis- turbed until needed. Throw away any unused food remaining in the bottle after a meal, never save it to be used with the next feeding. The loss of a little milk is better than to take any risks with the baby's life. Do not keep the baby's milk warm at night by putting it under the pillow, on the back of the stove or in the thermos bottle, for it may make the baby sick. Milk sours much more quickly if kept in a warm place than if kept on ice. Milk that has been kept warm for several hours may be soured slightly when it is time for it to be used. The con- sequence is that the baby's digestive system is upset. The mother who is bringing up her baby on a bottle must reconcile herself to the discomfort of arising at night to heat the milk if she values the health of her baby. 158 FEEDING THE BABY Sugar in the Baby's Milk When it is necessary to feed the baby from a bottle almost all prepared foods require to be sweet- ened. For this purpose only sugar of milk (milk- sugar) or malt sugar should be used. These can be obtained at any drug store. If ordinary sugar is used, the baby is liable to have colic, for the sugar ferments in the intestines and forms gas, which is the cause of colic. For this reason the common practice of feeding a baby sugar and water is harm- ful. Supplementary Feeding for the Baby In some cases the mother does not seem to have enough milk for her baby and yet desires to nurse it part of the time. Unthinkingly she is liable to pur- sue a course that tends to decrease the breast milk, for it is possible to dry up the mother's milk by put- ting the baby to the breast only at long intervals, as morning and evening or only at night. The bet- ter plan is to nurse the baby regularly and after the breasts are emptied to give the baby a little more food from a bottle. As the baby grows older the amount given at each feeding should be increased gradually. Usually it can be increased about one-fourth of an ounce each 159 YOUR BABY / week until the child is taking about five ounces. Then the strength of the mixture can be increased gradually by using a little more milk and a little less water. It may be necessary to vary the amount given according to the size of the baby. Naturally a large baby requires more nourishment than does a small one. The best indication for increasing the strength or quantity of the food is that the baby does not seem satisfied or is not gaining in weight, although the food is perfectly digested. It may be necessary to vary the proportion also if the milk does not seem to agree with the baby or if it has diarrhoea or constipation. The bowel movements should be watched closely as they are the best indication as to whether the milk is correct or not. If the baby is constipated this may be cor- rected by adding a little more cream, or by substitu- ting oatmeal water for plain water. Use a cup of oat- meal to five cups of water and boil four or five hours, adding water from time to time to keep the same amount. Strain through coarse muslin. If the stools are hard and lumpy with white curds, reduce the quantity of the milk. If the lumps in the move- ments are soft and grayish in color, the baby prob- ably is getting too much cream. If the stools are offensive, decrease the amount of milk and add 1 60 FEEDING THE BABY water. Do this also if the baby has diarrhoea. If the baby throws up its milk immediately after feed- ing reduce the quantity. Keep the baby quiet after feeding and give a little water between feed- ings. If the baby throws up its milk between meals decrease the quantity and add water. If it vomits copiously stop the milk and give boiled water. Whole Milk Method The whole milk method of feeding babies is being used quite extensively during the last few years. This method is much more simple for the average mother than is the top milk method. It has been found that an ounce and a half of a. good quality of cow's milk will furnish sufficient nourishment for twenty- four hours for a pound of baby, so that the amount of milk necessary for any baby can be obtained by multiplying one and a half ounces by the number of pounds the baby weighs. For illustration, a baby weighing eight pounds requires eight times one and a half ounces of milk or twelve ounces. Of course this must be diluted with sufficient water to make the necessary bulk, and also requires the addition of some form of sugar, as cow's milk is not as sweet as mother's milk. 161 YOUR BABY This sugar can be supplied in the form of cane sugar, milk sugar or malt sugar. Until very re- cently we have taken it for granted that milk sugar was the best, but now many consider that malt sugar is even better. However, the malt sugar is not used in its pure state, but in the form of extracts, as dextrimaltose. The amount of sugar to be added is determined by the number of feedings during the twenty-four hours and by the amount to be given at each meal. The number of feedings a baby requires during twenty-four hours is a question in the minds of many mothers. In days gone by, babies were fed whenever they cried, with the result that most of them were overfed and had so-called " three months colic." After a time we learned that a baby should be fed at regular intervals and we decided that every two hours was the proper interval. Later investiga- tions revealed that the stomach could not empty itself of milk in two hours, so we decided there must be a longer interval between feedings. In order to give the stomach a few moments' rest be- tween feedings, it has been found that four hour intervals were necessary and the best time for feed- ing the baby is at 6-10-2-6 and midnight. This 162 FEEDING THE BABY means a four hour interval during the day and a six hour interval at night. The first three months of a baby's life are the most difficult of nutrition. If the mother can nurse her baby for even three months the task of artificial feeding is much simplified. However, for those un- fortunate babies that must be given artificial food from birth, Dr. Grulee has given a simple method as follows : For the first twenty- four hours the baby should be given nothing but water (do not even add sugar). One to two ounces should be given every four hours at 6-10-2-6-10-2. The remainder of the first week three ounces of half milk and half water should be offered the baby every four hours. It is probable that the baby will not take all this, but gradually will take more and more. The second week a small amount of malt extract (about a level teaspoon ful) is added to the twenty- four hour quantity of food. The amount of this can be gradually increased until an ounce is used. If the baby shows any tendency to colic and the formation of gas, the sugar should be reduced in quantity. The amount of food given at each feeding can be 163 YOUR BABY increased gradually until by the end of the second month the baby is getting four to four and a half ounces at a feeding. During the second month one night feeding can be omitted and the other shifted to midnight, so that the baby is being fed at 6-10-2-6 and midnight. The strength and quantity of the milk and water mixture can be increased gradually, but the number of ounces of milk given during twenty-four hours never should be more than one and a half times the weight of the baby. Even the older baby never should be given more than a quart of milk in twenty- four hours. Other Foods Certain babies seem to be unable to digest modi- fied or whole milk. These require individual at- tention and their diet should be prescribed and watched carefully by the attending physician. In some cases boiled milk, skimmed milk or even butter- milk seems to agree with the baby. Condensed Milk Under certain conditions Eagle Brand condensed milk is the best food, for it can be prepared by any- body and does not require especial care. Some 164 FEEDING THE BABY babies born in well-equipped homes, but with little vitality, are able to digest this milk when they can- not take other food. Quite frequently, too, this is a desirable food for a baby on a journey, for it can be obtained the same anywhere, while dairy milk varies in different localities. It is best, however, not to continue this milk for many months. A young baby fed upon this food should be gradually changed to whole milk after the sixth month. Overfeeding Never coax a baby to take more food than he wants. Too much food and too frequent feedings overtax the digestion and lead to stomach and intes- tinal disturbances. This is one reason the baby cries. He cries because he has indigestion from too much food, not because he is hungry. Boil a pint of water every morning and put it in a clean bottle. Keep in a cool place. Warm it before giving it to the baby. Give as much as he will take between feedings. Selecting the Baby's Bottle and Nipple Whenever it becomes necessary to feed the baby from a bottle this should be selected with care as should the nipples. The first nursing bottle ever 165 YOUR BABY used was made of a cow's horn with a leather nipple. Naturally it was impossible to cleanse this thor- oughly even if this necessity had been understood at that time and it was found that the majority of babies fed from a bottle died of "the gripes." A few years ago the bottle in common use had a long rubber tube. This was almost as bad from the health standpoint, for it was impossible to cleanse the long rubber tubes thoroughly. In fact now we class bottles of this sort with the "baby killers," which should be avoided. It really should be con- sidered criminal to sell or manufacture such a bot- tle. Plain bottles with nipples that fit directly on the bottle should be used. The special bottle with straight sides and no neck naturally is the easiest to keep clean as it may be washed the same as is a cup. However, ordinary eight ounce medicine bot- tles may be used and as these are not expensive one can afford to have one for each feeding so that all the food for twenty-four hours may be prepared and measured at the same time. The nipple should be made of pure gum, the white rubber ones usually contain poisonous lead and are not desirable. The red rubber ones usually are con- sidered the best, although the black are about as 166 FEEDING THE BABY good. In selecting the nipple, care should be taken that the hole is not too large. It should be just large enough to allow the milk to drop through and not run in a stream when the bottle is turned upside down. If it is impossible to procure a nipple with a small hole, one can be purchased without any opening and then the proper hole can be made with a red hot needle. There should be two nipples in constant use and as many bottles as there are feed- ings in the twenty-four hours. Care of the Baby's Bottle It is absolutely necessary for the health of the bottle fed baby that both bottle and nipple be kept scrupulously clean. After each feeding any food that remains in the bottle should be thrown out, the bottle rinsed and filled with cold water to which a pinch of soda has been added. Every morning all the bottles should be scrubbed well with a bottle brush and hot water and soap, rinsed, boiled twenty minutes and rinsed again. The bottles now are sterile and should be filled at once, just enough in each bottle for one feeding. The bottles then should be stoppered with a little absorbent cotton and placed on ice until needed. Tf the food is such that it must be prepared at the 167 YOUR BABY time of feeding, the empty bottles should be stop- pered in the same manner, in order to protect them from the dust until needed. After each meal the nipple should be cleansed thoroughly, then dropped in a cup of boric acid solution and allowed to stand until needed. Every morning the nipples should be turned inside out and scrubbed with hot water and soap. A nipple can be used only about two weeks when it must be replaced by a new one. The more simple the bottle and nipple the better, for they are more easily kept clean, and cleanliness is the essential element. One can obtain beautiful bottles with all kinds of long rubber tubes and patent devices, labor saving inventions which are a delusion and a snare. They are made especially to sell and are not nearly as good for practical purposes as are the simple bottle and nipple. There is no royal road to feeding babies by the bottle. A bot- tle fed baby is a great care and the mother must make up her mind to go to some trouble and pains if she would insure the health of her child. Clean- liness is the first essential and this cannot be over- done. Many mothers kill their babies through care- lessness due to ignorance. In these days, igno- rance is a sin, since there are plenty of sources 1 68 FEEDING THE BABY of instruction for those who are willing to take the trouble to learn. The work of caring for the bottles will be sim- plified if a number of bottles are provided, enough so that there is one for each feeding during the twenty-four hours. Then they can be boiled all at once in the morning. All that is necessary during the remainder of the day is to rinse each bottle thoroughly after it has been emptied and then leave it in soda water until the next regular washing time. The majority of deaths of babies under one year of age are due to diarrhoeal troubles caused by lack of cleanliness and attention in the care of either the bottle or the milk. All the water used in the prep- aration of the food or in the cleansing of the bot- tles should have been boiled previously, for disease germs may be left in the bottle by being washed in impure water. The watchword of the mother should be