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Advice to a Mother on the Management of Her Children

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Title: Advice to a Mother on the Management of Her Children

Author: Pye Henry Chavasse


        
Release date: September 1, 2004 [eBook #6595]
                Most recently updated: December 29, 2020

Language: English

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*** START OF THE PROJECT GUTENBERG EBOOK ADVICE TO A MOTHER ON THE MANAGEMENT OF HER CHILDREN ***




Produced by Charles Aldarondo, Charles Franks, Arno Peters
and the Online Distributed Proofreading Team.

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ADVICE TO A MOTHER

ON THE
MANAGEMENT OF HER CHILDREN
AND ON THE
TREATMENT ON THE MOMENT
OF SOME OF THEIR MORE PRESSING ILLNESSES
AND ACCIDENTS


BY

PYE HENRY CHAVASSE,

FELLOW OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND, FELLOW OF THE
OBSTETRICAL SOCIETY OF LONDON, FORMERLY PRESIDENT OF QUEEN'S COLLEGE
MEDICO-CHIRURGICAL SOCIETY, BIRMINGHAM.


"Lo, children and the fruit of the womb are an heritage and gift that
cometh of the Lord."




PREFACE.

This Book has been translated into French, into German, into Polish,
and into Tamil (one of the languages of India); it has been
extensively published in America; and is well-known wherever the
English language is spoken.

The Twelfth Edition--consisting of twenty thousand copies--being
exhausted in less than three years, the THIRTEENTH EDITION is now
published.

One or two fresh questions have been asked and answered, and two or
three new paragraphs have I been added.

PYE HENRY CHAVASSE.

214, HAGLEY ROAD, EDGBASTON,
BIRMINGHAM, _June_, 1878.




CONTENTS.


PART I--INFANCY.

PRELIMINARY CONVERSATION
ABLUTION
MANAGEMENT OF THE NAVEL
NAVEL RUPTURE--GROIN RUPTURE
CLOTHING
DIET
VACCINATION AND RE-VACCINATION
DENTITION
EXERCISE
SLEEP
THE BLADDER AND THE BOWELS
AILMENTS, DISEASE, ETC.
CONCLUDING REMARKS ON INFANCY


PART II--CHILDHOOD

ABLUTION
CLOTHING
DIET
THE NURSERY
EXERCISE
AMUSEMENTS
EDUCATION
SLEEP
SECOND DENTITION
DISEASE, ETC.
WARM BATHS
WARM EXTERNAL APPLICATIONS
ACCIDENTS


PART III--BOYHOOD AND GIRLHOOD

ABLUTION, ETC.
MANAGEMENT OF THE HAIR
CLOTHING
DIET
AIR AND EXERCISE
AMUSEMENTS
EDUCATION
HOUSEHOLD WORK FOR GIRLS
CHOICE OF PROFESSION OR TRADE
SLEEP
ON THE TEETH AND GUMS
PREVENTION OF DISEASE, ETC.
CONCLUDING REMARKS
INDEX




ADVICE TO A MOTHER.



PART I.--INFANCY


  _Infant and suckling._--I. SAMUEL
  _A rose with all its sweetest leaves yet folded._--BYRON.
  _Man's breathing Miniature!_--COLERIDGE.



PRELIMINARY CONVERSATION


1. _I wish to consult you on many subjects appertaining to the
management and the care of children; will you favour me with your
advice and counsel_?

I shall be happy to accede to your request, and to give you the fruits
of my experience in the clearest manner I am able, and in the simplest
language I can command--freed from all technicalities. I will
endeavour to guide you in the management of the health of your
offspring;--I will describe to you the _symptoms_ of the diseases of
children;--I will warn you of approaching danger, in order that you
may promptly apply for medical assistance before disease has gained
too firm a footing;--I will give you the _treatment_ on the moment; of
some of their more pressing illnesses--when medical aid cannot at once
be procured, and where delay may be death;--I will instruct you, in
case of accidents, on the _immediate_ employment of remedies--where
procrastination may be dangerous;--I will tell you how a sick child
should be nursed, and how a sick-room ought to be managed;--I I will
use my best energy to banish injurious practices from the nursery;--I
will treat of the means to prevent disease where it be possible;--I
will show you the way to preserve the health of the healthy,--and how
to strengthen the delicate;--and will strive to make a medical man's
task more agreeable to himself,--and more beneficial to his
patient,--by dispelling errors and prejudices, and by proving the
importance of your _strictly_ adhering to his rules. If I can
accomplish any of these objects, I shall be amply repaid by the
pleasing satisfaction that I have been of some little service to the
rising generation.

2. _Then you consider it important that I should be made acquainted
with, and be well informed upon, the subjects you have just named_?

Certainly! I deem it to be your imperative duty to _study_ the
subjects well. The proper management of children is a vital
question,--a mother's question,--and the most important that can be
brought under the consideration of a parent; and, strange to say, it
is one that has been more neglected than any other. How many mothers
undertake--the responsible management of children without previous
instruction, or without forethought; they undertake it, as though it
may be learned either by intuition or by instinct, or by
affection. The consequence is, that frequently they are in a sea of
trouble and uncertainty, tossing about without either rule or compass;
until, too often, their hopes and treasures are shipwrecked and lost.

The care and management, and consequently the health and future
well-doing of the child, principally devolve upon the mother, "for it
is the mother after all that has most to do with the making or marring
of the man." [Footnote: _Good Words_, Dr W. Lindsay Alexander, March
1861.] Dr Guthrie justly remarks that--"Moses might have never been
the man he was unless he had been nursed by his own mother. How many
celebrated men have owed their greatness and their goodness to a
mother's training!" Napoleon owed much to his mother. "'The fate of a
child,' said Napoleon, 'is always the work of his mother;' and this
extraordinary man took pleasure in repeating, that to his mother he
owed his elevation. All history confirms this opinion..." The
character of the mother influences the children more than that of the
father, because it is more exposed to their daily, hourly
observation.--_Woman's Mission_.

I am not overstating the importance of the subject in hand when I say,
that a child is the most valuable treasure in the world, that "he is
the precious gift of God," that he is the source of a mother's
greatest and purest enjoyment, that he is the strongest bond of
affection between her and her husband, and that

  "A babe in a house is a well-spring of pleasure,
  A messenger of peace and love."--_Tupper_,

I have, in the writing of the following pages, had one object
constantly in view--namely, health--

  "That salt of life, which does to all a relish give,
  Its standing pleasure, and intrinsic wealth,
  The body's virtue, and the soul's good fortune--health."

If the following pages insist on the importance of one of a mother's
duties more than another it is this,--_that the mother herself look
well into everything appertaining to the management of her own child_.

Blessed is that mother among mothers of whom it can be said, that "she
hath done what she could" for her child--for his welfare, for his
happiness, for his health!

For if a mother hath not "done what she could for her
child"--mentally, morally, and physically--woe betide the unfortunate
little creature;--better had it been for him had he never been born!



ABLUTION


3. _Is a new-born infant, for the first time, to be washed in warm
or in cold water_?

It is not an uncommon plan to use _cold_ water from the first, under
the impression of its strengthening the child. This appears to be a
cruel and barbarous practice, and is likely to have a contrary
tendency. Moreover, it frequently produces either inflammation of the
eyes, or stuffing of the nose, or inflammation of the lungs, or
looseness of the bowels. Although I do not approve of _cold_ water, we
ought not to run into an opposite extreme, as _hot_ water would weaken
and enervate the babe, and thus would predispose him to disease. Luke
warm _rain_ water will be the best to wash him with. This, if it be
summer, should have its temperature gradually lowered, until it be
quite cold, if it be winter, a _dash_ of warm water ought still to be
added, to take oft the chill [Footnote: A nursery basin (Wedgwoode
make is considered the best), holding either six or eight quarts of
water, and which will be sufficiently large to hold the whole body of
the child. The baton is generally fitted into a wooden frame which
will raise it to a convenient height for the washing of the baby.] (By
thermometer = 90 to 92 degrees.)

It will be necessary to use soap--Castile soap being the best for the
purpose--it being less irritating to the skin than the ordinary
soap. Care should be taken that it does not get into the eyes, as it
may produce either inflammation or smarting of those organs.

If the skin be delicate, or if there be any excoriation or
"breaking-out" on the skin, then glycerine soap, instead of the
Castile soap, ought to be used.

4. _At what age do you recommend a mother to commence washing her
infant either in the tub, or in the nursery basin_?

As soon as the navel string comes away [Footnote: Sir Charles Locock
strongly recommends that an infant should be washed _in a tub_ from
the very commencement. He says,--"All those that I superintend _begin_
with a tub."--_Letter to the Author_.] Do not be afraid of water,--and
that in plenty,--as it is one of the best strengtheners to a child's
constitution. How many infants suffer, for the want of water from
excoriation!

5. _Which do you prefer--flannel or sponge--to wash a child with_?

A piece of flannel is, for the first part of the washing very
useful--that is to say, to use with the soap, and to loosen the dirt
and the perspiration; but for the finishing-up process, a sponge--a
large sponge--is superior to flannel, to wash all away, and to
complete the bathing. A sponge cleanses and gets into all the nooks,
corners, and crevices of the skin. Besides, sponge, to finish up with,
is softer and more agreeable to the tender skin of a babe than
flannel. Moreover, a sponge holds more water than flannel, and thus
enables you to stream the water more effectually over him. A large
sponge will act Like a miniature shower bath, and will thus brace and
strengthen him.

6. _To prevent a new-born babe from catching cold, is it necessary to
wash his head with brandy_?

It is _not necessary_. The idea that it will prevent cold is
erroneous, as the rapid evaporation of heat which the brandy causes is
more likely to give than to prevent cold.

7. _Ought that tenacious, paste like substance, adhering to the skin
of a new-born babe, to be washed off at the first dressing_?

It should, provided it be done with a soft sponge and with care. If
there be any difficulty in removing the substance, gently rub it, by
means of a flannel, [Footnote: Mrs Baines (who has written so much and
so well on the Management of Children), in a _Letter_ to the Author,
recommends flannel to be used in the _first_ washing of an infant,
which flannel ought afterwards to be burned; and that the sponge
should be only used to complete the process, to clear off what the
flannel had already loosened. She also recommends that every child
should have his own sponge, each of which should have a particular
distinguishing mark upon it, as she considers the promiscuous use of
the same sponge to be a frequent cause of _ophthalmia_ (inflammation
of the eyes). The sponges cannot be kept too clean.] either with a
little lard, or fresh butter, or sweet-oil. After the parts have been
well smeared and gently rubbed with the lard, or oil, or butter, let
all be washed off together, and be thoroughly cleansed away, by means
of a sponge and soap and warm water, and then, to complete the
process, gently put him in for a minute or two in his tub. If this
paste like substance be allowed to remain on the skin, it might
produce either an excoriation, or a "breaking-out" Besides, it is
impossible, if that tenacious substance be allowed to remain on it,
for the skin to perform its proper functions.

