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ADVICE TO A MOTHER
ON THE
MANAGEMENT OF HER CHILDREN
AND ON THE
TREATMENT ON THE MOMENT
OF SOME OF THEIR MORE PRESSING ILLNESSES
AND ACCIDENTS
BY
PYE HENRY CHAVASSE,
FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND, FELLOW OF THE
OBSTETRICAL SOCIETY OF LONDON, FORMERLY PRESIDENT OF QUEEN'S COLLEGE
MEDICO-CHIRURGICAL SOCIETY, BIRMINGHAM.
"Lo, children and the fruit of the womb are an heritage and gift that
cometh of the Lord."
PREFACE.
This Book has been translated into French, into German, into Polish,
and into Tamil (one of the languages of India); it has been
extensively published in America; and is well-known wherever the
English language is spoken.
The Twelfth Edition--consisting of twenty thousand copies--being
exhausted in less than three years, the THIRTEENTH EDITION is now
published.
One or two fresh questions have been asked and answered, and two or
three new paragraphs have I been added.
PYE HENRY CHAVASSE.
214, HAGLEY ROAD, EDGBASTON,
BIRMINGHAM, _June_, 1878.
CONTENTS.
PART I--INFANCY.
PRELIMINARY CONVERSATION
ABLUTION
MANAGEMENT OF THE NAVEL
NAVEL RUPTURE--GROIN RUPTURE
CLOTHING
DIET
VACCINATION AND RE-VACCINATION
DENTITION
EXERCISE
SLEEP
THE BLADDER AND THE BOWELS
AILMENTS, DISEASE, ETC.
CONCLUDING REMARKS ON INFANCY
PART II--CHILDHOOD
ABLUTION
CLOTHING
DIET
THE NURSERY
EXERCISE
AMUSEMENTS
EDUCATION
SLEEP
SECOND DENTITION
DISEASE, ETC.
WARM BATHS
WARM EXTERNAL APPLICATIONS
ACCIDENTS
PART III--BOYHOOD AND GIRLHOOD
ABLUTION, ETC.
MANAGEMENT OF THE HAIR
CLOTHING
DIET
AIR AND EXERCISE
AMUSEMENTS
EDUCATION
HOUSEHOLD WORK FOR GIRLS
CHOICE OF PROFESSION OR TRADE
SLEEP
ON THE TEETH AND GUMS
PREVENTION OF DISEASE, ETC.
CONCLUDING REMARKS
INDEX
ADVICE TO A MOTHER.
PART I.--INFANCY
_Infant and suckling._--I. SAMUEL
_A rose with all its sweetest leaves yet folded._--BYRON.
_Man's breathing Miniature!_--COLERIDGE.
PRELIMINARY CONVERSATION
1. _I wish to consult you on many subjects appertaining to the
management and the care of children; will you favour me with your
advice and counsel_?
I shall be happy to accede to your request, and to give you the fruits
of my experience in the clearest manner I am able, and in the simplest
language I can command--freed from all technicalities. I will
endeavour to guide you in the management of the health of your
offspring;--I will describe to you the _symptoms_ of the diseases of
children;--I will warn you of approaching danger, in order that you
may promptly apply for medical assistance before disease has gained
too firm a footing;--I will give you the _treatment_ on the moment; of
some of their more pressing illnesses--when medical aid cannot at once
be procured, and where delay may be death;--I will instruct you, in
case of accidents, on the _immediate_ employment of remedies--where
procrastination may be dangerous;--I will tell you how a sick child
should be nursed, and how a sick-room ought to be managed;--I I will
use my best energy to banish injurious practices from the nursery;--I
will treat of the means to prevent disease where it be possible;--I
will show you the way to preserve the health of the healthy,--and how
to strengthen the delicate;--and will strive to make a medical man's
task more agreeable to himself,--and more beneficial to his
patient,--by dispelling errors and prejudices, and by proving the
importance of your _strictly_ adhering to his rules. If I can
accomplish any of these objects, I shall be amply repaid by the
pleasing satisfaction that I have been of some little service to the
rising generation.
2. _Then you consider it important that I should be made acquainted
with, and be well informed upon, the subjects you have just named_?
Certainly! I deem it to be your imperative duty to _study_ the
subjects well. The proper management of children is a vital
question,--a mother's question,--and the most important that can be
brought under the consideration of a parent; and, strange to say, it
is one that has been more neglected than any other. How many mothers
undertake--the responsible management of children without previous
instruction, or without forethought; they undertake it, as though it
may be learned either by intuition or by instinct, or by
affection. The consequence is, that frequently they are in a sea of
trouble and uncertainty, tossing about without either rule or compass;
until, too often, their hopes and treasures are shipwrecked and lost.
The care and management, and consequently the health and future
well-doing of the child, principally devolve upon the mother, "for it
is the mother after all that has most to do with the making or marring
of the man." [Footnote: _Good Words_, Dr W. Lindsay Alexander, March
1861.] Dr Guthrie justly remarks that--"Moses might have never been
the man he was unless he had been nursed by his own mother. How many
celebrated men have owed their greatness and their goodness to a
mother's training!" Napoleon owed much to his mother. "'The fate of a
child,' said Napoleon, 'is always the work of his mother;' and this
extraordinary man took pleasure in repeating, that to his mother he
owed his elevation. All history confirms this opinion..." The
character of the mother influences the children more than that of the
father, because it is more exposed to their daily, hourly
observation.--_Woman's Mission_.
I am not overstating the importance of the subject in hand when I say,
that a child is the most valuable treasure in the world, that "he is
the precious gift of God," that he is the source of a mother's
greatest and purest enjoyment, that he is the strongest bond of
affection between her and her husband, and that
"A babe in a house is a well-spring of pleasure,
A messenger of peace and love."--_Tupper_,
I have, in the writing of the following pages, had one object
constantly in view--namely, health--
"That salt of life, which does to all a relish give,
Its standing pleasure, and intrinsic wealth,
The body's virtue, and the soul's good fortune--health."
If the following pages insist on the importance of one of a mother's
duties more than another it is this,--_that the mother herself look
well into everything appertaining to the management of her own child_.
Blessed is that mother among mothers of whom it can be said, that "she
hath done what she could" for her child--for his welfare, for his
happiness, for his health!
For if a mother hath not "done what she could for her
child"--mentally, morally, and physically--woe betide the unfortunate
little creature;--better had it been for him had he never been born!
ABLUTION
3. _Is a new-born infant, for the first time, to be washed in warm
or in cold water_?
It is not an uncommon plan to use _cold_ water from the first, under
the impression of its strengthening the child. This appears to be a
cruel and barbarous practice, and is likely to have a contrary
tendency. Moreover, it frequently produces either inflammation of the
eyes, or stuffing of the nose, or inflammation of the lungs, or
looseness of the bowels. Although I do not approve of _cold_ water, we
ought not to run into an opposite extreme, as _hot_ water would weaken
and enervate the babe, and thus would predispose him to disease. Luke
warm _rain_ water will be the best to wash him with. This, if it be
summer, should have its temperature gradually lowered, until it be
quite cold, if it be winter, a _dash_ of warm water ought still to be
added, to take oft the chill [Footnote: A nursery basin (Wedgwoode
make is considered the best), holding either six or eight quarts of
water, and which will be sufficiently large to hold the whole body of
the child. The baton is generally fitted into a wooden frame which
will raise it to a convenient height for the washing of the baby.] (By
thermometer = 90 to 92 degrees.)
It will be necessary to use soap--Castile soap being the best for the
purpose--it being less irritating to the skin than the ordinary
soap. Care should be taken that it does not get into the eyes, as it
may produce either inflammation or smarting of those organs.
If the skin be delicate, or if there be any excoriation or
"breaking-out" on the skin, then glycerine soap, instead of the
Castile soap, ought to be used.
4. _At what age do you recommend a mother to commence washing her
infant either in the tub, or in the nursery basin_?
As soon as the navel string comes away [Footnote: Sir Charles Locock
strongly recommends that an infant should be washed _in a tub_ from
the very commencement. He says,--"All those that I superintend _begin_
with a tub."--_Letter to the Author_.] Do not be afraid of water,--and
that in plenty,--as it is one of the best strengtheners to a child's
constitution. How many infants suffer, for the want of water from
excoriation!
5. _Which do you prefer--flannel or sponge--to wash a child with_?
A piece of flannel is, for the first part of the washing very
useful--that is to say, to use with the soap, and to loosen the dirt
and the perspiration; but for the finishing-up process, a sponge--a
large sponge--is superior to flannel, to wash all away, and to
complete the bathing. A sponge cleanses and gets into all the nooks,
corners, and crevices of the skin. Besides, sponge, to finish up with,
is softer and more agreeable to the tender skin of a babe than
flannel. Moreover, a sponge holds more water than flannel, and thus
enables you to stream the water more effectually over him. A large
sponge will act Like a miniature shower bath, and will thus brace and
strengthen him.
6. _To prevent a new-born babe from catching cold, is it necessary to
wash his head with brandy_?
It is _not necessary_. The idea that it will prevent cold is
erroneous, as the rapid evaporation of heat which the brandy causes is
more likely to give than to prevent cold.
7. _Ought that tenacious, paste like substance, adhering to the skin
of a new-born babe, to be washed off at the first dressing_?
