are usually cut in pairs. “I may say that nearly invariably the order
is—1st, the lower front incisors [cutting-teeth], then the upper front,
then the _upper_ two lateral incisors, and that not uncommonly a double
tooth is cut before the two _lower_ laterals; but at all events the
lower laterals come 7th and 8th, and not 5th and 6th, as nearly all
books on the subject testify.” [Sir Charles Locock, in a _Letter_ to the
Author.] Then the first grinders in the lower jaw, afterward the first
upper grinders, then the lower corner pointed or canine teeth, after
which the upper corner or eye-teeth, then the second grinders in the
lower jaw, and lastly, the second grinders of the upper jaw. They do
not, of course, always appear in this rotation. Nothing is more
uncertain than the order of teething. A child seldom cuts his second
grinders until after he is two years old. _He is usually, from the time
they first appear, two years in cutting his first set of teeth._ As a
rule, therefore, a child of two years old has sixteen, and one of two
years and a half old, twenty teeth.
60. _If an infant be either feverish or irritable, or otherwise poorly,
and if the gums be hot, swollen, and tender, are you an advocate for
their being lanced?_
Certainly; by doing so he will, in the generality of instances, be
almost instantly relieved.
61. _But it has been stated that lancing the gums hardens them?_
This is a mistake—it has a contrary effect. It is a well-known fact that
a part which has been divided gives way much more readily than one which
has not been cut. Again, the tooth is bound down by a tight membrane,
which, if not released by lancing, frequently brings on convulsions. If
the symptoms be urgent, it may be necessary from time to time to repeat
the lancing.
It would, of course, be the height of folly to lance the gums unless
they be hot and swollen, and unless the tooth or the teeth be near at
hand. It is not to be considered a panacea for every baby’s ill,
although, in those cases where the lancing of the gums is indicated, the
beneficial effect is sometimes almost magical.
62. _How ought the lancing of a child’s gums to be performed?_
The proper person, of course, to lance his gums is a medical man. But,
if perchance you should be miles away and be out of the reach of one, it
would be well for you to know how the operation ought to be performed.
Well, then, let him lie on the nurse’s lap upon his back, and let the
nurse take hold of his hands, in order that he may not interfere with
the operation.
Then, _if it be the upper gum_ that requires lancing, you ought to go to
the head of the child, looking over, as it were, and into his mouth, and
should steady the gum with the index finger of your left hand; then you
should take hold of the gum-lancet with your right hand—holding it as if
it were a table-knife at dinner—and cut firmly along the inflamed and
swollen gum and down to the tooth, until the edge of the gum-lancet
grates on the tooth. Each incision ought to extend along the ridge of
the gum to about the extent of each expected tooth.
_If it be the lower gum_ that requires lancing, you must go to the side
of the child, and should steady the outside of the jaw with the fingers
of the left hand, and the gum with the left thumb, and then you should
perform the operation as before directed.
Although the lancing of the gums, to make it intelligible to a
non-professional person, requires a long description, it is, in point of
fact, a simple affair, is soon performed, and gives but little pain.
63. _If teething cause convulsions, what ought to be done?_
The first thing to be done (after sending for a medical man) is to
freely dash cold water upon the face, and to sponge the head with cold
water, and as soon as warm water can be procured, to put him into a warm
bath of 98 degrees Fahrenheit. For the precautions to be used in putting
a child into a warm bath, see the answer to question on “Warm baths.”
No family where there are young children, should be without Fahrenheit’s
thermometer. If a thermometer be not at hand, you must plunge your own
elbow into the water: a comfortable heat for your elbow will be the
proper heat for the infant. He must remain in the bath for a quarter of
an hour, or until the fit be at an end. The body must, after coming out
of the bath, be wiped with warm and dry and coarse towels; he ought then
to be placed in a warm blanket. The gums must be lanced, and cold water
should be applied to the head. An enema, composed of table salt, of
olive oil, and warm oatmeal gruel—in the proportion of one tablespoonful
of salt, of one of oil, and a teacupful of gruel—ought then to be
administered, and should, until the bowels have been well opened, be
repeated every quarter of an hour; as soon as he comes to himself a dose
of aperient medicine ought to be given.
