After the birth of the child at full term, or at any other period of

pregnancy, the womb, which had attained such wonderful proportions in a

few months, begins to resume its former size. This process requires at

least six weeks after labor for its full accomplishment. Rest is

essential during this period. A too early return to the ordinary active

duties of life retards or checks this restoration to normal size, and

the womb being heavier, exposes the woman to great danger of uterine

displacements. Nor are these the only risks incurred by a too hasty

renewal of active movements. The surface, the substance, and the lining

membrane of the womb are all very liable, while this change from its

increased to its ordinary bulk is occurring, to take on inflammation

after slight exposure. The worst cases of uterine inflammation and

ulceration are thus caused. A 'bad getting-up,' prolonged debility,

pain, and excessive discharge, are among the least penalties consequent

upon imprudence after confinement. It is a mistake to suppose that

hard-working women in the lower walks of life attend with impunity to

their ordinary duties a few days after confinement. Those who suffer

most from falling of the womb and other displacements are the poor, who

are obliged to get up on the ninth day and remain upright, standing or

walking for many hours with an over-weighted womb. Every physician who

has practised much among the poor, has remarked upon the great frequency

of diseases of the womb, which is to be attributed to the neglect of

rest, so common among them, after childbirth. If this be true of

vigorous women accustomed to a hardy life, how much more apt to suffer

from this cause are the delicately nurtured, whose systems are already,

perhaps, deteriorated, and little able to resist any deleterious

influences!

A mother should remain in bed for at least two weeks after the birth of

the child, and should not return to her household duties under a month;

she should also take great pains to protect herself from cold, so as to

escape the rheumatic affections to which at this time she is

particularly subject. If these directions were generally observed, there

would be less employment for physicians with diseases peculiar to

women, and fewer invalids in our homes.

TO PRESERVE THE FORM AFTER CHILDBIRTH.

This is a matter of great anxiety with many women; and it is proper that

it should be, for a flabby, pendulous abdomen is not only destructive to

grace of movement and harmony of outline, but is a positive

inconvenience.

To avoid it, be careful not to leave the bed too early. If the walls of

the abdomen are much relaxed, the bed should be kept from two to three

weeks. Gentle frictions daily with spirits and water will give tone to

the muscles. But the most important point is to wear for several months

a _well-fitting_ bandage--not a towel pinned around the person, but a

body-case of strong linen, cut bias, setting snugly to the form, but not

exerting unpleasant pressure. The pattern for this has already been

given.

THE MOTHER.

_MATERNAL DUTIES AND PRIVILEGES._

It has been well said by Madame Sirey, that women who comprehend well

their rights and duties as mothers of families, certainly cannot

complain of their destiny. If there exists any inequality in the means

of pleasure accorded to the two sexes, it is in favor of the woman. The

mother who lives in her children and her grandchildren has the peculiar

privilege of not knowing the grief of becoming old.

'So low down in the scale of creation as we can go,' says Professor

Laycock of Edinburgh, 'wherever there is a discoverable distinction of

sex, we find that maternity is the first and most fundamental duty of

the female. The male never in a single instance, in any organism,

whether plant or animal, contributes nutrient material.'

Among the Romans, it was enacted that married women who had borne three

children, or if freed-women, four, had special privileges of their own

in cases of inheritance, and were exempted from tutelage. Juvenal has

recorded the reverence paid in Rome to the newly-made mother, and the

sign by which her house was designated and protected from rude

intruders, namely, by the suspension of wreaths over the door.

At various times, and in different countries, legislators have made laws

discriminating in favor of matrons, justly regarding the family as the

source of the wealth and prosperity of the State.

Louis XIV. granted, by the edict of 1666, certain pensions to parents of

ten children, with an increase for those who had twelve or more.

NURSING.

So soon as the infant is born, it ought to be placed at the breast. From

this source it should receive its _only_ nourishment during the first

four or six months, and in many cases the first year, of its life. The

child which the mother has carried for nine months and brought with

suffering into the world, still depends upon her for its existence. At

the moment of its birth her duties to the infant, instead of ceasing,

augment in importance. The obligation is imposed upon her of nourishing

it with _her own_ milk, unless there are present physical conditions

rendering nursing improper, of which we are about to speak. It is well

known that the artificial feeding of infants is a prominent cause of

mortality in early life. The foundlings of large cities furnish the most

striking and convincing proof of the great advantages of nursing over

the use of artificially-prepared food. On the continent of Europe, in

Lyons and Parthenay, where foundlings are wet-nursed from the time they

are received, the deaths are 33.7 and 35 per cent. In Paris, Rheims, and

Aix, where they are wholly dry-nursed, their deaths are 50.3, 63.9, and

80 per cent. In New York city, the foundlings, numbering several hundred

a year, were, until recently, dry-nursed, with the fearful and almost

incredible mortality of nearly one hundred per cent. The employment of

wet-nurses has produced a much more favorable result. Therefore, if for

any reason the mother cannot nurse her own child, a hired wet-nurse

should be procured. This brings us to the consideration of

HINDRANCES TO NURSING, AND WHEN IT IS IMPROPER.

Women who have never suckled often experience difficulty in nursing, on

account of the sunken and flat condition of the nipple. We have pointed

out the causes of this depression, and how by early attention before the

birth of the infant it may be prevented. If, however, these precautions

have been neglected, and it is found that the nipple is not sufficiently

prominent to be grasped by the child's mouth, it may be drawn out by a

common breast-pump, by suction with a tobacco-pipe, by the use of the

hot-water bottle in the manner described, or by the application of an

infant a little older. Neither the child nor the mother should be

constantly fretted in such cases by frequent ineffectual attempts at

nursing. Such unremitting attention and continual efforts produce

nervousness and loss of sleep, and result in a diminution of the

quantity of the milk. The child should not be put to the breast oftener

than once in an hour and a half or two hours. By the use of the

expedients mentioned, the whole difficulty will be overcome in a few

days.

_Delay in applying the child to the breast_ is a common cause of

trouble. After it has been fed for several days with the spoon or

bottle, it will often refuse to suck. When nursing is deferred, the

nipple also becomes tender. For these reasons, as well as the others

detailed in our directions for the care of the new-born infant, the

child should always, in say from two to three hours after labor, be

placed at the breast.

_Ulcerated and fissured nipples_ should be treated by the doctor in

attendance. As it is highly desirable, and nearly always possible, to

avoid them, we would again call attention to the manner of doing so,

indicated in a previous article. Fissured nipples sometimes do harm to

the infant, by causing it to swallow blood, disturbing in this way the

digestion. But all these local interferences with nursing can generally

be obviated in the course of a few weeks, and rarely entirely prevent

the exercise of this maternal pleasure and duty.

But there are certain _physical conditions which necessitate the

employment of a hired wet-nurse_, or weaning. If the mother belongs to a

consumptive family, and is herself pale, emaciated, harassed by a cough,

and exhausted by suckling, wet-nursing is eminently improper. A

temporary loss of strength under other circumstances should not induce a

mother at once to wean her child; for it is often possible, by the

judicious use of tonics, nourishing food, and stimulants, to entirely

restore the health with the child at the breast. It should always be

recollected, however, that the milk of those in decidedly infirm health

is incapable of properly nourishing the child. Professor J. Lewis Smith

of New York quotes, in his recent work on Diseases of Children, several

instructive cases which show the danger sometimes attending suckling,

and which may imperatively demand its discontinuance. 'A very

light-complexioned young mother, in very good health, and of a good

constitution, though somewhat delicate, was nursing for the third time,

and, as regarded the child, successfully. All at once this young woman

experienced a feeling of exhaustion. Her skin became constantly hot;

there were cough, oppression, night-sweats; her strength visibly

declined, and in less than a fortnight she presented the ordinary

symptoms of consumption. The nursing was immediately abandoned, and from

the moment the secretion of milk had ceased, all the troubles

disappeared.' Again: 'A woman of forty years of age having lost, one

after another, several children, all of which she had put out to nurse,

determined to nurse the last one herself. This woman being vigorous and

well built, was eager for the work, and, filled with devotion and

spirit, she gave herself up to the nursing of her child with a sort of

fury. At nine months she still nursed him from fifteen to twenty times a

day. Having become extremely emaciated, she fell all at once into a

state of weakness, from which nothing could raise her, and two days

after the poor woman died of exhaustion.'

It does not always follow, that because the mother is sick the child

should be taken from the breast. It is only necessary in those

affections in which there is great depression of the vital powers, or

in which there is danger of communicating the disease to the child. In

the city, where artificially-fed infants run great risks, extreme

caution should be exercised in early weaning.

_Inflammation of either of the breasts_ necessitates the removal of the

infant from the affected side, and its restriction to the other. As the

inflammation gets well and the milk reappears, the first of it should

always be rejected, as it is apt to be thick and stringy, after which

nursing may be resumed.

RULES FOR NURSING.

The new-born child should be nursed about every second hour during the

day, and not more than once or twice at night. Too much ardor may be

displayed by the young mother in the performance of her duties. Not

knowing the fact that an infant quite as frequently cries from being

overfed as from want of nourishment, she is apt to give it the breast at

every cry, day and night. In this manner her health is broken down, and

she is compelled perhaps to wean her child, which, with more prudence

and knowledge, she might have continued to nurse without detriment to

herself. It is particularly important that the child shall acquire the

habit of not requiring the breast more than once or twice at night.

This, with a little perseverance, can readily be accomplished, so that

the hours for rest at night, so much needed by the mother, may not be

interfered with. Indeed, if the mother does not enjoy good health, it is

better for her not to nurse at all at night, but to have the child fed

once or twice with a little cow's milk. For this purpose, take the

upper third of the milk which has stood for several hours and dilute it

with water, in the proportion of one part of milk to two of water.

In those cases in which the milk of the mother habitually disagrees with

the infant, the attention of the doctor should at once be called to the

circumstance. A microscopic examination will reveal to the intelligent

practitioner the cause of the difficulty, and suggest the remedy.

It may be well here to mention--as, judging from the practice of many

nurses and mothers, it seems to be a fact not generally known or

attended to--that human milk contains _all that is required_ for the

growth and repair of the various parts of the child's body. It should

therefore be the sole food in early infancy.

INFLUENCE OF DIET ON THE MOTHER'S MILK.

Certain articles of food render the milk acid, and thus induce colicky

pains and bowel complaints in the child. Such, therefore, as are found,

in each individual case, to produce indigestion and an acid stomach in

the mother, should be carefully avoided by her.

_Retention of the milk in the breasts_ alters its character. The longer

it is retained, the weaker and more watery it becomes. An acquaintance

with this fact is of practical importance to every mother; for it

follows from it, that the milk is richer the oftener it is removed from

the breast. Therefore, if the digestion of the child is disordered by

the milk being too rich, as sometimes happens, the remedy is to give it

the breast less frequently by which not only is less taken, but the

quality is also rendered poorer. On the contrary, in those instances in

which the child is badly nourished and the milk is insufficient in

quantity, it should be applied oftener, and the milk thus rendered

richer.

The milk which last flows is always the richest. Hence, when two

children are nursed, the first is the worse served.

INFLUENCE OF PREGNANCY ON THE MILK.