It should, provided it be done with a soft sponge and with care. If
there be any difficulty in removing the substance, gently rub it, by
means of a flannel, [Footnote: Mrs Baines (who has written so much and
so well on the Management of Children), in a _Letter_ to the Author,
recommends flannel to be used in the _first_ washing of an infant,
which flannel ought afterwards to be burned; and that the sponge
should be only used to complete the process, to clear off what the
flannel had already loosened. She also recommends that every child
should have his own sponge, each of which should have a particular
distinguishing mark upon it, as she considers the promiscuous use of
the same sponge to be a frequent cause of _ophthalmia_ (inflammation
of the eyes). The sponges cannot be kept too clean.] either with a
little lard, or fresh butter, or sweet-oil. After the parts have been
well smeared and gently rubbed with the lard, or oil, or butter, let
all be washed off together, and be thoroughly cleansed away, by means
of a sponge and soap and warm water, and then, to complete the
process, gently put him in for a minute or two in his tub. If this
paste like substance be allowed to remain on the skin, it might
produce either an excoriation, or a "breaking-out" Besides, it is
impossible, if that tenacious substance be allowed to remain on it,
for the skin to perform its proper functions.
8. _Have you any general observations to make on the washing of a
new-born infant_?
A babe ought, every morning of his life, to be thoroughly washed from
head to foot, and this can only be properly done by putting him bodily
either into a tub or into a bath, or into a large nursery basin, half
filled with water. The head, before placing him in the bath, should be
first wetted (but not dried), then immediately put him into the water,
and, with a piece of flannel well soaked, cleanse his whole body,
particularly his arm pits, between his thighs, his groins, and his
hams, then take a large sponge in hand, and allow the water from it,
well filled, to stream all over the body, particularly over his back
and loins. Let this advice be well observed, and you will find the
plan most strengthening to your child. The skin must, after every
bath, be thoroughly but quickly dried with warm, dry, soft towels,
first enveloping the child in one, and then gently absorbing the
moisture with the towel, not roughly scrubbing and rubbing his tender
skin as though a horse were being rubbed down.
The ears must, after each ablution, be carefully and well dried with a
soft dry napkin, inattention to this advice has sometimes caused a
gathering in the ear--a painful and distressing complaint, and at
other times it has produced deafness.
Directly after the infant is dried, all the parts that are at all
likely to be chafed ought to be well powdered. After he is well dried
and powdered, the chest, the back, the bowels, and the limbs should be
gently rubbed, taking care not to expose him unnecessarily during such
friction.
He ought to be partially washed every evening, indeed it may be
necessary to use a sponge and a little warm water frequently during
the day, namely, each time after the bowels have been relieved.
_Cleanliness is one of the grand incentives to health_, and therefore
cannot be too strongly insisted upon. If more attention were paid to
this subject, children would be more exempt from chafings,
"breakings-out," and consequent suffering, than they at present
are. After the second month, if the babe be delicate, the addition of
two handfuls of table-salt to the water he is washed with in the
morning will tend to brace and strengthen him.
With regard to the best powder to dust an infant with, there is
nothing better for general use than starch--the old fashioned starch
_made of wheaten flour_--reduced by means of a pestle and mortar to a
fine powder, or Violet Powder, which is nothing more than finely
powdered starch scented, and which may be procured of any respectable
chemist. Some others are in the habit of using white lead, but as
this is a poison, it ought _on no account_ to be resorted to.
9. _If the parts about the groin and fundament be excoriated, what is
then the best application_?
After sponging the parts with tepid _rain water_, holding him over his
tub, and allowing the water from a well filled sponge to stream over
the parts, and then drying them with a soft napkin (not rubbing, but
gently dabbing with the napkin), there is nothing better than dusting
the parts frequently with finely powdered Native Carbonate of
Zinc-Calamine Powder. The best way of using this powder is, tying up a
little of it in a piece of muslin, and then gently dabbing the parts
with it.
Remember excoriations are generally owing to the want of water,--to
the want of an abundance of water. An infant who is every morning well
soused and well swilled with water seldom suffers either from
excoriations, or from any other of the numerous skin diseases.
Cleanliness, then, is the grand preventative of, and the best remedy
for excoriations. Naaman the Syrian was ordered "to wash and be
clean," and he was healed, "and his flesh came again like unto the
flesh of a little child and he was clean." This was, of course, a
miracle; but how often does water, without any special intervention,
act miraculously both in preventing and in curing skin diseases!
An infant's clothes, napkins especially, ought never to be washed with
soda; the washing of napkins with soda is apt to produce excoriations
and breakings-out. "As washerwomen often deny that they use soda, it
can be easily detected by simply soaking a clean white napkin in fresh
water and then tasting the water; if it be brackish and salt, soda has
been employed." [Footnote: Communicated by Sir Charles Locock to the
Author.]
10. _Who is the proper person to wash and dress the babe_?
The monthly nurse, as long as she is in attendance; but afterwards the
mother, unless she should happen to have an experienced, sensible,
thoughtful nurse, which, unfortunately, is seldom the case. [Footnote:
"The Princess of Wales might have been seen on Thursday taking an
airing in a brougham in Hyde Park with her baby--the future King of
England--on her lap, without a nurse, and accompanied only by Mrs
Brace. The Princess seems a very pattern of mothers, and it is
whispered among the ladies of the Court that every evening the mother
of this young gentleman may be seen in a flannel dress, in order that
she may properly wash and put on baby's night clothes, and see him
safely in bed. It is a pretty subject for a picture."--_Pall Mall
Gazette_.]
11. _What is the best kind of apron for a mother, or for a nurse, to
wear, while washing the infant_?
Flannel--a good, thick, soft flannel, usually called
bathcoating--apron, made long and full, and which of course ought to
be well dried every time before it is used.
12. _Perhaps you will kindly recapitulate, and give me further advice
on the subject of the ablution of my babe_.
Let him by all means, then, as soon as the navel-string has separated
from the body, be bathed either in his tub, or in his bath, or in his
large nursery-basin, for if he is to be strong and hearty, in the
water every morning he must go. The water ought to be slightly warmer
than new milk. It us dangerous for him to remain for a long period in
his bath, this, of course, holds good in a ten fold degree if the
child have either a cold or pain in his bowels. Take care that,
immediately after he comes out of his tub, he is well dried with warm
towels. It is well to let him have his bath the first thing in the
morning, and before he has been put to the breast, let him be washed
before he has his breakfast, it will refresh him and give him an
appetite. Besides, he ought to have his morning ablution on an empty
stomach, or it may interfere with digestion, and might produce
sickness and pain. In putting him in his tub, let his head be the
first part washed. We all know, that in bathing in the sea, now much
better we can bear the water if we first wet our head, if we do not do
so, we feel shivering and starved and miserable. Let there be no
dawdling in the washing, let it be quickly over. When he is thoroughly
dried with warm _dry_ towels, let him be well rubbed with the warm
hand of the mother or of the nurse. As I previously recommended, while
drying him and while rubbing him, let him repose and kick and stretch
either on the warm flannel apron, or else on a small blanket placed on
the lap. One bathing in the tub, and that in the morning, is
sufficient, and better than night and morning. During the day, as I
before observed, he may, after the action either of his bowels or of
his bladder, require several spongings of lukewarm water, _for
cleanliness is a grand incentive to health and comeliness_.
Remember it is absolutely necessary to every child from his earliest
babyhood to have a bath, to be immersed every morning of his life in
the water. This advice, unless in cases of severe illness, admits of
no exception. Water to the body--to the whole body--is a necessity of
life, of health, and of happiness, it wards off disease, it brace? the
nerves, it hardens the frame, it is the finest tonic in the world. Oh,
if every mother would follow to the very letter this counsel how much
misery, how much ill-health might then be averted!
MANAGEMENT OF THE NAVEL.
13. _Should the navel-string be wrapped in SINGED rag_?
There is nothing better than a piece of fine old linen rag,
_unsinged_; when singed, it frequently irritates the infant's skin.
14. _How ought the navel-string to be wrapped in the rag_?
Take a piece of soft linen rag, about three inches wide and four
inches long, and wrap it neatly round the navel string, in the same
manner you would around a cut finger, and then, to keep on the rag,
tie it with a few rounds of whity-brown thread. The navel-string thus
covered should, pointing upwards, be placed on the belly of the child,
and must be secured in its place by means of a flannel belly-band.
15. _If after the navel-string has been secured, bleeding should (in
the absence of the medical man) occur, how must it be restrained_?
The nurse or the attendant ought immediately to take off the rag, and
tightly, with a ligature composed of four or five whity-brown threads,
retie the navel-string; and to make assurance doubly sure, after once
tying it, she should pass the threads a second time around the
navel-string, and tie it again; and after carefully ascertaining that
it no longer bleeds, fasten it up in the rag as before. Bleeding of
the navel-string rarely occurs, yet, if it should do so--the medical
man not being at hand--the child's after-health, or even his life,
may, if the above directions be not adopted, be endangered.
16. _When does the navel-string separate from the child_?
From five days to a week after birth; in some cases not until ten days
or a fortnight, or even, in rare cases, not until three weeks.
17. _If the navel-string does not at the end of a week came away,
ought any means to be used to cause the separation_?
Certainly not, it ought always to be allowed to drop off, which, when
in a fit state, it will readily do. Meddling with the navel string
has frequently cost the babe a great deal of suffering, and in some
cases even his life.
18. _The navel is sometimes a little sore, after the navel-string
comes away, what ought then to be done_?
A little simple cerate should be spread on lint, and be applied every
morning to the part affected, and a white-bread poultice, every night,
until it is quite healed.