cleanliness. Water for the Baby Every child should be urged to drink plenty of water between meals. Even the very small baby gets thirsty and should be given a little water sev- eral times a day. Many mothers make the mistake 169 YOUR BABY of overfeeding their babies. Whenever the baby cries, it is fed. Instead of this it should be given a drink of water and fed only at regular intervals. A small baby needs to be fed only once between ten o'clock at night and six in the morning. Some young mothers make the mistake of allowing the baby to keep the nipple in its mouth all night. As a result the mother gets no rest and the baby be- comes cross and fretful. Teas and Soothing Syrups Never give the baby any " teas " except upon the advice of a physician. Soothing syrups are harm- ful for they quiet the baby by means of some drug, as morphine. The mother who gives her baby soothing syrups or paregoric when it cries simply is deadening the pain and giving her baby slow poison. If the baby happens to be strong enough to throw off the effect of the poison she congratulates herself that she has brought up her baby satisfactorily. The ef- fect of these poisons is so slow when taken in this manner that few mothers are able to notice any effect. The slow poisons, soothing syrups, produce many symptoms that should have been considered a warning note. The baby who has been dosed 170 FEEDING THE BABY usually has a sallow skin and disordered digestion. The latter causes it to be fretful, so more soothing syrup is given, which only increases the disorder until finally the frail little body succumbs — an- other victim to ignorance and selfishness. Weaning the Baby At what age the baby should be weaned depends entirely upon the individual circumstances. In ideal cases, this would be at the age of one year. How- ever, with the stress and strain of present day living the majority of mothers find their milk is not suffi- cient after the eighth or ninth month, so it seems best to commence to wean the baby gradually. Until this time the baby should live almost entirely upon good, pure milk. It also requires a moderate amount of water every day. The only addition to its diet should be a teaspoonful of orange juice once a day after it is six months old. The habit of taking the baby to the table and giving it a taste of various things should not be allowed. The baby should be trained from birth so that it will lie quietly in its bed while the family- are having their meals. After the baby is eight or nine months old a little 171 YOUR BABY prune juice or pulp of a baked apple may be given once a day. Gradually other articles of food may be added, but these must be such as are easily di- gested. Meat broths, soft boiled eggs, cereals and baked potato moistened with milk should be the chief things given. At first, these should be given only at the noonday meal but gradually they may be added to other meals. Oatmeal is a good winter food for children but should not be given too often in summer as it is too heating. A well cooked cereal (farina, cream of wheat, strained oatmeal, etc., cooked three hours) can be given once a day in place of the noonday feedings. Beef juice with stale bread crumbs, broths or a soft boiled egg can be given in addition to the cereal after the tenth month. Ham, bacon or pork, cab- bage, pickles, tea, coffee, beer, bananas, berries, cake or ice cream should not be given to babies or to little children. After the twelfth month the baby should take all milk from a cup. If allowed to nurse too long it becomes too attached to this method and may refuse any other food. An older child who has become attached to a bottle may even refuse food for a day before he will take it from a cup. 172 FEEDING THE BABY The Older Child The question frequently is asked if a child's nat- ural fondness for sweets does not indicate a need of the system, or what should be done for a child who craves sweets and refuses other food. Cer- tainly a moderate amount of sweets is desirable as it supplies some of the child's energy. However, this sugar should be supplied in the form of milk, fruit, vegetables, jellies, simple puddings and only an occasional piece of candy at meal time instead of other dessert. All the sugar a child needs can be included with other foods at mealtime without the mistake of allowing the indulgence in sweets between meals. If a child is allowed to eat candy, cake, or other sweets between meals the appetite for more nourishing food is lost and mealtime be- comes a farce. The child has various intestinal and stomach troubles and muscles, nerves, blood and bones all suffer in consequence. A growing child needs nourishing food, as milk, eggs, cereals, fruit and vegetables, and cannot be rosy and whole- some if sweets are substituted for these desirable articles. Children should be trained from the first to regu- lar mealtime hours. With small children, besides 173 YOUR BABY the three meals a day, there should be an extra lunch about ten in the morning and two-thirty in the afternoon. School children need a light lunch after school in the afternoon. This should not be heavy enough to spoil the appetite for the evening meal, however. For a child two years of age or older a typical day's diet should be similar to the following: Breakfast — fruit, cereal, bread and butter and glass of milk. Ten o'clock — glass of milk or bread and milk. Dinner at noon — soup, small amount of beef or chicken, vegetable, bread and butter, dessert, as baked apple, rice pudding or custard. Two-thirty — glass of milk or bread and milk. The evening meal between five and six should be light and consist of milk toast, bread and milk, or thick soup with bread and butter. A little jam, jelly or other light dessert may be allowed. Sugar may be allowed with the cereal. Simple desserts and cooked fruits may be sweetened. When the child eats other food along with the sweet, the diet is not a one sided affair. We frequently hear that candy eating results in poor teeth and this is true in a different way than 174 FEEDING THE BABY many realize. A child who eats quantities of candy usually has no appetite for the bone- forming foods so that the body does not have material from which to make strong teeth. Likewise the other body structures are liable to be affected. 175 CHAPTER XIII INTESTINAL DISORDERS Constipation. With babies, a frequent cause of illness is constipation. The baby's bowels should be regulated carefully so that they move freely every day. After a baby is a month old it should have from one to three movements every twenty-four hours. In appearance they should be soft and yellow and should contain no lumps. The movements should be noted carefully as they are the best guide as to whether the baby is getting the proper food. With breast fed babies the bowels should be regu- lated through the mother's milk. Everything the mother eats affects the milk, so by changing her own diet she is able to regulate the baby's diet. The mother should watch her own bowels, for if she is constipated, the baby is quite certain to be so too. When necessary the mother should take a mild laxative but she never should take any heavy cathartic for if she does the baby is liable to have 176 INTESTINAL DISORDERS cramps. The mother usually can regulate her own bowels by eating laxative fruit, as prunes and oranges. Graham bread that is sweetened with molasses instead of sugar also will help. Even with the best of care it may be necessary to give the baby an occasional laxative. Olive oil is the best for this purpose. Castor oil should not be used as the after-effects are constipating. From one-half to a teaspoon ful of the olive oil may be given a baby morning and evening. This oil, be- sides acting as a laxative, helps to nourish the baby. Occasionally, it will be necessary to give the baby an enema or injection of warm water. If the baby has cramps, this is one of the quickest means of re- lief. It never is wise to get in the habit of giving the baby a laxative or injection every day or every week, for this habit will become so well established that even after the baby is grown, pills or other laxatives will be his constant crutch. Some people suffer from constipation all their lives because the habit was formed when they were babies. With babies that are fed upon cow's milk or one of the many prepared foods, the bowels may be regulated by a slight change in the food. The ad- dition of a little more cream to each feeding usually will be all that is necessary. Some babies suffer 177 YOUR BABY from fat-constipation. They are unable to digest the fat which forms an insoluble soap in the intes- tines. The bowel movements are inclined to be clay colored. It may be necessary to give such a baby skimmed milk for a time, gradually returning to whole milk. Oatmeal water is excellent in this case. After the baby is six months old, it may be given a teaspoonful of orange juice every day: and after it is eight to ten months old, it may be given a little prune juice or baked apple. These will help to keep the bowels free. Older children may be given graham bread or coarse cookies beside the fruit juice. The older baby whose diet has been chiefly milk often requires bulk to his diet in order to over- come the constipation. Bran cookies are excellent for this purpose. Massage for Constipation Aside from regulation of the diet one of the best measures to overcome constipation in babies is mas- sage of the abdomen. Start at the lower right side of the abdomen and work upward as far as the navel, then work across to the left side and down on that side. Fix the fingers firmly on the surface and move the muscles with a rotary or kneading 178 INTESTINAL DISORDERS motion. Do not allow the fingers to slip over the surface but lift them and move them from place to place. A few minutes' massage night and morn- ing will work wonders for the baby that has become constipated. If persisted in, this treatment with attention to diet will cure constipation. Summer Diarrhcea in Babies A wise saying of the ancients was " obsta prin- cipiis " — prevent the beginning. This is applicable especially in the treatment of summer diarrhcea of infants. The majority of cases of diarrhcea or summer complaint are due to ignorance or careless- ness. The mother or nurse is in a hurry and neg- lects to be quite as thorough as she should be in the cleansing of the bottles and nipples or in the care of the milk. As a result, the baby has diarrhcea and the mother wonders how it happened. It is a fact that bottle fed babies have diarrhceal troubles about ten times as frequently as do breast fed in- fants. It seems to be customary for many mothers to give their babies " tastes " of various things, such as ice cream, coffee, lemonade, even beer and cabbage. Small wonder that babies have intestinal troubles! It is a wonder that any of them live. Before wean- 179 YOUR BABY ing time babies should not be given anything except milk and water, with the exception of a little orange juice after they are six months old. One important thing for all mothers to remember is that babies do not " catch " digestive or diarrhceal troubles. They eat them or drink them. Diar- rhoea usually is the aftermath of some error in feed- ing, perhaps some one has been careless in the cleansing of the bottles or the care of the milk. The greatest element in the prevention of diar- rhoea is the proper care of the milk, bottles and nipples. Any impurities in either the milk or water will affect the baby. Over-rich milk sometimes will cause looseness of the bowels. If the movements are very thin and loose, scald (not boil) the milk for a few days. If the bowels are exceedingly loose and the movements are green, stop the milk and give only boiled water or barley water. To make this, take one tablespoon ful of pearl barley and let it soak over night. Then place it in a quart of water in a double boiler and boil for four hours down to a pint, adding water from time to time if necessary. Strain through a cloth. After the movements have become normal, return to the milk gradually. Babies with diarrhoea may seem to be hungry but in reality are thirsty. Give 1 80 INTESTINAL DISORDERS plenty of boiled water, as this washes out the bowels and carries away any irritating material. One dose of castor oil may be given to carry away the irri- tating material in the bowels. This is better than any other laxative in this case as the secondary ef- fects are constipating. The baby should have from one to three move- ments every twenty-four hours. In appearance they should be soft and yellow and should contain no lumps. The movements should be watched closely and at the slightest indication of looseness, should be corrected at once without waiting for the trouble to become severe. Be especially careful about the milk in the spring and fall when the cows change pasture. Too much attention cannot be given to the milk and water supply in summer. If one is not certain that the water is pure, it is better to boil all that is given to the baby. During the hot weather this is a wise precaution anyway. Another measure that will aid in the prevention of summer diarrhoea is the wearing of a woolen binder. Until the baby is about two years old it should have its abdomen protected by flannel at all times. No matter how warm the day may be, there are liable to be little drafts which will cause a sud- den chilling of the abdomen. The knitted bands 181 YOUR BABY with a shoulder strap probably are the most con- venient. They should be pinned to the diaper in front so they