8. _Have you any general observations to make on the washing of a
new-born infant_?

A babe ought, every morning of his life, to be thoroughly washed from
head to foot, and this can only be properly done by putting him bodily
either into a tub or into a bath, or into a large nursery basin, half
filled with water. The head, before placing him in the bath, should be
first wetted (but not dried), then immediately put him into the water,
and, with a piece of flannel well soaked, cleanse his whole body,
particularly his arm pits, between his thighs, his groins, and his
hams, then take a large sponge in hand, and allow the water from it,
well filled, to stream all over the body, particularly over his back
and loins. Let this advice be well observed, and you will find the
plan most strengthening to your child. The skin must, after every
bath, be thoroughly but quickly dried with warm, dry, soft towels,
first enveloping the child in one, and then gently absorbing the
moisture with the towel, not roughly scrubbing and rubbing his tender
skin as though a horse were being rubbed down.

The ears must, after each ablution, be carefully and well dried with a
soft dry napkin, inattention to this advice has sometimes caused a
gathering in the ear--a painful and distressing complaint, and at
other times it has produced deafness.

Directly after the infant is dried, all the parts that are at all
likely to be chafed ought to be well powdered. After he is well dried
and powdered, the chest, the back, the bowels, and the limbs should be
gently rubbed, taking care not to expose him unnecessarily during such
friction.

He ought to be partially washed every evening, indeed it may be
necessary to use a sponge and a little warm water frequently during
the day, namely, each time after the bowels have been relieved.
_Cleanliness is one of the grand incentives to health_, and therefore
cannot be too strongly insisted upon. If more attention were paid to
this subject, children would be more exempt from chafings,
"breakings-out," and consequent suffering, than they at present
are. After the second month, if the babe be delicate, the addition of
two handfuls of table-salt to the water he is washed with in the
morning will tend to brace and strengthen him.

With regard to the best powder to dust an infant with, there is
nothing better for general use than starch--the old fashioned starch
_made of wheaten flour_--reduced by means of a pestle and mortar to a
fine powder, or Violet Powder, which is nothing more than finely
powdered starch scented, and which may be procured of any respectable
chemist. Some others are in the habit of using white lead, but as
this is a poison, it ought _on no account_ to be resorted to.

9. _If the parts about the groin and fundament be excoriated, what is
then the best application_?

After sponging the parts with tepid _rain water_, holding him over his
tub, and allowing the water from a well filled sponge to stream over
the parts, and then drying them with a soft napkin (not rubbing, but
gently dabbing with the napkin), there is nothing better than dusting
the parts frequently with finely powdered Native Carbonate of
Zinc-Calamine Powder. The best way of using this powder is, tying up a
little of it in a piece of muslin, and then gently dabbing the parts
with it.

Remember excoriations are generally owing to the want of water,--to
the want of an abundance of water. An infant who is every morning well
soused and well swilled with water seldom suffers either from
excoriations, or from any other of the numerous skin diseases.
Cleanliness, then, is the grand preventative of, and the best remedy
for excoriations. Naaman the Syrian was ordered "to wash and be
clean," and he was healed, "and his flesh came again like unto the
flesh of a little child and he was clean." This was, of course, a
miracle; but how often does water, without any special intervention,
act miraculously both in preventing and in curing skin diseases!

An infant's clothes, napkins especially, ought never to be washed with
soda; the washing of napkins with soda is apt to produce excoriations
and breakings-out. "As washerwomen often deny that they use soda, it
can be easily detected by simply soaking a clean white napkin in fresh
water and then tasting the water; if it be brackish and salt, soda has
been employed." [Footnote: Communicated by Sir Charles Locock to the
Author.]

10. _Who is the proper person to wash and dress the babe_?

The monthly nurse, as long as she is in attendance; but afterwards the
mother, unless she should happen to have an experienced, sensible,
thoughtful nurse, which, unfortunately, is seldom the case. [Footnote:
"The Princess of Wales might have been seen on Thursday taking an
airing in a brougham in Hyde Park with her baby--the future King of
England--on her lap, without a nurse, and accompanied only by Mrs
Brace. The Princess seems a very pattern of mothers, and it is
whispered among the ladies of the Court that every evening the mother
of this young gentleman may be seen in a flannel dress, in order that
she may properly wash and put on baby's night clothes, and see him
safely in bed. It is a pretty subject for a picture."--_Pall Mall
Gazette_.]

11. _What is the best kind of apron for a mother, or for a nurse, to
wear, while washing the infant_?

Flannel--a good, thick, soft flannel, usually called
bathcoating--apron, made long and full, and which of course ought to
be well dried every time before it is used.

12. _Perhaps you will kindly recapitulate, and give me further advice
on the subject of the ablution of my babe_.

Let him by all means, then, as soon as the navel-string has separated
from the body, be bathed either in his tub, or in his bath, or in his
large nursery-basin, for if he is to be strong and hearty, in the
water every morning he must go. The water ought to be slightly warmer
than new milk. It us dangerous for him to remain for a long period in
his bath, this, of course, holds good in a ten fold degree if the
child have either a cold or pain in his bowels. Take care that,
immediately after he comes out of his tub, he is well dried with warm
towels. It is well to let him have his bath the first thing in the
morning, and before he has been put to the breast, let him be washed
before he has his breakfast, it will refresh him and give him an
appetite. Besides, he ought to have his morning ablution on an empty
stomach, or it may interfere with digestion, and might produce
sickness and pain. In putting him in his tub, let his head be the
first part washed. We all know, that in bathing in the sea, now much
better we can bear the water if we first wet our head, if we do not do
so, we feel shivering and starved and miserable. Let there be no
dawdling in the washing, let it be quickly over. When he is thoroughly
dried with warm _dry_ towels, let him be well rubbed with the warm
hand of the mother or of the nurse. As I previously recommended, while
drying him and while rubbing him, let him repose and kick and stretch
either on the warm flannel apron, or else on a small blanket placed on
the lap. One bathing in the tub, and that in the morning, is
sufficient, and better than night and morning. During the day, as I
before observed, he may, after the action either of his bowels or of
his bladder, require several spongings of lukewarm water, _for
cleanliness is a grand incentive to health and comeliness_.

Remember it is absolutely necessary to every child from his earliest
babyhood to have a bath, to be immersed every morning of his life in
the water. This advice, unless in cases of severe illness, admits of
no exception. Water to the body--to the whole body--is a necessity of
life, of health, and of happiness, it wards off disease, it brace? the
nerves, it hardens the frame, it is the finest tonic in the world. Oh,
if every mother would follow to the very letter this counsel how much
misery, how much ill-health might then be averted!


MANAGEMENT OF THE NAVEL.

13. _Should the navel-string be wrapped in SINGED rag_?

There is nothing better than a piece of fine old linen rag,
_unsinged_; when singed, it frequently irritates the infant's skin.

14. _How ought the navel-string to be wrapped in the rag_?

Take a piece of soft linen rag, about three inches wide and four
inches long, and wrap it neatly round the navel string, in the same
manner you would around a cut finger, and then, to keep on the rag,
tie it with a few rounds of whity-brown thread. The navel-string thus
covered should, pointing upwards, be placed on the belly of the child,
and must be secured in its place by means of a flannel belly-band.

15. _If after the navel-string has been secured, bleeding should (in
the absence of the medical man) occur, how must it be restrained_?

The nurse or the attendant ought immediately to take off the rag, and
tightly, with a ligature composed of four or five whity-brown threads,
retie the navel-string; and to make assurance doubly sure, after once
tying it, she should pass the threads a second time around the
navel-string, and tie it again; and after carefully ascertaining that
it no longer bleeds, fasten it up in the rag as before. Bleeding of
the navel-string rarely occurs, yet, if it should do so--the medical
man not being at hand--the child's after-health, or even his life,
may, if the above directions be not adopted, be endangered.

16. _When does the navel-string separate from the child_?

From five days to a week after birth; in some cases not until ten days
or a fortnight, or even, in rare cases, not until three weeks.

17. _If the navel-string does not at the end of a week came away,
ought any means to be used to cause the separation_?

Certainly not, it ought always to be allowed to drop off, which, when
in a fit state, it will readily do. Meddling with the navel string
has frequently cost the babe a great deal of suffering, and in some
cases even his life.

18. _The navel is sometimes a little sore, after the navel-string
comes away, what ought then to be done_?

A little simple cerate should be spread on lint, and be applied every
morning to the part affected, and a white-bread poultice, every night,
until it is quite healed.


NAVEL RUPTURE--GROIN RUPTURE.

19. _What are the causes of a rupture of the navel? What ought to be
done? Can it be cured_?

(1) A rupture of the navel is sometimes occasioned by a meddlesome
nurse. She is very anxious to cause the navel-string to separate from
the infant's body, more especially when it is longer in coming away
than usual. She, therefore, before it is in a fit state to drop off,
forces it away. (2) The rapture, at another time, is occasioned by the
child incessantly crying. A mother, then, should always bear in mind,
that a rupture of the navel is often caused by much crying, and that
it occasions much crying, indeed, it is a frequent cause of incessant
crying. A child, therefore, who, without any assignable cause, is
constantly crying, should have his navel carefully examined.

A rupture of the navel ought always to be treated early--the earlier
the better. Ruptures of the navel can only be _cured_ in infancy and
in childhood. If it be allowed to run on until adult age, a _cure_ is
impossible. Palliative means can then only be adopted.

The best treatment is a Burgundy pitch plaster, spread on a soft piece
of wash leather, about the size of the top of a tumbler, with a
properly-adjusted pad (made from the plaster) fastened on the centre
of the plaster, which will effectually keep up the rupture, and in a
few weeks will cure it. It will be necessary, from time to time, to
renew the plaster until the cure be effected. These plasters will be
found both more efficacious and pleasant than either truss or bandage;
which latter appliances sometimes gall, and do more harm than they do
good.

20. _If an infant have a groin-rupture (an inguinal rupture), can that
also be cured_?