NAVEL RUPTURE--GROIN RUPTURE.
19. _What are the causes of a rupture of the navel? What ought to be
done? Can it be cured_?
(1) A rupture of the navel is sometimes occasioned by a meddlesome
nurse. She is very anxious to cause the navel-string to separate from
the infant's body, more especially when it is longer in coming away
than usual. She, therefore, before it is in a fit state to drop off,
forces it away. (2) The rapture, at another time, is occasioned by the
child incessantly crying. A mother, then, should always bear in mind,
that a rupture of the navel is often caused by much crying, and that
it occasions much crying, indeed, it is a frequent cause of incessant
crying. A child, therefore, who, without any assignable cause, is
constantly crying, should have his navel carefully examined.
A rupture of the navel ought always to be treated early--the earlier
the better. Ruptures of the navel can only be _cured_ in infancy and
in childhood. If it be allowed to run on until adult age, a _cure_ is
impossible. Palliative means can then only be adopted.
The best treatment is a Burgundy pitch plaster, spread on a soft piece
of wash leather, about the size of the top of a tumbler, with a
properly-adjusted pad (made from the plaster) fastened on the centre
of the plaster, which will effectually keep up the rupture, and in a
few weeks will cure it. It will be necessary, from time to time, to
renew the plaster until the cure be effected. These plasters will be
found both more efficacious and pleasant than either truss or bandage;
which latter appliances sometimes gall, and do more harm than they do
good.
20. _If an infant have a groin-rupture (an inguinal rupture), can that
also be cured_?
Certainly, if, soon after birth, it be properly attended to. Consult a
medical man, and he will supply you with a well-fitting truss, _which
will eventually cure him_. If the truss be properly made (under the
direction of an experienced surgeon) by a skilful surgical-instrument
maker, a beautiful, nicely-fitting truss will be supplied, which will
take the proper and exact curve of the lower part of the infant's
belly, and will thus keep on without using any under-strap whatever--a
great desideratum, as these under-straps are so constantly wetted and
soiled as to endanger the patient constantly catching cold. But if
this under-strap is to be superseded, the truss must be made exactly
to fit the child--to fit him like a ribbon; which is a difficult thing
to accomplish unless it be fashioned by a skilful workman. It is only
lately that these trusses have been made without under-straps.
Formerly the under-straps were indispensable necessaries.
These groin-ruptures require great attention and supervision, as the
rupture (the bowel) must, before putting on the truss be cautiously
and thoroughly returned into the belly; and much care should be used
to prevent the chafing and galling of the tender skin of the babe,
which an ill-fitting truss would be sure to occasion. But if care and
skill be bestowed on the case, a perfect cure might in due time be
ensured. The truss must not be discontinued, until a _perfect_ cure be
effected.
Let me strongly urge you to see that my advice is carried out to the
very letter, as a groin-rupture can only be _cured_ in infancy and in
childhood. If it be allowed to ran on, unattended to, until adult age,
he will be obliged to wear a truss _all his life_, which would be a
great annoyance and a perpetual irritation to him.
CLOTHING.
21. _Is it necessary to have a flannel cap in readiness to put on as
soon as the babe is born_?
Sir Charles Locock considers that a flannel cap is _not_ necessary,
and asserts that all his best nurses have long discarded flannel
caps. Sir Charles states that since the discontinuance of flannel caps
infants have not been more liable to inflammation of the eyes. Such
authority is, in my opinion, conclusive. My advice, therefore, to you
is, discontinue by all means the use of flannel caps.
22. _What kind of a belly-band do you recommend--a flannel or a calico
one_?
I prefer flannel, for two reasons--first, on account of its keeping
the child's bowels comfortably warm; and secondly, because of its not
chilling him (and thus endangering cold, &c.) when he wets
himself. The belly-band ought to be moderately, but not tightly
applied, as, if tightly applied, it would interfere with the necessary
movement of the bowels.
23. _When should the belly-band be discontinued_?
When the child is two or three months old. The best way of leaving it
off is to tear a strip off daily for a few mornings, and then to leave
it off altogether. "Nurses who take charge of an infant when the
monthly nurse leaves, are frequently in the habit of at once leaving
off the belly-band, which often leads to ruptures when the child cries
or strains. It is far wiser to retain it too long than too short a
time; and when a child catches whooping-cough, whilst still very
young, it is safer to resume the belly-band." [Footnote: Communicated
by Sir Charles Locock to the Author.]
24. _Have you any remarks to make on the clothing of on infant_?
A babe's clothing ought to be light, warm, loose, and free from
pins. (1.) _It should be light_, without being too airy. Many infant's
clothes are both too long and too cumbersome. It is really painful to
see how some poor little babies are weighed down with a weight of
clothes. They may be said to "bear the burden," and that a heavy one,
from the very commencement of their lives! How absurd, too, the
practice of making them wear _long_ clothes. Clothes to cover a
child's feet, and even a little beyond, may be desirable; but for
clothes, when the infant is carried about, to reach to the ground, is
foolish and cruel in the extreme. I have seen a delicate baby almost
ready to faint under the infliction. (2.) _It should be warm_,
without being too warm. The parts that ought to be kept warm are the
chest, the bowels, and the feet. If the infant be delicate, especially
if he be subject to inflammation of the lungs, he ought to wear a fine
flannel, instead of his usual shirts, which should be changed as
frequently. (3.) _The dress should be loose_, so as to prevent any
pressure upon the blood-vessels, which would otherwise impede the
circulation, and thus hinder a proper development of the parts. It
ought to be loose about the chest and waist, so that the lungs and the
heart may have free play. It should be loose about the stomach, so
that digestion may not be impeded; it ought to be loose about the
bowels, in order that the spiral motion of the intestines may not be
interfered with--hence the importance of putting on a belly-band
moderately slack; it should be loose about the sleeves, so that the
blood may course, without let or hindrance, through the arteries and
veins; it ought to be loose, then, everywhere, for nature delights in
freedom from restraint, and will resent, sooner or later, any
interference. Oh, that a mother would take common sense, and not
custom, as her guide! (4.) _As few pins_ should be used in the
dressing of a baby as possible. Inattention to this advice has caused
many a little sufferer to be thrown into convulsions.
The generality of mothers use no pins in the dressing of their
children; they tack every part that requires fastening with a needle
and thread. They do not even use pins to fasten the baby's
diapers. They make the diapers with loops and tapes, and thus
altogether supersede the use of pins in the dressing of an infant.
The plan is a good one, takes very little extra time, and deserves to
be universally adopted. If pins be used for the diapers, they ought to
be the Patent Safety Pins.
25. _Is there any necessity for a nurse being particular in airing an
infant's clothes before they are put on? If she were less particular,
would it not make him more hardy_?
A nurse cannot be too particular on this head. A babe's clothes ought
to be well aired the day before they are put on, as they should _not_
be put on warm from the fire. It is well, where it can be done, to let
him have clean clothes daily. Where this cannot be afforded, the
clothes, as soon as they are taken off at night, ought to be well
aired, so as to free them from the perspiration, and that they may be
ready to put on the following morning. It is truly nonsensical to
endeavour to harden a child, or any one else, by putting on damp
clothes!
26. _What is your opinion of caps for an infant_?
The head ought to be kept cool; caps, therefore, are unnecessary. If
caps be used at all, they should only be worn for the first month in
summer, or for the first two or three months in winter. If a babe take
to caps, it requires care in leaving them off, or he will catch cold.
When you are about discontinuing them, put a thinner and a thinner one
on, every time they are changed, until you leave them off altogether.
But remember, my opinion is, that a child is better _without_ caps;
they only heat his head, cause undue perspiration, and thus make him
more liable to catch cold.
If a babe does not wear a cap in the day, it is not at all necessary
that he should wear one at night. He will sleep more comfortably
without one, and it will be better for his health. Moreover,
night-caps injure both the thickness and beauty of the hair.
27. _Have you any remarks to make on the clothing of an infant, when,
in the winter time, he is sent out for exercise_?
Be sure that he is well wrapped up. He ought to have under his cloak a
knitted worsted spencer, which should button behind, and if the
weather be very cold, a shawl over all, and, provided it be dry above,
and the wind be not in the east or in the north-east, he may then
brave the weather. He will then come from his walk refreshed and
strengthened, for cold air is an invigorating tonic. In a subsequent
Conversation I will indicate the proper age at which a child should be
first sent out to take exercise in the open air.
28. _At what age ought an infant "to be shortened?"_
This, of course, will depend upon the season. In the summer, the right
time "for shortening a babe," as it is called, is at the end of two
months, in the winter, at the end of three months. But if the right
time for "shortening" a child should happen to be in the spring, let
it be deferred until the end of May. The English springs are very
trying and treacherous, and sometimes, in April the weather is almost
as cold, and the wind as biting as in winter. It is treacherous, for
the sun is hot, and the wind, which is at this time of the year
frequently easterly, is keen and cutting I should far prefer "to
shorten" a child in the winter than in the early spring.
DIET
29. _Are you an advocate for putting a baby to the breast soon after
birth, or for waiting, as many do, until the third day_?
The infant ought to be put to the bosom soon after birth, the
interest, both of the mother and of the child demands it. It will be
advisable to wait three or four hours, that the mother may recover
from her fatigue, and, then, the babe must be put to the breast. If
this be done, he will generally take the nipple with avidity.