64. _A nurse is in the habit of giving a child who is teething either
coral or ivory to bite—do you approve of the plan?_
I think it a bad practice to give him any hard, unyielding substance, as
it tends to harden the gums, and by so doing causes the teeth to come
through with greater difficulty. I have found softer substances, such as
either a piece of wax-taper, or an india-rubber ring, or a piece of the
best bridle-leather, or a crust of bread, of great service. If a piece
of crust be given as a gum-stick, he must, while biting it, be well
watched, or by accident he might loosen a large piece of it, which might
choke him. The pressure of any of these excites a more rapid absorption
of the gum, and thus causes the tooth to come through more easily and
quickly.
65. _Have you any objection to my baby, when he is cutting his teeth,
sucking his thumb?_
Certainly not; the thumb is the best gum-stick in the world—it is
convenient, it is handy (in every sense of the word), it is of the right
size, and of the proper consistence—neither too hard nor too soft; there
is no danger, as of some artificial gum-sticks, of its being swallowed,
and thus of its choking the child. The sucking of the thumb causes the
salivary glands to pour out their contents, and thus not only to moisten
the dry mouth, but assists the digestion; the pressure of the thumb
eases, while the teeth are “breeding,” the pain and irritation of the
gums, and helps, when the teeth are sufficiently advanced, to bring them
through the gums. Sucking of the thumb will often make a cross infant
contented and happy, and will frequently induce a restless babe to fall
into a sweet refreshing sleep. Truly may the thumb be called a baby’s
comfort. By all means, then, let your child suck his thumb whenever he
likes, and as long as he chooses to do so.
There is a charming, bewitching little picture of a babe sucking his
thumb in Kingsley’s _Water Babies_, which I cordially commend to your
favorable notice and study.
66. _But if an infant be allowed to suck his thumb, will it not be
likely to become a habit, and stick to him for years—until, indeed, he
become a big boy?_
After he has cut the whole of his first set of teeth, that is to say,
when he is about two years and a half old, he might, if it be likely to
become a habit, be readily cured by the following method, namely, by
making a paste of aloes and water and smearing it upon his thumb. One or
two dressings will suffice, as after just tasting the bitter aloes he
will take a disgust to his former enjoyment, and the habit will at once
be broken.
Many persons, I know, have an objection to children sucking their
thumbs, as, for instance—
“Perhaps it’s as well to keep children from plums,
And from pears in the season, and sucking their thumbs.”
My reply is—
P’rhaps ’tis as well to keep children from pears;
The pain they might cause is oft followed by tears;
’Tis certainly well to keep them from plums;
But certainly not from sucking their thumbs!
If a babe suck his thumb
’Tis an ease to his gum;
A comfort; a boon; a calmer of grief;
A friend in his need, affording relief;
A solace; a good; a soother of pain;
A composer to sleep; a charm; and a gain;
’Tis handy at once to his sweet mouth to glide;
When done with, drops gently down by his side;
’Tis fixed like an anchor while the babe sleeps,
And the mother with joy her still vigil keeps.
67. _A child who is teething dribbles, and thereby wets his chest, which
frequently causes him to catch cold; what had better be done?_
Have in readiness to put on several _flannel_ dribbling-bibs, so that
they may be changed as often as they become wet; or, if he dribble _very
much_, the oiled silk dribbling-bibs, instead of the flannel ones, may
be used, and which may be procured at any baby-linen warehouse.
68. _Do you approve of giving a child, during teething, much fruit?_
No; unless it be a few ripe strawberries or raspberries, or a roasted
apple, or the juice of five or six grapes—taking care that he does not
swallow either the seeds or the skin—or the insides of ripe
gooseberries, or an orange. Such fruits, if the bowels be in a costive
state, will be particularly useful.
All stone fruits, _raw_ apples, or pears ought to be carefully avoided,
as they not only disorder the stomach and the bowels—causing
convulsions, gripings, etc.—but they have the effect of weakening the
bowels, and thus of engendering worms.