Certainly, if, soon after birth, it be properly attended to. Consult a
medical man, and he will supply you with a well-fitting truss, _which
will eventually cure him_. If the truss be properly made (under the
direction of an experienced surgeon) by a skilful surgical-instrument
maker, a beautiful, nicely-fitting truss will be supplied, which will
take the proper and exact curve of the lower part of the infant's
belly, and will thus keep on without using any under-strap whatever--a
great desideratum, as these under-straps are so constantly wetted and
soiled as to endanger the patient constantly catching cold. But if
this under-strap is to be superseded, the truss must be made exactly
to fit the child--to fit him like a ribbon; which is a difficult thing
to accomplish unless it be fashioned by a skilful workman. It is only
lately that these trusses have been made without under-straps.
Formerly the under-straps were indispensable necessaries.

These groin-ruptures require great attention and supervision, as the
rupture (the bowel) must, before putting on the truss be cautiously
and thoroughly returned into the belly; and much care should be used
to prevent the chafing and galling of the tender skin of the babe,
which an ill-fitting truss would be sure to occasion. But if care and
skill be bestowed on the case, a perfect cure might in due time be
ensured. The truss must not be discontinued, until a _perfect_ cure be
effected.

Let me strongly urge you to see that my advice is carried out to the
very letter, as a groin-rupture can only be _cured_ in infancy and in
childhood. If it be allowed to ran on, unattended to, until adult age,
he will be obliged to wear a truss _all his life_, which would be a
great annoyance and a perpetual irritation to him.


CLOTHING.

21. _Is it necessary to have a flannel cap in readiness to put on as
soon as the babe is born_?

Sir Charles Locock considers that a flannel cap is _not_ necessary,
and asserts that all his best nurses have long discarded flannel
caps. Sir Charles states that since the discontinuance of flannel caps
infants have not been more liable to inflammation of the eyes. Such
authority is, in my opinion, conclusive. My advice, therefore, to you
is, discontinue by all means the use of flannel caps.

22. _What kind of a belly-band do you recommend--a flannel or a calico
one_?

I prefer flannel, for two reasons--first, on account of its keeping
the child's bowels comfortably warm; and secondly, because of its not
chilling him (and thus endangering cold, &c.) when he wets
himself. The belly-band ought to be moderately, but not tightly
applied, as, if tightly applied, it would interfere with the necessary
movement of the bowels.

23. _When should the belly-band be discontinued_?

When the child is two or three months old. The best way of leaving it
off is to tear a strip off daily for a few mornings, and then to leave
it off altogether. "Nurses who take charge of an infant when the
monthly nurse leaves, are frequently in the habit of at once leaving
off the belly-band, which often leads to ruptures when the child cries
or strains. It is far wiser to retain it too long than too short a
time; and when a child catches whooping-cough, whilst still very
young, it is safer to resume the belly-band." [Footnote: Communicated
by Sir Charles Locock to the Author.]

24. _Have you any remarks to make on the clothing of on infant_?

A babe's clothing ought to be light, warm, loose, and free from
pins. (1.) _It should be light_, without being too airy. Many infant's
clothes are both too long and too cumbersome. It is really painful to
see how some poor little babies are weighed down with a weight of
clothes. They may be said to "bear the burden," and that a heavy one,
from the very commencement of their lives! How absurd, too, the
practice of making them wear _long_ clothes. Clothes to cover a
child's feet, and even a little beyond, may be desirable; but for
clothes, when the infant is carried about, to reach to the ground, is
foolish and cruel in the extreme. I have seen a delicate baby almost
ready to faint under the infliction. (2.) _It should be warm_,
without being too warm. The parts that ought to be kept warm are the
chest, the bowels, and the feet. If the infant be delicate, especially
if he be subject to inflammation of the lungs, he ought to wear a fine
flannel, instead of his usual shirts, which should be changed as
frequently. (3.) _The dress should be loose_, so as to prevent any
pressure upon the blood-vessels, which would otherwise impede the
circulation, and thus hinder a proper development of the parts. It
ought to be loose about the chest and waist, so that the lungs and the
heart may have free play. It should be loose about the stomach, so
that digestion may not be impeded; it ought to be loose about the
bowels, in order that the spiral motion of the intestines may not be
interfered with--hence the importance of putting on a belly-band
moderately slack; it should be loose about the sleeves, so that the
blood may course, without let or hindrance, through the arteries and
veins; it ought to be loose, then, everywhere, for nature delights in
freedom from restraint, and will resent, sooner or later, any
interference. Oh, that a mother would take common sense, and not
custom, as her guide! (4.) _As few pins_ should be used in the
dressing of a baby as possible. Inattention to this advice has caused
many a little sufferer to be thrown into convulsions.

The generality of mothers use no pins in the dressing of their
children; they tack every part that requires fastening with a needle
and thread. They do not even use pins to fasten the baby's
diapers. They make the diapers with loops and tapes, and thus
altogether supersede the use of pins in the dressing of an infant.
The plan is a good one, takes very little extra time, and deserves to
be universally adopted. If pins be used for the diapers, they ought to
be the Patent Safety Pins.

25. _Is there any necessity for a nurse being particular in airing an
infant's clothes before they are put on? If she were less particular,
would it not make him more hardy_?

A nurse cannot be too particular on this head. A babe's clothes ought
to be well aired the day before they are put on, as they should _not_
be put on warm from the fire. It is well, where it can be done, to let
him have clean clothes daily. Where this cannot be afforded, the
clothes, as soon as they are taken off at night, ought to be well
aired, so as to free them from the perspiration, and that they may be
ready to put on the following morning. It is truly nonsensical to
endeavour to harden a child, or any one else, by putting on damp
clothes!

26. _What is your opinion of caps for an infant_?

The head ought to be kept cool; caps, therefore, are unnecessary. If
caps be used at all, they should only be worn for the first month in
summer, or for the first two or three months in winter. If a babe take
to caps, it requires care in leaving them off, or he will catch cold.
When you are about discontinuing them, put a thinner and a thinner one
on, every time they are changed, until you leave them off altogether.

But remember, my opinion is, that a child is better _without_ caps;
they only heat his head, cause undue perspiration, and thus make him
more liable to catch cold.

If a babe does not wear a cap in the day, it is not at all necessary
that he should wear one at night. He will sleep more comfortably
without one, and it will be better for his health. Moreover,
night-caps injure both the thickness and beauty of the hair.

27. _Have you any remarks to make on the clothing of an infant, when,
in the winter time, he is sent out for exercise_?

Be sure that he is well wrapped up. He ought to have under his cloak a
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 north-east, 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 bosom 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, at so early a period that there is no milk in the
bosom; 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 bosom--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 not milk AT FIRST, what ought then to be done_?

Wait with patience; the child (if the mother have 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 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
consequently in pain, and he gives utterance to it by cries. How
absurd is such a practice! We may as well endeavour to put out a fire
by feeding it with fuel. An infant ought to be accustomed to
regularity in everything, in times for sucking, for sleeping, &c. 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 five or six 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 whilst ambling than at any other period of their lives.

It may be well, where artificial food, in addition to the mother's own
milk, is needed, and before giving any farinaceous food whatever (for
farinaceous food until a child is six or seven months old is
injurious), to give, through a feeding bottle, every night and
morning, in addition to the mother's breast of milk, the following
_Milk-Water-and Sugar-of Milk Food_--

  Fresh milk, from ONE cow,
  Warm water, of each a quarter of a pint,
  Sugar of milk one tea spoonful

The sugar of milk should first be dissolved in the warm water, and
then the fresh milk _unboiled_ should be mixed with it. The sweetening
of the above food with sugar-of-milk, instead of with lump sugar,
makes the food more to resemble the mother's own milk. The infant will
not, probably, at first take more than half of the above quantity at a
time, even if he does so much as that but still the above are the
proper proportions, and as he grows older, he will require the whole
of it at a meal.

34. _What food, when a babe is six or seven months old, 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 six or seven 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. [Footnote: "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.](4) Or Robb's Biscuits, as it is "among the best bread
compounds made out of wheat-flour, and is almost always readily
digested."--_Routh_.

(5) Another good food is the following--Take about a pound of flour
put it in a cloth, tie it up tightly, place it 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 colour. Baked flour
ought after it is baked, to be reduced, by means of a rolling pin, to
a fine powder, and should then be kept in a covered tin, ready for
use. (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 colour. 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, [Footnote: If there is
any difficulty in obtaining _prepared_ oatmeal, Robinson's Scotch
Oatmeal will answer equally as well.] 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 table-spoonful of it,
mixed with a quarter of a pint of milk, or milk and water, when well
boiled, flavoured 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 breasts, at the same
time relieving them of much draining and dragging whilst nursing with
an insufficiency of milk, as baked flour and oatmeal." [Footnote:
_British Medical Journal_, Dec 18, 1858]

(9) A ninth food may be made with "Farinaceous Food for Infants,
prepared by Hards of Dartford". If Hard's Farinaceous food produces
costiveness--as it sometimes does--let it be mixed either with equal
parts or with one third of Robinson's Scotch Oatmeal. 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. [Footnote: Lemann's Biscuit Powder cannot be
too strongly recommended--It is of the finest quality, and may be
obtained of Lemann, Threadneedle Street, London. An extended and an
extensive experience confirms me still more in the good opinion I have
of this food.] (13) Or, Brown and Polson's Patent Corn Flour will be
found suitable. Francatelli, the Queen's cook, in his recent valuable
work, gives the following formula for making it--"To one
dessert-spoonful of Brown and 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) A fourteenth is Neaves' Farinaceous Food for
Infants, which is a really good article of diet for a babe, it is not
so binding to the bowels as many of the farinaceous foods are, which
is a great recommendation.

(15) 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. This is an excellent food for weak bowels.

When the baby is six or seven 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.

(16.) For a delicate infant, lentil powder, better known as Du Barry's
"Ravalenta 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, but not otherwise. The following
(17) is a good food when an infant's bowels are weak and
relaxed:--"Into five large spoonfuls of the purest water, rub smooth
one dessert-spoonful 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 (18) genuine arrow-root
[Footnote: Genuine arrow-root, of first-rate quality, and at a
reasonable price, may be obtained of H. M. Plumbe, arrow-root
merchant, 8 Alie Place. Great Alie Street. Aldgate, London, E.] 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 equal parts of water and of good fresh
milk, and ought to be slightly sweetened with loaf sugar; a small
pinch of table salt should be added to it.