It might be said, at so early a period that there is no milk in the
bosom; but such is not usually the case. There generally is a
_little_ from the very beginning, which acts on the baby's bowels like
a dose of purgative medicine, and appears to be intended by nature to
cleanse the system. But, provided there be no milk at first, the very
act of sucking not only gives the child a notion, but, at the same
time, causes a draught (as it is usually called) in the breast, and
enables the milk to flow easily.
Of course, if there be no milk in the bosom--the babe having been
applied once or twice to determine the fact--then you must wait for a
few hours before applying him again to the nipple, that is to say,
until the milk be secreted.
An infant, who, for two or three days, is kept from the breast, and
who is fed upon gruel, generally becomes feeble, and frequently, at
the end of that time, will not take the nipple at all. Besides, there
is a thick cream (similar to the biestings of a cow), which, if not
drawn out by the child, may cause inflammation and gathering of the
bosom, and, consequently, great suffering to the mother. Moreover,
placing him _early_ to the breast, moderates the severity of the
mother's after pains, and lessens the risk of her flooding. A new-born
babe must _not_ have gruel given to him, as it disorders the bowels,
causes a disinclination to suck, and thus makes him feeble.
30. _If an infant show any disinclination to suck, or if he appear
unable to apply his tongue to the nipple, what ought to be done_?
Immediately call the attention of the medical man to the fact, in
order that he may ascertain whether he be tongue-tied. If he be, the
simple operation of dividing the bridle of the tongue will remedy the
defect, and will cause him to take the nipple with ease and comfort.
31. _Provided there be not milk AT FIRST, what ought then to be done_?
Wait with patience; the child (if the mother have no milk) will not,
for at least twelve hours, require artificial food. In the generality
of instances, then, artificial food is not at all necessary; but if it
should be needed, one-third of new milk and two-thirds of warm water,
slightly sweetened with loaf sugar (or with brown sugar, if the babe's
bowels have not been opened), should be given, in small quantities at
a time, every four hours, until the milk be secreted, and then it must
be discontinued. The infant ought to be put to the nipple every four
hours, but not oftener, until he be able to find nourishment.
If after the application of the child for a few times, he is unable to
find nourishment, then it will be necessary to wait until the milk be
secreted. As soon as it is secreted, he must be applied with great
regularity, _alternately_ to each breast.
I say _alternately_ to each breast. _This is most important
advice_. Sometimes a child, for some inexplicable reason, prefers one
breast to the other, and the mother, to save a little contention,
concedes the point, and allows him to have his own way. And what is
frequently the consequence?--a gathered breast!
We frequently hear of a babe having no notion of sucking. This "no
notion" may generally be traced to bad management, to stuffing him
with food, and thus giving him a disinclination to take the nipple at
all.
32. _How often should a mother suckle her infant_?
A mother generally suckles her baby too often, having him almost
constantly at the breast. This practice is injurious both to parent
and to child. The stomach requires repose as much as any other part of
the body; and how can it have if it be constantly loaded with
breast-milk? For the first month, he ought to be suckled, about every
hour and a half; for the second month, every two hours,--gradually
increasing, as he becomes older, the distance of time between, until
at length he has it about every four hours.
If a baby were suckled at stated periods, he would only look for the
bosom at those times, and be satisfied. A mother is frequently in the
habit of giving the child the breast every time he cries, regardless
of the cause. The cause too frequently is that he has been too often
suckled--his stomach has been overloaded, the little fellow is
consequently in pain, and he gives utterance to it by cries. How
absurd is such a practice! We may as well endeavour to put out a fire
by feeding it with fuel. An infant ought to be accustomed to
regularity in everything, in times for sucking, for sleeping, &c. No
children thrive so well as those who are thus early taught.
33. _Where the mother is MODERATELY strong, do you advise that the
infant should have any other food than the breast_?
Artificial food must not, for the first five or six months, be given,
if the parent be _moderately_ strong, of course, if she be feeble, a
_little_ food will be necessary. Many delicate women enjoy better
health whilst ambling than at any other period of their lives.
It may be well, where artificial food, in addition to the mother's own
milk, is needed, and before giving any farinaceous food whatever (for
farinaceous food until a child is six or seven months old is
injurious), to give, through a feeding bottle, every night and
morning, in addition to the mother's breast of milk, the following
_Milk-Water-and Sugar-of Milk Food_--
Fresh milk, from ONE cow,
Warm water, of each a quarter of a pint,
Sugar of milk one tea spoonful
The sugar of milk should first be dissolved in the warm water, and
then the fresh milk _unboiled_ should be mixed with it. The sweetening
of the above food with sugar-of-milk, instead of with lump sugar,
makes the food more to resemble the mother's own milk. The infant will
not, probably, at first take more than half of the above quantity at a
time, even if he does so much as that but still the above are the
proper proportions, and as he grows older, he will require the whole
of it at a meal.
34. _What food, when a babe is six or seven months old, is the best
substitute for a mother's milk?_
The food that suits one infant will not agree with another. (1) The
one that I have found the most generally useful, is made as
follows--Boil the crumb of bread for two hours in water, taking
particular care that it does not burn, then add only a _little_
lump-sugar (or _brown_ sugar, if the bowels be costive), to make it
palatable. When he is six or seven months old, mix a little new
milk--the milk of ONE cow--with it gradually as he becomes older,
increasing the quantity until it be nearly all milk, there being only
enough water to boil the bread, the milk should be poured boiling hot
on the bread. Sometimes the two milks--the mother's and the cow's
milk--do not agree, when such is the case, let the milk be left out,
both in this and in the foods following, and let the food be made with
water, instead of with milk and water. In other respects, until the
child is weaned, let it be made as above directed, when he is weaned,
good fresh cow's milk MUST, as previously recommended, be used. (2) Or
cut thin slices of bread into a basin, cover the bread with _cold_
water, place it in an oven for two hours to bake, take it out, beat
the bread up with a fork, and then slightly sweeten it. This is an
excellent food. (3) If the above should not agree with the infant
(although, if properly made, they almost invariably do), "tous
les-mois" may be given. [Footnote: "Tous les mois" is the starch
obtained from the tuberous roots of various species of _canna_, and is
imported from the West Indies. It is very similar to arrow root. I
suppose it is called "tous les-mois," as it is good to be eaten all
the year round.](4) Or Robb's Biscuits, as it is "among the best bread
compounds made out of wheat-flour, and is almost always readily
digested."--_Routh_.
(5) Another good food is the following--Take about a pound of flour
put it in a cloth, tie it up tightly, place it a saucepanful of water,
and let it boil for four or five hours, then take it out, peel off the
outer rind, and the inside will be found quite dry, which grate. (6)
Another way of preparing an infant's food, is to bake flour--biscuit
flour--in a slow oven, until it be of a light fawn colour. Baked flour
ought after it is baked, to be reduced, by means of a rolling pin, to
a fine powder, and should then be kept in a covered tin, ready for
use. (7) An excellent food for a baby is baked crumbs of bread. The
manner of preparing it is as follows--Crumb some bread on a plate, put
it a little distance from the fire to dry. When dry, rub the crumbs in
a mortar, and reduce them to a fine powder, then pass them through a
sieve. Having done which, put the crumbs of bread into a slow oven,
and let them bake until they be of a light fawn colour. A small
quantity either of the boiled, or of the baked flour, or of the baked
crumb of bread, ought to be made into food, in the same way as gruel
is made, and should then be slightly sweetened, according to the state
of the bowels, either with lump or with brown sugar.
(8) Baked flour sometimes produces constipation, when such is the
case, Mr. Appleton, of Budleigh Salterton, Devon, wisely recommends a
mixture of baked flour, and prepared oatmeal, [Footnote: If there is
any difficulty in obtaining _prepared_ oatmeal, Robinson's Scotch
Oatmeal will answer equally as well.] in the proportion of two of the
former and one of the latter. He says--"To avoid the constipating
effects, I have always had mixed, before baking, one part of prepared
oatmeal with two parts of flour, this compound I have found both
nourishing, and regulating to the bowels. One table-spoonful of it,
mixed with a quarter of a pint of milk, or milk and water, when well
boiled, flavoured and sweetened with white sugar, produces a thick,
nourishing, and delicious food for infants or invalids." He goes on to
remark--"I know of no food, after repeated trials, that can be so
strongly recommended by the profession to all mothers in the rearing
of their infants, without or with the aid of the breasts, at the same
time relieving them of much draining and dragging whilst nursing with
an insufficiency of milk, as baked flour and oatmeal." [Footnote:
_British Medical Journal_, Dec 18, 1858]
(9) A ninth food may be made with "Farinaceous Food for Infants,
prepared by Hards of Dartford". If Hard's Farinaceous food produces
costiveness--as it sometimes does--let it be mixed either with equal
parts or with one third of Robinson's Scotch Oatmeal. The mixture of
the two together makes a splendid food for a baby. (10) A tenth, and
an excellent one, may be made with rusks, boiled for an hour in water,
which ought then to be well beaten up, by means of a fork, and
slightly sweetened with lump sugar. Great care should be taken to
select good rusks, as few articles vary so much in quality. (11) An
eleventh is--the top crust of a baker's loaf, boiled for an hour in
water, and then moderately sweetened with lump sugar. If, at any time,
the child's bowels should be costive, _raw_ must be substituted for
_lump_ sugar. (12) Another capital food for an infant is that made by
Lemann's Biscuit Powder. [Footnote: Lemann's Biscuit Powder cannot be
too strongly recommended--It is of the finest quality, and may be
obtained of Lemann, Threadneedle Street, London. An extended and an
extensive experience confirms me still more in the good opinion I have
of this food.] (13) Or, Brown and Polson's Patent Corn Flour will be
found suitable. Francatelli, the Queen's cook, in his recent valuable
work, gives the following formula for making it--"To one
dessert-spoonful of Brown and Polson, mixed with a wineglassful of
cold water, add half a pint of boiling water, stir over the fire for
five minutes, sweeten lightly, and feed the baby, but if the infant is
being brought up by the hand, this food should then be mixed with
milk--not otherwise." (14) A fourteenth is Neaves' Farinaceous Food for
Infants, which is a really good article of diet for a babe, it is not
so binding to the bowels as many of the farinaceous foods are, which
is a great recommendation.