will protect the abdomen well. Colic The habit of regularity if well established and carried out will prevent many of the ills of baby- hood. Colic indicates that something is wrong in the care of the baby. The old superstition that all babies must have " three months " colic is a fallacy. It is no more necessary for babies to have colic continually than it is for adults to have indigestion. In a great many cases colic is due to overfeeding or too frequent or irregular feeding. Perhaps one reason why all babies used to have colic in our grandmother's days was because they were fed at irregular hours. It was customary to feed a baby whenever it cried no matter what was the cause of the crying. If baby has colic the first thing to be done is to relieve the present attack. This usually can be done by cleansing out the intestinal tract with an enema of warm water, then applying heat to the feet and abdomen. A little peppermint water may be given as this aids in the digestion of the food and also helps to dislodge any gas that may have accumu- 182 INTESTINAL DISORDERS lated and which is giving pain. Sometimes if the baby is turned over on its abdomen and the back gently patted the gas will become dislodged. As soon as the gas commences to pass off the baby is relieved, for it is the gas that causes the pain of colic. After the attack has been relieved, the mother should look for the cause so as to prevent future attacks. In the majority of cases this is due to an error in feeding. A mistaken kindness has al- lowed some one to give the baby some food besides the milk and baby is unable to digest this food. If the baby is breast fed, it may be that the mother has eaten something that has disagreed with the baby. Quite frequently acid fruit or vegetables are the cause of colic, but other food may be the cause. Even meat and potatoes, if taken in too great quan- tities and unmixed with other diet, may cause colic. The mother must watch her own diet carefully to see what food does and what does not agree with her baby. No exact rules can be laid down, for babies vary in their needs as do older people. Another cause of colic is that the baby eats too fast or too much at one time. This can be cor- rected easily. When colic occurs a pretty good rule is to increase the time between meals, and de- 183 YOUR BABY crease the amount of milk. Sometimes the milk is too rich for the baby. In this case a teaspoon ful of water given just before meals will dilute the milk in the stomach. Sometimes colic is caused because baby eats too fast. It should take a baby from fifteen to twenty minutes to nurse. If a baby eats too fast the nipple should be removed from the mouth several times during a meal and the baby al- lowed to lie quietly on the lap for a moment. With bottle fed babies the hole in the nipple often is too large. It should be of such a size that when the bottle is turned upside down the milk will drop quickly but not flow in a stream. Be sure to keep flannel (not outing flannel) across the baby's abdomen at all times. If the baby's abdomen becomes chilled colic almost al- ways results. Be sure that the feet are warm. Cold feet may cause colic. Sometimes colic is due to an error in the diet of the mother. The mother should watch her diet from day to day and she will be able to tell which foods seem to produce colic. This varies in differ- ent cases. As a rule, the mother's diet should be varied with the avoidance of indigestible and acid foods. Remember that any laxatives the mother takes may give the baby colic even though they do 184 INTESTINAL DISORDERS not seem to have a laxative effect upon the baby's bowels. Worry or deep emotions of the mother affect the milk and may be the cause of the baby's discomfort. This mother should take more out-of- door exercise, and avoid worry. l8 5 CHAPTER XIV SOME COMMON DISORDERS Jaundice of the New Born. A condition which is of little moment yet which causes con- siderable disturbance of the mental condition of the young and inexperienced mother is that of jaundice of the new born or, as the modern doctor would say, icterus neonatorum. Within a few days after birth many babies begin to turn " yellow," in other words, to become jaun- diced and the young mother naturally is much alarmed. If she listens to the neighbors she prob- ably will have some saffron tea brewed with which to give the baby generous doses. Jaundice occurs in from forty to eighty per cent, of the new born babies. Of nine hundred babies born in one maternity hospital three hundred be- came jaundiced. From the second to the fifth day is the usual time for the appearance of this condi- tion. It gradually increases in severity and then slowly disappears. The average duration in mild 1 86 SOME COMMON DISORDERS cases is three to four days but it may persist much longer. In very severe cases it has been known to continue two weeks. The jaundice is noticed first in the skin of the chest and face, then in the conjunctiva, finally spreading to other portions of the body. The skin varies in color from a pale yellow to an intense yel- lowish brown. The urine usually is normal as also are the bowel movements. In other forms of jaun- dice, the urine usually is highly colored and the stools are clay colored. The general health of the baby does not seem to be affected in any way. In the maternity hos- pitals it has been found that the babies that de- velop jaundice thrive as well as do those who are free from this disorder. However, in poorly nour- ished babies the discoloration seems to be more in- tense than in strong, healthy ones. The cause of this jaundice of the new born has not been determined definitely. One theory is that a slight delay in the changes that take place in the circulation of the child at birth or soon afterwards allows more than the normal amount of bile pig- ments to enter the blood the first few days after birth. This causes the jaundiced appearance of the skin. Another explanation is that owing to the 187 YOUR BABY change in the circulation in the liver at birth there is an active destruction of the red blood cells. In consequence of this destruction of red blood cells abundant material for the formation of bile pig- ment is formed. The more feeble the child the greater the destruction of red blood cells and, con- sequently, the greater degree of jaundice. Physiologic jaundice of the new born is not a serious condition, never proves fatal and usually will clear up without any treatment. It should not, however, be confused with other forms of icterus which may be the most noticeable symptom of some serious disease. Night Terrors It frequently happens that a baby will start out of its sleep in a state of fright, although there ap- parently is no cause for the condition. In some cases it is only after a long, hearty cry that the child drops to sleep again partly from exhaustion. In other cases the child arises in its sleep and walks to another room or, it may be, in perilous places. Children have been known to walk in places in their sleep where they could not possibly walk in their waking moments. If left alone, they 1 88 SOME COMMON DISORDERS will reach their destination in safety but if awak- ened in the midst of their progress, they may be- come mystified and have a severe fall. The cause of both of these conditions usually can be found in some habit of living. It may be that the child has eaten a hearty supper shortly be- fore bedtime, or it may be that the bedroom is too warm or poorly ventilated. It may be that the child has played too heartily before going to bed and the excitable nervous system has become so tense that the surplus energy must be exerted in some way. It rests with the parent to discover the cause of these night disturbances and remove it, after which the child usually will have a good night's sleep. Some children refuse to go to sleep unless there is a light in the room. This is due entirely to habit. A healthy child who has not been fright- ened with bug-a-boo stories will not be afraid of going to sleep in a darkened room. Parents do their children irreparable harm when they tell them stories of fanciful things and persons who may " get them in the dark." A child who has not been thus frightened and who has been trained properly from birth will not have any fear of the dark. 189 YOUR BABY However, if a child has become frightened, it is wrong to try to compel it to go to sleep in the dark. Such a child always should sleep in a darkened room but a door into an adjoining room where there is a light may be left open as the faint glimmer of light will allay the terrors, and assure him of the presence of his natural protectors. It only will make a child more nervous to sternly insist upon him going to sleep in the dark, as though he were being punished for some disobedience, when the truth is that the fault lies with the one who fright- ened him in the past. Occasionally these fears are due to some physi- cal condition that interferes with breathing, such as adenoids, enlarged tonsils and the like. Should a child show a tendency to sleep with his mouth open he should be taken to a physician and his throat examined and the cause removed if found. The slight operation may prevent a great deal of future trouble and unhappiness. In some cases an irritation of the nerves, as from a tight prepuce or from rectal worms, will be found to be the cause of these night terrors. Whenever a child has night terrors there is some cause for it and the wise parent will not rest until the cause is located. 190 SOME COMMON DISORDERS Bed Wetting The problem of bed wetting is a very common one and the treatment varies with the cause. In some cases it is due to a disorder of the brain, but in apparently healthy children it may be due to some irritation. If the boy (or girl) needs cir- cumcision or has worms these should be attended to first, as well as anything that affects the general health. A nervous, sickly child is liable to wet the bed because of lack of strength to control the mus- cles of the bladder. In many cases bed wetting is a habit established in infancy which is hard to break even though the child thinks he is trying. In some way an impression must be made upon the mind of the child that will remain even when he is asleep. Rewards have been found to produce good results. The promise of a much desired toy after a certain number of dry nights has proven successful in many cases. As a rule, punishments do not have as good effect in these cases as do re- wards. The payment of five cents for every dry night has brought better results than whippings for wet nights. During the day the child should be taught to hold his water as long as possible so as to expand the bladder and to gain control of the muscles. Liquids should not be given after four 191 YOUR BABY in the afternoon. The child should sleep in a well ventilated, cool room. The bed should be rather hard and not sag in the middle and the coverings should be as light as possible for warmth. Ele- vating the foot of the bed slightly sometimes has beneficial results by relieving the pressure on the bladder. Spina Bifida This is due to a failure of growth as is hare- lip or cleft palate. There is no special cause known. It is simply classed as an accident. The majority of such children die within the first few weeks. A very few live to adult life. If they live they are liable to have meningitis or lack con- trol over the bowels and bladder and be paralyzed in the lower limbs. Thumb Sucking Habit Various methods have been tried to break this habit of sucking the thumb but I have yet to learn of any reliable method. Some mothers put some- thing bitter on the baby's fingers. Others bandage the thumb for a time. One mother cured the habit by constant watchfulness for two weeks, taking the 192 SOME COMMON DISORDERS thumb out every time it went into the baby's mouth. Eczema In the majority of cases of eczema there is something wrong with the baby's diet, or the child is not getting enough fresh air, or too strong soaps are being used on the skin. With such a child oatmeal or bran bags should be used instead of the soap and the skin should not be bathed too frequently. The diet of the child inclined to eczema should be alka- line. Chafing This also is best treated by bran baths, after which the parts should be powdered well, or rubbed with castor oil or vaseline. Prickly Heat This is the result of excessive perspiration or irri- tation of flannel underclothing. The baby should be given a sponge bath and clothed less warmly. Sleeplessness Usually in these cases there is some nerve irrita- tion. It may be that the child plays too hard during the day and becomes too much excited. It would be 193 YOUR BABY well to keep the child rather quiet after four p. m. and give only a light supper at an early hour. It may be the cause is some local irritation, as from worms, a tight prepuce or constipation. Birthmarks The treatment varies with the extent and variety of the mark. In some instances electrical treatment has good results, but this should not be under- taken except by one who makes a specialty of this work. In many cases surgery gives the best out- come. Stuttering This is due to a nervous condition and usually is made worse by giving attention to it. Try the plan of not noticing it, but whenever the child talks es- pecially well praise him at the time. Never talk about his trouble when he can hear. Keep him out- of-doors as much as possible. In a few cases it may be necessary to send the child to a school which makes a specialty of treating