Menstruation is ordinarily absent, and pregnancy therefore impossible,

during the whole course of nursing, at least during the first nine

months. Sometimes, however, mothers become unwell at the expiration of

the sixth or seventh month; in rare instances, within the first five or

six weeks after confinement. When the monthly sickness makes its

appearance without any constitutional or local disturbance, it is not

apt to interfere with the welfare of the infant. When, on the contrary,

the discharge is profuse, and attended with much pain, it may produce

colic, vomiting, and diarrhoea in the nursling. The disturbance in the

system of the child ordinarily resulting from pregnancy in the mother is

such that, as a rule, it should be at once weaned so soon as it is

certain that pregnancy exists. The only exceptions to this rule are

those cases in the city, during the hot months, in which it is

impossible either to procure a wet-nurse or to take the child to the

country to be weaned. In cold weather an infant should certainly be

weaned, if it has attained its fifth or sixth month, and the mother has

become pregnant.

INFLUENCE OF THE MOTHER'S MIND OVER THE NURSING CHILD.

We have spoken, in treating of mothers' marks, of the influence of the

mother's mind upon her unborn offspring. The influence of the maternal

mind does not cease with the birth of the child. The mother continues

during the whole period of nursing powerfully to impress, through her

milk, the babe at her breast. It is well established, that mental

emotions are capable of changing the quantity and quality of the milk,

and of thus rendering it hurtful, and even dangerous, to the infant.

_The secretion of milk may be entirely stopped_ by the action of the

nervous system. Fear, excited on account of the child which is sick or

exposed to accident, will check the flow of milk, which will not return

until the little one is restored in safety to the mother's arms.

Apprehension felt in regard to a drunken husband, has been known to

arrest the supply of this fluid. On the other hand, the secretion is

often augmented, as every mother knows, by the _sight_ of the child,

nay, even by the _thought_ of him, causing a sudden rush of blood to the

breast known to nurses as the _draught_. Indeed a strong desire to

furnish milk, together with the application of the child to the breast,

has been effectual in bringing about its secretion in young girls, old

women, and even men.

Sir Astley Cooper states that 'those passions which are generally

sources of pleasure, and which when moderately indulged are conducive to

health, will, when carried to excess, alter, and even entirely check the

secretion of milk.'

But the fact which it is most important to know is, that _nervous

agitation may so alter the quality of the milk as to make it poisonous_.

A fretful temper, fits of anger, grief, anxiety of mind, fear, and

sudden terror, not only lessen the quantity of the milk, but render it

thin and unhealthful, inducing disturbances of the child's bowels,

diarrhoea, griping, and fever. Intense mental emotion may even so alter

the milk as to cause the death of the child. A physician states, in the

_Lancet_, that, having removed a small tumour from behind the ear of a

mother, all went on well until she fell into a violent passion. The

child being suckled soon afterwards, it died in convulsions. Professor

Carpenter records in his Physiology two other fatal instances: in one,

the infant put to the breast immediately after the receipt of

distressing news by the mother, died in her arms in the presence of the

messenger of the ill-tidings; in the other, the infant was seized with

convulsions on the right side and paralysis on the left, on sucking

directly after the mother had met with an agitating occurrence. Another

case of similar character may be mentioned. A woman while nursing became

violently excited on account of a loss she had just met with from a

theft. She gave her child the breast while in an intense passion. The

child first refused, but ultimately took it, when severe vomiting

occurred. In the course of some hours the child took the other breast,

was attacked at once with violent convulsions, and died in spite of all

that could be done for it.

The following cases are related by Professor Carpenter as occurring

within his own knowledge. They are valuable as a warning to nursing

mothers to avoid all exciting or depressing passions. A mother of

several healthy children, of whom the youngest was a vigorous infant a

few months old, heard of the death from convulsions of the infant child

of an intimate friend at a distance, whose family had increased in the

same manner as her own. The unfortunate circumstance made a strong

impression on her mind, and being alone with her babe, separated from

the rest of her family, she dwelt upon it more than she otherwise would

have done. With her mind thus occupied, one morning, shortly after

nursing her infant, she laid it in its cradle, asleep and apparently in

perfect health. Her attention was soon attracted to it by a noise. On

going to the cradle she found it in a convulsion, which lasted only a

few moments, and left it dead. In the other case, the mother had lost

several children in early infancy, from fits. One infant alone survived

the usually fatal period. While nursing him, one morning she dwelt

strongly upon the fear of losing him also, although he appeared to be a

very healthy child. The infant was transferred to the arms of the nurse.

While the nurse was endeavouring to cheer the mother by calling her

attention to the thriving appearance of her child, he was seized with a

convulsion, and died almost instantly in her arms. Under similar

circumstances, a child should not be nursed by its mother, but by one

who has reared healthy children of her own and has a tranquil mind.

An interesting illustration of the powerful sedative action of the

mother's milk--changed in consequence of great mental distress--upon the

impressible nervous system of the infant, is furnished by a German

physician. 'A carpenter fell into a quarrel with a soldier billeted in

his house, and was set upon by the latter with his drawn sword. The wife

of the carpenter at first trembled from fear and terror, and then

suddenly threw herself furiously between the combatants, wrested the

sword from the soldier's hand, broke it in pieces, and threw it away.

During the tumult, some neighbors came in and separated the men. While

in this state of strong excitement, the mother took up her child from

the cradle, where it lay playing and in the most perfect health, never

having had a moment's illness. She gave it the breast, and in so doing

sealed its fate. In a few minutes the infant left off sucking, became

restless, panted, and sank dead upon its mother's bosom. The physician,

who was instantly called in, found the child lying in the cradle as if

asleep, and with its features undisturbed; but all his resources were

fruitless. It was irrevocably gone.'

Professor William A. Hammond of New York mentions, in a recent number of

the _Journal of Psychological Medicine_, several instances, from his own

practice, of affections in the child caused by the mother's milk. 'A

soldier's wife, whilst nursing her child, was very much terrified by a

sudden thunderstorm, during which the house where she was then quartered

was struck by lightning. The infant, which had always been in excellent

health, was immediately attacked with vomiting and convulsions, from

which it recovered with difficulty.' 'A lady, three weeks after

delivery, was attacked with puerperal insanity. She nursed her child but

once after the accession of the disease, and in two hours subsequently

it was affected with general convulsions, from which it died during the

night. Previous to this event it had been in robust health.'

Again, Dr. Seguin of New York relates, in his work on Idiocy, a number

of cases of _loss of mind_ produced by the altered state of the mother's

milk. 'Mrs. B. came out from a ball-room, gave the breast to her baby,

three months old: he was taken with spasms two hours after, and since is

a confirmed idiot and epileptic.'

'In a moment of great anxiety Mrs. C. jumped into a carriage with her

suckling, a girl of fifteen months, so far very intelligent and

attractive. The child took the breast only once in a journey of twenty

miles, but before arriving at destination she vomited several times,

with no interruption but that of stupor, and after an acute fever the

little girl settled down into the condition of a cripple and idiot.'

The celebrated physician Boerhaave mentions the milk of an angry nurse

as among the causes of _epilepsy._

These facts show the importance of a placid mind and cheerful temper in

the mother while nursing.

POSITION OF THE MOTHER WHILE NURSING.

The habit of nursing a child while sitting up in bed or half reclining

upon a lounge is a wrong one. Such a position is injurious to the

breasts, hurtful to the woman's figure, and apt to cause backache. When

in bed, the mother ought always to be recumbent while the child is at

the breast, held upon the arm of the side upon which she lies. When out

of bed, she should sit upright while nursing.

QUANTITY OF MILK REQUIRED BY THE INFANT.

The amount of milk furnished every day by a healthy woman has been

estimated at from a quart to three pints. An infant one or two months of

age takes about two wine-glassfuls, or three ounces, every meal; that

is, as it sucks every two hours, excepting when asleep, about five

half-pints during the twenty-four hours. When it attains the age of

three months, it thrives well on five meals a day, the quantity taken at

each meal then, the stomach being more capacious, amounting to about

half a pint. A child above three months of age ordinarily requires three

pints daily.

A healthy mother is fully capable of furnishing this quantity of milk

per day, and of affording the child all the nourishment it needs until

four or six months after birth.

The quantity of the mother's milk varies according to many

circumstances. It is most abundant and also most nutritious in nursing

women between the ages of fifteen and thirty; least so, in those from

thirty-five to forty. There is likewise a great difference in different

women in this respect; and in the same woman varying conditions of

health influence the amount of milk secreted.

THE QUALITIES OF A GOOD NURSING MOTHER

are well described by Professor J. Lewis Smith. 'The best wet-nurses are

usually robust, without being corpulent. Their appetite is good, and

their breasts are distended, from the number and large size of the

blood-vessels and milk-ducts. There is but a moderate amount of fat

around the gland, and tortuous veins are observed passing over it. Such

nurses do not experience a feeling of exhaustion, and do not suffer from

lactation. The nutriment which they consume is equally expended on their

own sustenance and the supply of milk. There are other good wet-nurses

who have the physical condition described, but whose breasts are small.

Still the infant continues to suck till it is satisfied, and it thrives.

The milk is of good quality, and it appears to be secreted mainly during

the time of suckling. Other mothers evidently decline in health during

the time of nursing. They furnish milk of good quality and in abundance,

and their infants thrive; but it is at their own expense. They

themselves say, and with truth, that what they eat goes to milk. They

become thinner and paler, are perhaps troubled with palpitation, and are

easily exhausted. They often find it necessary to wean before the end of

the usual period of lactation. There is another class whose health is

habitually poor, but who furnish the usual quantity of milk without the

exhaustion experienced by the class just described. The milk of these

women is of poor quality. It is abundant, but watery. Their infants are

pallid having soft and flabby fibre.'

OVER-ABUNDANCE OF MILK.

An excessive amount of milk often distends the breasts of those women

who are prone to have long and profuse monthly sickness. It is also apt

to occur in those subject to bleeding piles. It may be produced by any

excitement of the womb or ovaries, and by over-nursing. In these cases

there is usually a constant oozing away and consequent loss of milk. The

mother is troubled by this over-flow, because it keeps her clothing wet;

and the child suffers because of the unnutritious, watery character of

the milk under such circumstances.

This over-abundant supply may be moderated and the quality improved by

diminishing the quantity of drink, and by the use of preparations of

iron. Fifteen drops of the muriatic tincture of iron, taken three times

a day in a little sweetened water, through a glass tube, will be useful.

It will lessen the amount of the milk, and make it richer. So soon as

these objects are accomplished, the medicine should be discontinued; as,

if taken too long, it may so much diminish the milk as to necessitate

weaning. The application of a cloth, wrung out in cold water, around the

nipples is also of value. It is to be removed so soon as it becomes

warm, and reapplied. In those cases in which the trouble seems to be not

so much an over-supply as an inability to retain the milk, the

administration of tonics addressed to the nervous system, and the local

use of astringents and of collodion around the nipples, will overcome

the difficulty; but these remedies can only be employed successfully by

the physician. And to him alone should be entrusted the use of those

medicines which directly diminish the amount of milk secreted within the

breasts. The expedients we have mentioned are the only ones which can be

safely employed by the mother herself in this annoying affection.

SCANTINESS OF MILK.

Some mothers have habitually an insufficiency of milk. They are most

numerous in large cities, and among working women whose daily

occupations require a separation from the infant. Indigestion, and the

want of a proper amount of nourishing food, cause a diminution in the

quantity of milk. So also do over-feeding and gormandizing. Age lessens

the secretion of milk, as has been already mentioned. Those who first

bear children late in life, have less milk for them than they who begin

earlier. In some cases want of milk in the breasts seems to be due to

its reabsorption. In such instances it may make its appearance at

distant parts. Thus, a case has been recorded of the coughing up of milk

following sudden arrest of the secretion, and others in which it

presented itself as an exudation in the groins.