(15) The following is a good and nourishing food for a baby:--Soak for
an hour, some _best_ rice in cold water; strain, and add fresh water
to the rice; then let it simmer till it will pulp through a sieve; put
the pulp and the water in a saucepan, with a lump or two of sugar, and
again let it simmer for a quarter of an hour; a portion of this should
be mixed with one-third of fresh milk, so as to make it of the
consistence of good cream. This is an excellent food for weak bowels.
When the baby is six or seven months old, new milk should be added to
any of the above articles of food, in a similar way to that
recommended for boiled bread.
(16.) For a delicate infant, lentil powder, better known as Du Barry's
"Ravalenta Arabica," is invaluable. It ought to be made into food,
with new milk, in the same way that arrow-root is made, and should be
moderately sweetened with loaf-sugar. Whatever food is selected ought
to be given by means of a nursing bottle.
If a child's bowels be relaxed and weak, or if the motions be
offensive, the milk _must_ be boiled, but not otherwise. The following
(17) is a good food when an infant's bowels are weak and
relaxed:--"Into five large spoonfuls of the purest water, rub smooth
one dessert-spoonful of fine flour. Set over the fire five spoonfuls
of new milk, and put two bits of sugar into it; the moment it boils,
pour it into the flour and water, and stir it over a slow fire twenty
minutes."
Where there is much emaciation, I have found (18) genuine arrow-root
[Footnote: Genuine arrow-root, of first-rate quality, and at a
reasonable price, may be obtained of H. M. Plumbe, arrow-root
merchant, 8 Alie Place. Great Alie Street. Aldgate, London, E.] a very
valuable article of food for an infant, as it contains a great deal of
starch, which starch helps to form fat and to evolve caloric
(heat)--both of which a poor emaciated chilly child stands so much in
need of. It must be made with equal parts of water and of good fresh
milk, and ought to be slightly sweetened with loaf sugar; a small
pinch of table salt should be added to it.
Arrow-root will not, as milk will, give bone and muscle; but it will
give--what is very needful to a delicate child--fat and
warmth. Arrow-root, as it is principally composed of starch, comes
under the same category as cream, butter, sugar, oil, and
fat. Arrowroot, then, should always be given with new milk (mixed with
one-half of water); it will then fulfil, to perfection, the exigencies
of nourishing, of warming, and fattening the child's body.
New milk, composed in due proportions as it is, of cream and of skim
milk--the very acme of perfection--is the only food, _which of itself
alone,_ will nourish and warm and fatten. It is, for a child, _par
excellence,_ the food of foods!
Arrow-root, and all other farinaceous foods are, for a child, only
supplemental to milk--new milk being, for the young, the staple food
of all other kinds of foods whatever.
But bear in mind, _and let there be no mistake about it,_ that
farinaceous food, be it what it may, until the child be six or seven
months old, until, indeed, he _begin_ to cut his teeth, is not
suitable for a child; until then, _The Milk-water-salt-and-sugar Food_
(see page 29) is usually, if he be a dry-nursed child, the best
artificial food for him.
I have given you a large and well-tried infant's dietary to chose
from, as it is sometimes difficult to fix on one that will suit; but,
remember, if you find one of the above to agree, keep to it, as a babe
requires a simplicity in food--a child a greater variety.
Let me, in this place, insist upon the necessity of great care and
attention being observed in the preparation of any of the above
articles of diet. A babe's stomach is very delicate, and will revolt
at either ill-made, or lumpy, or burnt food. Great care ought to be
observed as to the cleanliness of the cooking utensils. The above
directions require the strict supervision of the mother.
Broths have been recommended, but, for my own part, I think that, for
a _young_ infant, they are objectionable; they are apt to turn acid on
the stomach, and to cause flatulence and sickness, they, sometimes,
disorder the bowels and induce griping and purging.
Whatever artificial food is used ought to be given by means of a
bottle, not only as it is a more natural way than any other of feeding
a baby, as it causes him to suck as though he were drawing it from the
mother's breasts, but as the act of sucking causes the salivary glands
to press out their contents, which materially assist digestion.
Moreover, it seems to satisfy and comfort him more than it otherwise
would do.
One of the best, if not _the best_ feeding bottle I have yet seen, is
that made by Morgan Brothers, 21 Bow Lane, London. It is called "The
Anglo-French Feeding Bottle" S Maw, of 11 Aldersgate Street, London,
has also brought out an excellent one--"The Fountain Infant's Feeding
Bottle" Another good one is "Mather's Infant's Feeding Bottle" Either
of these three will answer the purpose admirably. I cannot speak in
terms too highly of these valuable inventions.
The food ought to be of the consistence of good cream, and should be
made fresh and fresh. It ought to be given milk warm. Attention must
be paid to the cleanliness of the vessel, and care should be taken
that the milk be that of ONE cow, [Footnote: I consider it to be of
immense importance to the infant, that the milk be had from ONE cow. A
writer in the _Medical Times and Gazette_ speaking on this subject,
makes the following sensible remarks--"I do not know if a practice
common among French ladies when they do not nurse, has obtained the
attention among ourselves which it seems to me to deserve. When the
infant is to be fed with cow milk that from various cows is submitted
to examination by the medical man and if possible, tried on some
child, and when the milk of any cow has been chosen, no other milk is
ever suffered to enter the child's lips for a French lady would as
soon offer to her infant's mouth the breasts of half a dozen
wet-nurses in the day, as mix together the milk of various cows, which
must differ, even as the animals themselves, in its constituent
qualities. Great attention is also paid to the pasture, or other food
of the cow thus appropriated."] and that it be new and of good
quality, for if not it will turn acid and sour, and disorder the
stomach, and will thus cause either flatulence or looseness of the
bowels, or perhaps convulsions. The only way to be sure of having it
from _one_ cow, is (if you have not a cow of your own), to have the
milk from a _respectable_ cow keeper, and to have it brought to your
house in a can of your own (the London milk cans being the best for
the purpose). The better plan is to have two cans, and to have the
milk fresh and fresh every night and morning. The cans, after each
time of using, ought to be scalded out, and, once a week the can
should be filled with _cold_ water, and the water should be allowed to
remain in it until the can be again required.
Very little sugar should be used in the food, as much sugar weakens
the digestion. A small pinch of table-salt ought to be added to
whatever food is given, as "the best savour is salt." Salt is most
wholesome--it strengthens and assists digestion, prevents the
formation of worms, and, in small quantities, may with advantage be
given (if artificial food be used) to the youngest baby.
35. _Where it is found to be absolutely necessary to give an infant
artificial food_ WHILST SUCKLING, _how often ought he to be fed_?
Not oftener than twice during the twenty four hours, and then only in
_small_ quantities at a time, as the stomach requires rest, and at the
same time, can manage to digest a little food better than it can a
great deal. Let me again urge upon you the importance, if it be at
all practicable, of keeping the child _entirely_ to the breast for the
first five or six months of his existence. Remember there is no
_real_ substitute for a mother's milk, there is no food so well
adapted to his stomach, there is no diet equal to it in developing
muscle, in making bone, or in producing that beautiful plump rounded
contour of the limbs, there is nothing like a mother's milk _alone_ in
making a child contented and happy, in laying the foundation of a
healthy constitution, in preparing the body for a long life, in giving
him tone to resist disease, or in causing him to cut his teeth easily
and well, in short, _the mothers milk is the greatest temporal
blessing an infant can possess_.
As a general rule, therefore, when the child and the mother are
tolerably strong, he is better _without artificial_ food until he have
attained the age of three or four months, then, it will usually be
necessary to feed him with _The Milk-water-and-sugar-of milk Food_
(see p 19) twice a day, so as gradually to prepare him to be weaned
(if possible) at the end of nine months. The food mentioned in the
foregoing Conversation will, when he is six or seven months old, be
the best for him.
36. _When the mother is not able to suckle her infant herself, what
ought to be done_?
It must first be ascertained, _beyond all doubt_, that a mother is not
able to suckle her own child Many delicate ladies do suckle their
infants with advantage, not only to their offspring, but to
themselves. "I will maintain," says Steele, "that the mother grows
stronger by it, and will have her health better than she would have
otherwise She will find it the greatest cure, and preservative for the
vapours [nervousness] and future miscarriages, much beyond any other
remedy whatsoever Her children will be like giants, whereas otherwise
they are but living shadows, and like unripe fruit, and certainly if a
woman is strong enough to bring forth a child, she is beyond all doubt
strong enough to nurse it afterwards."
Many mothers are never so well as when they are nursing, besides,
suckling prevents a lady from becoming pregnant so frequently as she
otherwise would. This, if she be delicate, is an important
consideration, and more especially if she be subject to miscarry. The
effects of miscarriage are far more weakening than those of suckling.