this disorder. Ear Ache . Many babies suffer from ear ache although no one realizes the source of their discomfort. If the 194 SOME COMMON DISORDERS baby cries as though in pain and continually puts its hand to its head one should try treatment for the ears. Put a drop of warm mineral oil into the ear and apply a hot water bag, or wash the ear care- fully with warm water in an ear syringe. If at any time there is a discharge from the ears a physi- cian should be consulted as often deafness or even death follows from a neglected ear trouble. Cross-eyes In older children cross-eyes usually can be cor- rected by wearing glasses, but with a small baby about the only remedy is a slight operation to cut the little muscles that are drawing the eye out of place. In many cases it seems wise to wait until the child is old enough to wear glasses. Some of the nerve tension can be relieved by applying a cloth wrung out of hot water over the eyes while the baby is sleeping. This will relax the muscles and allow the eyes to assume a natural position, al- though it will not cure the condition if there is defec- tive vision. Holding Breath Spells Sometimes a baby forms a habit of holding his breath whenever he is angry. He may hold it un- 195 YOUR BABY til he is quite exhausted and cause the mother much anxiety. The best treatment for this condition is to leave the child alone in the room and not pay any attention to him. There is absolutely no danger and if he finds no one is worried about him he will cease his habit. The condition is similar to hysteria in older people. The more attention is given, the worse the trouble becomes. Knock-knees, Pigeon-toes The best treatment for these is educational. De- vise various plays which require the child to keep a correct position, as playing soldier. If mother is captain and gives such commands as " Heads up ! Toes out ! March ! " the child will enjoy the play and, at the. same time, be learning to walk correctly. BOW-LEGS These usually are caused by allowing the baby to bear its weight on its feet before the bones have become strong enough to maintain the upright posi- tion. Rickets, or other diseases that show deficient bone formation predispose to this condition. The child should have more bone forming material added to his diet, should be kept from walking much for a time and should have the legs massaged daily. In 196 SOME COMMON DISORDERS giving the massage the legs should be gently bent to a correct position. An older child will be benefited by being allowed to ride a velocipede which should be large enough so that he will have to stretch to reach the pedals. While riding, the weight is taken off the legs, yet the muscles are given the needed ex- ercise. Rickets In some of the poorer localities, especially of the large cities, it is not uncommon to see a small child whose head not only appears too large for his body but seems to be square in outline. A further ex- amination usually reveals bow legs or knock-knees, while the long bones of the arm also may be bent. The ends of the bones frequently appear to be clubbed. If the chest is examined the sides appear to be flattened, while the sternum or breast bone is very prominent. Nodules, which are called the " rachitic rosary," may be felt where the ribs join the sternum. Such a child presents a typical picture of rickets or rachitis. This is a disease characterized by defect- ive nutrition of the bony tissues. The most marked changes appear in the ribs and long bones, although the condition is general. The condition seldom is 197 YOUR BABY seen at birth but develops during the first or second year. If it commences early, the mother notices that the " soft spot " on the top of the baby's head does not close as soon as it should. The average age at which this closes is eighteen months. This condition is due to lack of proper food and bad hygienic surroundings. For this reason it most frequently is seen among the poverty stricken who usually do not even have sufficient fresh air. At birth, the framework of the baby's body is com- posed partly of cartilage or gristle. If the breast bone of a young chicken is examined, it will be found that the lower portion is not bone but gristle. As the chicken grows older the gristle is replaced by bony substance. The same is true of the bones of a baby. As the child grows, lime salts are depos- ited in the tissues and bony substance takes the place of the gristle. In order for this to take place, the baby must have sufficient bone- forming food. The mother who nurses her baby can regu- late the amount of bone forming material in the milk for the babies. The poor bottle-fed babies brought up on a bottle must also have this matter attended to. The mothers in the poorer localities, even though they do nurse their babies, frequently do not have enough nourishing food to make good 198 SOME COMMON DISORDERS milk for the babies. The poor bottle-fed babies fare even worse. While the bones are soft, they are easily bent out of shape so that bow-legs and other deformities are frequent in these localities. The child with rickets needs to be placed in the fresh air and fed nourishing food. Under such treatment, the bones gradually become stronger and some of the deformities may disappear. However, if the condition has remained so long that the bones are badly out of shape, the only result will be a prevention of further deformity. Adenoids Adenoids are little growths in the passage from the nose to the throat. These growths resemble small bunches of grapes. When they fill the air passages, the air cannot reach the lungs properly. As a result, the lungs do not receive enough oxy- gen, the blood does not contain enough coloring matter, the child becomes pale and tired. Such a child is less able to resist disease, so is constantly subject to sore throat and colds, as well as being more liable to contract the more serious diseases. Besides this, the face becomes drawn and dull look- ing, the mouth breathing causes the face to become 199 YOUR BABY deformed, the palate is arched and the teeth do not have their proper contour. The protruding teeth of many children are due to adenoids or enlarged tonsils. The only remedy for this condition is the re- moval of the little growths that are causing all the trouble. If something were plugging up the water main in a town, it would not take long for the en- gineer to decide to remove the obstruction. It is just as reasonable to remove the obstruction that is plugging up the air passages in the child's body. The change resulting sometimes is surprising. The child begins to take an interest in the things around him, the frequent colds are a thing of the past, the child begins to take on flesh and has color in his cheeks. He is a normal child again ! Hernia A rupture or hernia is so common with babies, especially boy babies, that it is surprising that so few mothers really understand the condition. Try to imagine a person with a bag of coiled tubing. The bag is double, consisting of a lining and an outer covering. Someway a tear or rip has appeared in the lining. This allows the tubing to 200 SOME COMMON DISORDERS come out between the lining and the outside, mak- ing an irregular lump. This is just the condition with a rupture or hernia. The intestines or bowels have come out between the lining muscles and the skin through a little tear or opening in the muscles. This opening commonly is the inguinal canal through which the spermatic cord runs. A good housekeeper would sew up the rip or tear in the lining of the bag without any question. That is what a surgeon does when he operates for hernia. He sews up the tear in the muscles so the intestines cannot come down. If the baby is very young, an operation may not be necessary, for there is a chance that the muscles will grow together again if the intestines are held in place for awhile. A truss is a contrivance for holding these in place. It does not in itself cure the trouble. We see many advertisements saying, " Rupture cured without a knife." These are fakes. The most common treatment these adver- tisers use is to inject a little paraffin or wax under the skin to plug up the tear as a cork would stopper a bottle. This may keep the intestines up for a time and the patient is thought to be cured. How- ever, it is very common for this wax to become dis- 20 1 YOUR BABY placed a little and an examination will reveal that the tear has become larger than ever. These cases usually have to be operated upon eventually. If the hernia is not repaired, there is danger of what is known as strangulated hernia, that is, the in- testine comes down between the muscles and be- comes caught so that it cannot go back into place. This is a very serious condition, for the blood sup- ply usually is cut off and the intestine will become gangrenous (dead). This may result in death of the patient within a few hours. If a rupture ever becomes caught in this way, there is no time to be lost until the abdomen is opened by a surgeon and the intestine released. Rupture may be congenital, that is, present at birth, or it may be caused by heavy lifting or strain- ing. For this reason, a small child should not be allowed to strain himself by trying to lift a heavy object. Some children are inclined to attempt tasks too great for their strength and must be re- strained. Violent crying and straining at stool may produce a rupture if there is a weak spot in the muscles. This is one reason a baby should wear a band around the abdomen over the navel for the first few weeks after birth. 202 SOME COMMON DISORDERS Swallowing Foreign Bodies In this case, be sure the article has been swal- lowed and has not just slipped down in the bed or in some other place out of sight, then feed the baby dry bread. This has a tendency to coat whatever substance has been swallowed and usually will carry it safely through the intestinal tract. Even sharp substances often pass safely through in this manner. It usually requires three or four days and perhaps even ten days for the substance to pass, so the bowel movements should be watched carefully all this time. No laxative should be given as this is liable to cause the foreign body to pass on so quickly that it may injure the intestine. Taking Poison It is needless to say that every precaution should be taken to keep all poisons out of reach of baby's hands. However, should baby accidentally swal- low poison, no time should be lost in sending for the doctor. In the meantime, the baby should be given an emetic so as to produce vomiting. Quan- tities of water should be given to wash out the stomach. 203 YOUR BABY Convulsions or Spasms These usually result from indigestion although they may be the first symptoms of some systemic disease, as scarlet fever, or of other chronic condi- tions, as epilepsy. They may be due to some irri- tation as from rectal worms or a tight prepuce. The cause should be determined and proper treat- ment instituted to prevent future attacks. While waiting for the doctor, the mother is safe in giving an enema (injection) of warm water to wash out the bowel thoroughly. In many cases this is the only treatment necessary. Vaccination After a baby is a year old and before it associates much with other children, it is best to have vac- cination performed. As long as it is so well proven that this is a preventive of smallpox, it is best to be on the safe side. If done carefully by an experi- enced physician and taken care of afterwards there is little danger of any untoward effects. Hives or Nettle Rash This usually is due to indigestion. Certain arti- cles of food may be the cause. The itching of the parts may be relieved by bathing with warm water 204 SOME COMMON DISORDERS to which has been added a little common baking soda, or by powdering the parts with a good talcum powder. However, the cure rests in the thorough cleansing of the bowels and regulation of the diet. The Baby's Cry The cry of a child requires the closest observation if one would use this as a guide to the child's con- dition, yet a great deal can be told by the expres- sion, the character of the cry and the time of oc- currence. An unremitting cry usually is due to hunger or thirst, although it may be due to earache. Not every cry that ceases with nursing is due to hunger, as sometimes even colic is relieved temporally. The paroxysmal cry, very severe at times and then ceasing absolutely, probably is due to colic, par- ticularly if the abdomen is distended. The persistent cry may be due to some continued irritation as the pricking of a pin, or it may be caused by the constant itching of eczema. A sleepy child has a fretful cry often accompanied by rubbing of the eyes. A fretful, peevish, whining cry is heard in children with general poor health. In conditions of great weakness or exhaustion the baby moans feebly or may twist its face in position 205 YOUR BABY for crying and yet utter no sound. A loud violent cry coming on suddenly may indicate temper, but when a child two to six years of age awakens at night with violent screaming he probably is suffer- ing from night terrors. If the baby cries every time it is picked up, it is probable that pressure on the breast causes pain, the result of rickets or pleurisy. If the baby cries when a certain spot is touched, this suggests that something is wrong with that particular part. A shrill cry uttered now and then often indicates in- flammation of the brain. In diseases of the lungs, the cry is short, as the child cannot hold its breath long; while a nasal cry indicates a cold in the head. A short cry immediately after coughing indicates that the cough and cry hurts the breast, while a crying spell when the bowels move indicates pain at that time. Crying when anything is taken into the mouth indicates some trouble there, while if the crying occurs during swallowing it is probable that the throat is inflamed. 