BABY’S BIRTHDAY
CHOOSING THE NURSE AND DOCTOR—SANITARY BEDROOM AND ITS EQUIPMENT—THE
BABY’S LAYETTE—PREVENTION OF BLINDNESS IN NEW-BORN BABIES—THE BABY’S
FIRST BATH
The ushering of a new life into the world is an event so momentous and
fraught with such wonderful possibilities for both mother and child
that it should be planned with every possible precaution. No item of
preparation, however trifling, should be left to the last moment. The
mother should be able to find relief in the thought that all things are
in readiness for the safety and comfort of herself and her child.
The doctor who will be in attendance should be chosen early in the
period of pregnancy and consulted whenever the expectant mother feels
any anxiety about herself. In this matter the wishes of the woman
should be supreme, for her dread of confinement will be greatly
lessened if she feels confidence in her physician. I have known women
to become extremely nervous because, for reasons of expediency, they
were forced to accept the services of a physician desired by husband
or family. No one has a right to dictate in this matter to her who
must pass through the ordeal of labor. If the woman prefers the family
physician to the obstetrician recommended to her husband by friends,
relatives, or neighbors, her wishes should be respected. Or if, on the
other hand, she decides in favor of the obstetrician instead of the
family doctor, there should be no interference. The faith which casts
out fear, that indefinable sense of security which she feels in her
chosen physician, supports her through the hours of confinement.
During the months of pregnancy the physician thus consulted will follow
the changes in his patient and study particularly her nervous condition.
The nurse chosen should also be congenial to the expectant mother, who
will depend upon her for assistance and comfort in the last trying
hours before actual confinement. The engagement with the nurse should
be so made as to insure her freedom to answer the call at least a week
in advance. It is poor economy to let a nurse work on another case up
to the last moment. Better to pay for a week of idleness and be in
command of her services. To prevent misunderstanding, the date on which
her pay is to begin, irrespective of the actual date of confinement,
should be named definitely.
A few weeks before the date on which the confinement is expected the
nurse should come to the house and make herself thoroughly familiar
with the plan of the rooms, the water supply, closets, etc. There is
nothing more trying for the expectant mother than to have a nurse
arrive at the last moment, asking questions and locating needed
articles, when she should be rendering service.
When the woman is confined in her own home, the nurse is engaged to
remain at least two weeks after the baby is born, and three or four
weeks, if the family purse will permit.
In cities the custom of going to a hospital for confinement is growing
steadily. It is recognized that the hospital is cheaper, safer and
more convenient. The sanitation is perfect, danger from infection is
practically nil, and there are expert nurses and house physicians at
hand should an emergency arise. It is cheaper because the hospital
equipment is at the command of all patients; while, in the home,
individual equipment must be bought outright. Moreover, if labor is
normal, a special nurse is not required at the hospital, but the
patient is cared for by the ward or corridor nurse.
There are women, however, for whom the hospital holds a terror which
doctor, husband and friends cannot eradicate. Other women have a deep
sentiment or home instinct. They do not want to be taken from the
familiar environment of their family. When the question has been
placed before the woman in every possible light, and she elects to
remain at home, undue pressure should not be brought to bear upon her.
The result to her nervous and mental condition may be quite serious.
The room in which the mother will be confined at home should be the
most comfortable, cheerful, and the best ventilated room in the house.
If there is any room which has an open fireplace, this should be
selected, as it improves the ventilation and makes the room cheerful.
Two sets of shades, light and dark, should be provided; but heavy
hangings, upholstered furniture and dusty carpets should be removed.
Small, clean rugs on the floor, and simple, light furniture, which can
be easily moved about, are preferable.
A strong single or three-quarter bed is better than the double size,
and it should be so placed that it can be reached from all sides by the
nurse and doctor. If it is possible to rent a high iron bed, such as is
used in hospitals, the work of the doctor and nurse will be lightened.
If this cannot be done, a bed of ordinary height can be raised on four
strong blocks of wood.
There should be an ample supply of old soft night-dresses, either open
all the way down the front or, better still, open in the back and tied
at the neck with tapes. For the mother’s convalescence there should be,
especially in cold weather, dainty short negligées or dressing-sacques
in softly tinted silk and wool, albatross, or outing flannel.
For the home confinement the following equipment should be purchased
under the direction of doctor or nurse:
One and one-half yards of rubber sheeting, 36 inches wide, or more—or
ordinary white table oilcloth—to stretch over the mattress.
One 2-quart fountain syringe.
Two agateware basins, 11 inches and 16 inches in diameter,
respectively.