A hireling, let her be ever so well inclined, can never have the
affection and unceasing assiduity of a mother, and, therefore, cannot
perform the duties of suckling with equal advantage to the baby.
The number of children who die under five years of age is
enormous--many of them from the want of the mother's milk. There is a
regular "parental baby-slaughter"--"a massacre of the innocents"--
constantly going on in England, in consequence of infants being thus
deprived of their proper nutriment and just dues! The mortality from
this cause is frightful, chiefly occurring among rich people who are
either too grand, or, from luxury, too delicate to perform such
duties; poor married women, as a rule, nurse their own children, and,
in consequence reap their reward.
If it be ascertained, _past all doubt_, that a mother cannot suckle
her child, then, if the circumstances of the parents will allow--and
they ought to strain a point to accomplish it--a healthy wet-nurse
should be procured, as, of course, the food which nature has supplied
is far, very far superior to any invented by art. Never bring up a
baby, then, if you can possibly avoid it, on _artificial_
food. Remember, as I proved in a former Conversation, there is in
early infancy no _real_ substitute for either a mother's or a
wet-nurse's milk. It is impossible to imitate the admirable and subtle
chemistry of nature. The law of nature is, that a baby, for the first
few months of his existence, shall be brought up by the breast, and
nature's law cannot be broken with impunity. [Footnote: For further
reasons why artificial food is not desirable, at an early period of
infancy, see answer to 35th question, page 26.] It will be
imperatively necessary then--
"To give to nature what is nature's due."
Again, in case of a severe illness occurring during the first nine
months of a child's life, what a comfort either the mother's or the
wet-nurse's milk is to him! It often determines whether he shall live
or die. But if a wet-nurse cannot fill the place of a mother, then
asses' milk will be found the best substitute, as it approaches
nearer, in composition, than any other animal's, to human milk; but it
is both difficult and expensive to obtain. The next best substitute is
goats' milk. Either the one or the other ought to be milked fresh and
fresh, when wanted, and should be given by means of a feeding-bottle.
Asses' milk is more suitable for a _delicate_ infant, and goats' milk
for a _strong_ one.
If neither asses' milk nor goats' milk can be procured, then the
following _Milk-water-salt-and-sugar Food_, from the very
commencement, should be given; and as I was the author of the formula,
[Footnote: It first appeared in print in the 4th edition of _Advice to
a Mother_, 1852.] I beg to designate it as--_Rye Chavasse's Milk
Food_:--
New milk, the produce of ONE _healthy_ cow;
Warm water, of each, equal parts;
Table salt, a few grains--a small pinch;
Lump sugar, a sufficient quantity, to slightly sweeten it.
The milk itself ought not to be heated over the fire, [Footnote: It
now and then happens that if the milk be not boiled, the motions of an
infant are offensive; _when such is the case_, let the milk be boiled,
but not otherwise.] but should, as above directed, be warmed by the
water; it must, morning and evening, be had fresh and fresh. The milk
and water should be of the same temperature as the mother's milk, that
is to say, at about ninety degrees Fahrenheit. It ought to be given by
means of either Morgan's, or Maw's, or Mather's feeding-bottle,
[Footnote: See answer to Question 24, page 24.] and care must be
taken to _scald_ the bottle out twice a day, for if attention be not
paid to this point, the delicate stomach of an infant is soon
disordered. The milk should, as he grows older, be gradually increased
and the water decreased, until two-thirds of milk and one-third of
water be used; but remember, that either _much_ or _little_ water must
_always_ be given with the milk.
The above is my old form, and which I have for many years used with
great success. Where the above food does not agree (and no food except
a healthy mother's own milk does _invariably_ agree) I occasionally
substitute sugar-of milt for the lump sugar, in the proportion of a
tea spoonful of sugar-of milk to every half pint of food.
If your child bring up his food, and if the ejected matter be
sour-smelling, I should advise you to leave out the sugar-of milk
altogether, and simply to let the child live, for a few days, on milk
and water alone, the milk being of _one_ cow, and in the proportion of
two-thirds to one-third of _warm_ water--not _hot_ water, the milk
should not be scalded with _hot_ water, as it injures its properties,
besides, it is only necessary to give the child his food with the
chill just off. The above food, where the stomach is disordered, is an
admirable one, and will often set the child to rights without giving
him any medicine whatever. Moreover, there is plenty of nourishment in
it to make the babe thrive, for after all it is the milk that is the
important ingredient in all the foods of infants, they can live on it,
and on it alone, and thrive amazingly.
Mothers sometimes say to me, that farinaceous food makes their babes
flatulent, and that my food (_Pye Chavasse's Milk Food_) has not that
effect.
The reason of farinaceous food making babes, until they have
_commenced_ cutting their teeth, "windy" is, that the starch of the
farinaceous food (and all farinaceous foods contain more or less of
starch) is not digested, and is not, as it ought to be, converted by
the saliva into sugar [Footnote: See Pye Chavasse's _Counsel to a
Mother_, 3d edition.] hence "wind" is generated, and pain and
convulsions often follow in the train.
The great desideratum, in devising an infant's formula for food, is to
make it, until he be nine months old, to resemble as much as possible,
a mother's own milk, and which my formula, as nearly as is
practicable, does resemble hence its success and popularity.
As soon as a child begins to cut his teeth the case is altered, and
_farinaceous food, with milk and with water_, becomes an absolute
necessity.
I wish, then, to call your especial attention to the following-facts,
for they are facts--Farinaceous foods, _of all kinds_, before a child
_commences_ cutting his teeth (which is when he is about six or seven
months old) are worse than useless--they are, positively, injurious,
they are, during the early period of infant life, perfectly
indigestible, and may bring on--which they frequently do--
convulsions. A babe fed on farinaceous food alone would certainly die
of starvation, for, "up to six or seven months of age, infants have
not the power of digesting farinaceous or fibrinous substances"--Dr
Letheby on _Food_.
A babe's salivary glands, until he be six or seven months old, does
not secrete its proper fluid--namely, ptyalin, and consequently the
starch of the farinaceous food--and all farinaceous food contains
starch--is not converted into dextrine and grape-sugar, and is,
therefore, perfectly indigestible and useless--nay, injurious to an
infant, and may bring on pain and convulsions, and even death, hence,
the giving of farinaceous food, until a child be six or seven months
old, is one and the principal cause of the frightful infant mortality
at the present time existing in England, and which is a disgrace to
any civilized land!
In passing, allow me to urge you never to stuff a babe--never to
overload his little stomach with food, it is far more desirable to
give him a little not enough, than to give him a little too much. Many
a poor child has been, like a young bird, killed with stuffing. If a
child be at the breast, and at the breast alone, there is no fear of
his taking too much, but if he be brought up on artificial food, there
is great fear of his over loading his stomach. Stuffing a child brings
on vomiting and bowel-complaints, and a host of other diseases which
now it would be tedious to enumerate. Let me, then, urge you on no
account, to over load the stomach of a little child.
There will, then, in many cases, be quite sufficient nourishment in
the above. I have known some robust infants brought up on it, and on
it along, without a particle of farinaceous food, or of any other
food, in any shape or form whatever. But if it should not agree with
the child, or if there should not be sufficient nourishment in it,
then the food recommended in answer to No. 34 question ought to be
given, with this only difference--a little new milk must from the
beginning be added, and should be gradually increased, until nearly
all milk be used.
The milk, as a general rule, ought to be _unboiled_; but if it purge
violently, or if it cause offensive motions--which it sometimes
does--then it must be boiled. The moment the milk boils up, it should
be taken off the fire.
Food ought for the first month to be given about every two hours; for
the second month, about every three hours; lengthening the space of
time as the baby advances in age. A mother must be careful not to
over-feed a child, as over-feeding is a prolific source of disease.
Let it be thoroughly understood, and let there be no mistake about it,
that a babe during the first nine months of his life, MUST have--it is
absolutely necessary for his very existence--milk of some kind, as the
staple and principal article of his diet, either mother's,
wet-nurse's, or asses', or goats', or cow's milk.
37. _How would you choose a wet-nurse_?
I would inquire particularly into the state of her health; whether she
be of a healthy family, of a consumptive habit, or if she or any of
her family have laboured under "king's evil;" ascertaining if there be
any seams or swellings about her neck; any eruptions or blotches upon
her skin; if she has a plentiful breast of milk, and if it be of good
quality [Footnote: "It should be thin, and of a bluish-white colour,
sweet to the taste, and when allowed to stand, should throw up a
considerable quantity of cream,"--_Maxell and Evenson on the Diseases
of Children_.] (which may readily be ascertained by milking a little
into a glass); if she has good nipples, sufficiently long for the baby
to hold; that they be not sore; and if her own child be of the same,
or nearly of the same age, as the one you wish her to nurse.
Ascertain, whether she menstruate during suckling; if she does, the
milk is not so good and nourishing, and you had better decline taking
her. [Footnote: Sir Charles Locock considers that a woman who
menstruates during lactation is objectionable as a wet-nurse, and
"that as a mother with her first child is more liable to that
objection, that a second or third child's mother is more eligible than
a first"--_Letter to the Author_.] Assure yourself that her own babe
is strong and healthy that he be free from a sore mouth, and from a
"breaking-out" of the skin. Indeed, if it be possible to procure such
a wet-nurse, she ought to be from the country, of ruddy complexion, of
clear skin, and of between twenty and five-and-twenty years of age, an
the milk will then be fresh, pure, and nourishing.