In the treatment of a scanty formation of milk, one of the best measures

which can be resorted to is the frequent application of the child to the

breast. In addition, the flow may be increased by milking the breasts by

means of the thumb and finger, suction through a tobacco-pipe, or the

breast-pump, or by the use of another infant. Friction of the breasts,

and forcible drawing upon the nipples, will make them sore, and so

irritate them as to defeat the object in view. A change of scene, fresh

air, and outdoor exercise, attention to personal cleanliness, and the

improvement of the general health, all increase the quantity, and

produce a favourable effect upon the quality, of the milk. A sojourn at

the sea-side often promotes an abundant secretion of milk. The diet

should be regulated by the condition of the constitution. By those who

are weak and pale, a large proportion of meat is required. On the

contrary, those who are full-blooded and corpulent should restrict the

amount of their animal food, and take more exercise in the open air.

Oatmeal gruel enjoys a reputation for increasing the flow of milk. A

basin of it sometimes produces an immediate effect. The same is true of

cow's milk. Porter or ale once or twice a day, in those with reduced

systems and impaired digestion and appetite, will be found useful.

Anise, fennel, and caraway-seeds, given in soup, act sometimes as

stimulants upon the secretion of milk. The application of a poultice

made from the pulverized leaves of the castor-oil plant is a most

efficient remedy when milk fails to make its appearance in the breast in

sufficient quantity after confinement.

WET-NURSING BY VIRGINS, AGED WOMEN, AND MEN.

As a rule, the secretion of milk is limited to one sex, and in that is

confined to a short period after childbirth. But there are many cases on

record of the flowing of milk in women not recently mothers, in girls

before the age of puberty, in aged women, and even in individuals of the

male sex. In such instances, the secretion is induced by the combined

influence, acting through the nervous system, of a strong desire for its

occurrence, of a fixed attention towards the mammary glands, and of

suction from the nipples.

Travellers among savage nations report many examples of such unnatural

nursing. Dr. Livingstone says he has frequently seen in Africa a

grandchild suckled by a grandmother. Dr. Wm. A. Gillespie, of Virginia

records, in the _Boston Medical and Surgical Journal_, the case of a

widow, aged about sixty, whose daughter having died, leaving a child two

months old, took the child and tried to raise it by feeding. The child's

bowels became deranged, and being unable to procure a nurse, and her

breasts being large and full, he advised her to apply the child, in hopes

milk would come. She followed his advice perseveringly, and, to her

astonishment, a plentiful secretion of milk was the result, with which

she nourished the child, which afterwards became strong and healthy. A

similar instance, still more remarkable, is recorded of a woman at

seventy years, who twenty years wet-nursed a grandchild after her last

confinement.

Cases of nursing in the opposite extreme of life are also well

authenticated. The distinguished French physician Baudelocque has

related that of a deaf and dumb girl, eight years old, who, by the

repeated application to her breast of a young infant, which her mother

was suckling, had sufficient milk to nourish the child for a month,

while the mother was unable to nurse it on account of sore nipples. The

little girl was shown to the Royal Academy of Surgery on the 16th of

February, 1783. The quantity of milk was such, that by simply pressing

the breast it was made to flow out in the presence of the Academy, and

on the same day, at the house of Baudelocque, before a large class of

pupils. Again, an interesting case is known of a young woman, who, in

consequence of the habit of applying the infant of her mistress to her

breast in order to quiet it, caused a free secretion of milk. In the

Cape de Verde Islands, it is stated that virgins, old women, and even

men, are frequently employed as wet-nurses. Humboldt speaks of a man,

thirty-two years old, who gave the breast to his child for five months.

Captain Franklin saw a similar case in the Arctic regions. Professor

Hall presented to his class in Baltimore a negro, fifty-five years old,

who had been the wet-nurse of all the children of his mistress.

Instances of powers of _prolonged nursing_ in mothers are not uncommon.

Indeed it is the habit among some nations to suckle children until they

are three or four years of age, even though another pregnancy may

intervene, so that immediately one child is succeeded at the breast by

another. In those who have thus unnaturally excited the mammary glands,

an irrepressible flow sometimes continues after the demand for it has

ceased. Dr. Green published, some years ago, in the _New York Journal of

Medicine and Surgery_, the case of a woman, aged forty-seven, the

mother of five children, who had had an abundant supply of milk for

_twenty-seven years_ consecutively. A period of exactly four years and a

half occurred between each birth, and the children were permitted to

take the breast until they were running about at play. At the time when

Dr. G. wrote, she had been nine years a widow, and was obliged to have

her breasts drawn daily, the secretion of milk being so copious. When,

therefore, it is desirable, on account of the feebleness of the child,

to protract the period of nursing, a wet-nurse should relieve the mother

at the end of twelve or fifteen months.

RULES FOR CARE OF HEALTH WHILE NURSING.

From what we have previously said of the influence of the nervous system

over the quantity and quality of the milk, and the instances we have

adduced of the danger to the infant of all violent passions--such as

anger, terror, anxiety, and grief--on the part of the mother, it will be

apparent that it is of the greatest moment, during the whole course of

nursing, to maintain a tranquil state of mind. Pleasing and peaceful

emotions favor the normal secretion of milk, and go far towards securing

the health of the child. When strongly affected by any powerful

feelings, mothers should not give the breast, but should wait until they

have calmed down to their usual tenor of temper. A case is related of a

woman who was always excited by a highly electrical state of the

atmosphere, and particularly during stormy weather. If when thus

influenced she nursed her child he was sure to fall into convulsions;

while, if she delayed doing so until this nervous excitement had passed,

no unpleasant symptoms occurred. But we have already dwelt at length

upon this subject in speaking of the influence of the mind of the mother

over the child at her breast, and need not therefore recur to it. The

_food_ while nursing must be nutritious and varied, though simple and

unstimulating; and should consist both of meat and vegetables, soups,

fish, flesh, and fowl, either in combination or succession. When the

digestion requires stimulation and aid, a glass of mild ale twice a day

will be useful. Wines, brandy, and whisky should not be taken without

the advice of a physician. Moderate exercise in the open air and regular

habits are necessary. A defective or excessive diet, fatigue, loss of

rest at night, and irregularities and excesses of all kinds are

unfavorable to mother and child. The proper methods of combating a

tendency to over-abundance or to scantiness of milk have been alluded

to. Medicines, unless prescribed by the medical attendant, should rarely

or never be taken during this period, as many of them enter the milk and

may thus affect the child.

RELATIONS OF HUSBAND AND WIFE DURING NURSING.

After a natural and healthful confinement, the nurse usually remains

with the mother for a period of four weeks. During the whole of this

time the husband should occupy a separate apartment, and, according to

some physicians, this separation should be protracted during the entire

period of nursing. But this is unusual, and in most cases unnecessary.

Only those women who are warned by the recurrence of their monthly

illness that they are liable to another pregnancy immediately, should

insist on such an ascetic rule as this.

Unquestionably the quality of the milk is much deteriorated by a

conception; and therefore, both in the interest of the mother and child,

the husband should renounce his usual privileges at such times.

Most women do not have their periodical illness, and consequently are

not liable to a second pregnancy, before seven months have elapsed after

childbirth. There are, however, numerous exceptions to this rule, and it

is impossible to foretell who will and who will not be the exception.

Moreover, as any excitement of the passions alters to some extent the

secretion of the breasts, often to the injury of the child, it is every

way advisable that great temperance be exercised in all cases in the

marital relations at these epochs.

SIGNS OF OVER-NURSING.

The symptoms of over-nursing may be enumerated as follows:--Aching pain

in the back; often, pain across the shoulders, and on the top of the

head or forehead; marked paleness of the face; inability to sleep;

frightful dreams when sleep does come; great debility; extreme

depression of the spirits; disorders of the sight, and mental

disturbances, which take on the form of melancholia, the delusions

relating mostly to subjects of a religious character, to the effect that

the unpardonable sin has been committed, and the like. The headache is

situated on the top of the head, and this spot may be noticed to be

perceptibly hotter to the touch than other parts of the head. These

symptoms indicate that the process of nursing is making too great a

drain upon the system.

A woman in ordinary health will generally be able to suckle her child

for twelve months without experiencing any bad effects. When the child

is kept at the breast much beyond this time, most mothers render

themselves liable to the injurious consequences we have mentioned. Some,

indeed, cannot furnish the child all the nourishment it needs longer

than three or four months, without detriment to themselves. In such

cases, by feeding the child two or three times a day, the mother may be

relieved of the burden of its entire support, and may thus be enabled to

continue nursing. The proper food for infants, under these

circumstances, will be shortly mentioned. The prostrating effects of

nursing upon the body and mind of the mother are in some, though

comparatively rare, instances so marked, as to render it altogether

improper from the commencement.

The treatment of the condition of system described as resulting from

over-nursing is, if it cannot be remedied by partially feeding the

infant and the use of tonics, to remove the child from the breast

altogether, and either procure a wet-nurse for it, or wean it. The

wet-nurse is greatly to be preferred; and the preference is the

stronger, the younger the child. We have already alluded to the great

difficulty of rearing children from birth by the hand. But after the

infant has attained the age of several months, the danger of artificial

feeding is much lessened, provided that the weaning does not take place

during hot weather. This brings us to the consideration of the regimen

of the mother who cannot nurse her own child, of the rules for the

selection of a wet-nurse, of the directions for bringing up by hand, and

of the proper method of weaning. These subjects we will now take up in

the order mentioned.

DIRECTIONS FOR MOTHERS WHO CANNOT NURSE THEIR OWN CHILDREN.

There are many reasons why a mother should, if possible, nurse her own

child. 'One of the principal is,' says the distinguished Dr. Tilt, 'that

as nursing, generally speaking, prevents conception up to the tenth

month, so it prevents the ruin of the mother's constitution by the too

rapid bringing forth of children, and, we might even add, prevents a

deterioration of the race, by the imperfect bringing up of this

too-fast-got family.'

The same author appropriately adds: 'But while advocating maternal

nursing, we must not forget that woman is not now the Eve of a primeval

world; that human nature, wherever it is now met, in barbarous tribes or

in civilised communities, is frequently so deteriorated, so diseased or

prone to disease, that, by nursing, a mother may sometimes undermine her

own frail constitution for the sake of giving an imperfect sustenance,

and perhaps a poisonous heritage, to her babe.'

Some mothers, however anxiously they may wish to do so, cannot nurse

their children. They are shut out from this charming and tender

experience in the life of a woman. The milk that comes is not

sufficient, and quickly disappears. Because of the influence of the mind

of the mother over the child at her breast, to which we have before

called attention, women who are very hysterical and nervous, subject to

violent perturbations of the mind, should not, particularly if there be

any family tendency to insanity, expose the child to the mischievous

effects latent in their milk. So, also, the presence of certain diseases

forbids wet-nursing. Thus it is ordinarily prohibited by consumption,

scrofula, skin affections of long standing, and cancer. In consumption,

all efforts to suckle are frequently equally fatal to the mother and

child. Even a strong hereditary predisposition to this disease may

render it advisable, in the opinion of the family physician,--who should

always be consulted in such a case,--to counteract the family taint by

giving the milk of the healthiest nurse that can be procured. The

condition of the nipples and of the breast may not permit of nursing. We

have pointed out how best to guard against such an occurrence, in

treating of the care of the nipples during pregnancy.

She who is to be debarred from nursing her own child should take care

that it is not allowed to approach her breasts, as sometimes the mental

and physical excitement caused by such an approach is of an injurious

and lasting character.

Ordinarily, if this direction be followed out, the mother will have

little trouble in regard to herself. Under such circumstances, the

chief danger is to the child. Hence the importance of knowing

HOW TO SELECT A WET-NURSE.