69. _Is a child, during teething, more subject to disease, and if so, to
what complaints, and in what manner may they be prevented?_
The teeth are a fruitful source of suffering and of disease, and are
with truth styled “our first and our last plagues.” Dentition is the
most important period of a child’s life, and is the exciting cause of
many infantile diseases; during this period, therefore, he requires
constant and careful watching. When we consider how the teeth elongate
and enlarge in his gums, pressing on the nerves and on the surrounding
parts, and thus how frequently they produce pain, irritation, and
inflammation; when we further contemplate what sympathy there is in the
nervous system, and how susceptible the young are to pain, no surprise
can be felt at the immense disturbance and the consequent suffering and
danger frequently experienced by children while cutting their _first_
set of teeth.
The complaints or the diseases induced by dentition are numberless,
affecting almost every organ of the body,—the _brain_, occasioning
convulsions, water on the brain, etc.; the _lungs_, producing
congestion, inflammation, cough, etc.; the _stomach_, exciting sickness,
flatulence, acidity, etc.; the _bowels_, inducing griping, at one time
costiveness, and at another time purging; the _skin_, causing
“breakings-out.”
To prevent these diseases, means ought to be used to invigorate a
child’s constitution by plain, wholesome food, as recommended under the
article of diet; by exercise and fresh air; by allowing him, weather
permitting, to be out of doors a great part of every day; by lancing the
gums when they get red, hot, and swollen; by attention to the bowels,
and if he suffer more than usual, by keeping them rather in a relaxed
state by any simple aperient, such as either castor oil or magnesia and
rhubarb, etc.; and, let me add, by attention to his temper. Many
children are made feverish and ill by petting and spoiling them. On this
subject I cannot do better than refer you to an excellent little work
entitled Abbott’s _Mother at Home_, wherein the author proves the great
importance of _early_ training. The young of animals seldom suffer from
cutting their teeth—and what is the reason? Because they live in the
open air and take plenty of exercise, while children are frequently
cooped up in close rooms and are not allowed the free use of their
limbs. The value of fresh air is well exemplified in the
Registrar-General’s Report for 1843: he says that in 1,000,000 deaths
from all diseases, 616 occur in the town from teething, while 120 only
take place in the country from the same cause.
70. _Have the goodness to describe the symptoms and the treatment of
Painful Dentition._
Painful dentition may be divided into two forms—(1.) the Mild; and (2.)
the Severe. In the _mild_ form the child is peevish and fretful, and
puts his fingers, and everything within reach, to his mouth; he likes to
have his gums rubbed, and takes the breast with avidity; indeed, it
seems a greater comfort to him than ever. There is generally a
considerable flow of saliva, and he has frequently a more loose state of
bowels than is his wont.
Now, with regard to the more _severe_ form of painful dentition: The
gums are red, swollen, and hot, and he cannot, without expressing pain,
bear to have them touched; hence, if he be at the breast, he is
constantly loosing the nipple. There is dryness of the mouth, although
before there had been a great flow of saliva. He is feverish, restless,
and starts in his sleep. His face is flushed. His head is heavy and hot.
He is sometimes convulsed. (See answer to Question 63.) He is frequently
violently griped and purged, and suffers severely from flatulence. He is
predisposed to many and severe diseases.
The _treatment_ of the _mild_ form consists of friction of the gums with
the finger; with a little “soothing syrup,” as recommended by Sir
Charles Locock; a tepid bath of about 92 degrees Fahrenheit, every night
at bedtime; attention to diet and bowels; fresh air and exercise.
“‘Soothing Syrup.’ Some of them probably contain opiates, but a
perfectly safe and useful one is a little nitrate of potassa in syrup of
roses—one scruple to half an ounce.”—Communicated by Sir Charles Locock
to the Author. For the mild form, the above plan will usually be all
that is required. If he dribble and the bowels be relaxed, so much the
better; the flow of saliva and the increased action of the bowels afford
relief, and therefore must not be interfered with. In the _mild_ form
lancing of the gums is not desirable. The gums ought not to be lanced
unless the teeth be near at hand, and unless the gums be red, hot, and
swollen.
In the _severe_ form a medical man should be consulted early, as more
energetic remedies will be demanded; that is to say, the gums will
require to be freely lanced, warm baths to be used, and medicines to be
given, to ward off mischief from the head, from the chest, and from the
stomach.
If you are living in the town and your baby suffers much from teething,
take him into the country. It is wonderful what change of air to the
country will often do, in relieving a child who is painfully cutting his
teeth. The number of deaths in London from teething is frightful; it is
in the country comparatively trifling.