I consider it to be of great importance that the infant of the
wet-nurse should be, as nearly as possible, of the same age as your
own, as the milk varies in quality according to the age of the
child. For instance, during the commencement of suckling, the milk is
thick and creamy, similar to the biestings of a cow, which, if given
to a babe of a few months old, would cause derangement of the stomach
and bowels. After the first few days, the appearance of the milk
changes; it becomes of a bluish-white colour, and contains less
nourishment. The milk gradually becomes more and more nourishing as
the infant becomes older and requires more support.
In selecting a wet-nurse for a very small and feeble babe, you must
carefully ascertain that the nipples of the wet-nurse are good and
soft, and yet not very large. If they be very large, the child's mouth
being very small, he may not be able to hold them. You must note, too,
whether the milk flows readily from the nipple into the child's mouth;
if it does not, he may not have strength to draw it, and he would soon
die of starvation. The only way of ascertaining whether the infant
really draws the milk from the nipple, can be done by examining the
mouth of the child _immediately_ after his taking the breast, and
seeing for yourself whether there be actually milk, or not, in his
mouth.
Very feeble new-born babes sometimes cannot take the bosom, be the
nipples and the breasts ever so good, and although Maw's nipple-shield
and glass tube had been tried. In such a case, cow's
milk-water-sugar-and-salt, as recommended at page 29, must be given in
small quantities at a time--from two to four tea-spoonfuls--but
frequently; if the child be awake, every hour, or every half hour,
both night and day, until he be able to take the breast. If, then, a
puny, feeble babe is only able to take but little at a time, and that
little by tea-spoonfuls, he must have little and often, in order that
"many a little might make a mickle."
I have known many puny, delicate children who had not strength to hold
the nipple in their mouths, but who could take milk and water (as
above recommended) by tea-spoonfuls only at a time, with steady
perseverance, and giving it every half hour or hour (according to the
quantity swallowed), at length be able to take the breast, and
eventually become strong and hearty children; but such cases require
unwearied watching, perseverance, and care. Bear in mind, then, that
the smaller the quantity of the milk and water given at a time, the
oftener must it be administered, as, of course, the babe must have a
certain quantity of food to sustain life.
38. _What ought to be the diet either of a wet-nurse, or of a mother,
who is suckling_?
It is a common practice to cram a wet-nurse with food, and to give her
strong ale to drink, to make good nourishment and plentiful milk! This
practice is absurd; for it either, by making the nurse feverish, makes
the milk more sparing than usual, or it causes the milk to be gross
and unwholesome. On the other hand, we must not run into an opposite
extreme. The mother, or the wet-nurse, by using those means most
conducive to her own health, will best advance the interest of her
little charge.
A wet-nurse, ought to live somewhat in the following way:--Let her for
breakfast have black tea, with one or two slices of cold meat, if her
appetite demand it, but not otherwise. It is customary for a wet-nurse
to make a hearty luncheon; of this I do not approve. If she feel
either faint or low at eleven o'clock, let her have either a tumbler
of porter, or of mild fresh ale, with a piece of dry toast soaked in
it. She ought not to dine later than half-past one or two o'clock; she
should eat, for dinner, either mutton or beef, with either mealy
potatoes, or asparagus, or French beans, or secale, or turnips, or
broccoli, or cauliflower, and stale bread. Rich pastry, soups,
gravies, high-seasoned dishes, salted meats, greens, and cabbage, must
one and all be carefully avoided; as they only tend to disorder the
stomach, and thus to deteriorate the milk.
It is a common remark, that "a mother who is suckling may eat
anything." I do not agree with this opinion. Can impure or improper
food make pure and proper milk, or can impure and improper milk make
good blood for an infant, and thus good health?
The wet-nurse ought to take with her dinner a moderate quantity of
either sound porter, or of mild (but not old or strong) ale. Tea
should be taken at half past five or six o'clock; supper at nine,
which should consist either of a slice or two of cold meat, or of
cheese if she prefer it, with half a pint of porter or of mild ale;
occasionally a basin of gruel may with advantage be substituted. Hot
and late suppers are prejudicial to the mother, or to the wet-nurse,
and, consequently, to the child. The wet-nurse ought to be in bed
every night by ten o'clock.
It might be said, that I have been too minute and particular in my
rules for a wet-nurse; but when it is considered of what importance
good milk is to the well-doing of an infant, in making him strong and
robust, not only now, but as he grows up to manhood, I shall, I trust,
be excused for my prolixity.
39. _Have you any more hints to offer with regard to the management of
a wet-nurse_?
A wet-nurse is frequently allowed to remain in bed until a late hour
in the morning, and during the day to continue in the house, as if she
were a fixture! How is it possible that any one, under such
treatment, can continue healthy! A wet nurse ought to rise early, and,
if the weather and season will permit, take a walk, which will give
her an appetite for breakfast, and will make a good meal for her
little charge. This, of course, cannot, during the winter mouths, be
done; but even then, she ought, some part of the day, to take every
opportunity of walking out; indeed, in the summer time she should live
half the day in the open air.
She ought strictly to avoid crowded rooms; her mind should be kept
calm and unruffled, as nothing disorders the milk so much as passion,
and other violent emotions of the mind; a fretful temper is very
injurious, on which account you should, in choosing your wet-nurse,
endeavour to procure one of a mild, calm, and placid disposition.
[Footnote: "'The child is poisoned.'
'Poisoned! by whom?'
'By you. You have been fretting.'
'Nay, indeed, mother. How can I help fretting!'
'Don't tell me, Margaret. A nursing mother has no business to
fret. She must turn her mind away from her grief to the comfort that
lies in her lap. Know you not that the child pines if the mother vexes
herself?'"--_The Cloister and the Hearth_. By Charles Reade.]
A wet-nurse ought never to be allowed to dose her little charge either
with Godfrey's Cordial, or with Dalby's Carminative, or with Syrup of
White Poppies, or with medicine of any kind whatever. Let her
thoroughly understand this, and let there be no mistake in the
matter. Do not for one moment allow your children's health to be
tampered and trifled with. A baby's health is too precious to be
doctored, to be experimented upon, and to be ruined by an ignorant
person.
40. _Have the goodness to state at what age a child ought to be
weaned_?
This, of course, must depend both upon the strength of the child, and
upon the health of the parent; on an average, nine months is the
proper time. If the mother be delicate, it may be found necessary to
wean the infant at six months; or if he be weak, or labouring under
any disease, it may be well to continue suckling him for twelve
months; but after that time, the breast will do him more harm than
good, and will, moreover, injure the mother's health, and may, if she
be so predisposed, excite consumption.
41. _How would you recommend a mother to act when, she weans her
child_?
She ought, as the word signifies, do it gradually--that is to say, she
should, by degrees, give him less and less of the breast, and more and
more of artificial food; at length, she must only suckle him at night;
and lastly, it would be well for the mother either to send him away,
or to leave him at home, and, for a few days, to go away herself.
A good plan is, for the nurse-maid to have a half-pint bottle of new
milk--which has been previously boiled [Footnote: The previous boiling
of the milk will prevent the warmth of the bed turning the milk sour,
which it otherwise would do.]--in the bed, so as to give a little to
him in lieu of the breast. The warmth of the body will keep the milk
of a proper temperature, and will supersede the use of lamps, of
candle-frames, and of other troublesome contrivances.
42. _While a mother is weaning her infant, and after she have weaned
him, what ought to be his diet_?
Any one of the foods recommended in answer to question 34.
43. _If a child be suffering severely from "wind," is there any
objection to the addition of a small quantity either of gin or of
peppermint to his food to disperse it_?
It is a murderous practice to add either gin or peppermint of the
shops (which is oil of peppermint dissolved in spirits) to his
food. Many children have, by such a practice, been made puny and
delicate, and have gradually dropped into an untimely grave. An infant
who is kept, for the first five or six months, _entirely_ to the
breast--more especially if the mother be careful in her own
diet--seldom suffers from "wind;" those, on the contrary, who have
much or improper food, [Footnote: For the first five or six months
never, if you can possibly avoid it, give artificial food to an infant
who is sucking. There is nothing, in the generality of cases, that
agrees, for the first few months, like the mother's milk _alone_.]
suffer severely.
Care in feeding, then, is the grand preventative of "wind;" but if,
notwithstanding all your precautions, the child be troubled with
flatulence, the remedies recommended under the head of Flatulence will
generally answer the purpose.
44. _Have you any remarks to make on sugar for sweetening a baby's
food_?
A _small_ quantity of sugar in an infant's food is requisite, sugar
being nourishing and fattening, and making cow's milk to resemble
somewhat, in its properties human milk; but, bear in mind, _it must be
used sparingly._ _Much_ sugar cloys the stomach, weakens the
digestion, produces acidity, sour belchings, and wind:--
"Things sweet to taste, prove in digestion sour."
_Shakspeare._
If a babe's bowels be either regular or relaxed, _lump_ sugar is the
best for the purpose of sweetening his food; if his bowels are
inclined to be costive, _raw_ sugar ought to be substituted for lump
sugar, as _raw_ sugar acts on a young babe as an aperient, and, in the
generality of cases, is far preferable to physicking him with opening
medicine. An infant's bowels, whenever it be practicable (and it
generally is), ought to be regulated by a judicious dietary rather
than by physic.
VACCINATION AND RE-VACCINATION.
45. _Are you an advocate for vaccination_?