'These suggestions are of importance to the young mother who frequently confuses the cry of temper with the cry of pain, or the cry of pain with the cry of hunger. 206 CHAPTER XV ACCIDENTS AND DISEASES OF CHILDHOOD When Baby Has Croup. Perhaps no two words carry dread to so many mothers as do croup and pneumonia. Croup, while usually the less seri- ous of the two, is perhaps the most alarming to a young mother, for it generally makes its unwelcome visit about midnight. When one is awakened from a sound sleep to find a child, who has gone to bed apparently in the best of health, struggling for breath, one naturally is alarmed. Yet, if one can keep her presence of mind, the attack usually can be relieved in a short time and the child will drop to sleep to awaken in the morning as well as ever. One almost is inclined to think the night experience only has been a dreadful nightmare. However, a child who has had one attack of croup is liable to have repeated attacks for several succes- sive nights, so it is wise to fortify against them. No matter how frequently one sees cases of croup, it never fails to instill a feeling of terror. The 207 YOUR BABY oppression and distress for a time are very serious, the face usually is congested, sometimes almost cya- notic, the breathing is noisy, hard and labored, while the sound of the hard metallic cough makes an im- pression never to be forgotten. The child seems to be making an almost superhuman struggle for breath. This struggle for breath is caused by a spasm of the larynx which does not allow enough air to enter the lungs. If a physician is present he may relax the spasm by a few whiffs of chloroform, but the same results may be accomplished almost as readily by a mild emetic. This relaxes the muscles and also empties the overloaded stomach. For it is a fact that an overloaded stomach usually pre- cedes an attack of croup. A child who is subject to croup should eat a very light and easily digested evening meal. Every nursery should be provided with emergency remedies to be used when necessary. If a child is subject to croup, the mother should request her family physician to keep her supplied with a remedy to be used whenever an attack comes on. The attack often can be alleviated by moist in- halations. A few drops of turpentine may be poured into a pan of boiling water and the child allowed to breathe the vapor. Breathing the hot, 208 ACCIDENTS AND DISEASES dry air from a stove or furnace predisposes to croup. A pan of water should be placed so as to keep the air in the room moist. A very cold or a hot cloth applied directly to the chest sometimes helps to relieve the attack of croup, while a common treatment is to place the child in a tub of water as hot as can be borne. An enema of warm water may be given. No especial after- treatment is necessary for ordinary cases of croup. Every effort should be made to prevent the attacks by regulating the food and insisting upon plenty of fresh air at all times. The child should be clad warmly when out of doors. Especially the feet should be well protected and under no circumstances should the child be allowed to remain with wet or cold feet. Adenoids or other unhealthy conditions should be corrected. Colds Colds are another common disorder, in winter time especially. It is a good plan for every mother to purchase a clinical thermometer and learn how to use it. Variation in the temperature is one of the first signs of illness in babies. With a baby the best way to take the temperature is to insert the thermometer about an inch and a half into the rec- 209 YOUR BABY turn and allow it to remain in place for two or three minutes. The normal temperature of a baby is about 99 F. Whenever the baby does not seem well the mother should take its temperature and see if it has any fever, then she will be able to judge better as to the seriousness of the illness. One can- not always tell by the first symptoms presented what is the true cause of the illness. Many a mother sends for the doctor because the baby's stomach is upset. When the doctor makes an examination he may find that this is not the most serious symptom present. Frequently in the beginning of pneumonia in babies there is vomiting or diarrhcea or constipa- tion. If the mother would observe closely she would notice that the baby was breathing faster than usual and she would at once suspect that there was some trouble with the lungs. Whenever a baby has a cold or its stomach is upset, the mother is per- fectly safe in giving it an enema, or injection, of warm water. No nursery or home should be with- out a syringe, for one always is needed where there is a baby. Another home remedy that may be used in the case of a cold is the old-fashioned onion poultice. Doubtless this has saved the lives of hundreds of babies. In our grandmother's days it frequently 210 ACCIDENTS AND DISEASES was the case that the doctor had to ride fifty miles on horseback in order to see a patient, so he could not be summoned unless the baby was seriously ill and home remedies had failed. Our grandmothers always kept on hand a supply of home remedies which were very efficacious. Every nursery should be supplied with a few simple remedies, as essence of peppermint, castor oil, turpentine and oil. Pneumonia Pneumonia usually follows exposure of some sort, but lack of fresh air and nourishing food predispose to it, that is, make the child more liable to contract the disease. A child whose body is in a good con- dition is much better able to resist exposure than is one who is debilitated from insufficient food or oxy- gen starvation. With babies, there is a short, catchy cry that is characteristic of acute pneumonia, or bronchitis. Although there are several forms of pneumonia, the one called broncho-pneumonia is most common with babies and small children. The chief symptoms are rapid, difficult respirations and a rapid pulse rate. The child may breathe as frequently as sixty times a minute. The skin feels dry and hot indicating a YOUR BABY feverish condition. The child usually is very rest- less. Cough may or may not be present. Some- times, the onset of the disease is marked by vomit- ing and, rarely, by convulsions. Intestinal compli- cations are common, there often being four or five green stools a day. The urine usually is scanty and highly colored. The disease varies in severity. Some cases would get well with no treatment, while some babies die within twelve hours. As a rule, the baby has a better chance for life if the treatment is commenced in the early stages of the disease. It is here the mother's work is needed. There are many things she can do before the arrival of the doctor. In fact, if those who lived far from a doctor waited until he arrived before anything was done, the baby would have a poor chance for its life. One of the chief requirements is good ventilation. It is better to have the room cold than to have poor air in the room. The baby should be kept warm by clothing and by hot water bottles placed near it. It may be given hot drinks to help induce perspira- tion. Its position should be changed frequently. The old-fashioned onion poultice applied to the chest in the early stages doubtless has saved the lives of many babies. Good results may be obtained by rubbing the chest and neck with turpentine and oil. 212 ACCIDENTS AND DISEASES Moist inhalations are as beneficial here as they are in croup. The child should inhale the steam for ten to fifteen minutes four or five times a day. The bowels should be kept free. Although the baby will have no appetite and can be coaxed to take only a small amount of nourishment, it will be thirsty and should be given as much water as it can drink. If there are signs of collapse, a hot mustard bath may be given. However, the chief aim of the mother should be to keep the baby warm enough to induce perspiration while at the same time it has plenty of fresh air to breathe. If the doctor has left directions, they should be followed exactly and the medicine given on time, otherwise it is useless for the doctor to prescribe. Measles It is customary to regard measles as a joke or at least as a matter of no importance. The majority of parents make no effort to have their children avoid the contagion. In many towns the cases are not quarantined. In times past, it was customary to regard an epi- demic of any disease as a visitation of Providence. With our recent knowledge, we know that epidemics are flue to carelessness or lack of sanitation. With 213 YOUR BABY many of the contagious diseases, a rigid system of quarantine is enforced. In the larger cities measles are classed where they belong, with the contagious diseases, but in many of the smaller towns no at- tention is paid to this disease. Children continue in school even though they daily associate with their brothers and sisters who have the disease. As a result, the contagion spreads through the lower grades until, frequently, half the pupils are ill. Those afflicted stay at. home for a week and then calmly return to school as though nothing had hap- pened, and as though they were not carrying the dis- ease to others. If measles were as simple a disease as the ma- jority think, this would be all well and fair. But measles is not a simple disease. The acute attack may be light, but the sequela may be the opposite. Frequently a mild attack of measles is followed by a serious inflammation of the kidneys which may cost the life of the child. Otitis media, or an in- flammation of the middle ear, is another complica- tion to be avoided as permanent deafness sometimes results from this. In order to avoid these dangers, the child should have close attention while it is having the measles, no matter how light the attack may be. The child 214 ACCIDENTS AND DISEASES should be kept warm in a well ventilated room. Hot drinks should be given frequently as these help to " bring out the rash." A sudden chilling sends the blood to the internal organs and may cause a congestion of the kidneys. The latter always should be watched and if a child is not passing a normal amount of urine, the physician should be consulted. The nose and throat should be sprayed several times a day with a mild antiseptic solution, as boric acid solution. The child should not be allowed to blow his nose violently as this act may force some of the secretions from the nose into the ear pas- sages where they will cause serious trouble. The room should be kept darkened as the light hurts the child's eyes. Several times a day the eyes should be bathed with the boric acid solution. If they are much inflamed, a cloth wet with the solu- tion laid across the eyes will give relief. The child should not return to school until all discharges from the eyes, ears, throat or nose have ceased and until everything has been fumigated thoroughly. Mumps One of the most painful disorders of childhood is mumps. This is an acute, contagious disease, the YOUR BABY chief characteristic of which is the inflammation of the parotid and, perhaps, other salivary glands. The mother may notice that the child's neck ap- pears to be swollen. This swelling is below and in front of the ear, is pyriform in shape and has a doughy feel. An older child may complain of an inability to swallow, acid food especially giving ex- cruciating pain. The jaw is moved with difficulty. The swelling may be on one or both sides. Usually it appears on one side first and then a few days later on the other. The mouth is dry as the saliva usually is lessened. There may have been symptoms previous to the swelling such as headache, vomiting, or pains in the back and limbs. Inquiry usually reveals that the child has been exposed to the mumps one to three weeks previously. The disease usually is acquired through direct con- tact and probably from the secretions of the salivary and parotid glands. It is contagious from the be- ginning of the symptoms and for about three weeks after the swelling first appears. For this reason, the patient should be isolated and not allowed to come in contact with other children. The disease is very rarely fatal although there may be death from complications if the patient is not given good 216 ACCIDENTS AND DISEASES care. One attack confers immunity from later ex- posures. The patient should be kept in bed and the chief treatment should be measures to relieve the aching pain. For this purpose hot poultices usually are applied. One of the quickest and most effective remedies is hot fomentations. The skin over the affected area should be rubbed with a mixture of turpentine and olive oil (one part of turpentine to about eight of olive oil), then flannel cloths should be wrung out of hot water and applied to the parts. Over these should be placed a dry cloth and the whole held in place by bandages. The hot moist heat seems to penetrate better than dry heat and so is more effective. Flaxseed or linseed meal poultices are excellent. If a little olive oil is added after the mush is prepared, the poultice will not become hard and dry so easily. Hot salt bags, or hot water bags may be used if it is impossible to apply the hot moist heat, in fact, any hot application affords con- siderable relief. The diet should be light and nourishing. As it often is