71. _Should an infant be purged during teething, or indeed, during any
other time, do you approve of either absorbent or astringent medicines
to restrain it?_
Certainly not. I should look upon the relaxation as an effort of nature
to relieve itself. A child is never purged without a cause; that cause,
in the generality of instances, is the presence of either some
undigested food, or acidity, or depraved motions that want a vent.
The better plan is, in such a case, to give a dose of aperient medicine,
such as either castor oil or magnesia and rhubarb, and thus work it off.
IF WE LOCK UP THE BOWELS, WE CONFINE THE ENEMY, AND THUS PRODUCE
MISCHIEF. [“I should put this in capitals, it is so important and so
often mistaken.”—C. Locock.] If he be purged more than usual, attention
should be paid to the diet—if it be absolutely necessary to give him
artificial food while suckling—and care must be taken not to overload
the stomach.
72. _A child is subject to a slight cough during dentition—called by
nurses “tooth-cough”—which a parent would not consider of sufficient
importance to consult a doctor about; pray tell me if there is any
objection to a mother giving her child a small quantity either of syrup
of white poppies or of paregoric to ease it?_
A cough is an effort of nature to bring up any secretion from the lining
membrane of the lungs, or from the bronchial tubes, hence it ought not
to be interfered with. I have known the administration of syrup of white
poppies, or of paregoric, to stop the cough, and thereby to prevent the
expulsion of the phlegm, and thus to produce either inflammation of the
lungs or bronchitis. Moreover, both paregoric and syrup of white poppies
are, for a young child, dangerous medicines (unless administered by a
judicious medical man), and _ought never to be given by a mother_.
In the month of April, 1844, I was sent for in great haste to an infant,
aged seventeen months, who was laboring under convulsions and extreme
drowsiness, from the injudicious administration of paregoric, which had
been given to him to ease a cough. By the prompt administration of an
emetic he was saved.
73. _A child who is teething is subject to a “breaking-out,” more
especially behind the ears—which is most disfiguring, and frequently
very annoying; what would you recommend?_
I would apply no external application to cure it, as I should look upon
it as an effort of the constitution to relieve itself; and should
expect, if the “breaking-out” were repelled, that either convulsions, or
bronchitis, or inflammation of the lungs, or water on the brain would be
the consequence.
The only plan I should adopt would be, to be more careful in his diet:
to give him less meat (if he be old enough to eat animal food), and to
give him, once or twice a week, a few doses of mild aperient medicine;
and, if the irritation from the “breaking-out” be great, to bathe it
occasionally either with a little warm milk and water, or with rose
water.
EXERCISE.
74. _Do you recommend exercise in the open air for a baby? and if so,
how soon after birth?_
I am a great advocate for having exercise in the open air. “The infant
in arms makes known its desire for fresh air by restlessness—it cries,
for it cannot speak its wants: is taken abroad, and is quiet.”
The age at which he ought to commence taking exercise will, of course,
depend upon the season and upon the weather. If it be summer, and the
weather be fine, he should be carried in the open air a week or a
fortnight after birth; but if it be winter, he ought not, on any
account, to be taken out under the month, and not even then, unless the
weather be mild for the season, and it be the middle of the day. At the
end of two months he should breathe the open air more frequently. And
after the expiration of three months he ought to be carried out _every
day_, even if it be wet under foot, provided it be fine above, and the
wind be neither in an easterly nor in a northeasterly direction; by
doing so we shall make him strong and hearty, and give the skin that
mettled appearance which is so characteristic of health. He must, of
course, be well clothed.
I cannot help expressing my disapprobation of the practice of smothering
up an infant’s face with a handkerchief, with a veil, or with any other
covering, when he is taken out into the air. If his face be so muffled
up, he may as well remain at home; as, under such circumstances, it is
impossible for him to receive any benefit from the invigorating effects
of the fresh air.
75. _Can you devise any method to induce a baby himself to take
exercise?_
He must be encouraged to use muscular exertion; and, for this purpose,
he ought to be frequently laid either upon a rug, or carpet, or the
floor: he will then stretch his limbs and kick about with perfect glee.