Two agateware pitchers, holding one quart or more.
One slop-jar or covered enameled bucket.
One douche pan.
One nailbrush.
One medicine glass.
One medicine dropper.
Several cakes of castile or pure white soap.
One jar of vaseline.
Fifty bichloride of mercury tablets, clearly marked, for disinfectant
purposes.
One ounce fluid extract of ergot, bought one week before confinement.
Pint bottle of chloroform.
Small bottle of brandy.
Quart bottle of alcohol for rubbing purposes.
Two dozen large safety-pins.
Two yards stout muslin for abdominal binders.
Two old sheets.
One dozen old soft towels.
One yard of bobbin, or very narrow tape, or braided silk, for tying
the cord.
Twenty-five yards of sterile gauze.
Four rolls of cotton-batting.
Three pounds of absorbent cotton.
The ergot and chloroform need not be provided by the city mother, with
the drugstore close at hand, but for the suburban or country mother
their presence in the house, if the doctor is summoned hastily and
there is no drugstore near by, may save confusion and perhaps futile
errand running. Neither drug is to be used without the permission of
the doctor, for, if chloroform is administered too soon, it may hinder
the progress of labor. If given in too large a quantity it increases
the possibilities of hemorrhage.
The gauze, cotton-batting and absorbent cotton are used for dressings
for the bed. These may be made by the mother or the nurse. They must
then be sterilized and put in an air-tight box or drawer until needed.
With great care they may be sterilized by dry heat in the oven, but as
there is danger from scorching, steam is more satisfactory. The most
convenient way is to utilize a washboiler, one-fourth full of water.
The dressings are laid, first in loose cheese-cloth bags, then in a
hammock-shaped strip of muslin attached by either end to the handles of
the boiler. The hammock should be swung high enough in the boiler so
that it does not actually touch the water. The lid is fastened on tight
and the steaming goes on for an hour. The dressings are then dried in
the sun or in the oven. In the latter case great care must be taken or
they will be scorched.
In preparing an outfit for the baby, it should be borne in mind
that this is an age of simplicity in dressing children; also that a
baby outgrows its first clothes very quickly. The essentials for the
new-born baby are:
Four abdominal bands of soft flannel, unhemmed, six to eight inches
wide, twenty inches long.
Four shirts of wool and silk mixed, or wool and cotton, in size 2.
Four flannel skirts, hung from the shoulder, not made with bands to
pin around the abdomen.
Four nightgowns or wrappers of outing flannel, which button in the
front.
Three knitted bands of wool and cotton mixed, with shoulder straps.
Six white slips, made very simply.
Four dozen diapers, made of cheese-cloth or a material known as stork
diapering, which is much like Turkish toweling.
Three pairs of socks, if it is a summer baby.
Three pairs of long white merino stockings, if it is a winter baby.
One simple cloak, made of soft material.
One cap lined with silk.
Mittens for the winter baby.
One bath blanket, made from an old summer weight blanket.
Several crocheted, knitted, or flannel blankets.
Soft material should be used for making the baby’s garments and neither
lace nor embroidery should be employed around the necks and sleeves of
the little slips, as they may chafe the tender skin and cause eczema.
Cleanliness is the one demand for the baby until it has passed safely
through the first month of its life, when the mother may give more
attention to its raiment.
In this day when cotton materials are highly mercerized and bleached,
it is safest to wash the little garments made from them before they are
worn by the new-born baby with its delicate skin. Diapers in particular
should be washed, and dried, but not ironed. The necks of dresses or
slips should be loose and tied with tape; buttons or fancy pins may
cause discomfort to the baby.
Every woman knows that efficiency in all branches of home-making
depends largely on having the proper tools. This is true in the nursery
as well as in the kitchen. There is no more delightful occupation for
the last two months before confinement than fitting up a nursery for
the little guest. A modern nursery equipped with all the up-to-date
appliances is not within the purse or even the house limitations of
many mothers, but there is no reason why the new baby should not have
its own corner in the house whether this be an entire room or just one
end of “mother’s room.”
The expectant mother with a modern house, plenty of rooms, electric
light, and running water, at her command, has half of the problem
solved for her. She will choose for the nursery a room opening off her
own, and convenient to the bathroom. This need not be large, but it
should be well ventilated, and, if possible, have a southern exposure
in order that it may be flooded with air and sunshine. The walls
should be painted, not papered, and the floor should be of hard wood
or stained pine, never carpeted. A few rugs that can be washed or
cleaned will be sufficient floor covering. It is better not to have
a stationary washstand in this room, because, unless the plumbing is
above suspicion, the pipes may breed germs.
