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, or
wet-nurse’s, or asses’, or goat’s, or cow’s own 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, or a consumptive habit, or if she or any of her
family have labored 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 (which may readily be ascertained by milking a little into a
glass. “It should be thin, and of a bluish-white color, sweet to the
taste, and when allowed to stand should throw up a considerable quantity
of cream.”—_Maunsell and Evertson on the Diseases of Children._) 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 menstruates
during suckling; if she does, the milk is not so good and nourishing,
and you had better decline taking her. 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 a third child’s mother is more eligible
than a first.”—_Letter to the Author._ Assure yourself that her own babe
is strong and healthy, and that he is 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, as
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 color, 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 actually
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 in his mouth.
Very feeble new-born babes sometimes cannot take the bosom, be the
nipples and the breasts ever so good. In such a case, cow’s milk and
water, sugar and salt, as recommended at page 45, must be given in small
quantities at a time—from two to four teaspoonfuls—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 teaspoonfuls,
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 teaspoonfuls 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 brocoli, 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 or 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 months, 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, endeavor to
procure one of a mild, calm, and placid disposition.
“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 laboring 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—in the bed, so as to give a little
to him in lieu of the breast. The previous boiling of the milk will
prevent the warmth of the bed turning the milk sour, which it would
otherwise do. The warmth of the body will keep the milk of a proper
temperature, and will supersede the use of lamps, of candle-frames, and
other troublesome contrivances.
42. _While a mother is weaning her infant, and after she has weaned him,
what ought to be his diet?_
Any one of the foods recommended in answer to question 34, page 36.
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 three or four 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, suffer severely. For
the first three or four 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_.
Care in feeding, then, is the grand preventive 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 cows’ 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.
If a baby’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, _brown_ sugar ought to be substituted for lump sugar, as
_brown_ 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.
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 _revaccinated_,—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 only be known 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
revaccinated?_
I decidedly do; it would be an excellent plan for _every_ person, once
every seven years, to be revaccinated, and even oftener, if small-pox be
rife in the neighborhood. 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 is 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 civilized 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 revaccinated once every seven years,
or even oftener, if there was an epidemic of small-pox in the
neighborhood.
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 tenfold 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 be 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
neighborhood, 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.” Communicated by
Sir Charles Locock to the author.
51. _Do you consider that the 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 has 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.” 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 neighborhood, 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, and 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 a 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 a 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 in 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
relief and comfort.
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.”
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.”
_Act 2, sc, 5._
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_?