Keeping a Baby Comfortable
WOMEN and their WORK
It Isn’t Likely That He Cries Through Contrariness or Even to Develop His Lungs—There’s a Reason
IT takes a person of rare sensibility to get the viewpoint of a baby—a keen imagination to understand" his feelings and a heroic self-restraint to respect them. Somehow or other the idea has got abroad that a baby is made to be played with, while as a matter of fact, he’s the soberest human being alive for the first few months of his life, and wants nothing in the world more than to be left alone. There will come a time, as sure as the cocoon unfolds into a butterfly, when he will invite you to a game with him, but he has a perfect right to choose his own time. He was not born solely for his relatives’ pride or amusement. He is beginning a very important career of his
This is the supreme test. Have we the intelligent unselfishness to let the baby go his own gait, or Nature’s gait? She is doing her level best to make a success of him. What we need most is what one doctor calls “a masterly inactivity,” the patience to go carefully, to study out just what he needs and what he can’t stand without suffering for it now or later. The longest list will be what he can’t stand. The things he needs for the first few months won’t include much but the right kind of food, a chance to sleep, fresh air, cleanliness and room to grow—yes and mothering. The best authorities now reeognize the fact that this is quite as important as food scales and charts. One half of the babies in foundling asylums die within the first year. They have good scientific care, but they are not mothered. The most sympathetic parent, however, realizes that for the first while the best expression of this natural instinct is a certain wholesome awe of the newcomer. Surely there’s miracle enough in his very existence to warrant that.
A NEW WORLD OF SOUND AND LICHT
AN amazing number of women don’t know that a baby is born deaf and blind—that owing to a stoppage of mucus he can’t hear anything for a day or two, and after that his sense of hearing is
painfully acute. Sudden noises, startling clapping and booings all do their part toward making him nervous and irritable. More serious still, nervous ailments brought on during the first year are seldom completely overcome. Many a grown-up neurotic can trace his trouble
to an unquiet babyhood. Light is also an entirely new thing in his experience. For the first week or two his little corner of the world should be kept in semi-darkness, and never should his eyes be left unprotected from the direct glare of the light Over and over again we see a helpless mite lying on his back in a carriage, or even held in his mother’s arms, with hia eyes turned right up to the sun, and his face wrinkled up in a frown which should explain his discomfort to anyone. This is one of the most common causes of headache, fretfulness, indigestion and sleeplessness. Then when he “begins to notice” his ocular troubles come in dead earnest. Every one wants to “amuse" him, and his weak, dazzled eyes still vague in their perceptions are teased into following bright and rapidly moving objects until he cries in weariness and protest. A very few of these movements are sufficient to tire him. We can’t remember how we felt about it, of course, but we can try to imagine.
This playing, of course, is done with the kindest intentions, often by parents who want to see just what progress the baby is making. There is no reason, however, to be at all concerned about his hearing or seeing or any of his other faculties so long as he has a good, healthy grip. The one thing really significant of mental or bodily weakness, during the first few weeks is the feeble or absent hand-grasp. Any normal child, even during the first week, will hold on to your finger with a clutch like little forceps.
CLEANLINESS FROM A NURSE’S STANDPOINT
SOMEHOW or other, possibly from the fact that the healthiest, happiest children play in sand piles and dig in the earth, a certain sect of theorists hold the opinion that children thrive in dirt. And because an opposite sect of extremists made themselves ridiculous by preaching surgical sterilization of everything pertaining to the nursery, the first view seemed rational by contrast Experience proves, however, that cleanliness is essential to the comfort and health and happiness of the baby. Statistics show that in the slum districts where least attention is given to sanitation, the infant mortality is so great that in spite of the very high birth-rate the population is not more than keeping even with that in the better localities. The ideal of mothercraft is to strike a common-sense middle path between neglect ar\d overeare, but its idea of cleanliness as related to the care of infants means cleanliness from a nurse’s standpoint, something more than is required for the protection of healthy adults.
Then one of the most important, as well as the most thrilling event of the whole day is the bath. For the first two weeks this is a professional’s job. After that the mother usually takes charge of it, and if she is entirely inexperienced, she approaches the task with real panic in her heart. If a bunch of practical, capable mothers of grown-up families would hold an experience meeting on this topic, it would soon leak out that the majority of them finished bathing their first baby “wringing with perspiration” and nervously exhausted, that the baby screamed through the entire process, and that the job was by no means thoroughly done. No wonder the mothers who “got along without mothercraft” look kindly upon a form of education which will spare their daughters the bitter experiences through which they had to learn.