Arrow-root will not, as milk will, give bone and muscle; but it will
give--what is very needful to a delicate child--fat and
warmth. Arrow-root, as it is principally composed of starch, comes
under the same category as cream, butter, sugar, oil, and
fat. Arrowroot, then, should always be given with new milk (mixed with
one-half of water); it will then fulfil, to perfection, the exigencies
of nourishing, of warming, and fattening the child's body.

New milk, composed in due proportions as it is, of cream and of skim
milk--the very acme of perfection--is the only food, _which of itself
alone,_ will nourish and warm and fatten. It is, for a child, _par
excellence,_ the food of foods!

Arrow-root, and all other farinaceous foods are, for a child, only
supplemental to milk--new milk being, for the young, the staple food
of all other kinds of foods whatever.

But bear in mind, _and let there be no mistake about it,_ that
farinaceous food, be it what it may, until the child be six or seven
months old, until, indeed, he _begin_ to cut his teeth, is not
suitable for a child; until then, _The Milk-water-salt-and-sugar Food_
(see page 29) is usually, if he be a dry-nursed child, the best
artificial food for him.

I have given you a large and well-tried infant's dietary to chose
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 babe
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 breasts, but as the act of sucking causes the salivary glands
to press out their contents, which materially assist digestion.
Moreover, it seems to satisfy and comfort him more than it otherwise
would do.

One of the best, if not _the best_ feeding bottle I have yet seen, is
that made by Morgan Brothers, 21 Bow Lane, London. It is called "The
Anglo-French Feeding Bottle" S Maw, of 11 Aldersgate Street, London,
has also brought out an excellent one--"The Fountain Infant's Feeding
Bottle" Another good one is "Mather's Infant's Feeding Bottle" Either
of these three will answer the purpose admirably. I cannot speak in
terms too highly of these valuable inventions.

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, [Footnote: 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."] 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. 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 savour 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_ WHILST 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 five or six 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 mothers 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 have
attained the age of three or four months, then, it will usually be
necessary to feed him with _The Milk-water-and-sugar-of milk Food_
(see p 19) 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, when he is six or seven months old, be
the best for him.

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
vapours [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 afterwards."

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 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. [Footnote: For further
reasons why artificial food is not desirable, at an early period of
infancy, see answer to 35th question, page 26.] 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, when wanted, and should be given by means of a feeding-bottle.
Asses' milk is more suitable for a _delicate_ infant, and goats' milk
for a _strong_ one.

If neither asses' milk nor goats' milk can be procured, then the
following _Milk-water-salt-and-sugar Food_, from the very
commencement, should be given; and as I was the author of the formula,
[Footnote: It first appeared in print in the 4th edition of _Advice to
a Mother_, 1852.] I beg to designate it as--_Rye Chavasse's Milk
Food_:--

  New milk, the produce of ONE _healthy_ cow;
  Warm water, of each, equal parts;
  Table salt, a few grains--a small pinch;
  Lump sugar, a sufficient quantity, to slightly sweeten it.

The milk itself ought not to be heated over the fire, [Footnote: 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.] but should, as above directed, be warmed by the
water; it must, morning and evening, be had fresh and fresh. The milk
and water should be of the same temperature as the mother's milk, that
is to say, at about ninety degrees Fahrenheit. It ought to be given by
means of either Morgan's, or Maw's, or Mather's feeding-bottle,
[Footnote: See answer to Question 24, page 24.] 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. The milk should, as he grows older, be gradually increased
and the water decreased, until two-thirds of milk and one-third of
water be used; but remember, that either _much_ or _little_ water must
_always_ be given with the milk.

The above is my old form, and which I have for many years used with
great success. Where the above food does not agree (and no food except
a healthy mother's own milk does _invariably_ agree) I occasionally
substitute sugar-of milt for the lump sugar, in the proportion of a
tea spoonful of sugar-of milk to every half pint of food.

If your child bring up his food, and if the ejected matter be
sour-smelling, I should advise you to leave out the sugar-of milk
altogether, and simply to let the child live, for a few days, on milk
and water alone, the milk being of _one_ cow, and in the proportion of
two-thirds to one-third of _warm_ water--not _hot_ water, the milk
should not be scalded with _hot_ water, as it injures its properties,
besides, it is only necessary to give the child his food with the
chill just off. The above food, where the stomach is disordered, is an
admirable one, and will often set the child to rights without giving
him any medicine whatever. Moreover, there is plenty of nourishment in
it to make the babe thrive, for after all it is the milk that is the
important ingredient in all the foods of infants, they can live on it,
and on it alone, and thrive amazingly.

Mothers sometimes say to me, that farinaceous food makes their babes
flatulent, and that my food (_Pye Chavasse's Milk Food_) has not that
effect.

The reason of farinaceous food making babes, until they have
_commenced_ cutting their teeth, "windy" is, that the starch of the
farinaceous food (and all farinaceous foods contain more or less of
starch) is not digested, and is not, as it ought to be, converted by
the saliva into sugar [Footnote: See Pye Chavasse's _Counsel to a
Mother_, 3d edition.] hence "wind" is generated, and pain and
convulsions often follow in the train.

The great desideratum, in devising an infant's formula for food, is to
make it, until he be nine months old, to resemble as much as possible,
a mother's own milk, and which my formula, as nearly as is
practicable, does resemble hence its success and popularity.

As soon as a child begins to cut his teeth the case is altered, and
_farinaceous food, with milk and with water_, becomes an absolute
necessity.

I wish, then, to call your especial attention to the following-facts,
for they are facts--Farinaceous foods, _of all kinds_, before a child
_commences_ cutting his teeth (which is when he is about six or seven
months old) are worse than useless--they are, positively, injurious,
they are, during the early period of infant life, perfectly
indigestible, and may bring on--which they frequently do--
convulsions. A babe fed on farinaceous food alone would certainly die
of starvation, for, "up to six or seven months of age, infants have
not the power of digesting farinaceous or fibrinous substances"--Dr
Letheby on _Food_.

A babe's salivary glands, until he be six or seven months old, does
not secrete its proper fluid--namely, ptyalin, and consequently the
starch of the farinaceous food--and all farinaceous food contains
starch--is not converted into dextrine and grape-sugar, and is,
therefore, perfectly indigestible and useless--nay, injurious to an
infant, and may bring on pain and convulsions, and even death, hence,
the giving of farinaceous food, until a child be six or seven months
old, is one and the principal cause of the frightful infant mortality
at the present time existing in England, and which is a disgrace to
any civilized land!

In passing, allow me to urge you never to stuff a babe--never to
overload his little stomach with food, it is far more desirable to
give him a little not enough, than to give him a little too much. Many
a poor child has been, like a young bird, killed with stuffing. If a
child be at the breast, and at the breast alone, there is no fear of
his taking too much, but if he be brought up on artificial food, there
is great fear of his over loading his stomach. Stuffing a child brings
on vomiting and bowel-complaints, and a host of other diseases which
now it would be tedious to enumerate. Let me, then, urge you on no
account, to over load the stomach of a little child.

There will, then, in many cases, be quite sufficient nourishment in
the above. I have known some robust infants brought up on it, and on
it along, without a particle of farinaceous food, or of any other
food, in any shape or form whatever. 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.

Let it be thoroughly understood, and let there be no mistake about it,
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,
wet-nurse's, or asses', or goats', or cow's 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, of a consumptive habit, or if she or any of
her family have laboured 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 [Footnote: "It should be thin, and of a bluish-white colour,
sweet to the taste, and when allowed to stand, should throw up a
considerable quantity of cream,"--_Maxell and Evenson on the Diseases
of Children_.] (which may readily be ascertained by milking a little
into a glass); 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 menstruate during suckling; if she does, the
milk is not so good and nourishing, and you had better decline taking
her. [Footnote: 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 third child's mother is more eligible than
a first"--_Letter to the Author_.] Assure yourself that her own babe
is strong and healthy that he be 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, an
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 colour, 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
really 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, or not, in his
mouth.

Very feeble new-born babes sometimes cannot take the bosom, be the
nipples and the breasts ever so good, and although Maw's nipple-shield
and glass tube had been tried. In such a case, cow's
milk-water-sugar-and-salt, as recommended at page 29, must be given in
small quantities at a time--from two to four tea-spoonfuls--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 tea-spoonfuls, 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 tea-spoonfuls 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
broccoli, 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 and 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 mouths, 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,
endeavour to procure one of a mild, calm, and placid disposition.
[Footnote: "'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 labouring 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 [Footnote: The previous boiling
of the milk will prevent the warmth of the bed turning the milk sour,
which it otherwise would do.]--in the bed, so as to give a little to
him in lieu of the breast. The warmth of the body will keep the milk
of a proper temperature, and will supersede the use of lamps, of
candle-frames, and of other troublesome contrivances.

42. _While a mother is weaning her infant, and after she have weaned
him, what ought to be his diet_?

Any one of the foods recommended in answer to question 34.

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 five or six 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, [Footnote: For the first five or six 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_.]
suffer severely.

Care in feeding, then, is the grand preventative 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 cow's 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:--

  "Things sweet to taste, prove in digestion sour."

  _Shakspeare._

If a babe'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, _raw_ sugar ought to be substituted for lump
sugar, as _raw_ 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 AND RE-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 _re-vaccinated_,--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 be known only 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 re-vaccinated_?

I decidedly do: it would be an excellent plan for _every_ person, once
every seven years to be re-vaccinated, and even oftener, if small-pox
be rife in the neighbourhood. 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 be 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 civilised 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 re-vaccinated
once every seven years, or even, oftener, if there was an epidemic of
small-pox in the neighbourhood.

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 ten-fold 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 he 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
neighbourhood, 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." [Footnote: Communicated by Sir Charles Locock to the Author.]

51. _Do you consider that 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 have 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."--_Dendy_. 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 neighbourhood, 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, 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 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 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 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 comfort and relief.

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."--
_Gregory_.


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."

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_?

The first or temporary set consists of twenty. The first set of teeth
are usually cut in pairs. "I may say that nearly invariably the order
is--1st, the lower front incissors [cutting teeth], then the upper
front, then the _upper_ two lateral incissors, 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." [Footnote: Sir Charles
Locock in a _Letter_ to the Author.] Then the first grinders, in the
lower jaw, afterwards 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 the 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 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 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 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 [Footnote: For the precautions to be used in putting a child
into a warm bath, see the answer to question on "Warm Baths."] of 98
degrees Fahrenheit. If a thermometer be not at hand, [Footnote: No
family, where there are young children, should be without Fahrenheit's
thermometer.] 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 table-spoonful of
salt, of one of oil, and a tea-cupful 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.