The choosing of a wet-nurse is a matter of great moment and

responsibility. She should not be over thirty years of age, and should,

if possible, be one who has previously suckled and had charge of

children. Her own infant should be under the age of six months, for when

above that age the milk sometimes disagrees with her new-born charge.

One who has had several children should be preferred, because her milk

is richer than after the first confinement.

The doctor should always examine carefully into the condition of the

nurse's health, and into the quality and quantity of her milk. Various

diseases and taints of the system are so hidden, while yet communicable

to the child, that the knowledge and skill of a professional expert are

required for their detection, and the protection of the nursling. In

testing the quality of the milk, the experienced physician allows a

little to rest on his finger nail, and by its examination readily

decides as to its richness and fitness to nourish the little applicant

for food. It is not necessary that the breasts should be large, as those

of moderate size often furnish a sufficient amount of milk. But it is

important that the nipples should be well developed. Those wet-nurses

should be preferred in whom large blood-vessels are seen prominently

passing in blue lines over the surface of the breasts. The possession of

a vigorous, healthful infant is a good recommendation for a nurse, but

care should be taken to ascertain that it is her _own_, as nurses have

been known to borrow for such an occasion and so obtain credit not

justly their due.

The moral and mental as well as physical characteristics should be

considered. Temperance and cleanliness are indispensable in a wet-nurse,

and the want of either should be an imperative reason for rejection.

Equanimity of temper, cheerfulness, and an open, frank, affectionate

disposition, are of course greatly to be desired.

If the nurse becomes 'unwell,' shall the child be taken from her? Should

the monthly sickness reappear early, and both nurse and child be in good

health, suckling may be continued. But when the return happens about the

ninth or tenth month, the child should be weaned or the nurse changed.

There is no physiological reason for preventing the nurse from living

matrimonially; but if pregnancy occurs, the child should be taken from

her.

The same rules that we have laid down for the mother for the care of her

health while nursing, are of course applicable to the hired wet-nurse,

and should be insisted upon and enforced.

_Changing a nurse._--When it becomes necessary to change a nurse, for

any of the reasons above mentioned, it may be done without injury to the

child. For fear of the effect of the unwelcome tidings upon the mind of

the nurse, and the possible influence upon the milk, she should not be

informed of the projected change until a successor has been secured to

take her place at once. In choosing the second nurse, the same

precautions should be had as in the selection of the first.

THE CHILD.

_THE CARE OF INFANCY._

By infancy we mean that portion of the life of the child between birth

and the completion of the teething--about two and a half years. The care

of this period of human life is entrusted to the mother. It forms an

important era in the physical life of woman. Its discussion is therefore

germane to our subject. In order that the young mother may fully

appreciate the responsibilities of her position, she should know

something of the liability of infants to sickness and death.

Out of one thousand children born, one hundred and fifty die within the

first year, and one hundred and thirteen during the next four years.

Thus two hundred and sixty-three, or _more than one-fourth, die within

five years after birth_. Between the ages of five and ten, thirty-five

die. During the next five years eighteen more are recorded on the

death-list. Hence, at fifteen years of age only six hundred and

eighty-five remain out of the one thousand born. When these figures are

considered, and the additional fact that out of those who survive very

many bear permanent marks of imperfect nourishment or of actual disease,

the consequence of maladies contracted in early life, the importance of

our present inquiry--the care of infancy--will be apparent to all

mothers.

The younger the infant, the greater the danger of death. _One-tenth of

all children born die within the first month after birth_, and four

times as many as during the second month.

The mortality is much larger in cities than in the country. In Dublin,

during 1867, very nearly one-third of all the persons who died were

under five years of age. In the same year forty-three per cent. of those

who died in the eight principal towns of Scotland were children below

the age of five. In Philadelphia, during the same year, forty-five per

cent. of all the deaths were of children under five years of age. In New

York fifty-three per cent. of the total number of deaths occur under the

age of five years, and twenty-six per cent. under the age of one year.

The danger of death lessens as the period of puberty approaches. Yet,

even in the last years of childhood there is a greater liability to

disease and a larger proportionate loss of life than during youth or

middle age.

CAUSES OF INFANT MORTALITY.

What are the causes of this startling mortality of infant life? Why does

one child out of ten die in the first month, and only three out of four

live to be five years old? And what are the means of prevention?

Some of the causes which are active in producing this mortality among

the little ones cannot be successfully opposed after birth. Such, for

instance, are imperfect and vicious developments of internal organs

existing when born. These malformations often result from inflammation

while in the womb, excited by some taint of the mother's blood, or by

some agitation of her nervous system. Means of prevention in those cases

are therefore to be directed to the mother, in the manner indicated in

treating of pregnancy. But other causes of death begin to act only after

birth, and are to a greater or less extent avoidable. These are largely

traceable to ignorance, negligence, and vice.

One cause of death to which infants are peculiarly liable, and which

alone is said to have destroyed forty thousand children in England

between the years 1686 and 1799, is being _overlain_ by the parents. For

this reason, some physicians caution the mother against having the

infant in bed with her while she sleeps.

The frightful waste of life caused by bringing children up by hand has

been mentioned, and the importance of avoiding it when possible.

The natural feebleness of the system of infants is the reason why they

succumb so easily to any malady. Deaths from any given disease are more

numerous among infants than children, and among children than adults.

Hence the importance of timely corrective measures in infantile

affections; hence, also, the need that mothers should know and practise

the means best adapted to preserve the health of their frail charges.

These means we shall proceed to give in detail, commencing with

directions for

BRINGING UP BY HAND.

We have already alluded to the great danger to the child, particularly

in a city, that is artificially fed from birth. But as there are many

mothers who are unable, on account of the expense, to have a wet-nurse

for the child they cannot suckle themselves, we will give such

directions in regard to the diet as are best calculated to lessen the

risk invariably incurred under such circumstances.

The child's food should be of the best quality, and prepared with the

most scrupulous attention to cleanliness. The milk of the cow is

preferable to that of the ass or of the goat, the former of which it is

difficult to procure, and the latter having a disagreeable odour. For a

child under three months of age, cow's milk should be used as the only

food. It should be fresh, and if possible from one cow. When of the

ordinary richness, it is to be diluted with an equal quantity of water

or thin barley-water. If, however, the first milking can be obtained,

which is more watery, and bears a closer resemblance in its chemical

composition to human milk, but little dilution will be required. If

green and acrid stools make their appearance, accompanied by emaciation

and vomiting, the milk must be more diluted, and given less frequently.

If the symptoms of indigestion do not yield, milk containing an excess

of cream should be used. To procure it, allow fresh milk to stand for

two or three hours, and remove the upper third, to which add two or

three parts of warm water or barley-water, after having dissolved in it

a little sugar of milk. Should this food also disagree, any of the

preparations we are about to mention may be prepared and tried.

Professor Falkland recommends the following method of preparing milk for

infants, as affording a product more nearly like the natural

secretion:--'One third of a pint of pure milk is allowed to stand until

the cream has risen. The latter is removed, and to the blue milk thus

obtained about a square inch of rennet is to be added, and the

milk-vessel placed in warm water. In about five minutes the curd will

have separated, and the rennet, which may again be repeatedly used,

being removed, the whey is carefully poured off, and immediately heated

to boiling, to prevent it becoming sour. A further quantity of curd

separates, and must be removed by straining through calico. In

one-quarter of a pint of this hot whey three-eighths of an ounce of milk

sugar are to be dissolved; and this solution, along with the cream

removed from the one-third of a pint of milk, must be added to half a

pint of new milk. This will constitute the food for an infant from five

to eight months old for twelve hours; or, more correctly speaking, it

will be one-half of the quantity required for twenty-four hours. It is

absolutely necessary that a fresh quantity should be prepared every

twelve hours; and it is scarcely necessary to add, that the strictest

cleanliness in all the vessels used is indispensable.'

Dr. J. Forsyth Meigs directs the following article of diet as one which

he has found to agree better with the digestive system of the infant

than any other kind of food:--'A scruple of gelatine (or a piece two

inches square of the flat cake in which it is sold) is soaked for a

short time in cold water, and then boiled in half a pint of water, until

it dissolves--about ten or fifteen minutes. To this is added, with

constant stirring, and just at the termination of the boiling, the milk

and arrowroot, the latter being previously mixed into a paste with a

little cold water. After the addition of the milk and arrowroot, and

just before the removal from the fire, the cream is poured in, and a

moderate quantity of loaf sugar added. The proportions of milk, cream,

and arrowroot must depend on the age and digestive powers of the child.

For a healthy infant, within the month, I usually direct from three to

four ounces of milk, half an ounce to an ounce of cream, and a

tea-spoonful of arrowroot to half a pint of water. For older children,

the quantity of milk and cream should be gradually increased to a half

or two-thirds milk, and from one to two ounces of cream. I seldom

increase the quantity of gelatine or arrowroot.'

The egg is a valuable article of food for infants and young children,

especially in conditions of debility. It should be given nearly raw, and

is best prepared by placing it in boiling water for two minutes. It is

then easily digested.

Beef-tea, prepared in the manner described on page 234, is highly

nutritious and useful as a food for infants: if it produce a laxative

effect, it should be discontinued. When the child shows signs of

weakness or of a scrofulous condition its nutrition will be improved by

mingling with its food a small piece of butter or mutton suet.

During the first four or five months the food should be thin, and taken

through a teat, thus preventing the stuffing of the infant.

On attaining the age of twelve or fifteen months, infants are usually

able to digest ordinary wholesome solid food, neatly and well cooked,

when mashed or cut into fine pieces.

An article of food employed for the diarrhoea of infants is prepared as

follows:--'A pound of dry wheat flour of the best quality is packed

snugly in a bag and boiled three or four hours. When it is taken from

the bag it is hard, resembling a piece of chalk, with the exception of

the exterior, which is wet, and should be removed. The flour grated from

the mass should be used the same as arrowroot or rice.'

Infants nourished by prepared food thrive well enough during cool

weather, but during the warm months of the year they are exceedingly

liable to bowel complaint, of which large numbers of the spoon-fed

infants of cities die each summer season. Hence the importance of taking

them into the country; and keeping them there until the return of cool

weather lessens the danger of city life.

WEANING.

This should take place when the child is about twelve months of

age--sometimes a few months earlier, often a few later. If the mother's

health be good, and her milk abundant, it may be deferred until the

canine teeth appear--between the fifteenth and twentieth month. The

child will then have sixteen teeth with which it can properly masticate

soft solid food.

_Time of the year for._--The infant should not be taken from the breast

during or immediately preceding warm weather. If the mother, either on

account of sickness or failure in her breast-milk, is obliged during the

summer to give up nursing, she should at once procure a wet-nurse. If

she cannot, the child must be sent into the country. To wean an infant

in the city in hot weather, is to expose it to almost certain death.

_Proper method._--The process of weaning should be a very slow one. No

definite day should be fixed for it. Little by little, from week to

week, the amount of spoon-food is to be increased and the nursing

lessened--being first given up at night. The breast should never be

suddenly denied to a child unaccustomed to artificial food, but be

displaced by degrees, by the bottle and the spoon. This gradual change

will neither fret the child nor annoy the mother, as sudden weaning

always does.