painful and difficult to chew the food, it is better to give a liquid diet for a few days. This may be taken through a tube. The bowels should be kept open. A warm bath 217 YOUR BABY or alcohol rub morning and evening is very refresh- ing and restful and relieves the aching limbs. In young children there seldom are any serious complications, as there are in older people. In a few cases deafness has followed but this is not com- mon. Whooping Cough Spring housecleaning and whooping cough seem to be boon companions. Whenever moving days and housecleaning come, the typical whoop is heard on all sides. We might wonder at the coincidence if we did not know that whooping cough was a contagious disease and that the germs of the disease would live from year to year. They find lodging places in the rugs, the curtains and the furniture where they remain in repose until disturbed from their rest by the zealous housewife. As they are driven out of their dwelling they ride on air cur- rents until they find a resting place in some little child's air passages. Here they begin to grow and produce various symptoms. Probably the first symptom noticed by the mother is a slight hacking cough. This gradually is prolonged and increases in severity. It does not respond to the ordinary home remedies. The 218 ACCIDENTS AND DISEASES child's sleep is disturbed at night, for the paroxysms of coughing seem to be worse when the child is lying down. The general health is not much im- paired although a paroxysm of coughing may be followed by vomiting. Usually the typical whoop is not heard until about three weeks. This is a long drawn, shrill, whooping inspiration due to a spas- modic closure of the glottis. The number of par- oxysms varies from twelve to fifty in twenty- four hours. The duration of this stage of whooping is about three weeks, but the cough may continue for some time afterwards. The entire course of the disease extends over a period from a few weeks to several months. The chief dangers are from the complications or sequela. Pneumonia or tuberculosis may be the closing chapters of this disease. Indeed the latter especially is a danger for it makes its appearance so insidiously that the parents do not realize that another disease has appeared until it is too late to save the child's life. The treatment consists first in isolation and quar- antine to protect others, followed by thorough disin- fection so that the germs may not remain until the next year. A tight binder pinned around the abdomen will 219 YOUR BABY be found to lessen the paroxysms of coughing and, also, will tend to prevent vomiting. Fresh air, sunlight and protection from exposure to inclement weather are necessary. The room should be well ventilated ; for rebreathing of the in- fected air prolongs the duration of the disease. In the later stages, sea air is especially beneficial. If the coughing period is prolonged, the lungs should be tested at intervals so that tuberculosis may not become established without the knowledge of the parents. The diet should be light and nutritious. On ac- count of the vomiting, it is better to feed a small amount at frequent intervals instead of limiting the child to the regular meals. In the early stages the severity may be lessened by spraying the mouth, throat and nose with a mild antiseptic solution. This should be done several times a day. Scarlet Fever One of the most contagious of the children's dis- eases is scarlet fever. It usually occurs in epidemic form and may assume alarming proportions if not held in check by quarantine and other measures of sanitary importance. 220 ACCIDENTS AND DISEASES The onset of scarlet fever usually is abrupt. A child, who previously has been well, suddenly will commence to vomit without any apparent cause. If it is old enough to do so, it may complain of a head- ache and a sore throat with difficulty in swallowing. An examination of the throat shows the tonsils and all the posterior region of the mouth fiery red. The temperature is high and the pulse rate fast. The second day the eruption appears. It is a scarlet, punctate eruption, which usually commences on the throat and chest and then spreads to other parts of the body. About this time, the tongue takes on the typical appearance. It is coated white but the papillae become enlarged and protrude giving the " strawberry " appearance. On the fourth day the rash commences to dis- appear and three days later desquamation or " peel- ing " begins. The temperature begins to fall when the rash appears. The complications may be numerous. Otitis media, or inflammation of the middle ear, is one of the most common. The mastoid cells may become involved, causing mastoiditis. Endocarditis, or inflammation of the heart, is not uncommon. A patient who has struggled through 221 YOUR BABY the acute attack of the disease may be left with a weakened heart to trouble him the remainder of his life. Nephritis or inflammation of the kidneys quite commonly follows an attack of this disease. It may not appear until the child apparently has been well for a week or two. The danger of nephritis and other complications may be lessened by careful nursing. The child should not be allowed to leave his bed too early. His diet should be regulated carefully for several weeks. He should not be ex- posed to any drafts or inclement weather for some time. In the treatment of this disease, the patient should be kept in bed in a well ventilated room. He should be isolated and no one except the doctor and nurse allowed in the room. The diet should be light but nourishing. Milk and other liquids should be the chief articles of diet. Water should be given in abundance. A daily sponge bath with warm water, followed by an oil rub is very beneficial. The oil keeps the skin softened and also relieves the itching that usu- ally accompanies the desquamation. The mouth, nose and throat should be sprayed 222 ACCIDENTS AND DISEASES several times a day with a mild antiseptic solution. The urine should be measured daily and any diminu- tion of the quantity should be reported to the physi- cian as this may indicate the commencement of seri- ous kidney trouble. No case of scarlet fever is too mild to be given the best of care, for frequently the mild cases are followed by the most severe sequela. When Baby Becomes Burned Almost every day we hear of some little baby be- coming badly burned or scalded. In a number of cases serious results might have been averted by proper care given immediately. Whenever an accident occurs many people be- come panic stricken and do the worst possible thing. For instance, if the baby's clothing has caught fire many a frightened mother runs to the neighbor's while every second the baby is becom- ing more burned. The proper course of action would have been for her to grab the nearest heavy cloth, a coat, a heavy skirt, a portiere, even a rug, anything she can find in which to wrap the baby quickly. Fire cannot burn without air, so if the air is excluded from the fire it will go out immedi- 223 YOUR BABY ately. Throwing water on burning clothing often spreads the fire more. Smothering it with a blanket is the best means of quenching it. As soon as the fire is out not a moment should be lost until a remedy is applied. In the case of a burn the remedy should be of such a nature that it will keep out the air and also allay the intolerable burning. One of the best remedies is Carron oil. This is made by mixing equal parts of lime water and raw linseed oil. In every home where there are children there should be an emergency chest in some convenient location. In this chest should be a bottle of lime water and another of raw linseed oil. Pieces of soft cloth, or better still, a package of sterile gauze also should be in the emergency chest. Pieces of gauze should be saturated with Carron oil and applied to the burned parts immedi- ately. They should be held in place by bandages, but first of all the burned surfaces should be cov- ered. In the absence of Carron oil, lard and baking soda form a good preparation. In the absence of any remedies immerse the burned portions in water until a remedy can be procured. The water keeps the air from reaching the burn and is preferable to 224 ACCIDENTS AND DISEASES something that will cling to the raw surfaces, as flour and water. If the burn is at all extensive, the doctor should be called at once as some complications may result. In extensive burns the kidneys are liable to become affected and these must be watched carefully. The urine should be measured daily. Be Careful of Drugs There are so many accidents and deaths recorded due to carelessness in the handling of medicines that the necessity for caution cannot be impressed too strongly. If drugs of any sort are kept in the house, they should be placed out of the reach of the children and preferably under lock and key. Children are as liable to drink poison as they are lemonade if it has a pretty color, so it is better to avoid all pos- sibility of an accident by keeping all drugs in a safe place. As it usually is necessary and desirable to keep a few remedies in the house, it is better to have a special place provided for them. Then they not only will be out of the reach of small children but also will be where they can be found quickly in an emergency. 225 YOUR BABY Look Twice Before Giving or Taking Any Medicine One never should take a dose of medicine in the dark no matter how certain she is that she knows exactly what she is taking. There always is a pos- sibility that some one else has exchanged the bottles since the last daylight visit. It takes so little time to strike a match that it seems strange that any one would risk taking medicine in the dark. In taking medicine one should look carefully at the label before pouring out the dose and again after it has been poured but before it has been taken. This extra precaution may seem unnecessary, but its adoption would avoid many accidental deaths. Do not Keep Unlabeled Bottles No unlabeled bottles should be kept. If the label has been destroyed accidentally, unless it is replaced at once, it is better to throw out the contents of the bottle than risk a possible accident. 226 CHAPTER XVI THE DISCIPLINE OF CHILDREN How to Spoil the Baby. A baby can be so " spoiled " before it is twenty-four hours old that it will take weeks of discipline to overcome this first impression ! Upon the care and attention given the baby the first day of its life, depend, to a great extent, the requirements of the next few months. As soon as it is born it should be wrapped comfortably and laid on a pillow until the nurse has time to dress it. Then it should be bathed, dressed, given a teaspoon- ful of warm water and put to bed. The less a baby is handled, the better for its health : the more it is allowed to lie quietly, the better will be the condi- tion of its nervous system. Movements of any kind excite the nervous system. Rocking is as ex- citing to a new born babe as is " shooting the chutes " to an older person. Excited nerves crave more excitement which means more care for the mother. 227 YOUR BABY Before a baby is many hours old, it will cry. The tendency is to pick it up, cuddle it, rock it and fuss over it generally. This is entirely wrong if the mother would be saved hours of unnecessary work. If the baby cries it should be examined to see that there are no pins pricking the tender flesh, no annoying wrinkles in the clothing, nor anything materially wrong, then it should be given a drink of water and turned in a different position. It may cry for several hours at first but if it finds that it will not be taken up it will go to sleep again. One can prove that a baby often cries just because it wants to be held, by taking it up once or twice and noting how quickly it becomes quiet. It takes a baby only a few days to learn if it will be held every time it cries, it takes only a few days to es- tablish a habit of rocking the baby to sleep. Many mothers are made slaves to their babies be- cause they think the baby is too young to be disci- plined. They become drudges who continually rock back and forth or walk the floor. Their health and happiness are lost. They do not derive any com- fort, only care, from the presence of the little one. This should not be. A well baby should not usurp the entire time of its mother. It should be able to amuse itself the greater part of the time. It should THE DISCIPLINE OF CHILDREN be trained from the first to go to sleep with no one near, not to require rocking and coddling. The baby should not be held except when being fed or bathed. The remainder of the time it should lie quietly in bed and require little attention. The more attention one gives a baby the more is re- quired. This does not mean the baby should be neglected in any way, but he should not be pampered and " spoiled." The Secret of Discipline The secret of discipline is honesty. Many moth- ers would resent the implication that they were dis- honest with their children, yet such is the case. It does not take a child long to decide if he can de- pend on his mother's word or not. If he decides he cannot, then discipline flies out of the window. Recently I noticed a mother and her two-year- old daughter leaving a restaurant. The child had been eating candy and still had a rather large piece in her hand. The mother said, " Here, give me that candy. You cannot have any more until we get home." The child at once began to cry so the mother broke off a small piece of the candy and put it in the child's mouth saying, " Well, that is all you