There are two ways of providing against draughts: one of these is the
use of a screen that can be placed around the baby’s bed; the other is
a wooden board, about five or six inches high, and long enough to fit
the window when the lower sash is raised. The upper sash can then be
dropped to let the impure air out, and the clean, pure air will enter
the room between the upper and lower sashes.
The windows should have both light and dark shades. Babies stare at
the light, and, especially during the first few weeks after birth,
the nursery should be kept dark, or at least with only a dim light.
The custom of hanging an old shawl or dark curtain over the window is
not sanitary. At no time should the young baby’s eyes be exposed to
a strong light, either artificial light or sunlight. The crib should
be so placed that the baby looks away from the light, not toward
it. Protecting the baby’s eyes from glare may mean guarding it from
defective vision.
Except for very cold weather an open fireplace is the best possible
method of heating the room. When there is no fireplace, hot water
heating is best for the nursery; as it is for the entire house. When
steam or hot air is used, a pan of water, changed daily, should always
be kept in the room to relieve dryness in the atmosphere. Air-tight
coal stoves, gas or oil stoves should never be used in the nursery.
For the first week or so after the baby’s birth the nursery should be
kept at a temperature of 70° F. by day and 64° F. by night. As the
child grows older, the temperature may gradually be reduced at night.
Electric lighting is the best for the nursery. If this is not a part
of the equipment of the house, neither gas nor an oil lamp should be
allowed to burn in the room at night; a candle or wax night light
should be at hand. These can be bought at any house-furnishing store.
It is very important that the nursery should be fitted with screens
to keep out flies and mosquitoes. Mosquitoes carry malaria, and the
foot of a fly brings germs from the street, garbage and trash piles
far beyond the limits of the most sanitary nursery. The nursery should
furnish the baby’s first protection from contagious diseases. It must
be a veritable haven of safety. Therefore, no household work of any
kind should be done in the room, such as washing or drying the baby’s
clothes. The floors and the furniture should be wiped daily with damp
cloths. A dry cloth or feather duster should never be used to scatter
dust around the room.
Very important are the bath equipment, fully described in Chapter VIII,
“Cleanliness and Health,” and the baby’s toilet basket. The latter is
most sanitary when made of wicker, plain or enameled, and fitted with
celluloid or ivorine boxes. Swiss lining, with lace-trimmed pockets and
bows, soon soils and catches dust and germs.
The equipment of the nursery should include a crib of enameled iron,
a low table, a screen, a closet or chest for the baby’s clothing and
supplies, a small clothes-rack, a pair of scales, and a low chair—a
rocker without arms if the mother prefers it. If these are all painted
white, they give the room a very sanitary appearance.
The crib should be supplied with springs, mattress—preferably of
hair—a piece of India-rubber sheeting, and several cotton pads which
can be washed, half a dozen cotton sheets, a pair of light woolen
blankets—woven especially for cribs, or made from old blankets on hand,
carefully washed and bound, or wide flannel by the yard finished with
binding ribbon. The quilt should be of eider-down or a light-weight
cotton-batting, covered with silk or silkaline. If the bed clothing
is heavy, the baby will perspire and take cold more easily. A small
hair pillow is better than feathers, and the pillow-slip should not be
embroidered. It is far better to start the baby early in life sleeping
without any pillow at all. A hot-water bottle or bag, covered with
flannel, should always be at hand for warming the baby’s cold feet.
Many mothers cannot provide either a separate room or the modern
equipment described; but a resourceful woman will supply admirable
substitutes. If she can do no better, she will arrange one corner of
her own bedroom for the baby. To make this sanitary she will follow the
general plan of a bare floor, painted walls, and even sacrifice her
ruffled curtains to the health of her baby. The baby’s corner can be
separated from the rest of the room by screens. A screen may be made
from an ordinary clothes-horse, enameled white, and covered with heavy
dotted Swiss or silkaline, which can be taken off and washed.
If the white enameled crib is beyond the family purse, there are
several substitutes which can be placed on an ordinary table with the
legs cut off a few inches. One woman whom I met at a contest had found
an old kitchen table in the attic. Her husband first cut off the legs
evenly and then inserted casters, painting the whole white. On this she
placed an ordinary marketing basket, with the handle sawed off. This,
too, was painted with white enamel. In it she laid a hair pillow, cut
down to the size of the basket, and then added the usual protecting
piece of rubber cloth, sheets, and bedding. This basket was closely
woven, and when the paint filled all the cracks, it made a snug little
bed. If an open-work basket or an ordinary laundry basket is used, it
may be draped on the outside with plain muslin, fastened with thumb
tacks so that it can easily be removed and washed. Decorating the
basket with frills of dotted Swiss over paper-muslin or silesia may
give very attractive results, but it is not sanitary.