The infant may begin to be accustomed to artificial food at the age of

four months. At first, only diluted cow's milk should be given it

occasionally between the times of nursing. In a tumbler one-third full

of water dissolve a tea-spoonful of sugar of milk; add to the sweetened

water an equal quantity of fresh cow's milk; then, if the child's stools

are at all green, mix with this two tea-spoonfuls of lime water. Instead

of pure water, barley-water made in the usual way, and boiled to the

consistency of milk, may be employed in this preparation--being added,

while still warm, to an equal amount of milk. Or, toast-water may be

substituted as a diluter of the milk. Cow's milk should not be boiled,

if it can be preserved in any other way. As the infant advances in

months, some solid food may be allowed. After six months, pap, made with

stale bread and tops and bottoms, is proper once or twice a day.

Beef-tea, made according to the recipe we have given, and chicken, lamb,

or mutton broth, may now also be occasionally taken. As the quantity of

milk diminishes towards the close of the first year, the spoon-food

should be resorted to more frequently to supply the want. Solid food

ought not to be given before the child is a year old.

The breasts usually cause little trouble when the weaning is performed

in the gradual manner which has been recommended. The mother should

during this time drink as little as possible, refrain from stimulating

food, and take occasionally a little cream of tartar, citrate of

magnesia, or a seidlitz powder. If the breasts continue to fill with

milk, _they should not be drawn_. The 'drying up of the milk' may be

facilitated by gently rubbing the breasts several times a day with

camphorated oil, made by dissolving over the fire, in a saucer of sweet

oil, as much camphor as it will take up. Tea made from the marshmallow

has also been recommended for this purpose.

TEETHING.

The period at which the teeth first make their appearance is not a fixed

one. It varies considerably even within the limits of perfect health.

It may be said, as a rule, that the babe begins to cut its teeth at the

age of six or seven months. Quite frequently, however, the first teeth

appear as early as the fourth month, or are delayed until the eighth. In

some instances children come into the world with their teeth already

cut. This is said to have been the case with Louis XIV. and with

Mirabeau. King Richard the Third is another example. Shakspeare makes

the Duke of York refer to this circumstance in these words:

'Marry, they say my uncle grew so fast,

That he could gnaw a crust at two hours old:

'Twas two full years ere I could get a tooth.'

It does not follow that children whose teeth show themselves early, will

have, therefore, a quicker general development. Such cases are merely

instances of irregularity in the time of dentition, and carry with them

no particular significance. Irregularities in regard to the order in

which the teeth are cut are also of frequent occurrence.

While, therefore, it cannot be maintained that all healthy children cut

their teeth in a certain regular order and time, yet it is certain that

those children who follow the general rule which prevails in this

respect, suffer least from the difficulties and effects of dentition. As

all mothers desire to know at what time they may expect the teeth, we

will state the rule of their development in the great majority of cases.

The lower teeth generally precede those of the upper jaw by two to three

months.

The twenty milk-teeth usually appear in the five following groups:--

_First_, Between the fourth and eighth months of life the two lower

front middle teeth appear almost simultaneously; then a pause of from

three to nine weeks ensues.

_Second_, Between the eighth and tenth months of life the five upper

front teeth appear, following shortly upon each other, the two central

preceding the two on each side of them. Another pause of from six to

twelve weeks succeeds.

_Third_, Between the twelfth and sixteenth months of life six teeth

appear nearly at once. They are first the two front grinding teeth in

the upper jaw, leaving a space between them and the front teeth which

before appeared; next the two lower front teeth, situated one on each

side of the central ones, which were the first to appear; and, lastly,

the two front grinders of the lower jaw. A pause until the eighteenth

month now ensues.

_Fourth_, Between the eighteenth and twenty-fourth months of life the

canine teeth cut through (the upper ones are called eye-teeth). Again a

pause until the thirtieth month.

_Fifth_, Between the thirtieth and thirty-sixth months the second four

grinders finally make their appearance.

This concludes the first teething. The child has now twenty milk-teeth.

We have mentioned that children are sometimes born with teeth. It is

also true that sometimes they never acquire any. Instances are on record

of adults who have never cut any teeth. Dentition has been known to

take place very late in life. A case is related, on excellent authority,

of an old lady aged eighty-five, who cut several teeth after attaining

that age.

APPEARANCE OF THE PERMANENT TEETH.

Between the fifth and sixth years of life the second dentition begins.

The front grinders are the ones first cut through. Between the sixth and

tenth years all the front teeth appear, followed by the canines before

the twelfth year. At this time the second grinders show themselves; and

finally, between the sixteenth and twenty-fourth year, the wisdom-teeth

complete the dental furniture of the mouth.

VACCINATION.

This operation, to which every infant should be subjected, is one of

great practical importance. The attempt has been made of late to shake

the public faith in its efficacy, and to revive the old fabulous stories

and foolish notions as to the production of serious affections of the

blood and skin in this manner. At the same time, the increasing

frequency and virulence of small-pox are becoming only too evident. We

therefore consider it our duty, in treating of the maternal management

of infancy, to lay some stress upon the necessity for vaccination as a

preservative of life and health. If observation and experience ever

taught anything, they have taught the protective power of this operation

against the most loathsome and one of the most fatal diseases that ever

afflicted the human race. And that mother who is careless and

indifferent in this matter neglects for her children a means of

preventing disfigurement and saving life, compared with which all other

means are scarcely worthy of mention.

In order to appreciate the value of vaccination, it is only necessary to

consider what small-pox was before its discovery,--to look at that

disease through the eyes of our fathers and grandfathers. Until the

close of the last century it was the most terrible of all the ministers

of death. It filled the churchyards with corpses. When Jenner published

his great discovery, about seventy years ago, the annual death-rate from

small-pox in England was estimated at three thousand in the million of

population. In other countries of Europe the rate reached as high as

four thousand in the million. And these fatal cases must be multiplied

by five or six, to give the entire number of persons annually attacked

by the disease. It spared neither high nor low. Macaulay informs us that

Queen Mary, the wife of William III., fell a victim to it. Those in whom

the disease did not prove fatal, carried about with them the hideous

traces of its malignity; for it 'turned the babe into a changeling at

which the mother shuddered,' and made 'the eyes and cheeks of the

betrothed maiden objects of horror to the lover.' Few escaped being

attacked by this fell disease. Nearly one-tenth of all the persons who

died in London during the last century died of this one cause. Children

were peculiarly its victims. In some of the great cities of England more

than one-third of all the deaths among children under ten years of age

arose from small-pox. Two-thirds of all the applicants for relief at

the Hospital for the Indigent Blind had lost their sight by small-pox.

The number of hopeless deafened ears, crippled joints, and broken-down

constitutions from the same cause cannot be accurately computed, but was

certainly very large. Vaccination is all that now stands between us and

all these horrors of the last century.

Is the strength of this barrier doubted?--Its efficacy is readily

proved. In England, during the twelve years (1854-1865) in which

vaccination has been to a certain extent compulsory, the average annual

rate of deaths by small-pox has been two hundred and two in the million

of population. Contrast this with the annual death-rate of three

thousand to the million, which was the average of thirty years previous

to the introduction of vaccination. Mr. John Simon, medical officer of

Her Majesty's Privy Council, one of the best statisticians in England,

has collected a formidable array of figures, 'to doubt which would be to

fly in the face of the multiplication-table.' From his mountain-height

of statistics Mr. Simon says: 'Wheresoever vaccination falls into

neglect, small-pox tends to become again the same frightful pestilence

it was in the days before Jenner's discovery; and wherever it is

universally and properly performed, small-pox tends to be of as little

effect as any extinct epidemic of the Middle Ages.'

Are other diseases ever produced by vaccination?--The popular belief

would answer this question in the affirmative. All affections of the

skin and swelling's of the glands noticed in children soon after

vaccination, are attributed by parents in many cases to this operation.

They forget that such diseases are met with constantly in infancy and

childhood, as often among the unvaccinated as the vaccinated.

Observation does not show that they occur with greater frequency among

the vaccinated. An English physician has been at the trouble to examine

and record a thousand cases of skin disease in children: he found no

evidence whatever that vaccination disposes the constitution to such

affections. It has been stated with apparent justness, that parental

complaints of this kind frequently arise from their unwillingness to

believe there is anything wrong in their offspring. Hence, when other

diseases follow, vaccination gets blamed for what is really and truly

due to other causes. So far from doing any harm to the system, it has

been observed in those countries where vaccination has been most

thoroughly practised, that, leaving small-pox out of the question, there

have been fewer deaths from other maladies. This is especially true of

two of the most important classes of diseases, namely, scrofulous

affections and low fever. For this reason, some medical statisticians

have attributed to vaccination an indirect protective influence against

these disorders.

At what _age_ should the child be vaccinated?--If the health permit, the

operation should always be performed in very early infancy. The chief

sufferers from small-pox are young children. One-fourth of all who die

from this fatal disease in England are children under the age of one

year. In Scotland, where until recently vaccination has been much more

neglected than in England, the proportion even amounted to nearly

one-third; and of these, one-fourth were under the age of three months.

The great risk, particularly in large towns, where small-pox is seldom

absent, of delaying vaccination is obvious. City children, if hearty,

should be vaccinated when a month or six weeks old. Rarely or never

ought it to be delayed beyond two or three months. This early period of

life is also particularly suitable to vaccination, because the

accompanying fever will then be over before the disturbing influence of

teething begins.

RE-VACCINATION.

If the first vaccination be found imperfect in character, that is, if it

has not properly 'taken,' the operation should be repeated at the

earliest opportunity. It has been recommended, in all cases, to perform

a second vaccination not later than the sixth or eighth year. If

small-pox be prevailing, it is proper to vaccinate all who have not been

vaccinated within three or four years. In any event, re-vaccination at

or after the period of puberty is of extreme importance. It will give

additional security even to those whose original vaccination was

perfect. In some cases, the susceptibility to small-pox is not wholly

exhausted by one vaccination. Inasmuch as it is desirable for every one

to escape this disease, even in its most modified form, re-vaccination

should always be performed, as it affords a very sure and trustworthy

means of such escape. After successful re-vaccination, small-pox, even

in its mildest shape, is rarely met with. In girls especially, in whom

the changes which occur at puberty are most marked, re-vaccination

should be performed about the age of fourteen.

GROWTH AND DEVELOPMENT.

During infancy the body grows with great rapidity. About the end of the

third year one-half of the adult height of the body is attained. After

this period growth is more gradual; for in order to reach the remaining

half, about eighteen years more are required. At twenty years of age the

height is somewhat more than three and a half times that at birth, and

the weight about twenty times. Development does not go on at an equal

rate in all parts of the body. The lower limbs, small at birth, increase

proportionally more rapidly, while the head, relatively large at birth,

developes more slowly. The muscular system is gradually strengthened. At

the end of the third month the infant is able, if in good health,

readily to support its head; at the fourth month it can be held upright;

at the ninth month it crawls about the floor; by the end of the year it

is able with assistance to step; and between one and two years, at

different times, according to its vigor and activity, it acquires the

power of standing and walking alone. The periods of greatest and least

growth of the child are, on the one hand, spring and summer; on the

other, autumn and winter. It has long been known that animals grow more

rapidly in the spring than at any other season of the year. This has

been attributed to the abundance of herbage they are then able to

obtain. It has been ascertained by actual measurement, that children

grow chiefly in the spring.

At six months of age the child begins to lisp, and at twelve months it

is usually able to utter distinct and intelligible sounds of one or two

syllables. The development of the senses and of the mind proceeds

gradually. The sense of hearing is more active and further advanced than

that of sight. Sounds are appreciated sooner than light or bright

colored objects. The next sense which is developed is perhaps that of

taste; then follow smell and touch.

THE FOOD OF INFANTS AND CHILDREN.