It may be well, for the comfort of a mother, to state that a child in
convulsions is perfectly insensible to all pain whatever; indeed, a
return to consciousness speedily puts convulsions to the rout.

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 assist 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 contended 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 heartily commend to your
favourable 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 have 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." [Footnote:
  _Ingoldsby Legends_.]

My reply is,--

  P'rhaps 'tis as well to keep children from pears;
  The pain they might cause, is oft follow'd 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 fix'd, 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 ware
house.

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 fruit, _raw_ apples or pears, ought to be carefully avoided,
as they not only disorder the stomach and the bowels,--causing
convulsions, gripings, &c.,--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, &c.;
the _lungs_, producing congestion, inflammation, cough, &c.; the
_stomach_, exciting sickness, flatulence, acidity, &c,; 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; [Footnote: 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.] 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, &c.;
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
Abbot's _Mother of Home_, wherein the author proves the great
importance of _early_ training.

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 flashed. His head is
heavy and hot. He is sometimes convulsed. [Footnote: 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 gum
with the finger, with a little "soothing syrup," as recommended by Sir
Charles Locock, [Footnote: Soothing syrup--Some of them probably
contain opiates, but a perfectly safe and useful one is a little
Nitrate of Potass in syrup of Roses--one scruple to half an
ounce.--_Communicated by Sir Charles Locock to the Author._ This
'soothing syrup' is not intended to be given us a mixture but to be
used as an application to rub the gums with. It may be well to state
that it is a perfectly harmless remedy even if a little of it were
swallowed by mistake.] a tepid bath of about 92 degrees Fahrenheit,
every night at bed time, attention to diet and to bowels, fresh air
and exercise. 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. [Footnote: I should put this in capitals, it is so
important and is 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, is there 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 labouring 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 his 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 he 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
north-easterly direction. By doing so we shall make him strong and
hearty, and give the skin that mottled 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 babe 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 untrammelled. 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 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
exercises 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_
afterwards, 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 bedroom
without a fire, or by dipping him in _cold_ water, or by keeping him
with scant clothing on his bed. The temperature of a bedroom, in the
winter time, should be, as nearly as possible, at 60 deg. 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_?

If the head of the crib be covered, the babe cannot breathe freely,
the air within the crib becomes contaminated, and thus the lungs
cannot properly perform their functions. If his sleep is to be
refreshing, he must breathe pure air. I do not even approve of a head
to a crib. A child is frequently allowed to sleep on a bed with the
curtains drawn completely close, as though it were dangerous for a
breath of air to blow upon him [Footnote: I have somewhere read that
if a cage containing a canary, be suspended at night within a bed
where a person is sleeping, and the curtains be drawn closely around,
that the bird will, in the morning, in all probability, be found
dead!] This practice is most injurious. An infant must have the full
benefit of the air of the room, indeed, the bed room door ought to be
frequently left ajar, so that the air of the apartment may be changed,
taking care, of course, not to expose him to a draught. If the flies,
while he is asleep, annoy him, let a net veil be thrown over his face,
as he can readily breathe through net, but not through a handkerchief.

82. _Have you any suggestions to offer as to the way a babe should be
dressed when he is put down to sleep_?

Whenever he be put down to sleep, be more than usually particular that
his dress be loose in every part, be careful that there be neither
strings nor bands, to cramp him. Let him, then, during repose, be more
than ordinarily free and unrestrained--

  "If, whilst in cradled rest your infant sleeps.
   Your watchful eyes unceasing vigil keeps
   Lest cramping bonds his pliant limbs constrain,
   And cause defects that manhood may retain."

83. _Is it a good sign for a young child to sleep much_?

A babe who sleeps a great deal thrives much more than one who does
not. I have known many children, who were born [Footnote: It may be
interesting to a mother to know the average weight of new born
infants. There is a paper on the subject in the _Medical Circular_
(April 10, 1861) and which has been abridged in _Braithwaite's
Retrospect of Medicine_ (July and December 1861). The following are
extracts--"Dr. E. von Siebold presents a table of the weights of 3000
infants (1586 male and 1414 female) weighed immediately after
birth. From this table (for which we have not space) it results that
by far the greater number of the children, 2215 weighed between 6 and
8 lbs. From 5 3/4 to 6 lbs. the number rose from 99 to 268, and from 8 to
8 1/4 lbs. they fell from 226 to 67, and never rose again at any weight
to 100. From 8 3/4 to 9 1/2 lbs. they sank from 61 to 8, rising however at
9 1/2 lbs. to 21. Only six weighed 10 lbs., one 10 3/4 lbs. and two 11
lbs. The author has never but once met with a child weighing 11
lbs. The most frequent weight in the 3000 was 7 lbs, numbering 426. It
is a remarkable fact, that until the weight of 7 lbs the female
infants exceeded the males in number, the latter thenceforward
predominating.

From these statements, and those of various other authors here quoted,
the conclusion may be drawn that the normal weight of a mature new
born infant is not less than six nor more than 8 lbs., the average
weight being 6 1/2 or 7 lbs., the smaller number referring to female and
the higher to male infants."] small and delicate, but who slept the
greatest part of their time, become strong and healthy. On the other
hand, I have known those who were born large and strong, yet who slept
but little, become weak and unhealthy.

The common practice of a nurse allowing a baby to sleep upon her lap
is a bad one, and ought never to be countenanced. He sleeps cooler,
more comfortably, and soundly in his crib.

The younger an infant is the more he generally sleeps, so that during
the early months he is seldom awake, and then only to take the breast.

84. _How is it that much sleep causes a young child to thrive so
well_?

If there be pain in any part of the body, or if any of the functions
be not properly performed, he sleeps but little. On the contrary, if
there be exemption from pain, and if there be a due performance of all
the functions, he sleeps a great deal, and thus the body becomes
refreshed and invigorated.

85. _As much sleep is of such advantage, if an infant sleep but
little, would you advise composing medicine to be given to him_?

Certainly not. The practice of giving composing medicine to a young
child cannot he too strongly reprobated. If he does not sleep enough,
the mother ought to ascertain if the bowels be in a proper state,
whether they be sufficiently opened, that the motions be of a good
colour--namely, a bright yellow, inclining to orange colour--and free
from slime or from bad smell. An occasional dose of rhubarb and
magnesia is frequently the best composing medicine he can take.

86. _We often hear of coroner's inquests upon infants who have been
found dead in bed--accidentally overlaid what is usually the cause_?

Suffocation, produced either by ignorance, or by carelessness. From
_ignorance_ in mothers, in their not knowing the common laws of life,
and the vital importance of free and unrestricted respiration, not
only when babies are up and about, but when they are in bed and
asleep. From _carelessness_, in their allowing young and thoughtless
servants to have the charge of infants at night, more especially as
young girls are usually heavy sleepers, and are thus too much
overpowered with sleep to attend to their necessary duties.

A foolish mother sometimes goes to sleep while allowing her child to
continue sucking. The unconscious babe, after a tune, looses the
nipple, and buries his head in the bed-clothes. She awakes in the
morning, finding, to her horror, a corpse by her side, with his nose
flattened, and a frothy fluid, tinged with, blood, exuding from his
lips. A mother ought, therefore, never to go to sleep until her child
have finished sucking.

_The following are a few rules to prevent an infant from being
accidentally overlaid_--(1.) Let your baby while asleep have plenty of
room in the bed. (2.) Do not allow him to be too near to you; or if he
he unavoidably near you (from the small size of the bed), let his face
be turned to the opposite side. (3.) Let him lie fairly either on his
side, or on his back. (4.) Be careful to ascertain that his mouth be
not covered with the bed-clothes; and, (5.) Do not smother his face
with clothes, as a plentiful supply of pure air is as necessary when
he is awake, or even more so, than when he is asleep. (6.) Never let
him lie low in the bed. (7.) Let there be _no_ pillow near the one
his head is resting on, lest he roll to it, and thus bury his head in
it Remember, a young child has neither the strength nor the sense to
get out of danger; and, if he unfortunately either turn on his face,
or bury his head in a pillow that is near, the chances are that he
will be suffocated, more especially as these accidents usually occur
at night, when the mother, or the nurse, is fast asleep. (8.) Never
intrust him at night to a young and thoughtless servant.


THE BLADDER AND THE BOWELS OF AN INFANT.

87. _Have you any hints to offer respecting the bowels and the bladder
of an infant during the first three months of his existence_?

A mother ought daily to satisfy herself as to the state of the bladder
and the bowels of her child. She herself should inspect the motions,
and see that they are of a proper colour (bright-yellow, inclining to
orange), and consistence (that of thick gruel), that they are neither
slimy, nor curdled, nor green; if they should be either the one or the
other, it is a proof that she herself has, in all probability, been
imprudent in her diet, and that it will be necessary for the future
that she be more careful both in what she eats and in what she drinks.

She ought, moreover, to satisfy herself that the urine does not smell
strongly, that it does not stain the diapers, and that he makes a
sufficient quantity.

A frequent cause of a child crying is, he is wet, and uncomfortable,
and wants drying and changing, and the only way he has of informing
his mother of the fact is by crying lustily, and thus telling her in
most expressive language of her thoughtlessness and carelessness.

88. _How soon may an infant dispense with diapers_?

A babe of three months and upwards, ought to be held out, at least, a
dozen times during the twenty-four hours; if such a plan were adopted,
diapers might at the end of three months be dispensed with--a great
_desideratum_-and he would be inducted into clean habits--a blessing
to himself, and a comfort to all around, and a great saving of dresses
and of furniture. "Teach your children to be clean. A dirty child is
the mother's disgrace," [Footnote: Hints on Household Management, By
Mrs C. L. Balfour.] Truer words were never written,--A DIRTY CHILD IS
THE MOTHER'S DISGRACE.


AILMENTS, DISEASE, ETC.

89. _A new born babe frequently has a collection of mucus in the air
passages, causing him to wheeze: is it a dangerous symptom_?

No, not if it occur _immediately_ after birth; as soon as the bowels
have been opened, it generally leaves him, or even before, if he give
a good cry, which as soon as he is born he usually does. If there be
any mucus either within or about the mouth, impeding breathing, it
must with a soft handkerchief be removed.

90. _Is it advisable, as soon as an infant is born, to give him
medicine_?

It is now proved that the giving of medicine to a babe _immediately_
after birth is unnecessary, nay, that it is hurtful--that is, provided
he be early put to the breast, as the mother's _first_ milk is
generally sufficient to open the bowels. Sir Charles Locock [Footnote:
In a _Letter_ to the Author.] makes the following sensible remarks on
this subject:--"I used to limit any aperient to a new-born infant to
those which had not the first milk, and who had wet nurses, whose milk
was, of course, some weeks old, but for many years I have never
allowed any aperient at all to any new born infant, and I am satisfied
it is the safest and the wisest plan."