The baby is about ten days old when it is first put into the tub. At this age the temperature of the water should be about 100 degrees F. The nurse should have a bath-apron of flannel or other soft absorbent material, gathered upon a waistband like a kitchen apron: this protection from dampness is especially important when the mother takes charge of things. The head and face are washed and dried first, then the body is gently soaped all over, immersed quickly, and patted dry, not rubbed. The baby’s skin is sensitive, of course, so only the best soap should be used, different wash cloths should be used for the face and the body, and sponges should never be used at all. A sponge absolutely cannot be kept clean, but it is easv to have a good supply of old damask or cheesecloth or Turkish towelling wash-cloths, so that they can be washed after each time they are used.
For the young baby the temperature of the water does not go below 95 degrees, and is decreased gradually to 85 degrees by the end of the first year. Properly, this warm bath is followed by a cool rub over, to close the pores against cold, and to stimulate: a cool bath would never be given at night. Neither is the baby ever put into a cold bath. The water should be merely cool or tepid, and a cloth dipped in the cool water rubbed gently over the body as soon as it is taken from the warm bath. After the bath, rice powder or talcum should be dusted into the creases to prevent chafing, but if it is lavished all oyer the body and rubbed in (though rubbing in itself is soothing) there is danger of the powder clogging the pores. Vaseline or sweet oil should be kept on hand in case the chafing becomes serious.
THE MIRACLES OF BORACIC
/"A NE of the first requisites of a baby’s V toilet equipment is a bottle of boracic acid solution, made of one teaspoonful of the powder to a pint of water, and used tepid. As a healing disinfectant for the eyes and mouth it has the field almost en-
tirely to itself. Clean cotton must be used each time, however, or the treatment may do more harm than good. In fact there is a pronounced reaction nowadays among pediatricians against the frequent washing of the mouth. The danger of infection is too great. Gentle manipulation is also important. It is very easy to injure the delicate mucous membrane and then all kinds of trouble may follow. If what is commonly called “sore mouth” should occur, it should be washed carefully after each feeding with a solution of borax or baking soda, one teaspoonful to a cup of water, and four times a day the boracic acid solution should be used. And this is another place where we are likely to be thoughtless. We forget how small the baby’s mouth is. A piece of cotton, dipped in the solution, should be wrapped around the smallest finger (Dr. Holt says around a toothpick, but a toothpick seems scarcely sensitive enough for probing about the delicate membrane) and the gums washed as gently as possible. Irritation always invites inflammation.
Few people realize the danger of infection in a baby’s eyes. It’s about the first thing the nurse thinks about after he is born, and the danger doesn’t all end then. The washing of the eyes with the boracic acid solution should follow the bath as regularly as the dressing of the youngster. The solution should be allowed to drip gently from a piece of clean cotton into the eyes rather than to touch the eyes with cotton. If pus appears at all this treatment should be given every hour, and if the trouble is too severe for this to control, a physician should be called at once or the child may lose his eyesight. This is not over-anxiety. The worst has happened very often.
Another part of the toilet equipment is a bundle of toothpicks, ridiculous as it may sound. It may be necessary to wrap a piece of aseptic cotton about the end of a toothpick to use for cleaning nostrils. This is a painful effort for the novice, and the bahvigorously resents it, but if it isn’t done, the interference with breathing may be serious. It scarcely needs to be mentioned that no toothpick nor anything else should be used for poking about in baby’s ears. The treatment is as dangerous as it is painful.
THF all-important question of feeding will be considered by itself at another time. It might be repeated that the baby who has to be fed artificially is unfortunate, indeed, and that any expense or trouble to prevent or overcome this will pay in the long run. Even where a baby is fed naturally, however, there is a dangerous inclination among even ordinarily intelligent people to give him a few extras on the side. It is pretty well known that a baby comes into the world loaded. He doesn’t need anything to eat for the first three days and Nature has provided nothing for him. If less intelligent human beings can refrain from putting anything into his stomach except a few teaspoons of warm water, they will have lost their first chance of starting him off a colicky baby. In fact during the first year anyway the great majority of cases of illness among children come from giving them the wrong things. From the proverbial sausage in the slum districts of our cities to the “soothing syrups” and patent foods of some of the wealthiest homes, there is a lot of almost vicious ignorance on the subject. A “soothing syrup” is simply a drug. If a grown man were to get the
same dose in proportion to his size he, too, would go to sleep.
