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 northeast, 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 breast 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 that at so early a period there is no milk in the
breast; 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 breast—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 no milk_ AT FIRST, _what ought then to be done_?
Wait with patience: the child (if the mother has 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 it 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 constantly
in pain, and he gives utterance to it by cries. How absurd is such a
practice! We may as well endeavor to put out a fire by feeding it with
fuel. An infant ought to be accustomed to regularity in every thing—in
times for suckling, for sleeping, etc. 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 three or four 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
while suckling than at any other period of their lives.
34. _What food 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 five or six
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. (4.) Or, Robb’s Biscuit,
as it is “among the best bread compounds made out of wheat-flour, and is
almost always readily digested.”—_Routh._ “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.
(5.) Another good food is the following: Take about a pound of flour,
put it in a cloth, tie it up tightly, place it in 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 color. (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 color. 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, 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 tablespoonful of it, mixed
with a quarter of a pint of milk, or milk and water, when well boiled,
flavored, 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 breast, at the same time
relieving them of much draining and dragging while nursing with an
insufficiency of milk, as baked flour and oatmeal.” If there is any
difficulty in obtaining _prepared_ oatmeal, Robertson’s Patent Groats
will answer equally as well.
(9.) A ninth food may be made with “Farinaceous Food for Infants,
prepared by Hards of Dartford.” If Hards’ Farinaceous Food produces
costiveness—as it sometimes does—let it be mixed either with equal parts
or with one-third of Robertson’s Patent Groats. 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. (13.) Or, Brown and Polson’s Patent Corn Flour will be
found suitable. The Queen’s cook, in his recent valuable work, gives the
following formula for making it: “To one dessertspoonful of Brown &
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.) 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.
When the baby is five or six 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.
(15.) For a delicate infant, lentil powder, better known as Du Barry’s
“Revalenta 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. The following (16.) is a good food when an
infant’s bowels are weak and relaxed: “Into five large spoonfuls of the
purest water rub smooth one dessertspoonful 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 (17.) genuine arrow-root 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 good fresh milk, and ought to be slightly
sweetened with loaf sugar; a small pinch of table salt should be added
to it.
I have given you a large and well-tried infant’s dietary to choose 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 baby 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
breast, but as the act of sucking causes the salivary glands to press
out their contents, which materially assists digestion. Moreover, it
seems to satisfy and comfort him more than it otherwise would do.
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, 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. 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.”
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 savor 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_ WHILE 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 three or
four 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 mother’s
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 has
attained the age of three or four months; then it will usually be
necessary to feed him 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 be the best for him, commencing
_without_ the cow’s milk, but gradually adding it, as less mother’s milk
and more artificial food be given.
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 vapors [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 afterward.”
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 a 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. For further reasons why
artificial food is not desirable at an early period of infancy, see
answer to 35th question. 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, as
it is wanted, and should be given by means of a feeding-bottle.
Asses’ milk is more suitable for _delicate_ infants, and goats’ milk for
those who are _strong_.
If neither asses’ milk nor goats’ milk can be procured, then the
following from the very commencement should be given:
New milk, the produce of ONE _healthy_ cow,
Warm water, of each, equal parts;
Table salt, a few grains;
Lump sugar, a sufficient quantity to slightly sweeten it.
Liebig, the great chemist, asserts that a small quantity of table salt
to the food is essential to the health of children. The milk itself
ought not to be heated over the fire, but should, as above directed, be
warmed by the water; it must, morning and evening, be had fresh and
fresh. 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. The milk and water should be of the same
temperature as the mother’s milk, that is to say, at about ninety to
ninety-five degrees Fahrenheit. It ought to be given by means of a
feeding-bottle, 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. As he grows older the milk should be
gradually increased, and the water decreased, until nearly all milk be
given.
There will, in many cases, be quite sufficient nourishment in the above;
I have known some robust infants brought up on it alone. 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.