The diet of children is frequently improper either in regard to

quantity, quality, or variety. In 1867, a committee, of which Professor

Austin Flint, Jr., was chairman, was appointed in New York city to

revise the 'Dietary Table of the Children's Nurseries on Randall's

Island.' In the report rendered, attention was forcibly called to the

fact that in childhood 'the demands of the system for nourishment are in

excess of the waste, the extra quantity being required for growth and

development. If the proper quantity and variety of food be not provided,

full development cannot take place, and the children grow up, if they

survive, into young men and women, incapable of the ordinary amount of

labor, and liable to diseases of various kinds. This is frequently

illustrated in the higher walks of life, particularly in females; for

many suffer through life from improper diet in boarding schools, due to

false and artificial notions of delicacy or refinement. After a certain

period of improper and deficient diet in children, the appetite becomes

permanently impaired, and the system is rendered incapable of

appropriating the amount of matter necessary to proper development and

growth.'

Charlotte Bronté has drawn, in _Jane Eyre_, a graphic and

physiologically true picture of the effects upon young girls of

long-continued insufficiency of food. Let mothers bear in mind that

proper food cannot be too abundantly eaten by children, and that the

greatest danger to which they are exposed arises from defective

nutrition. We would again urge the value of a large amount of _milk_ in

the dietary of young people. The disorders of the bowels, which are not

uncommon in infancy and childhood, are due to errors in diet by which

improper food is supplied, and not to an excess of simple and proper

nourishment.

We have already given some directions for the preparation of infants'

food in treating of 'bringing-up by hand.' In addition to the various

substitutes for the mother's milk there mentioned, we wish to note that

known as _Liebig's soup_. This great chemist thus describes the method

of making it:

'Half an ounce of wheat flour, half an ounce of malt meal, and seven and

a half grains of bicarbonate of potass, are weighed off. They are first

mixed by themselves, then with the addition of one ounce of water, and

lastly, of five ounces of milk. This mixture is then heated upon a slow

fire, being constantly stirred until it begins to get thick. At this

period the vessel is removed from the fire, and the mixture is stirred

for five minutes, is again heated and again removed when it gets thick,

and, lastly, it is heated till it boils. This soup is purified from bran

by passing it through a fine sieve (a piece of fine muslin), and now it

is ready for use.'

Barley-malt can be obtained at any brewery. First, it is separated from

the impurities, and then ground in an ordinary coffee-mill to a coarse

meal. Care should be taken to get the common fresh wheat-flour, _not the

finest_, because the former is richest in starch.

In practice, the troublesome weighing of the materials may be dispensed

with, as a heaped table-spoonful of wheat-flour weighs pretty nearly

half an ounce, and a like table-spoonful of malt-meal, not quite as

heaped, weighs also half an ounce. The bicarbonate of potass can be

obtained from the druggist put up in powders of seven and a half grains,

each ready for use. The amount of water and of milk prescribed can be

attained with sufficient accuracy by means of the table-spoon; two

table-spoonfuls will give the quantity of water (one ounce), and ten

table-spoonfuls the quantity of milk (five ounces). These directions

will enable any sensible mother to make the preparation without

difficulty. The soup tastes tolerably sweet, and, when diluted with

water, may be given to very young infants.

Although the method of preparing Liebig's soup is a somewhat tedious

one, yet, as it is a combination which has long been so highly

recommended by physicians of the largest experience for having visibly

saved the lives of many wasting children, it deserves a trial in all

cases in which the ordinary kinds of food disagree.

On page 276 are recorded the directions given by Dr. J. Forsyth Meigs

for an article of diet, consisting of gelatine and arrowroot, which he

prefers to all other kinds of artificial infant food. Another method of

preparing a useful arrowroot mixture is as follows:--

Place a tea-spoonful of arrowroot in a porcelain vessel, with as much

cold water as will make it into a fine dough; then add a cupful of

boiling milk or of beef-tea; stir the mixture a little, and allow it to

boil for a few minutes until the whole acquires the consistency of a

fine light jelly.

The _manner_ in which nutriment is administered to infants is not

immaterial. The custom of feeding them from a small spoon, or from a cup

with a snout, is objectionable. The use of a sucking-bottle most nearly

imitates the way in which nature designed the nursling to obtain its

nourishment. By the act of sucking, the muscles of the face are

exercised in an equal manner, and the saliva is mixed with the food to

an extent which is not possible if any other mode of feeding be resorted

to. Children drink very readily out of the perforated rubber nipples,

which are now so popular for this purpose: they are made to fit over the

mouth of the bottle, and are especially to be recommended on account of

their cleanliness. The bottle should never be refilled until both it and

the rubber cap have been thoroughly cleansed in warm water. A white

glass bottle only should be employed in order that any want of

cleanliness may readily be detected. It should be recollected that milk

very quickly sours when kept in this way in a warm room; it is therefore

better always to empty the bottle and fill it afresh each time it is

given to the child, rather than to wait until its contents are exhausted

before replenishing it.

We have hitherto been treating mainly of the diet proper for the first

year of life. In the second year children may be permitted to have soft,

finely-cut meat. Fresh ripe fruit in season ordinarily agrees

excellently well. But boiled green vegetables and husk fruits are very

apt to cause indigestion and diarrhoea. Fruit for children should be

freed from the stones and skins; which latter are indigestible, and

often do harm.

As an example of a diet suitable for a child two years of age we append

the following:--In the mornings, between six and seven o'clock in

summer, or between seven and eight in winter, milk-gruel; between nine

and ten o'clock, a piece of wheat bread with a little butter on it; at

twelve o'clock, well-prepared beef-tea, or chicken, lamb, mutton broth,

or meat with a little gravy; or in place of the meat, a meal-broth

prepared with eggs, but with very little fat; green vegetables to be

allowed very rarely, and in very small quantities. At this noon meal a

mealy well-mashed potato is unobjectionable; so also is rice pudding for

a change. In the afternoon, between three and four, bread and milk, with

the addition in summer of fresh ripe fruit; in the evening, at seven,

bread and milk.

It will be observed that this dietetic table calls for five meals a day.

Should the child eat so frequently? We answer yes. But the meals should

be at regular intervals. A child, in order to replace the waste of the

system, and to furnish over and above sufficient material to build up

the growing body, requires a much larger proportionate amount of food

than an adult. It also requires its food at shorter intervals. By

observing the hours for meals stated above, _regularity_, which is of so

much importance to the health of the digestive organs, will be secured.

If a young child be allowed only the three ordinary meals of the family,

it will crave for something between times, and too often have its

craving met with a piece of cake or other improper food. Its appetite

for dinner or supper will in this manner be destroyed, and the stomach

and the general health suffer.

After the third or fourth year children are able to eat all kinds of

vegetables. They may then very appropriately be allowed to eat at the

table with the family. It is only necessary to refuse them very salt,

sour, and highly-spiced victuals. Of all others they may partake in

moderation. Neither wine nor any malt liquor should be given them. Tea

and coffee are also, to say the least, unnecessary. They should have a

regular luncheon between the meals which are furthest apart. This must

be at a regular hour, and consist of bread and butter, with milk or

water.

Pains should be taken to see that children do not fall into the habit

of eating rapidly. Too often this pernicious habit, so destructive to

healthy digestion, is formed in early life, and becomes the source of

that dyspepsia which is the bane of so many lives. Food that is gulped

down enters the stomach unmasticated, and unmixed with the secretions of

the mouth. A dog may bolt his food without injury, but a human being

cannot.

A child should be taught to eat everything that is wholesome, and not be

permitted to become finical or fastidious in its appetite. It ought not,

however, to be forced to eat any particular article for which it is

found that there is an invincible dislike. Variety of diet is good for a

child, after the second or third year.

THE POSITION OF THE CHILD WHEN FED.

An infant, no matter how young, should not receive its meals when lying.

Its head should always be raised in the nurse's arm, if it be too young

to support it itself. The practice of _jolting_ and _dandling_ the

infant after eating is a wrong one. Rest of the body should be secured

by placing the child on a bed, or holding it on the mother's knee, for a

half hour or so. Observe the inclination which all animals show for

repose and sleep after a full repast, and respect the same inclination

in the infant.

In our remarks upon bathing we pointed out the importance of the mother

herself performing for her child this office. So again, in connection

with children's food, we must notice the necessity of the mother being

always present at their meals, in order that they may be taught to take

them quietly, with cleanliness and without hurry. Such advice is not

needed by the poor nor by women of moderate fortune, who ordinarily have

their children constantly under their eyes. But affluence brings with it

many occupations which are frequently deemed of more moment than

presiding over a child's dinner.

CONCERNING SLEEP IN EARLY LIFE.

There is a natural desire for much sleep during infancy, childhood, and

youth; and there is reason for its free indulgence. Infants pass the

greater portion of both day and night in sleep. Children up to the age

of six years require, as a rule, twelve hours of repose at night,

besides an hour or more in the middle of the day. About the sixth year

the noon nap may be discontinued, but the night sleep ought not to be

abridged before the tenth year, and then only to a moderate extent until

the age of puberty. From this time the period of slumber may be

gradually reduced to nine or ten hours. No further diminution should be

attempted until the completion of growth, when another hour or two may

be taken away, leaving about eight hours of daily sleep as the proper

amount during middle life.

It is wrong, therefore, to wake a young child in the morning. It should

be allowed to sleep as long as it will, which will be until the wants of

the system are satisfied, if it be not aroused by noise or light.

When after a few months the infant is awake a considerable portion of

the day, it should be brought into the habit of taking its second sleep

near the middle of the day, say from eleven to one o'clock, and again,

from half an hour to an hour, about three o'clock. It should not be

permitted a nap later than this in the afternoon, as it would be very

apt to cause a disturbed night. Although some physicians recommend that

the sleep during the day be discontinued after the infant has attained

the age of fifteen months, the wisdom of such advice may well be

doubted. As soon as the child begins to walk, not only are its movements

very constant and active, but its mind is busily employed and its

nervous system excited. It therefore thrives better if its day be

divided into two by sleep for an hour or two.

_Should the infant sleep alone?_--We have mentioned the danger of being

overlain to which it is exposed when in bed with its mother or nurse. On

the other hand, it must be remembered that an infant keeps warm with

difficulty even when well covered, and that contact with the mother's

body is the best way of securing its own warmth. Hence, during the first

months the child had better be allowed to sleep with its mother. How,

then, can the risk of being suffocated, which is no imaginary one, be

lessened? The following rules are those given by a physician of

reputation, to prevent an infant from being accidentally overlain.

'Let the baby while asleep have plenty of room in the bed. Do not allow

him to be too near, or, if this be unavoidable from the small size of

the bed, let his face be turned to the opposite side. Let him lie

fairly, either on his side or on his back. Be careful to ascertain that

his mouth be not covered with the bed-clothes. Do not smother his face

with clothes, as a plentiful supply of pure air is as necessary as when

he is awake. Never let him lie low in the bed. Let there be no pillow

near the one his head is resting on, lest he roll to it and bury his

head in it. Remember a young child has neither the strength nor the

sense to get out of danger; and if he unfortunately either turn on his

face or bury his head in a pillow that is near, the chances are that he

will be suffocated, more especially as these accidents usually occur at

night, when the mother or the nurse is fast asleep. Never entrust him at

night to a young, giddy, and thoughtless servant. A foolish mother

sometimes goes to sleep while allowing her child to continue sucking.

The unconscious babe, after a time, loses the nipple, and buries his

head in the bed-clothes. She awakes in the morning, finding, to her

horror, a corpse by her side! A mother ought therefore never to go to

sleep until her child has ceased sucking.'