Another substitute for a crib is an ordinary packing box, which can be
bought from any grocer or shoe dealer, scrubbed, dried and then painted
white inside and out, and covered with muslin attached with thumb tacks.
If a feather pillow, instead of hair, must be used, it should be
completely covered with rubber cloth or ordinary table oilcloth,
because the feathers are heating and should be separated from the baby
by the rubber.
If a good-sized basket or box is chosen, the baby can sleep in this
until it is several months old.
On the day of baby’s birth, his clothes-rack and toilet basket, a low
chair, and a table with basin should be placed near the fireplace,
stove, or radiator. On the clothes-rack hang the first garments he will
wear. On the chair hang an outing flannel or soft woolen apron for the
nurse, and the soft shawl or blanket in which the little newcomer will
be wrapped directly after birth. The toilet basket should contain the
following supplies:
Four dozen safety-pins in assorted sizes.
A roll of old soft towels.
Soft wash-cloths and squares of sterile gauze to be thrown away after
using.
Talcum powder.
Castile or Ivory soap.
Very soft hair-brush.
Small bottle of olive oil.
Two-ounce bottle of boric acid.
Every item mentioned in these preparations for the baby’s birth is
important, as it bears directly upon sanitation, the comfort of the
mother, and the safety of the child. This is no hour in which to take
chances through false economy or procrastination.
Directly after the child is born and the navel cord has been tied,
either the nurse or doctor should give attention to the baby’s eyes.
Science has proved that a large proportion of blindness is preventable,
if prompt care is given to the eyes of new-born children. Hundreds of
children are blind from birth through infection which might have been
prevented.
The eyes of the new-born baby are generally closed and covered with
mucus. This should be washed off very gently with absorbent cotton
dipped in boracic acid solution, starting at the nose and wiping
outward, without opening the lids. To remove any chance of infection
which leads to blindness, or ophthalmia neonatorum, as it is known
to the medical profession, the nurse then applies a few drops of
antiseptic solution, provided by the physician. For this purpose she
uses a medicine dropper. So successful has been this treatment in
reducing the percentage of blindness at birth, that many health boards,
notably in New York, demand such precautions of physicians and midwives.
If for any reason the treatment is not given, the mother will do well
to watch the baby’s eyes for such symptoms as redness, swollen lids,
and a slight discharge oozing from under the lids. If these symptoms
appear, the parents should insist upon summoning a physician, for at
this time prompt treatment may save the child’s sight. Neglect may
result in total blindness or, at best, permanently impaired vision.
The baby’s eyes should be washed daily with boracic acid solution, the
cotton or gauze used for this purpose being destroyed and never used a
second time.
Next, the baby’s skin should receive the nurse’s attention. Before it
is bathed, the entire surface of the body should be covered with olive
oil or vaseline; after this process, the baby may be wrapped warmly
in a blanket and tucked into a safe corner, while the nurse turns her
attention to the mother. The baby need not be bathed until the mother
has been made comfortable.
By this time the olive oil or vaseline has softened the cheese-like
substance which encrusts the skin of the new-born baby. The nurse fills
the basin or tub with water, which registers 100 degrees F., if a
bath thermometer is used, or which will feel comfortably warm when she
thrusts her bare elbow into the water. Making a soft suds with Castile
or Ivory soap, the nurse then lathers the entire body, taking great
care not to get soap in the baby’s eyes. The soap is rinsed off with
gauze or old linen and clear water, and the flesh is patted dry with
old soft towels which have been warmed. The tender skin must never be
rubbed. Talcum powder is then applied, and the baby is ready to be
dressed in flannel binder, shirt, soft diaper, flannel skirt and outing
flannel wrapper.
As the little body is indescribably tender and sensitive at this time,
the nurse must handle it with exquisite care, always supporting the
head and back and protecting it from draughts; she must be very careful
not to let a strong light strike the eyes. If the baby is normally
healthy and has been made comfortable, it now falls sound asleep. This
is nature’s way of permitting the mother to recuperate before nursing
the baby for the first time. When the baby wakens, the mother will have
regained her strength in that amazing way which is appreciated only by
those who have watched her pass from the ordeal of labor into the joys
of maternity as through a miracle. The baby should be given the breast
when it awakens from its first sleep, and if there is any flow of milk
whatever, no artificial food should be supplied. Thus does the baby
start aright its splendid progress toward a normal, healthy childhood.