can have anyway." That mother was not honest 229 YOUR BABY with her child for she made one statement and then did not carry it out. Another day I heard a mother say to her small daughter, "If you get your dress soiled you cannot go riding with me." Mary immediately reached for some candy and proceeded to cover her dress with the ' chocolate coating. Of course there was a scene, some scolding and tears, but it ended by a clean dress being forthcoming, as otherwise the mother would have had to stay at home, too. These are incidents of every-day life. Every- where we hear scoldings and bribes on the part of the mothers, tears and wails on the part of chil- dren — ending in the child having its own way. Every defeat for the mother makes it just so much harder for her to have any discipline. Every compromise makes her position a little less secure. There is only one way to have discipline without tears and whippings. That way is to be perfectly honest with the child. If the child is told to do anything and he does not, he should be punished im- mediately, but the punishment should be a natural sequence of the wrong. For instance, if Johnnie is told he may cut the pictures out of a paper but must not touch anything else, and he goes ahead 230 THE DISCIPLINE OF CHILDREN and cuts some books, he naturally should be de- prived of the scissors until he is large enough to be trusted with them. If Mary marks the couch or the rug with her colored crayons when she has been given some paper upon which to mark, it would be natural that she should not be allowed to have the crayons for several days. It is not wise to threaten children. One never should say, " Now, Johnnie, if you do not get your hands washed I shall have to punish you." That puts the wrong idea into the child's head. The better way would be to give him the suggestion as it is to be carried out. " Johnnie, I wish you would show me how nice and clean you can get your hands." Then if he does not respond, the punishment should be certain but very moderate. A punishment never should be promised unless one intends to keep the promise. Suggestion During Babyhood The power of suggestion with children is enor- mous. It can do more good than any rod and more harm than any laxity of discipline. A baby is born into the world without any definite ideas of his surroundings. He acquires his ideas through imi- 231 YOUR BABY tation of others, or by suggestions given him either consciously or unconsciously. In the last few years much has been written concerning psychic or mental treatment, how dis- ease has been cured, homes made happy, the weak strong and the struggling made competent by the power of mind over body. To have any idea of this great subject, there are a few basic principles that must be understood. One of these is the existence of two component parts of the mind. These have been named vari- ously but the terms commonly used are the con- scious and the subconscious mind. Briefly, the con- scious mind controls our voluntary acts and the subconscious mind acts as a reservoir for all the impressions received from earliest infancy. The experiences of our childhood, which long have been forgotten, are stored up here and may be brought to light later if the right key is touched. This reservoir of knowledge is ever at our command if we but knew how to use it. By some of the modern methods of education we are learning how to de- velop our power over this subconscious mind so that it may be of great service to us. It is considered that every habit we have acquired can be accounted for by some previous experience. 232 THE DISCIPLINE OF CHILDREN Therefore, if we wish children to acquire correct habits we must see that they receive the right im- pressions on the subconscious mind. It has been proven by experiment that it is pos- sible to influence the habits and character of a child to a great extent by the mental impressions given it. Constant repetition of anything tends to form an impression on the mind that will develop into a habit even though the one who gave the impression desired the opposite effect. Thus, the mother who constantly reiterates in the presence of her son that " Johnnie is such a naughty boy. He will not do a thing I tell him to do," is making a mental impres- sion that she does not desire. The mother must bear in mind that she must make the statements that she would wish to have true. Even though Johnnie has been naughty she would make a better mental impression by saying, " Johnnie usually is such a nice boy. He loves mother and tries to do what she would like to have him do. I am certain Johnnie did not mean to do anything that would cause mother to feel badly. He is going to help mother now." Even in talking to a young baby it is possible to make mental impressions that are lasting. If the mother says, " naughty baby," a great many times 233 YOUR BABY the ideal left in the child's mind will be very dif- ferent from that left by the mother who says, " Baby is sweet. Mother loves baby." Training Babies While They Sleep It is claimed that much can be done to influence a child's conduct by talking to it while it is asleep. Of course the theory of this is based on the suppo- sition that the subconscious mind never sleeps but always is ready and willing to receive impressions. We know that a person awakens in the morning much better prepared for the daily tasks of life if he has had a peaceful sleep in a quiet room, while if his sleep has been disturbed or the surroundings are noisy he awakens in an irritable frame of mind. With a baby, the same effects are true to an even greater extent, for the child's nervous system is very susceptible. Many times a child awakens cross and fretful when the main cause is that his position during sleep has not been restful, or the ventilation in the room has been so poor that the lungs have not had a sufficient supply of oxygen to carry off the toxins of the body. The fretful baby may be lulled into a reposeful slumber by his mother's crooning lullaby. Let the mother break forth in a swinging melody sung in a 234 THE DISCIPLINE OF CHILDREN high key and see how quickly the baby is disturbed and awakened. It is the tune sung in a low sooth- ing tone that is the most quieting. The words of the song have little influence on the child. It is the tone of voice more than words. The mother may change the words of the song and even carry on a conversation, if she keeps the same pitch and rhythm, and the child will not be disturbed. Psychologists have carried on numerous experi- ments to determine the extent to which a child can be influenced by its surroundings during sleep. It is claimed that wonderful results have been obtained by having the mother talk to her child while it is sleeping. Perhaps the best results are obtained during the period that just precedes sound sleep, when the conscious will has been soothed into quietude and yet all the receptive faculties are still awake. Even though the words themselves and the thought are not understood by the infantile mind, at any rate, the quiet repetition of the words and phrases soothes the nervous system and makes it more capable of withstanding the irritations com- mon even to normal life. With the experiments carried on the mother sat by the bedside of her child just as it was going to slumberland and repeated over and over again in 235 YOUR BABY a quiet well-modulated voice the things she wished to impress upon the child. It is better not to try to give more than one thought at a time, although this may be expressed in several different ways. For instance, the mother sitting by the bedside of the baby that has been irritable and cross might say, " To-morrow baby is going to be good. He is go- ing to have a nice sleep now and when he awakens he will feel so rested and will be such a good boy." Just how much can be accomplished by this proce- dure is a matter for conjecture, but at any rate a trial can do no harm. Habits of Regularity One of the most important things in the training of babies is the training in habits of regularity, — regularity in sleeping, in eating, in going to the toilet. The old saying, — " as a twig is bent so the tree inclines," is true of babies. The habits babies establish during the first year will cling to them all their lives. This makes it very important that the mother should start the child right. Many an adult suffers from constipation and indigestion all the years of his life because his mother did not know the necessity of establishing regular habits of living. 236 THE DISCIPLINE OF CHILDREN Many an adult fails in his purpose in life because he never has been trained to correct habits, but only to self-indulgence, because of the mistaken ideas of kindness which refused to deny him anything his fancy desired. A child will not crave any article of food which lie never has tasted. A desire for certain indigest- ible articles is taught the child by being given " tastes " of various things. The child who is al- lowed to follow his own whims, no matter how un- wise, will grow up to be a disagreeable, self-cen- tered, selfish individual cordially disliked by his companions. Discipline does not mean punishment. It means being truthful or consistent. It means carrying out all promises. It does not mean punishing to-day for what was overlooked yesterday. Fear in Children Children are born without fear. It is taught to them by their mothers, fathers and associates. A young child fears nothing. He will place his hand upon a hot stove or under a falling axe without hesitation. A small baby will go to any one who cares to hold him. ?37 YOUR BABY Children need to be taught caution but they do not need to be taught fear. Rather they need to be encouraged to self-confidence. At an early age children are taught fear by their mothers. "Look out or the bogie man will get you." " Be good, or I'll put you out in the dark." These are expressions commonly heard and the child is taught to regard the dark as full of name- less terrors. "If you are not a good boy I will send for the doctor." This threat has caused a great deal of trouble for the mother as well as for others, for when the doctor really was needed the child would cry with terror at his presence. Children should be taught to regard the doctor as a dear friend who makes people well again, not as an object of terror. Some children are naturally timid (perhaps due to prenatal influence) and they should have their fears driven away by a few simple explanations. If something, in which there is no harm, excites them this should be explained to them so that they will not fear it again. Children will not have so many accidents if taught self-confidence and self-reliance. 238 INDEX PAGE Abdomen, care of 66 Abdominal binder for pressure 80 Abdominal supporter 64 Accidents of pregnancy 75 Adenoids 199 Cause night terrors 190 Alcoholic habit formed through food 99 Antiseptic 59 Applicator 130 Areola, darkening of 29 Bands, abdominal for baby 55, 115, 153, 184 Prevent diarrhoea 181 Prevent rupture 202 Baths, for baby 113, 129 For mother 65 Necessary for health 131 Various kinds 66 Barley water 180 Bed, for baby 134, 138 For confinement 83 Warming in cold weather 152 Bed pan 60 Bed wetting 191 Binder, for baby (see bands) For mother 59, 88 In whooping cough 219 239 INDEX PAGE Birth, emergency 60 Infection of eyes 108 Marks 194 Registration 118 Without pain 36 Bladder, disturbance 29 Irritability 80 Blankets for baby 57 Blindness, prevention of 107 Blue baby 113 Bone forming diet 102 Bonnet for baby 57 Boric acid 57, 59 For eyes 107 Bottles, care of 158, 167 First nursing bottle 165 Selection of 165 Bowels, and kidneys 65 After confinement 89 Mother's 71 (See stools, constipation, diarrhoea) Bow legs due to diet 102, 196 Breasts, care of 66, 67 Massage of 101 Breath, holding 195 Bronchitis 211 Broncho-pneumonia 211 Burns 223 Buttermilk for baby 164 Caesarian section 34 Candy for children 173 Cape for baby 57 240 INDEX PAGE Carron oil 224 Castor oil, after confinement 89 In constipation 177 In diarrhcea 181 Catheterization after confinement 89 Chafing 193 Prevention of 133 Chapping, oatmeal bags for 130 Childbed fever 86 Childbirth 82 Natural process 34 Painless 34 Preparations for 36 Chloroform in confinement 49 Circumcision 132 To cure night terrors 190 To cure bed wetting 191 Cleanliness essential 169 Cleft palate 192 Clitoris 132 Clothing, for baby 54, 152 For mother 62 Coat for baby 57 Colds 209 Adenoids predispose to 199 From thin soles 151 Colic 182, 184 Cry of 205 Due to frequent feeding 95 Due to mother's diet 98 Due to sugar 116, 159 Three months 162, 182 To avoid 117 241 INDEX PAGE Condensed milk lacking lime 102 Confinement (see childbirth) 82 Care after 87 Date of 30 No one method 50 Constipation, baby's 99, 176 Establishment of 177 Fat 178 First symptom of disease 210 Mother's yy, 99 Convulsions in babies 204 In pneumonia 212 Of mother 33, 78 Cord, care of 60, 112 Corsets for mother 62 Cotton, absorbent 58 Cradle 139 Crying 205 Night cry 188, 206 Of indigestion 165 Of spoiled baby 228 Cross eyes 195 Dark, fear of 189 Deafness following measles 214 Deaths from diarrhoea 169 Preventable 154 Despondency 73 Dextrimaltose 162 Diapers, 56, 115, 152 Rubber 56 Diarrhoea in babies 179 Deaths from 169 242 INDEX PAGE Diarrhoea in babies — continued Feeding in 160 First symptom of disease 210 In pneumonia 212 Diet for mother 98 After confinement 89 Of prospective mother 69 Diet of baby (see feeding) Bone forming 102 Changing baby's 100 For older child 173 Discharge from female organs of baby 133 Discipline 