When a couple of months have elapsed, the child, if a healthy one, may

sleep alone. What the child sleeps in is not a matter of great moment,

provided it has a sufficiency of clothing, and be not exposed to

currents of air. A large clothes-basket will serve all the purposes of a

crib. The mistake is often made of burying the child under too heavy a

mass of bed-clothes in a warm room when asleep. And this inconsistency

is committed by the very mothers who scantily clad the child during the

day in order to inure it to the cold. The great transition from its

wrappings by night to those by day is injurious to the health and

comfort of the infant.

'In arranging night coverings, the soft feather-bed is very often

estimated as nothing; or, in other words, the same provision of blankets

is considered indispensable, whether we lie upon a hard mattress or

immersed in down. The mother, looking only to the covering laid over the

child, forgets those on which it lies, although in reality the latter

may be the warmer of the two. An infant deposited in a downy bed has at

least two-thirds of its body in contact with the feathers, and may thus

be perspiring at every pore, when, from its having only a single

covering thrown over it, the mother may imagine it to be enjoying the

restorative influence of agreeable slumber. In hot weather much mischief

might be done by an oversight of this kind.'

It is of course essential to the health and comfort of the infant that

its bed and bed-clothing be kept perfectly dry and sweet. They should

frequently be taken out and exposed to the air.

A child should be accustomed early to sleep in a darkened room. Plutarch

praises the women of Sparta for, among other things, teaching their

children not to be afraid in the dark. He says they 'were so careful and

expert, that without swaddling-bands their children were all straight

and well proportioned; and they brought them up not to be afraid in the

dark or of being alone, and never indulged them in crying, fretfulness,

and ill-humour; upon which account Spartan nurses were often bought by

people of other countries.'

_Position in sleeping._--It has long been a popular opinion that the

position of our bodies at night, with reference to the cardinal points

of the compass, has some influence on the health. This belief has

recently been corroborated by some observations made by a prominent

physician, Dr. Henry Kennedy. In an essay on the 'Acute Affections of

Children,' published in the Dublin _Quarterly Journal of Medical

Science_, he states that for several years he has put in force in his

practice a plan of treatment by means of the position of the patient,

and often with very marked results. He asserts that, in order to ensure

the soundest sleep, the head should lie to the north. Strange as this

idea may at first sight appear, it has more in it than might be

supposed. There are known to be great electrical currents always

coursing in one direction around the globe. In the opinion of Dr.

Kennedy there is no doubt that our nervous systems are in some

mysterious way connected with this universal agent, as it may be called,

electricity. He relates several cases of acute diseases in children, in

which, by altering the position of the body so that the patient should

lie from north to south instead of from east to west, quiet sleep was

induced. This plan of invoking sleep is often successful; but not always

so, for all are not equally susceptible. It applies likewise to adults.

It is not so striking in its effects on the poorer as on the richer

classes of society. This is what might be expected, for it cannot be

doubted that the nervous system in the middle and upper ranks is always

in a much more sensitive state than with their poorer brethren. It is

worth noting, that even in healthy persons sleep will often be absent or

of a broken kind, from the cause of which we are now speaking. It is

very common to hear people saying they can never sleep in a strange bed.

Although many causes may conspire to this, Dr. Kennedy cannot doubt that

amongst these ought to be placed the one to which we are now drawing

attention.

THE CLOTHING OF INFANTS AND YOUNG CHILDREN.

A fertile cause of disease and death is to be found in the negligence or

ignorance displayed in regard to the dress of children. And it is not

the poorly attired, but nearly always the fashionably robed child, which

suffers the most. To parental vanity can be traced many a catarrh on the

chest or the inflammation of the bowels which has resulted in death.

Most mothers appear to be ignorant of the fact that children are

exceedingly susceptible to the influence of cold. The returns of the

Registrar-General of England show that a very cold week always greatly

increases the mortality of the very young. While adults carefully

protect themselves against every change of the weather, and against

currents of air, children, who most need such protection, are too often

neglected.

The warmth of the infant's body is best secured by that of the nurse,

and by warm clothing. It is more effectually and healthfully provided

for in this manner than by confining the child to a warm atmosphere.

Young children should never be dressed _décolleté_--in low necks and

short sleeves. That fashion is a dangerous one which leaves the neck,

shoulders, and arms uncovered. To this irrational custom may be traced a

vast amount of the suffering and many of the deaths of early life;

doubtless, also, in many cases it lays the foundation of consumption,

which manifests itself a little later. But, it is said, the child will

be 'hardened' by having its chest and limbs thus exposed. The surest and

safest way to harden the child is to so care for it that it shall pass

through its first months and years of life without any ailment. Every

mother should see to it, that her charge is so clothed that every part

of the body is effectually protected from dampness and cold. She can

then best secure for it a hardened constitution by carrying it daily

into the sunlight of the open air.

_The material_ of the clothing should be such as will unite lightness

with warmth. Flannel and calico are therefore to be preferred. At first,

as the skin of the child is very delicate, a shirt of fine linen may be

interposed between it and the flannel. But, after the first few months,

the gentle friction of fine soft flannel next the skin is desirable, as

it stimulates the circulation of the blood on the surface of the body,

and promotes health. Flannel under-clothing should be continued all the

year, during the summer months a very light texture being used. When the

dress of the child is shortened, care must be taken that the feet are

well covered with soft stockings of cotton or woollen (which in winter

should extend up above the knees), and with light leather shoes.

The _night-dress_, at least during cold weather, is best made of

flannel, thin or thick according to the climate. It has been recommended

that, after the child is somewhat advanced, the night-clothes be

constructed in the form of night-pants, so that it may not be exposed if

the bed-clothing be thrown off. Every article of dress worn during the

day ought to be removed at night.

The rule in regard to the _quantity of clothing_ is, that it should be

in sufficient amount to preserve due warmth. It must therefore be

regulated by the season of the year and the state of the weather. We

have mentioned the fatal practice of leaving bare at all seasons of the

year the upper part of the chest and arms of the little one, while the

rest of the body is warmly clad. We can scarcely speak too emphatically

nor too often of the danger to which the mother thus exposes that life,

which it is her duty to wisely and safely conduct through the period of

dependent infancy and childhood. It is of course possible for the child

to be too closely enveloped, and the skin thus rendered highly

susceptible to the impressions of cold. The prevalent error, however, at

the present time, is in the direction of too scanty clothing.

_The make of the dress_ should be loose and easy, so as to permit of the

free movement of all portions of the body; it should be cut high in the

neck, and with sleeves to the wrists; its construction should be simple,

so that it may be quickly put off and on; and the fastenings employed

should, as far as possible, be tapes, not pins. In the clothing of

children the laws of hygiene, and not the code of fashion, should direct

the shape and style.

THE BATHING OF INFANTS AND YOUNG CHILDREN.

Many advantages attach to the daily use of the bath for infants. It

secures cleanliness, strengthens the nervous system, and preserves from

colds and coughs.

We have already endeavoured to impress upon the mind of the reader the

great susceptibility to cold which exists in early life. On this account

the water for the bath should be warm (96° or 98°) for the first few

weeks of infancy, especially during the winter season. Gradually the

temperature may be reduced to that of the apartment, never to actual

coldness. It is as foolish and hazardous to attempt to 'harden' infants

by plunging them into cold water, as it is by carrying them with

uncovered necks, chests, and limbs into the keen and damp air. Knowledge

of these facts would bring safety to many children who now suffer,

because of the dangerous ignorance of mothers in regard to the

susceptibility of the infant organisation.

An infant should be immersed in its tub every morning. Besides the

regular morning bath, it is often advisable to put the child for a few

minutes in tepid water in the evening. This will quiet the nervous

system, and induce sleep. The bath should not be too long a one, for

fear of exciting perspiration; nor, for the same reason, should the

water be too warm. If the child be of a delicate constitution, the

evening bath will be especially useful, and can be made more so by the

addition of two table-spoonfuls of salt to the water necessary for the

bath.

The time immediately after nursing or feeding is not proper for bathing.

An hour or two after a meal should be allowed to elapse. Neither should

a bath ever be given in a cold room. Even in a warm atmosphere, care

should be taken, both after and during the ablution, that the wet skin

of the infant be not exposed to the air. Its body should be completely

immersed; it should not be held up out of the water, nor, if it be old

enough, allowed to stand or sit in the tub. It is well also to have a

warm blanket in which to receive the child as it comes dripping from the

bath. It should be wrapped up in this for a few minutes, to absorb a

part of the moisture. Then a portion of the body should be uncovered at

a time, and dried before exposing the rest.

_Drying the skin._--For this purpose a piece of soft flannel will be

found serviceable. By gently rubbing the surface of the body with it the

skin will be warmed and stimulated, and the resulting glow will be as

agreeable to the child as is that in the adult which follows the Turkish

bath. The actual grooming of the human body is very useful to improve

the health of scrofulous children.

At first from three to five minutes will be a sufficiently long

immersion. In a little while, however, this period may be lengthened,

all the precautions mentioned against injurious exposure being observed.

The lukewarm daily bath, taken either in the morning or evening, ought

to be continued until at least the age of four years. If, after the

fourth or fifth year, ablutions of the entire body be resorted to only

every second or third day, the practice should be commenced of sponging

the chest every morning with cold, or alternately with cold and hot

water, followed by brisk frictions.

Soap is to be used but sparingly in the bath of young children. It must

be of the blandest and purest quality. Various eruptions are caused by

the employment of impure soaps, and even by the excessive application of

the best kind.

In illustration of the importance of our present subject, we may state

that Dr. Hufeland, to whose admirable work on the art of prolonging life

we have before alluded, lays down, as one of the means which lengthen

life, the care of the skin. He dwells upon the benefit of paying such

attention to it from infancy that it may be kept in a lively, active,

and useful condition.

The power of the bath to ward off disease in childhood is not

sufficiently appreciated by parents. Properly managed, it soothes, but

never increases, any internal irritation which may exist, and often does

away with the necessity of resorting to the administration of drugs. If

due attention were paid to the condition of the skin in early life, many

of the most common ailments of childhood would be averted. The daily

employment of the bath, and scrupulous attention to cleanliness of the

person and clothing, would materially lessen the demand both for

purgative medicines and for soothing syrups.

One word more in regard to the washing of the infant. The mother

herself, if she be in health, should always perform this office, and not

entrust it to the child's nurse. Plutarch awards high praise to Cato

the censor, for his invariable custom of being present when his child

was washed. Every mother, at least, would do well to follow the example

of this old Roman. It will give her the opportunity to detect many

incipient affections which would for a long while escape her attention

if she saw the child only when dressed. The mother will also take pains

to engage the mind of the little one, and render the bath a source of

amusement to it.

After the fourth or fifth year, two or three baths a week during the

colder seasons of the year will be sufficient to keep the skin clean,

and properly active. During the summer, however, a daily bath is of

great advantage to children, and ought not to be neglected.

Swimming is very useful and very invigorating to the health of both

sexes. It is desirable that children be taught this art.

The importance of the _culture of the skin_ to the well-being of infancy

and childhood cannot be brought too prominently to the notice of all

mothers. We have therefore endeavoured to give some useful hints in

regard both to the preservation of its cleanliness, and to the

prevention, by means of garments and warming, of its exposure to too

great changes of temperature.

By proper attention to the skin in the manner pointed out, many of the

eruptions with which children are afflicted might be prevented. The

appearance of these the mother ought to regard as a great calamity, for

they are often difficult of cure, and render the child an object of

disgust. She ought also to look upon them as the mischievous

consequences of the neglect of those laws of health which it is her duty

to learn and observe.