It is a pretty sight, to see a little fellow kicking and sprawling on
the floor. He crows with delight, and thoroughly enjoys himself: it
strengthens his back; it enables him to stretch his limbs, and to use
his muscles; and is one of the best kinds of exercise a very young child
can take. While going through his performances, his diaper, if he wear
one, should be unfastened, in order that he might go through his
exercises untrammeled. By adopting the above plan, the babe quietly
enjoys himself—his brain is not over-excited by it; this is an important
consideration, for both mothers and nurses are apt to rouse and excite
very young children, to their manifest detriment. A babe requires rest,
and not excitement. How wrong it is, then, for either a mother or a
nurse to be exciting and rousing a new-born babe. It is most injurious
and weakening to his brain. In the early period of his existence his
time ought to be almost entirely spent in sleeping and in sucking!
76. _Do you approve of tossing an infant much about?_
I have seen a child tossed up nearly to the ceiling! Can anything be
more cruel or absurd? Violent tossing of a young babe ought never to be
allowed: it only frightens him, and has been known to bring on
convulsions. He should be gently moved up and down (not tossed): such
exercise causes a proper circulation of the blood, promotes digestion,
and soothes to sleep. He must always be kept quiet immediately after
taking the breast: if he be tossed _directly_ afterward, it interferes
with his digestion, and is likely to produce sickness.
SLEEP.
77. _Ought the infant’s sleeping apartment to be kept warm?_
The lying-in room is generally kept too warm, its heat being, in many
instances, more that of an oven than of a room. Such a place is most
unhealthy, and is fraught with danger both to the mother and the baby.
We are not, of course, to run into an opposite extreme, but are to keep
the chamber at a moderate and comfortable temperature. The door ought
occasionally to be left ajar, in order the more effectually to change
the air and thus to make it more pure and sweet.
A new-born babe, then, ought to be kept comfortably warm, but not very
warm. It is folly in the extreme to attempt to harden a very young child
either by allowing him, in the winter time, to be in a bed-room without
a fire, or by dipping him in _cold_ water, or by keeping him with scant
clothing on his bed. The temperature of a bed-room, in the winter time,
should be, as nearly as possible, at 60° Fahr. Although the room should
be comfortably warm, it ought, from time to time, to be properly
ventilated. An unventilated room soon becomes foul, and, therefore,
unhealthy. How many in this world, both children and adults, are
“poisoned with their own breaths!”
An infant should not be allowed to look at the glare either of a fire or
of a lighted candle, as the glare tends to weaken the sight, and
sometimes brings on an inflammation of the eyes. In speaking to and in
noticing a baby, you ought always to stand _before_ and not _behind_
him, or it might make him squint.
78. _Ought a babe to lie alone from the first?_
Certainly not. At first—say for the first few months—he requires the
warmth of another person’s body, especially in the winter; but care must
be taken not to overlay him, as many infants, from carelessness in this
particular, have lost their lives. After the first few months, he had
better lie alone, on a horse-hair mattress.
79. _Do you approve of rocking an infant to sleep?_
I do not. If the rules of health be observed, he will sleep both soundly
and sweetly without rocking; if they be not, the rocking might cause him
to fall into a feverish, disturbed slumber, but not into a refreshing,
calm sleep. Besides, if you once take to that habit, he will not go to
sleep without it.
80. _Then don’t you approve of a rocking-chair, and of rockers to the
cradle?_
Certainly not: a rocking-chair, or rockers to the cradle, may be useful
to a lazy nurse or mother, and may induce a child to sleep, but that
restlessly, when he does not need sleep, or when he is wet and
uncomfortable, and requires “changing;” but will not cause him to have
that sweet and gentle and exquisite slumber so characteristic of a baby
who has no artificial appliances to make him sleep. No! rockers are
perfectly unnecessary, and the sooner they are banished the nursery the
better will it be for the infant community. I do not know a more
wearisome and monotonous sound than the everlasting rockings to and fro
in some nurseries; they are often accompanied by a dolorous lullaby from
the nurse, which adds much to the misery and depressing influence of the
performance.
81. _While the infant is asleep, do you advise the head of the crib to
be covered with a handkerchief, to shade his eyes from the light, and,
if it be summer time, to keep off the flies?_