The advice of Sir Charles Locock--_to give no aperient to a new-born
infant_--is most valuable, and ought to be strictly followed. By
adopting his recommendation, much after misery might be averted. If a
new born babe's bowels be costive, rather than give him an aperient,
try the effect of a little moist sugar, dissolved in a little water,
that is to say, dissolve half a tea-spoonful of pure unadulterated
_raw_ sugar in a tea-spoonful of warm water and administer it to him,
if in four hours it should not operate, repeat the dose. Butter and
raw sugar is a popular remedy, and is sometimes used by a nurse to
open the bowels of a new born babe, and where there is costiveness,
answers the purpose exceedingly well, and is far superior to castor
oil. Try by all means to do, if possible, without a particle of
opening medicine. If you once begin to give aperients, you will have
frequently to repeat them. Opening physic leads to opening physic,
until at length his stomach and bowels will become a physic shop! Let
me, then, emphatically say, avoid, if possible, giving a new born babe
a drop or a gram of opening medicine. If from the first you refrain
from giving an aperient, he seldom requires one afterwards. It is the
_first_ step, in this as in all other things, that is so important to
take.

If a new-born babe have _not_ for twelve hours made water, the medical
man ought to be informed of it, in order that he may inquire into the
matter, and apply the proper remedies. Be particular in attending to
these directions, or evil consequences will inevitably ensue.

91. _Some persons say, that new-born female infants have milk in their
bosoms, and that it is necessary to squeeze them, and apply plasters
to disperse the milk_.

The idea of there being real milk in a baby's breast is doubtful, the
squeezing of the bosom is barbarous, and the application of plasters
is useless. "Without actually saying," says Sir Charles Locock, "there
is milk secreted in the breasts of infants, there is undoubtedly not
rarely considerable swelling of the breasts both in _female_ and
_male_ infants, and on squeezing them a serous fluid oozes out. I
agree with you that the nurses should never be allowed to squeeze
them, but be ordered to leave them alone." [Footnote: _Letter_ to the
Author.]

92. _Have the goodness to mention the SLIGHT ailments which are not of
sufficient importance to demand the assistance of a medical man_?

I deem it well to make the distinction between _serious_ and _slight_
ailments, I am addressing a mother. With regard to serious ailments, I
do not think myself justified, except in certain _urgent_ cases, in
instructing a parent to deal with them. It might be well to make a
mother acquainted with the _symptoms_, but not with the _treatment_,
in order that she might lose no time in calling in medical aid. This I
hope to have the pleasure of doing in future Conversations.

_Serious diseases, with a few exceptions_, and which I will indicate
in subsequent Conversations, ought never to be treated by a parent,
not even in the _early_ stages, for it is in the early stages that the
most good can generally be done. It is utterly impossible for any one
who is not trained to the medical profession to understand a _serious_
disease in all its bearings, and thereby to treat it satisfactorily.

There are some exceptions to these remarks. It will be seen in future
Conversations that Sir CHARLES LOCOCK considers that a mother ought to
be made acquainted with the _treatment_ of _some_ of the more
_serious_ diseases, where delay in obtaining _immediate_ medical
assistance might be death. I bow to his superior judgment, and have
supplied the deficiency in subsequent Conversations.

The ailments and the diseases of infants, such as may, in the absence
of the doctor, be treated by a parent, are the following:--Chafings,
Convulsions, Costivenesa, Flatulence, Gripings, Hiccup, Looseness of
the Bowels (Diarrhoea), Dysentery, Nettle-rash, Red-gum, Stuffing of
the Nose, Sickness, Thrush. In all these complaints I will tell
you--_What to do_, and--_What NOT to do_.

93. _What are the causes and the treatment of Chafing_?

The want of water: inattention and want of cleanliness are the usual
causes of chafing.

_What to do._--The chafed parts ought to be well and thoroughly
sponged with tepid _rain_ water--allowing the water from a well-filled
sponge to stream over them,--and, afterwards, they should be
thoroughly, but tenderly, dried with a soft towel, and then be dusted,
either with finely-powdered starch, made of wheaten flour, or with
Violet Powder, or with finely-powdered Native Carbonate of Zinc, or
they should be bathed with finely-powdered Fuller's-earth and tepid
water.

If, in a few days, the parts be not healed discontinue the above
treatment, and use the following application:--Beat up well together
the whites of two eggs, then add, drop by drop, two table-spoonfuls of
brandy. When well mixed, put it into a bottle and cork it up. Before
using it let the excoriated parts be gently bathed with luke-warm rain
water, and, with a soft napkin, be tenderly dried; then, by means of a
camel's hair brush, apply the above liniment, having first shaken the
bottle. But bear in mind, after all that can be said and done, _that
there is nothing in these cases like water_--there is nothing like
keeping the parts clean, and the only way of thoroughly effecting this
object is _by putting him every morning INTO his tub_.

_What NOT to do_.--Do not apply white lead, as it is a poison. Do not
be afraid of using _plenty_ of water, as cleanliness is one of the
most important items of the treatment.

94. _What are the causes of Convulsions of an infant_?

Stuffing him, in the early months of his existence, _with food_, the
mother having plenty of breast milk the while, the constant physicking
of child by his own mother, teething, hooping-cough, when attacking a
very young baby.

I never knew a case of convulsions occur--say for the first four
months--(except in very young infants labouring under hooping-cough),
where children lived on the breast-milk alone, and where they were
_not_ frequently quacked by their mothers.

For the treatment of the convulsions from teething, see page 46.

_What to do_ in a case of convulsions which has been caused by feeding
an infant either with too much or with _artificial_ food. Give him,
every ten minutes, a tea-spoonful of ipecacuanha wine, until free
vomiting be excited then put him into a warm bath (see Warm Baths),
and when he comes out of it administer to him a tea-spoonful of castor
oil, and repeat it every four hours, until the bowels be well opened.

_What NOT to do_--Do not for at least a month after the fit, give him
artificial food, but keep him entirely to the breast. Do not apply
leeches to the head.

_What to do in a case of convulsions from hooping cough_--There is
nothing better than dashing cold water on the face, and immersing him
in a warm bath of 98 degrees Fahr. If he be about his teeth, and they
be plaguing him, let the gums be both freely and frequently
lanced. Convulsions seldom occur in hooping-cough, unless the child be
either very young or exceedingly delicate. Convulsions attending an
attack of hooping-cough make it a _serious_ complication, and requires
the assiduous and skilful attention of a judicious medical man.

_What NOT to do in such a case_--Do not apply leeches, the babe
requires additional strength, and not to be robbed of it, and do not
attempt to treat the case yourself.

95. _What are the best remedies for the Costiveness of an infant_?

I strongly object to the frequent administration of opening medicine,
as the repetition of it increases the mischief to a tenfold degree.

_What to do_.--If a babe, after the first few months, were held out,
and if, at regular intervals, he were put upon his chair, costiveness
would not so much prevail. It is wonderful how soon the bowels, in
the generality of cases, by this simple plan, may be brought into a
regular state. Besides, it inducts an infant into clean habits, I know
many careful mothers who have accustomed their children, after the
first three months, to do without diapers altogether. It causes at
first a little trouble, but that trouble is amply repaid by the good
consequences that ensue; among which must be named the dispensing with
such encumbrances as diapers. Diapers frequently chafe, irritate, and
gall the tender skin of a baby. But they cannot of course, at an early
age be dispensed with, unless a mother have great judgment, sense,
tact, and perseverance, to bring her little charge into the habit of
having his bowels relieved and his bladder emptied every time he is
either held out or put upon his chair.

Before giving an infant a particle of aperient medicine, try, if the
bowels are costive, the effect of a little _raw_ sugar and water,
either half a tea-spoonful of raw sugar dissolved in a tea-spoonful or
two of water, or give him, out of your fingers, half a tea-spoonful of
raw sugar to eat. I mean by _raw_ sugar, not the white, but the pure
and unadulterated sugar, and which you can only procure from a
respectable grocer. If you are wise, you will defer as long as you can
giving an aperient. If you once begin, and continue it for a while,
opening medicine becomes a dire necessity, and then woe betide the
poor unfortunate child. Or, give a third of a tea-spoonful of honey,
early in the morning, occasionally. Or administer a warm water
enema--a tablespoonful, or more, by means of a 2 oz. India Rubber
Enema Bottle.

_What NOT to do_.--There are two preparations of mercury I wish to
warn you against administering of your own accord, viz.--(1) Calomel,
and a milder preparation called (2) Grey-powder (mercury with
chalk). It is a common practice in this country to give calomel, on
account of the readiness with which it can be administered it being
small in quantity, and nearly tasteless. Grey powder also, is, with
many mothers, a favourite in the nursery. It is a medicine of immense
power--either for good or for evil, in certain cases it is very
valuable, but in others, and in the great majority, it is very
detrimental. This practice, then, of a mother giving mercury, whether
in the form either of calomel or of grey powder, cannot be too
strongly reprobated, as the frequent administration either of the one
or of the other weakens the body, predisposes it to cold, and
frequently excites king's-evil--a disease too common in this
country. Calomel and grey-powder, then, ought never to be administered
unless ordered by a medical man.

Syrup of buckthorn and jalap are also frequently given, but they are
griping medicines for a baby, and ought to be banished from the
nursery.

The frequent repetition of opening medicines, then, in any shape or
form, very much interferes with digestion, they must, therefore, be
given as seldom as possible.

Let me, at the risk of wearying you, again urge the importance of your
avoiding, as much as possible, giving a babe purgative medicines. They
irritate beyond measure the tender bowels of an infant, and only make
him more costive afterwards, they interfere with his digestion, and
are liable to give him cold. A mother who is always, of her own
accord, quacking her child with opening physic, is laying up for her
unfortunate offspring a debilitated constitution--a miserable
existence.

For further information on this important subject see the 3d edition
of _Counsel to a Mother (being the companion volume of Advice to a
Mother)_, on the great importance of desisting from irritating, from
injuring, and from making still more costive, the obstinate bowels of
a costive child,--by the administration of opening medicine,--however
gentle and well-selected the aperients might be. Oh, that the above
advice could be heard, and be acted upon, through the length and the
breadth of the land, how much misery and mischief would then be
averted!

96. _Are there any means of preventing the Costiveness of an infant_?