Certainly. I consider it to be one of the greatest blessings ever
conferred upon mankind. Small-pox, before vaccination was adopted,
ravaged the country like a plague, and carried off thousands annually;
and those who did escape with their lives were frequently made
loathsome and disgusting objects by it. Even inoculation (which is
cutting for the small-pox) was attended with danger, more especially
to the unprotected--as it caused the disease to spread like wildfire,
and thus it carried off immense numbers.
Vaccination is one, and an important cause of our increasing
population; small-pox, in olden times, decimated the country.
46. _But vaccination does not always protect a child from, small-pox_?
I grant you that it does not _always_ protect him, _neither does
inoculation_; but when he is vaccinated, if he take the infection, he
is seldom pitted, and very rarely dies, and the disease assumes a
comparatively mild form. There are a few, very few fatal cases
recorded after vaccination, and these may be considered as only
exceptions to the general rule; and, possibly, some of these may be
traced to the arm, when the child was vaccinated, not having taken
proper effect.
If children, and adults were _re-vaccinated_,--say every seven years
after the first vaccination,--depend upon it, even these rare cases
would not occur, and in a short time small-pox would be known only by
name.
47. _Do you consider it, then, the imperative duty of a mother, in
every case, to have, after the lapse of every seven years, her
children re-vaccinated_?
I decidedly do: it would be an excellent plan for _every_ person, once
every seven years to be re-vaccinated, and even oftener, if small-pox
be rife in the neighbourhood. Vaccination, however frequently
performed, can never do the slightest harm, and might do inestimable
good. Small-pox is both a pest and a disgrace, and ought to be
constantly fought and battled with, until it be banished (which it may
readily be) the kingdom.
I say that small-pox is a pest; it is worse than the plague, for if
not kept in subjection, it is more general--sparing neither young nor
old, rich nor poor, and commits greater ravages than the plague ever
did. Small-pox is a disgrace: it is a disgrace to any civilised land,
as there is no necessity for its presence, if cow-pox were properly
and frequently performed, small-pox would be unknown. Cow-pox is a
weapon to conquer small-pox and to drive it ignominiously from the
field.
My firm belief, then, is, that if _every_ person were, _every seven
years_, duly and properly vaccinated, small-pox might be utterly
exterminated; but as long as there are such lax notions on the
subject, and such gross negligence, the disease will always be
rampant, for the poison of small-pox never slumbers nor sleeps, but
requires the utmost diligence to eradicate it. The great Dr Jenner,
the discoverer of cow-pox as a preventative of small-pox, strongly
advocated the absolute necessity of _every_ person being re-vaccinated
once every seven years, or even, oftener, if there was an epidemic of
small-pox in the neighbourhood.
48. _Are you not likely to catch not only the cow-pox, but any other
disease that the child has from whom the matter is taken_?
The same objection holds good in cutting for small pox
(inoculation)--only in a ten-fold degree--small-pox being such a
disgusting complaint. Inoculated small-pox frequently produced and
left behind inveterate "breakings-out," scars, cicatrices, and
indentations of the skin, sore eyes, blindness, loss of eyelashes,
scrofula, deafness--indeed, a long catalogue of loathsome diseases. A
medical man, of course, will be careful to take the cow-pox matter
from a healthy child.
49. _Would it not be well to take the matter direct from the cow_?
If a doctor be careful--which, of course, he will be--to take the
matter from a healthy child, and from a well-formed vesicle, I
consider it better than taking it _direct_ from the cow, for the
following reasons:--The cow-pox lymph, taken direct from the cow,
produces much more violent symptoms than after it has passed through
several persons; indeed, in some cases, it has produced effects as
severe as cutting for the small-pox, besides, it has caused, in many
cases, violent inflammation and even sloughing of the arm. There are
also several kinds of _spurious_ cow-pox to which the cow is subject,
and which would be likely to be mistaken for the _real_ lymph. Again,
if even the _genuine_ matter were not taken from the cow _exactly_ at
the proper time, it would he deprived of its protecting power.
50. _At what age do you recommend an infant to be first vaccinated_?
When he is two months old, as the sooner he is protected the
better. Moreover, the older he is the greater will be the difficulty
in making him submit to the operation, and in preventing his arm from
being rubbed, thus endangering the breaking of the vesicles, and
thereby interfering with its effects. If small-pox be prevalent in the
neighbourhood, he may, with perfect safety, be vaccinated at the
month's end; indeed if the small-pox be near at hand, he _must_ be
vaccinated, regardless of his age, and regardless of everything else,
for small-pox spares neither the young nor the old, and if a new-born
babe should unfortunately catch the disease, he will most likely die,
as at his tender age he would not have strength to battle with such a
formidable enemy. "A case, in the General Lying-in-Hospital, Lambeth,
of small-pox occurred in a woman a few days after her admission, and
the birth of her child. Her own child was vaccinated when only four
days old, and all the other infants in the house varying from one day
to a fortnight and more. All took the vaccination; and the woman's own
child, which suckled her and slept with her; and all escaped the small
pox." [Footnote: Communicated by Sir Charles Locock to the Author.]
51. _Do you consider that taking of matter from a child's arm weakens
the effect of vaccination on the system_?
Certainly not, provided it has taken effect in more than one
place. The arm is frequently much inflamed, and vaccinating other
children from it abates the inflammation, and thus affords relief. _It
is always well to leave one vesicle undisturbed_.
52. _If the infant have any "breaking out" upon the skin, ought that
to be a reason for deferring the vaccination_?
It should, as two skin diseases cannot well go on together; hence the
cow-pox might not take, or, if it did, might not have its proper
effect in preventing small-pox. "It is essential that the vaccine bud
or germ have a congenial soil, uncontaminated by another poison,
which, like a weed, might choke its healthy growth."--_Dendy_. The
moment the skin be free from the breaking-out, he must be
vaccinated. A trifling skin affection, like red gum, unless it be
severe, ought not, at the proper age to prevent vaccination. If
small-pox be rife in the neighbourhood, the child _must_ be
vaccinated, regardless of any "breaking-out" on the skin.
53. _Does vaccination make a child poorly_?
At about the fifth day after vaccination, and for three or four days,
he is generally a little feverish; the mouth is slightly hot, and he
delights to have the nipple in his mouth. He does not rest so well at
night; he is rather cross and irritable; and, sometimes, has a slight
bowel-complaint. The arm, about the ninth or tenth day, is usually
much inflamed--that is to say it is, for an inch or two or more around
the vesicles, red, hot, swollen, and continues in this state for a day
or two, at the end of which time the inflammation gradually
subsides. It might be well to state that the above slight symptoms are
desirable, as it proves that the vaccination has had a proper effect
on his system, and that, consequently, he is more likely to be
thoroughly protected from any risk of catching small-pox.
54. _Do you approve, either during or after vaccination, of giving
medicine, more especially if he be a little feverish_?
No, as it would be likely to work off some of its effects, and thus
would rob the cow-pox of its efficacy on the system. I do not like to
interfere with vaccination _in any way whatever_ (except, at the
proper time, to take a little matter from the arm), but to allow the
pock to have full power upon his constitution.
What do you give the medicine for? If the matter that is put into the
arm be healthy, what need is there of physic! And if the matter be not
of good quality, I am quite sure that no physic will make it so! Look,
therefore, at the case in whatever way you like, physic after
vaccination is _not_ necessary; but, on the contrary, hurtful. If the
vaccination produce slight feverish attack, it will, without the
administration of a particle of medicine, subside in two or three
days.
55. _Have you any directions to give respecting the arm AFTER
vaccination_?
The only precaution necessary is to take care that the arm be not
rubbed; otherwise the vesicles may be prematurely broken, and the
efficacy of the vaccination may be lessened. The sleeve, in
vaccination, ought to be large and soft, and should not be tied
up. The tying up of a sleeve makes it hard, and is much more likely to
rub the vesicles than if it were put on the usual way.
56. _If the arm, AFTER vaccination, be much inflamed, what ought to be
done_?
Smear frequently, by means of a feather or a camel's hair brush, a
little cream on the inflamed part. This simple remedy will afford
great comfort and relief.
57. _Have the goodness to describe the proper appearance, after the
falling-off of the scab of the arm_?
It might be well to remark, that the scabs ought always to be allowed
to fall off of themselves. They must not, on any account, be picked or
meddled with. With regard to the proper appearance of the arm, after
the falling-off of the scab, "a perfect vaccine scar should be of
small size, circular, and marked with radiations and indentations."--
_Gregory_.
DENTITION
58. _At what time does dentition commence_?
The period at which it commences is uncertain. It may, as a rule, be
said that a babe begins to cut his teeth at seven months old. Some
have cut teeth at three months; indeed, there are instances on record
of infants having been born with teeth. King Richard the Third is said
to have been an example. Shakspeare notices it thus:--
"YORK.--Marry, they say my uncle grew so fast,
That he could gnaw a crust at two hours old.
'Twas full two years ere I could get a tooth,
Grandam, this would have been a biting jest."
When a babe is born with teeth, they generally drop out. On the other
hand, teething, in some children does not commence until they are a
year and a half or two years old, and, in rare cases, not until they
are three years old. There are cases recorded of adults who have never
cut any teeth. An instance of the kind came under my own observation.
Dentition has been known to occur in old age. A case is recorded by
M. Carre, in the _Gazette Medicale de Paris_ (Sept 15, 1860), of an
old lady, aged eighty-five, who cut several teeth after attaining that
age!
59. _What is the number of the FIRST set of teeth, and in what order
do they generally appear_?