But the most common danger in infant feeding in the majority of homes is, to put it brutally, the lack of cleanliness— not the lack of cleanliness from a housekeeper's standpoint, but as a surgeon sees it. For there are such things as germs. You can actually see them through a magnifying glass, and starting with a few in the right conditions of food, warmth and moisture, you can soon develop a thriving little colony. And the same germs that would be harmless to a healthy adult might be fatal to a baby. It isn’t enough to give a baby clean water, it isn’t safe for him until it has been boiled. It isn’t enough to wash his bottle. It isn’t safe until it has been boiled or at least scalded, and bottles with sharp angles which cannot be brushed out thoroughly after each use are never safe. The nipples, too, must be cleaned as soon as they have been used; they are more dangerous than the bottles if left with milk in them. After they have been washed and scalded they should be immersed in a solution of boracic acid until they are to be used again.
Lots of people will think this is only nonsense, even when they know that every farmer who owns a milking machine, after he has washed and scalded. the rubber parts, keeps them in a solution of lime water until they are to be used again.
THE LAZIEST METHOD OF STOPPING CRYING
A ND right along this line of sanitation comes the question of the “comfort” —one of the most vicious contrivances ever invented for infants. It is not clean because it falls repeatedly to the floor, it is a lazy means of stopping crying when the real cause should be investigated, and it is frequently the cause of deforming the face and the mouth and nasal passage. The constant shaping of the mouth to hold the comfort and to draw in air makes the lips protrude, and causes the roof of the mouth to become high-arched and narrow so that the air passages in the nose are crowded and adenoids are likely to result.
But someone says this is all nonsense. If the babies are to live they will live anyway in spite of everything. Perhaps. But out of every one hundred babies born in Ontario in the year 1916 there were eleven who, so far as health authorities know, should have lived, but they died. It means that a baby has less chance to live a week than an old man of eighty, and it doesn’t seem as though Nature would intend that. Orators and writers have for a long time spent a lot of their talents in condemning the birth rate. It is about time some practical scientists got after the death rate of the children who are born. And the practical scientists who can accomplish the most are the parents themselves. They won’t be content to limit their interest just to the question of whether the baby lives or (lies. The baby himself if he had the choice might prefer being weeded out by Nature in the beginning rather than to be left handicapped for life by ill-health that might have been prevented.
More than anyone else in the house the baby requires an abundant supply of fresh air. There is absolutely no danger of his catching cold through the exposure of his face or through his nóse if he is well wrapped up otherwise, unless the air he has to breathe contains germs, gases or dust. Babies are exceedingly sensitive
to foul or overheated air, but not in the least to cool, fresh air. His windows should be open towards Jerusalem or any other place, day or night. In extremely cold or windy weather, a window-board can be used which leaves a narrow opening between the two sashes, and gives a ventilation superior to that of any artificial system.
After the first two weeks, the daytime sleeps should be taken in the open air in some sheltered, sunny spot so long as the temperature is about or above freezing. The baby heart is not stout enough to pump in defiance of any temperature so it is not common sense to make a rule that he shall sleep outdoors whatever the weather may be. The fresh-air treatment, however, is now considered the only treatment for pneumonia and bronchitis, even when the poor little gaspers have to have the snow .swept away to make room for their beds on hospital balconies, or even for serious cases of summer diarrhoea when they have to be taken out under the trees and kept there day and night.
Another thing the baby needs is sunlight. If we have a sun-room in the house it cannot possibly serve a better purpose than to be turned into a day nursery for the baby’s first year. After he is about five weeks old, in addition to being taken outdoors at least twice a day, the baby should be taken out of his cot, slipped into loose pyjamas or something that gives him lots of room, laid on a folded quilt on the floor in the sun, and allowed to kick and wriggle to his heart’s content. A little later he can have this sun-bath without being cumbered by any clothes at all. This is the beginning of his desire to play. As soon as it begins to show itself we have no right to keep him tucked down m a cot from which he can’t even lift his head.
J^nd just one other idea with all this. When you have the baby’s viewpoint so clear that you can distinguish what he wants from what he needs, don’t try to make the whole house revolve around him. It takes a level head to stand being lionized and wonderful as he is, he’s only human. His discipline, like his health care, can’t begin too early.