If greater care were paid to the rules of health, such as attention to
diet, exercise in the open air, thorough ablution of the _whole_
body--more especially when he is being washed--causing the water, from
a large and well-filled sponge, to stream over the lower part of his
bowels; the regular habit of causing him, at stated periods, to be
held out, whether he want or not, that he may solicit a stool. If all
these rules were observed, costiveness would not so frequently
prevail, and one of the miseries of the nursery would be done away
with.

Some mothers are frequently dosing their poor unfortunate babes either
with magnesia to cool them, or with castor oil to heal their bowels!
Oh, the folly of such practices! The frequent repetition of magnesia,
instead of cooling an infant, makes him feverish and irritable. The
constant administration of castor oil, instead of healing the bowels,
wounds them beyond measure. No! it would be a blessed thing if a babe
could be brought up without giving ham a particle of opening medicine;
his bowels would then act naturally and well: but then, as I have just
now remarked, a mother, must be particular in attending to Nature's
medicines--to fresh air, to exercise, to diet, to thorough ablution,
&c. Until that time comes, poor unfortunate babies must be,
occasionally, dosed with an aperient.

97. _What are the causes of, and remedies for, Flatulence_?

Flatulence most frequently occurs in those infants who live on
_artificial_ food, especially if they be over-fed. I therefore beg to
refer you to the precautions I have given, when speaking of the
importance of keeping a child for the first five or six months
_entirely_ to the breast; and, if that be not practicable, of the
times of feeding, and of the _best_ kinds of artificial food, and of
those which are least likely to cause "wind."

_What to do._--Notwithstanding these precautions, if the babe should
still suffer, "One of the best and safest remedies for flatulence is
Sal volatile,--a tea-spoonful of a solution of one drachm to an ounce
and a half of water" [Footnote: Sir Charles Locock, in a _Letter_ to
the Author Since Sir Charles did me the honour of sending me, for
publication, the above prescription for flatulence, a new "British
Pharmacopoeia" has been published in which the sal volatile is much
increased in strength it is therefore necessary to lessen the sal
volatile in the above prescription one half--that is to say, a tea
spoonful of the solution of _half_ a drachm to an ounce and a half of
water.] Or, a little dill or aniseed may be added to the food--half a
tea-spoonful of dill water Or, take twelve drops of oil of dill, and
two lumps of sugar, rub them well in a mortar together, then add, drop
by drop, three table-spoonfuls of spring water, let it be preserved in
a bottle for use. A tea-spoonful of this, first shaking the vial, may
be added to each quantity of food. Or, three tea-spoonfuls of bruised
caraway-seeds may be boiled for ten minutes in a tea-cupful of water,
and then strained. One or two tea-spoonfuls of the caraway tea may be
added to each quantity of his food, or a dose of rhubarb and magnesia
may occasionally be given.

Opodeldoc, or warm olive oil, well rubbed, for a quarter of an hour at
a time, by means of the warm hand, over the bowels, will frequently
give relief. Turning the child over on his bowels, so that they may
press on the nurses' lap, will often afford great comfort. A warm
bath (where he is suffering severely) generally gives _immediate_ ease
in flatulence, it acts as a fomentation to the bowels. But after all,
a dose of mild aperient medicine, when the babe is suffering severely,
is often the best remedy for "wind."

Remember, at all times, prevention, whenever it be--and how frequently
it is--possible, is better than cure.

_What NOT to do_--"Godfrey's Cordial," "Infants' Preservative," and
"Dalby's Carminative," are sometimes given in flatulence, but as most
of these quack medicines contain, in one form or another, either opium
or poppy, and as opium and poppy are both dangerous remedies for
children, ALL quack medicines must be banished the nursery.

Syrup of poppies is another remedy which is often given by a nurse to
afford relief for flatulence; but let me urge upon you the importance
for banishing it from the nursery. It has (when given by
unprofessional persons) caused the untimely end of thousands of
children. The medical journals and the newspapers teem with cases of
deaths from mothers incautiously giving syrup of poppies to ease pain
and to procure sleep.

98. _What are the symptoms, the causes, and the treatment of
"Gripings" of an infant_?

_The symptoms._--The child draws up his legs; screams violently; if
put to the nipple to comfort him, he turns away from it and cries
bitterly; he strains, as though he were having a stool; if he have a
motion, it will be slimy, curdled, and perhaps green. If, in addition
to the above symptoms, he pass a large quantity of watery fluid from
his bowels, the case becomes one of _watery gripes_, and requires the
immediate attention of a doctor.

The _causes_ of "gripings" or "gripes" may proceed either from the
infant or from the mother. If from the child, it is generally owing
either to improper food or to over-feeding; if from the mother, it may
be traced to her having taken either greens, or port, or tart beer, or
sour porter, or pickles, or drastic purgatives.

_What to do._--The _treatment_, of course, must depend upon the
cause. If it arise from over-feeding, I would advise a dose of castor
oil to be given, and warm fomentations to be applied to the bowels,
and the mother, or the nurse, to be more careful for the future. If it
proceed from improper food, a dose or two of magnesia and rhubarb in a
little dill water, made palatable with simple syrup. [Footnote:

  Take of--Powdered Turkey Rhubarb, half a scruple;
           Carbonate of Magnesia, one scruple;
           Simple Syrup, three drachms;
           Dill Water, eight drachms;

Make a Mixture, One or two tea-spoonfuls (according to the age of the
child) to be taken every four boors, until relief be obtained--first
shaking the bottle.) If it arise from a mother's imprudence in eating
trash, or from her taking violent medicine, a warm bath, a warm bath,
indeed, let the cause of "griping" be what it may, usually affords
instant relief.

Another excellent remedy is the following--Soak a piece of new
flannel, folded into two or three thicknesses, in warm water, wring it
tolerably dry, and apply as hot as the child can comfortably bear it
to the bowels, then wrap him in a warm, dry blanket, and keep him, for
at least half an hour, enveloped in it. Under the above treatment, he
will generally soon fall into a sweet sleep, and awake quite
refreshed.

_What NOT to do_--Do not give opiates, astringents, chalk, or any
quack medicine whatever.

If a child suffer from a mother's folly in her eating improper food,
it will be cruel in the extreme for him a _second_ time to be
tormented from the same cause.

99. _What occasions Hiccup, and what is its treatment_?

Hiccup is of such a trifling nature as hardly to require
interference. It may generally be traced to over feeding. Should it be
severe, four or five grains of calcined magnesia, with a little syrup
and aniseed water, and attention to feeding are all that will be
necessary.

100. _Will you describe the symptoms of Infantile Diarrhoea_?

Infantile diarrhoea, or _cholera infantum_, is one of the most
frequent and serious of infantile diseases, and carries off, during
the year, more children than any other complaint whatever a knowledge
of the symptoms, therefore, is quite necessary for a mother to know,
in order that she may, at the proper tune, call in efficient medical
aid.

It will be well, before describing the symptoms, to tell you how many
motions a young infant ought to have a day, their colour, consistence,
and smell. Well, then, he should have from three to six motions in
the twenty four hours, the colour ought to be a bright yellow,
inclining to orange, the consistence should be that of thick gruel;
indeed, his motion, if healthy, ought to be somewhat of the colour
(but a little more orange-tinted) and of the consistence of mustard
made for the table; it should be nearly, if not quite, devoid of
smell; it ought to have a faint and peculiar, but not a strong
disagreeable odour. If it have a strong and disagreeable smell, the
child is not well, and the case should be investigated, more
especially if there be either curds or lumps in the motions; these
latter symptoms denote that the food has not been properly digested.

Now, suppose a child should have a slight bowel complaint--that is to
say, that he has six or eight motions during the twenty-four
hours,--and that the stools are of a thinner consistence than what I
have described,--provided, at the same time, that he be not griped,
that he have no pain, and have not lost his desire for the
breast:--What ought to be done?_Nothing_. A slight looseness of the
bowels should _never_ be interfered with,--it is often an effort of
nature to relieve itself of some vitiated motion that wanted a
vent--or to act as a diversion, by relieving the irritation of the
gums. Even if he be not cutting his teeth, he may be "breeding"
them--that is to say, the teeth may be forming in his gums, and may
cause almost as much, irritation as though he were actually cutting
them. Hence, you see the immense good a slight "looseness of the
bowels" may cause. I think that I have now proved to you the danger of
interfering in such a case, and that I have shown you, the folly and
the mischief of at once giving astringents--such as Godfrey's Cordial,
Dalby's Carminative, &c.--to relieve a _slight_ relaxation.

A moderate "looseness of the bowels," then, is often a safety-valve,
and you may, with as much propriety, close the safety-valve of a steam
engine, as stop a moderate "looseness of the bowels!"

Now, if the infant, instead of having from three to six motions,
should have more than double the latter number; if they be more
watery; if they become slimy and green, or green in part and curdled;
if they should have an unpleasant smell; if he be sick, cross,
restless, fidgety, and poorly; if every time he have a motion he be
griped and in pain, we should then say that he is labouring under
Diarrhoea; then, it will be necessary to give a little medicine, which
I will indicate in a subsequent Conversation.

Should there be both blood and slime mixed with the stool, the case
becomes more serious; still, with proper care, relief can generally be
quickly obtained. If the evacuations--instead of being stool--are
merely blood and slime, and the child strain frequently and violently,
endeavouring thus, but in vain, to relieve himself, crying at each
effort, the case assumes the character of Dysentery. [Footnote: See
Symptoms and Treatment of Dysentery.]

If there be a mixture of blood, slime, and stool from the bowels, the
case would be called Dysenteric-diarrhoea. The latter case requires
great skill and judgment on the part of a medical men, and great
attention and implicit obedience from the mother and the nurse. I
merely mention these diseases in order to warn you of their
importance, and of the necessity of strictly attending to a doctor's
orders.

101. _What are the causes of Diarrhoea--"Looseness of the bowels?"_

Improper food; overfeeding; teething; cold; the mother's milk from
various causes disagreeing, namely, from her being out of health, from
her eating unsuitable food, from her taking improper and drastic
purgatives, or from her suckling her child when she is pregnant. Of
course, if any of these causes are in operation, they ought, if
possible, to be remedied, or medicine to the babe will be of little
avail.

102. _What is the treatment of Diarrhoea_?