AIR AND VENTILATION IN CHILDHOOD.

Fresh air is necessary for the robust development of infancy and

childhood. Infants born in the summer season should be carried out daily

when the weather is pleasant, from the second or third day after birth.

Those born in the winter should be kept in the house for two or three

months before being introduced to the outer world on some sunny noonday.

Older children can scarcely pass too much time in the open air.

A change in the dress must, of course, be made before exposing the child

to the outdoor air. The head should be covered, and the chest and limbs

well protected from the cold.

As a rule, a child ought to be carried out, or permitted, when old

enough, to walk out, at least once every pleasant day during the year.

The time of the day is to be varied with the season. In the winter, the

middle of the day is to be chosen; in summer, the early portion of the

forenoon, a few hours after sunrise.

Children show very quickly, even when in ill-health, the beneficial

results of a ride or walk. It quiets the irritability to which they are

liable, more effectually than any other procedure. For a delicate child,

or one recovering from sickness, fresh air and sunshine are the best

tonics which can be administered. A fretful, peevish child will soon

learn to look forward to its daily jaunt on the street or road, and will

be quieted by it for the rest of the day.

At all times of the year regard must be had to the state of the weather.

The infant ought never to be taken out on a wet day. Exposure to a damp

atmosphere is one of the most powerful causes of catarrh on the chest

and inflammation of the lungs, to which young children are so subject. A

very high wind, even though the day be bright and dry, is injurious to a

young infant, as it has been known to suspend its breathing for a time,

which accident might, if not at once observed, bring about a fatal

result.

Besides fresh air, _light_ is an indispensable requisite to the health

of children. Nothing can compensate for the absence of its beneficial

effects. It is to be remembered, however, that during the first week or

two the eyes of the new-born babe are not strong enough to bear the full

glare of light. The first eight days of its existence should be spent in

a half-darkened room. Gradually the apartment may be brightened, until

finally, after about two weeks, the young eyes become entirely

accustomed to the light, and may be exposed to it without injury. A

neglect of this precaution is one of the most common causes of the bad

inflammation of the eyes so frequently met with among young infants.

After the sight has become quite strong, a bright room will strengthen

the eyes, not weaken them; for light is the natural stimulant of the

eye, as exercise is of the muscles, or food of the stomach.

Scrofulous diseases are the heritage of those children who are deprived

of a plentiful supply of pure air and light. A distinguished writer upon

the laws of health ascribes to the careful avoidance of the salutary

influence of air and light by so many young girls, who are fearful of

walking out while the sun is powerful, much of their sickly appearance,

the loss of consistency of their bones, and their being able to afford

but a deformed temple to the immortal soul.

Humboldt states that, during a five years' residence in South America,

he never saw any national deformity amongst the men or women belonging

to the Carif, Muyscas, Indian, Mexican, or Peruvian races. If parents in

our own country were to accustom their daughters from an early age to

daily exercise in the open air and sunlight, there would be fewer weak

backs requiring the support of apparatus from the surgical-instrument

maker, and less pallor in lips and cheeks to be remedied by iron from

the shop of the apothecary.

EXERCISE IN CHILDHOOD.

The first exercise which a child obtains, is had of course in its

nurse's arms. Are there any directions, then, to be noticed in regard to

the _manner of carrying an infant_?--Dr. Eberle gives the following

useful advice upon this subject:--'The spine and its muscles seldom

acquire sufficient strength and firmness before the end of the third

month to enable the child to support its body in an upright position

without inconvenience or risk of injury. Until this power is manifestly

acquired, the infant should not be carried or suffered to sit with its

body erect, without supporting it in such a manner as to lighten the

pressure made on the spine, and aid it in maintaining the upright

posture of its head and trunk; therefore, at first (a few days after

birth), the infant should be taken from its cradle or bed two or three

times daily and laid on its back upon a pillow, and carried gently about

the chamber. After the third or fourth week, the child may be carried in

a reclining posture on the arms of a careful nurse, in such a manner as

to afford entire support both to body and head. This may be done by

reclining the infant upon the forearm, the hand embracing the upper and

posterior part of the thighs, whilst its body and head are supported by

resting against the breast and arm of the nurse. When held in this way,

it may be gently moved from side to side, or up and down, while it is

carefully carried through a well-ventilated room.'

After the child is three months old, it will probably have become strong

enough to maintain itself in a sitting position. It may then be carried

about in this upright posture, with the spine and head carefully

supported by the nurse, which aid ought not to be withdrawn until the

age of six or seven months.

'In _lifting_ young children,' as has been well observed by Dr. Barlow,

'the nurse should be very careful never to lay hold of them by the arms,

as is sometimes thoughtlessly done; but always to place the hands, one

on each side of the chest, immediately below the armpits. In infancy the

sockets of the joints are so shallow, and the bones so feebly bound

down and connected with each other, that dislocation and even fracture

of the collar-bone may easily be produced by neglecting this rule. For

the same reason, it is a bad custom to support a child by one or even by

both arms, when he makes his first attempt to walk. The grand aim which

the child has in view, is to preserve his equilibrium. If he is

partially supported by one arm, the body inclines to one side, and the

attitude is rendered most unfavorable to the preservation of his natural

balance; and consequently, the moment the support is in the least

relaxed, the child falls over and is caught up with a jerk. Even when

held by both arms, the attitude is unnatural and unfavorable to the

speedy attainment of the object. To assist the child, we ought to place

one hand on each side of the chest in such a way as to give the

slightest possible support, and to be ready instantly to give more if he

lose his balance. When this plan is followed, all the attitudes and

efforts of the child are in a natural direction; and success is attained

not only sooner, but more gracefully, than by any ill-judged support

given to one side.

'There is one very common mode of exercising infants, which we think

deserves particular notice: we mean the practice of hoisting or raising

them aloft in the air. This practice is of such venerable antiquity, and

so universal, that it would be vain to impugn it. The pleasure, too,

which most children evince under it, seems to show that it cannot be so

objectionable as a cursory observer would be disposed to consider it.

Still there are hazards which ought not to be overlooked. The risk of

accident is one of some amount: children have slipped from the hands,

and sustained serious injury. Some people are so energetic as to throw

up children and catch them in descending. This rashness there can be no

hesitation in reprobating; for, however confident the person may be of

not missing his hold, there must ever be risks of injury from the

concussion suffered in the descent, and even from the firmness of the

grasp necessary for recovering and maintaining the hold. The motion of

the body, too, has a direct tendency to induce vertigo; and when the

liability of the infant brain to congestion and its consequences is

considered, when the frequency of hydrocephalus in infants is borne in

mind, an exercise which impels blood to the brain will not be regarded

as wholly insignificant. There is one more objection which seems not to

have attracted attention. The hold taken of the child in the act of

hoisting him is by the hand grasping the chest. The fingers and thumb,

placed on each side of the breast-bone, compress the ribs; and any one

with the hand so placed will at once perceive that if the pressure were

strong, and the resistance from the elasticity of the ribs weak, the

impression on the chest resulting would correspond exactly with the

deformity named chicken-breast. That any force is ever used capable of

inducing speedily such a change, is in the highest degree improbable;

but that reiterated pressure of this kind, however slight, would in a

weakly child have power to impress and distort the chest, few, we

imagine, will doubt.'

LEARNING TO WALK.

When two or three months old, the infant may be placed on a soft

mattress upon the floor or on the carpet. He can then toss his limbs

about without danger, and develope the powers of his muscular system.

'The best mode of teaching a child how to walk,' says Dr. Bull, 'is to

let it teach itself; and this it will do readily enough. It will first

learn to crawl: this exercises every muscle in the body, does not

fatigue the child, throws no weight upon the bones, but imparts vigor

and strength, and is thus highly useful. After a while, having the

power, it will wish to do more. It will endeavor to lift itself upon its

feet by the aid of a chair; and though it fail again and again in its

attempts, it will still persevere until it accomplish it. By this, it

learns first to raise itself from the floor; and secondly, to stand, but

not without keeping hold of the object on which it has seized. Next it

will balance itself without holding, and will proudly and laughingly

show that it can stand alone. Fearful, however, as yet of moving its

limbs without support, it will seize a chair or anything else near it,

when it will dare to advance as far as the limits of its support will

permit. This little adventure will be repeated day after day with

increased exultation; when, after numerous trials, he will feel

confident of his power to balance himself, and he will run alone. Now

time is required for this gradual self-teaching, during which the

muscles and bones become strengthened; and when at last called upon to

sustain the weight of the body, are fully capable of doing so.'

It is not merely want of strength which prevents an infant from walking

at first. The natural shape of the legs renders it impossible. The feet

are turned in so that the inner sides look upwards. When placed upon its

feet, therefore, the soles will not rest upon the ground. In a short

time the position of the feet changes, and they become fitted for the

purposes of support and locomotion. When he begins to walk, the child

should have shoes with tolerably broad soles, which ought to be at least

half an inch longer than the foot.

The first efforts of the little one to support and propel itself are to

be carefully watched, but not unnecessarily interfered with; neither

frightened by expressions of fear, nor rendered timid by too frequent

warnings.

ADVANTAGES OF GAMES AND PLAYS.

The first seven years of life should be one grand holiday for all sports

and amusements which will bring into play the muscles, and divert at the

same time the mind. Time cannot be more usefully employed than in thus

laying the foundation of health, upon which alone can rest the physical,

mental, and moral well-being of after-life.

No greater mistake can be made by parents than to deprive the young of

the innocent pleasures of childhood. Yet there are persons occasionally

met with who think it their duty to check the natural lightness and

gaiety of heart of their children for fear that they shall become too

fond of pleasure. In this way great harm is done to both mind and body,

and the very fault created which it is desired to avoid.

The wise parent sees in the games and plays of childhood not only

necessary recreation and exercise, but a valuable means of education--of

moral, mental, and physical training. He also seeks to impress early

upon the young mind that play is most enjoyed when it has been earned by

work, and that pleasure flies from those who continually pursue it.

The faculties of _memory_ and _attention_ can be called upon and

developed by proper games in a most satisfactory manner. These exercises

are all the more effective because the pleasure conceals, as it were,

the mental labor, and the intellectual efforts are made, in a sense,

unconsciously, though none the less efficiently.

Certain plays form a valuable means of educating the eyes and other

senses. Such, for instance, are the toys which represent objects of

natural history or of different trades and arts; the pictures which

teach through the quick eye of the child what no dry descriptions could

ever convey; and the games which develope closeness of observation and

habits of order. A genial French physician has happily said, 'Every time

I see a toy based on the reproduction of a scientific fact or of an

industrial process, and which pleases while it enlightens, I feel a

sentiment of real gratitude to him who has designed it.'

We are glad to see that each year more and more attention is being paid

to the utilization, as it were, of the games of infancy. Although all

education can never be made a play, all play can be made an effective

education. Do not therefore, reader, restrict the games of your

children, but direct them; do not render them less amusing, but seek to

make them more instructive.

The schooling afforded by instructive plays should be the only schooling

of the first seven years of life. Late springs produce the most abundant

harvests in the mind as in the field. Precocious and delicate children

especially should be kept from a too early and close application to

books. By means of healthful and instructive games and sports; by visits

to workshops and factories where familiar objects are made; and by a

cultivation of the sense of the beautiful in nature and art, more can be

done towards securing a sound mind in a sound body than by the easier

and more common method of sending the child to school almost as soon as

it can walk.

IMPORTANCE OF TEACHING CHILDREN HYGIENIC HABITS.