227 Early 126 Secret of 126, 229 Douches 66 After labor 89 External 89 Dresses for baby 56 Disinfection following measles 215 Following whooping cough 219 Ear, ache 194 Cleansing of 129 Discharge from 194 Inflammation of 221 Inflammation following measles 214 Eclampsia 33 Avoided 78 Eczema , 130, 193 Cry of 205 Emergency chest 224 Endocarditis in scarlet fever 221 243 INDEX PAGE Enema before labor 82 Epidemics, cause of 213 Epilepsy 21 Convulsions in 204 Eugenics 17 Exercise, after childbirth 35 For baby 141 For expectant mother 23, 64 For mother 92, 99 Eyes, care 109, 129 Care in measles 215 Crossed 195 Infected at birth 108 Of new born 107 Wash 57 When baby begins to see 122 Fainting y-j Fear, curse of humanity 41 In children 237 Result of ignorance 41 Feeblemindedness, inherited 18 Feeding 154 Artificial 156 Best food 155 In diarrhoea and constipation 160 Over feeding 165, 170 Regularity of 31, 95, 136, 161 Supplementary 159 Whole milk method 161 Feet, swelling of 78 Fever, childbed 86 Inanition 86 244 INDEX PAGE First care of baby 107 Flaxseed poultice 217 Flow after confinement 89 Fomentations 217 Fontanel, when closed 198 Foods, for prospective mother 69 Laxative 71 Foreskin retracted daily 132 Fresh air for baby 144 For expectant mother 23 Schools 145 Fruit for prospective mother 70 Fumigation (see disinfection) Garters for mother 63 Gauze, sterile 58 Generative organs, cleansing of 132 Gertrudes for baby 55 Gripes 165 Grulee method 163 Habits established early 31, 125, 136 Impressed upon the mind 232 Of regularity 236 Harelip 192 Hearing of young baby 122 Heat rash 193 Heart beats of foetus 28 Heart, inflammation of 221 Heredity, definition 21 Feeblemindedness 18 Syphilis 20 245 INDEX PAGE Heredity — continued Tendency to disease 19 Tuberculosis 20 Hernia 200 Strangulated 202 Hives 204 Holding breath spells 195 Holding the baby 97 Hospital, desirable for confinement 48 What to take to 84 Hot water bottle 117 Housework for mother 64 Icterus neonatorum 186 Inanition fever 123 Incidents of pregnancy 75 Indigestion due to lack of sleep 134 From overfeeding 165 Intestinal disorders 176 Jaundice 186 Kidneys 78 Care of 65 Condition indicated by urine 32 Inflammation following burns 225 Inflammation following measles 214 Inflammation in scarlet fever 222 Kimonos for baby 56 Kindergarten methods begun early 128 Knee chest position 81 After confinement 92 246 INDEX PAGE Knock knees 196 Knowledge of baby necessary 121 Labor 60, 82 Date of 30 Premature 34 Laxatives 78 Foods 71 For mother 104 Layette 54 Legs, swelling of 78 Life, feeling of 29 Light at night 189 Lime water in food 102, 157 Liquor amni 28 Lying-in period 87 Malt sugar 159 Marital relations 67 After confinement 90 Marking child 69 Massage, of breasts 67, 101 For baby 142 For bow legs 196 For constipation 178 Mastoiditis in scarlet fever 221 Maternity outfit 57 Measles 213 Medicines, care of 225 Menses, in babies 133 Suppression of 29 247 INDEX PAGE Mental condition of mother 21, 73 Influence on physical 21 Suggestion for children 233 Midwife, danger of 86 Milk, affected by worry 185 Boiled 164 Buttermilk 164 Condensed 164 Increased by massage 67 Keeping warm at night 158 Of magnesia 104 Secretion 29, 123 Sugar 159 To increase 100 Top milk method 157 Whole milk method 161 Morning sickness 29, 75 Mother, care of 62 Health 91 Rest of 3 1 Mouth breathing 199 Care during pregnancy 68 Care of baby's in, 129, 147 Sore 147 Wash 57, i°7 Mumps 2I 5 Mustard bath in pneumonia 213 Nausea of pregnancy 29, 75 Navel, care of 60, 113 Nephritis in scarlet fever 222 Nervousness due to lack of sleep 134 Nettle rash 204 248 INDEX PAGE Night terrors 188 Nipples, care of mother's 67, 101 Selection of bottle 165 Nurse engaging and qualifications 30, 31 Nursery 61 Emergency chest for 224 Supplies of 211 Nursing, baby 97 Difficult 117 Frequently 95 When not desirable 156 Nursing bottle 165 Oatmeal bags 130 Oil for skin 66 Olive oil 57 For constipation 177 Rub at night 142 Onion poultice 210 Ophthalmia neonatorium 108 Orange juice for baby 171 Otitis media, in measles 214 In scarlet fever 221 Outfit, maternity 57 Overfeeding 165, 170 Over-lying 134 Overwork 64 Pads, sanitary 58 Painless childbirth 34 Pains, unnecessary 38 Petticoat for baby 55 249 INDEX PAGE Physician, directions of • • • 2I 3 Engaging early 2 4» 3° Protects public 4$ Qualifications of 3 2 When needed at labor 82 Pigeon toes x 9^ Pinless garments 57 Pinning blanket XI 5 Pituitary extract 5 2 Pleurisy, cry of 2o6 Pneumonia 2I ° Following whooping cough 2I 9 Poison, taking 2I 3 Pop corn for nausea 7° Poultice, flaxseed 2I 7 Onion 210 Powder 57 Powdering baby r *4> x 33 Pregnancy, symptoms of 2 9 Prenatal influences 2I Preparations, necessary 54 For baby l8 - 54 Prepuce, tight, cause of night terrors 19° Cause of convulsions 2I 4 Prickly heat '93 Prospective mother, care of ._ 62 Punishments 2 3° Pruritis ^ Quarantine 2I 4 In whooping cough 2I 9 Quickening 29> 3° Quinine in confinement 5 2 250 INDEX PAGE Rachitic rosary 197 Registering birth 118 Rest, baby's 135 For expectant mother 8i, 94 For mother 31, 67 Rickets 197 Cry of 206 Rosary, rachitic 197 Rubber, diaper 56 Sheet 58, 139 Rupture 200 Safety pins 57 Scarlet fever 220 Convulsions in 204 Schools, fresh air 145 Sewing for baby 72 Sex of baby 26 Determination xj Influenced by diet 27 Sex toilet 132 Sheet, rubber 58 Shawls for baby 57 Shirts for baby 55, 115 Shoes for baby 57, 1 50 For mother 64 Sick room, preparation of 87 Signs of pregnancy 29 Silver nitrate for eyes 108 Size of baby 119 Skin and kidneys 65 Irritation of 66 Skirts for baby 55 -'51 INDEX PAGE Sleep, and conduct 2 34 Baby's J 33 For expectant mother 2 3 For mother 6 7 Out of doors for baby *44 Sleeplessness, of baby x 93 Of mother 7^ Slips for baby 5& Soother n 7 Soothing syrups 95» l 7° Spasms in babies 20 4 Spina bifida x 9 2 Spoiling baby 3h 136, 22 7 Stockings for baby 57 Stools of baby Il8 Green 2I2 Stubborn child : 3 X Stuttering x 94 Sugar, in baby's milk *59> 162 For children x 74 Of milk x 59 Suggestion, power of 2 3 I Supplementary feeding for baby *59 Supporter, abdominal °4 Swallowing foreign bodies 20 3 Swelling of legs and feet 7 8 Swimming " 4 Syphilis 20 Syringe ^ Talking, first attempt I26 Tears, repaired 9 2 Teas, for baby 95, "6, 170 252 INDEX PAGE Teeth, baby's 102, 126, 146, 148 Care of 146 Mother's 68, 104 Protruding 200 Teething, care during 149 Temper, cry of 206 Temperature, how to take, variation 209 Of nursery 61 Thermometer 209 Thirst, in pneumonia 213 Of babies 169 Of new born 122 Thumb sucking habit 192 Tonsils, enlarged, cause of night terrors 190 Top milk method 157 Toys for bath 130 Training will (see discipline) Truss 201 Tuberculosis, heredity of 20 Cause of 20 Following whooping cough 219 Turpentine and oil in pneumonia 212 Twilight sleep 42 Discarded 46 Undergarments for mother 62 Urination, after confinement 89 Delayed 117 Frequent 81 Urine, collection of 32 Examination of 32, 78 In pneumonia 212 253 INDEX PAGE Vaccination 204 Varicose veins 63 Due to pressure 78 Knee chest position in 81 Veins, varicose 63 Ventilation, in measles 215 In pneumonia 212 In whooping cough 220 Vernix caseosa 113 Vomiting of baby, after feeding 161 First symptom of disease 210 In scarlet fever 221 In whooping cough 219 Vomiting of pregnancy 29, 75 Walking, exercise for mother 64 In sleep 188 When attempted by the baby 126 Water for baby 95, 116, 165, 169 Boiled 169 Water drinking for mother 65 Weaning baby roo, 171 Weight of baby 119 Loss after birth 120 Well born child 17 Wetting bed 191 Whooping cough 218 Wool undergarments for prospective mother 64 Womb, following confinement 91 Tears of 92 Worms, cause of bed wetting 191 Cause convulsions 204 Cause night terrors 190 Worry, affecting milk 185 254 By E. B. Lowry, M.D. HERSELF TALKS WITH WOMEN CONCERNING THEMSELVES This book contains sex truths vitally important to every woman. The health and happiness of mothers and their children depend upon their knowledge of the facts here given with great clear- ness and conciseness by a physician of national reputation in the scientific care of women. " Herself " is superior to all books on its subject: — The Independent. It stands alone in the literature of the subject and I am losing no opportunity to commend it. — The Rev. Lyman P. Powell. Well written, skillful and conscientious. — Margaret E. Songster. A book the world has long needed. — Mrs. W. N. Hutt, National Chairman, School Hygiene, General Federation of Women's Clubs. A very excellent book that will save many from physical and mental suffering. — Iowa Medical Journal. Should be recommended by physicians to all their female patients. — The Lancet-Clinic . It is a book for the reading of which almost any woman would be the better and give thanks. — Chicago Record-Herald. Illustrated. Cloth, i2mo. Price, $1.00 net; by mail, $1.10 For sale by all booksellers and the publishers, FORBES & CO., 443 S. Dearborn St., CHICAGO By E. B. Lowry, M.D. HIMSELF TALKS WITH MEN CONCERNING THEMSELVES This is regarded by all authorities as the best book on sexual hygiene for men. No man know- ing its contents would be without this important book. It tells plainly all of the facts about sex and leads to health, happiness and success. A book that points the way to strong vitality and healthy manhood. Every man ought to read this excellent, reliable book. — Philadelphia Telegraph. The best book on sexual hygiene for men and we highly commend it. — Baltimore American. The more widely this splendid book is read the bet- ter it will be for men and women. — Boston Globe. Every youth and man who can read the English language should study this book. — Portland Oregonian. A rare book that treats its subject in a common- sense fashion. — Pittsburgh Post. This is a storehouse of knowledge that should be in the hands of every man. — United States Medical Journal. It is utterly free from hysteria and sticks straight to the unadulterated truth. A valuable addition to any man's library. — Spokane Chronicle. It is as good a book as a physician could recom- mend. — Northwest Medicine. Clear, accurate, easily understood. — Chicago Jour- nal. Illustrated. Cloth, i2mo. Price, $1.00 net; by mail, $1.10 For sale by all booksellers and the publishers, FORBES & CO., 443 S. Dearborn St., CHICAGO By E. B. Lowry, M.D. CONFIDENCES TALKS WITH A YOUNG GIRL CONCERNING HERSELF A book explaining the origin and development of life in lan- guage intelligible to young girls. The author, who is a phy- sician of wide experience and a pleasing writer, has very deli- cately and adequately treated this important subject. Carefully written and should be given to every young girl. — American Motherhood. Every physician should read and circulate this book. — Jour- nal of Therapeutics. Neatly bound in cloth. i6mo. Price, 50 cents net; by mail, 55 cents TRUTHS TALKS WITH A BOY CONCERNING HIMSELF A book containing the simple truths of life development and sex which should be given to every boy approaching manhood. His future welfare demands it. This is the first book to ade- quately and delicately present these truths in language intelli- gible to boys from ten to fourteen years of age. The first satisfactory book on the subject. — Health Culture Magazine. Many a mother will be glad that such a book is within the reach of her child. — Seattle Post Intelligencer. Attractively bound in cloth. i6mo. Price, 50 cents net; by mail, 55 cents FALSE MODESTY THAT PROTECTS VICE BY IGNORANCE The most thorough and convincing appeal ever made for the proper education of the young in matters pertaining to sexual hygiene by the foremost writer on the subject. Dr. Lowry's books combine medical knowledge, simplicity, and purity in an unprecedented way. They are chaste and void of offense to the most delicate natures. — The Journal of Edu- cation, Boston. Cloth, i6mo. Price, 50 cents net; by mail, 55 cents For sale by all booksellers and the publishers, FORBES & CO., 443 S. Dearborn St., CHICAGO By E. B. Lowry, M.D. THE HOME NURSE This very useful book gives helpful directions for the care of the sick in the home and tells how to co-operate with the physician in providing for the comfort and cure of invalids. Full directions for first aid to the injured are also given. Technical terms are avoided and a complete index makes it possible to refer quickly to the desired information. As sensible a book of directions as we have come across. — New York Sun. It will be a great help to all mothers. — American Club Woman, New York. A good book to put in the hands of a prospective nurse and of any one who desires to do nursing. — Medical World, Philadelphia. Uniting practical common sense with the best medical knowledge, it forms a safe guide. — American Journal of Nursing, Baltimore. This book, quite unlike the majority of those writ- ten on this subject is full of common sense. It is of distinct value to the household. — Boston Advertiser. It serves a very useful purpose and is readily un- derstood. Physicians will welcome the circulation of this excellent book. — Medical Sentinel, Portland, Ore. This book will be a decidedly welcome visitor to any home. — Journal of Education, Boston. " The Home Nurse " is a sensible book, and it should be in every home bookshelf. — Northwest Medicine. Seattle. Any housewife can practically apply the information contained in this admirable book. — Rochester Post Express. Cloth, i2mo. Price, $1.00; by mail, $1.10 For sale b\> all booksellers and the publishers. FORBES & CO.. 443 S. Dearborn St., CHICAGO LIBRARY OF CONGRESS 4 iiiiriiiiiiiiiiiiiiiiif 022 169 351 6