_What to do._--If the case be _slight_, and has lasted two or three
days (do not interfere by giving medicine at first), and if the cause,
as it probably is, be some acidity or vitiated stool that wants a
vent, and thus endeavours to obtain one by purging, the best treatment
is, to assist nature by giving either a dose of castor oil, or a
moderate one of rhubarb and magnesia, [Footnote: For a rhubarb and
magnesia mixture prescription, see page 71 (_note_).] and thus to work
off the enemy. After the enemy has been worked off, either by the
castor oil, or by the magnesia and rhubarb, the purging will, in all
probability, cease; but if the relaxation still continue, that is to
say, for three or four days--then, if medical advice cannot be
procured, the following mixture should be given:--

  Take of--Aromatic Powder of Chalk and Opium, ten grains;
           Oil of Dill, five drops;
           Simple Syrup, three drachms;
           Water, nine drachms;

Make a Mixture, [Footnote: Let the mixture be made by a chemist.] Half
a tea-spoonful to be given to an infant of six months and under, and
one tea-spoonful to a child above that age, every four hours--first
shaking the bottle.

If the babe be at the breast, he ought, for a few days, to be kept
_entirely_ to it. The mother should be most particular in her own
diet.

_What NOT to do._--The mother must neither take greens, nor cabbage,
nor raw fruit, nor pastry, nor beer; indeed, while the diarrhoea of
her babe continues, she had better abstain from wine, as well as from
fermented liquors. The child, if at the breast, ought _not_, while
the diarrhoea continues, to have any artificial food. He must neither
be dosed with grey-powder (a favourite, but highly improper Remedy, in
these cases), nor with any quack medicines, such as Dalby's
Carminative or Godfrey's Cordial.

103. _What are the symptoms of Dysentery_?

Dysentery frequently arises from a neglected diarrhoea. It is more
dangerous than diarrhoea, as it is of an inflammatory character; and
as, unfortunately, it frequently attacks a delicate child, requires
skilful handling; hence the care and experience required in treating a
case of dysentery.

Well, then, what are the symptoms? The infant, in all probability, has
had an attack of diarrhoea--bowel complaint as it is called--for
several days; he having had a dozen or two of motions, many of them
slimy and frothy, like "frog-spawn," during the twenty-four hours.
Suddenly the character of the motion changes,--from being principally
stool, it becomes almost entirely blood and mucus; he is dreadfully
griped, which causes him to strain violently, as though his inside
would come away every time he has a motion,--screaming and twisting
about, evidently being in the greatest pain, drawing his legs up to
his belly and writhing in agony. Sickness and vomiting are always
present, which still more robs him of his little remaining strength,
and prevents the repair of his system. Now, look at his face! It is
the very picture of distress. Suppose he has been a plump, healthy
little fellow, you will see his face, in a few days, become
old-looking, care-worn, haggard, and pinched. Day and night the enemy
tracks him (unless proper remedies be administered); no sleep, or if
he sleep, he is, every few minutes, roused. It is heart-rending to
have to attend a bad case of dysentery in a child,--the writhing, the
screaming, the frequent vomiting, the pitiful look, the rapid wasting
and exhaustion, make it more distressing to witness than almost any
other disease a doctor attends.

104. _Can anything be done to relieve such a case_?

Yes. A judicious medical man will do a great deal. But, suppose that
yon are not able to procure one, I will tell you _what to do_ and
_what NOT to do_.

_What to do_.--If the child be at the breast, keep him to it, and let
him have nothing else for dysentery is frequently caused by improper
feeding. If your milk be not good, or it be scanty, _instantly_
procure a healthy wet-nurse. _Lose not a moment;_ for in dysentery,
moments are precious. But, suppose that you have no milk, and that no
wet-nurse can be procured: what then? Feed him entirely on cow's
milk--the milk of _one_ healthy cow; let the milk be unboiled, and be
fresh from the cow. Give it in small quantities at a time, and
frequently, so that it may be retained on the stomach. If a
table-spoonful of the milk make him sick, give him a dessert-spoonful;
if a dessert-spoonful cause sickness, let him only have a tea-spoonful
at a time, and let it be repeated every quarter of an hour. But,
remember, in such a case the breast milk--the breast milk alone--is
incomparably superior to any other milk or to any other food whatever.

If he be a year old, and weaned, then feed him, as above recommended,
on the cow's milk. If there be extreme exhaustion and debility, let
fifteen drops of brandy be added to each table-spoonful of new milk,
and let it be given every half hour.

Now with regard to medicine. I approach this part of the treatment
with some degree of reluctance,--for dysentery is a case requiring
opium--and opium I never like a mother of her own accord to
administer. But suppose a medical man cannot be procured in time, the
mother must then prescribe, or the child will die! _What then is to
be done?_ Sir Charles Locock considers "that, in severe dysentery,
especially where there is sickness, there is no remedy equal to pure
Calomel, in a full dose without opium." [Footnote: Communicated by Sir
Charles Locock to the Author.] Therefore, at the very _onset_ of the
disease, let from three to five grains (according to the age of the
patient) of Calomel, mixed with an equal quantity of powdered white
sugar, be put dry on the tongue. In three hours after let the
following mixture be administered:--

  Take of--Compound Powder of Ipecacuanha, five grains;
           Ipecacuanha Wine, one drachm;
           Simple Syrup, three drachms;
           Cinnamon Water, nine drachms;

To make a Mixture, A tea-spoonful to be given every three or four
hours, first _well_ shaking the bottle.

Supposing he cannot retain the mixture--the stomach rejecting it as
soon as swallowed--what then? Give the opium, mixed with small doses
of mercury with chalk and sugar, in the form of powder, and put one of
the powders _dry_ on the tongue, every three hours:--

  Take of--Powdered Opium, half a grain;
           Mercury with chalk, nine grains;
           Sugar of Milk, twenty-four grains;

Mix well in a mortar, and divide into twelve powders.

Now, suppose the dysentery has for several days persisted, and that,
during that time, nothing but mucus and blood--that no real stool--has
come from the bowels, then a combination of castor oil and opium
[Footnote: My friend, the late Dr Baly, who had made dysentery his
particular study, considered the combination of opium and castor oil
very valuable in dysentery.] ought, instead of the medicine
recommended above, to be given:--

  Take of--Mucilage of Gum Acacia, three drachms;
           Simple Syrup, three drachms;
           Tincture of Opium, ten drops (_not_ minims);
           Castor Oil, two drachms;
           Cinnamon water, four drachms:

Make a Mixture. A tea spoonful to be taken every four hours, first
_well_ shaking the bottle.

A warm bath, at the commencement of the disease, is very efficacious;
but it must be given at the _commencement_. If he has had dysentery
for a day or two, he will be too weak to have a warm bath; then,
instead of the bath, try the following:--Wrap him in a blanket, which
has been previously wrung out of hot water; over which envelope him in
a _dry_ blanket. Keep him in this hot, damp blanket for half an hour;
then take him out, put on his nightgown and place him in bed, which
has been, if it be winter time, previously warmed. The above "blanket
treatment" will frequently give great relief, and will sometimes cause
him to fall into a sweet sleep. A flannel bag, filled with hot
powdered table salt, made hot in the oven, applied to the bowels, will
afford much comfort.

_What NOT to do_.--Do not give aperients unless it be, as before
advised, the castor oil guarded with the opium; do not stuff him with
artificial food; do not fail to send for a judicious and an
experienced medical man; for, remember, it requires a skilful doctor
to treat a case of dysentery, more especially in a child.

105. _What are the symptoms, the causes and the treatment of
Nettle-rash_?

Nettle-rash consists of several irregular, raised wheals, red at the
base, and white on the summit, on different parts of the body; _but it
seldom attacks the face_. It is not contagious, and it may occur at
all ages and many times. It comes and goes, remaining only a short
time in a place. It puts on very much the appearance of the child
having been stung by nettles--hence its name. It produces great heat,
itching, and irritation, sometimes to such a degree as to make him
feverish, sick, and fretful. He is generally worse when he is warm in
bed, or when the surface of his body is suddenly exposed to the air.
Rubbing the skin, too, always aggravates the itching and the tingling,
and brings out a fresh crop.

The _cause_ of nettle-rash may commonly be traced to improper feeding;
although, occasionally, it proceeds from teething.

_What to do_.--It is a complaint of no danger, and readily gives way
to a mild aperient, and to attention to diet. There is nothing better
to relieve the irritation of the skin than a warm bath. If it be a
severe attack of nettle-rash, by all means call in a medical man.

_What NOT to do_.--Do not apply cold applications to his skin, and do
not wash him (while the rash is out) in quite _cold_ water. Do not
allow him to be in a draught, but let him be in a well-ventilated
room. If he be old enough to eat meat, keep it from him for a few
days, and let him live on milk and farinaceous diet. Avoid strong
purgatives, and calomel, and grey-powder.

106. _What are the symptoms and the treatment of Red-gum_?

Red-gum, tooth-rash, red-gown, is usually owing to irritation from
teething; not always from the cutting but from the evolution--the
"breeding," of the teeth. It is also sometimes owing to unhealthy
stools irritating the bowels, and showing itself, by sympathy, on the
skin. Red-gum consists of several small papulae, or pimples, about the
size of pins' heads, and may be known from measles--the only disease
for which it is at all likely to be mistaken--by its being unattended
by symptoms of cold, such as sneezing, running, and redness of the
eyes, &c., and by the patches _not_ assuming a crescentic--half-moon
shape; red-gum, in short, may readily he known by the child's health
being unaffected, unless, indeed, there be a great crop of pimples;
then there will be slight feverishness.

_What to do_.--Little need be done. If there be a good deal of
irritation, a mild aperient should be given. The child ought to be
kept moderately, but not very warm.

_What NOT to do_.--Draughts of air, or cold should be carefully
avoided; as, by sending the eruption suddenly in, either convulsions
or disordered bowels might be produced. Do not dose him with
grey-powder.

107. _How would you prevent "Stuffing of the nose" in a new-born
babe_?

Rubbing a little tallow on the bridge of the nose is the old-fashioned
remedy, and answers the purpose. It ought to be applied every evening
just before putting him to bed. If the "stuffing" be severe, dip a
sponge in hot water, as hot as he can comfortably bear; ascertain that
it be not too hot, by previously applying it to your own face, and
then put it for a few minutes to the bridge of his nose. As soon as
the hard mucus is within reach, it should be carefully removed.

108. _Do you consider sickness injurious to an infant_?

Many thriving babies are, after taking the breast, frequently sick;
still we cannot look upon sickness otherwise than as an index of
either a disordered or of an overloaded stomach. If the child be sick,
and yet be thriving, it is a proof that he overloads his stomach. A
mother, then, must not allow him to suck so much, at a time. She
should, until he retain all he takes, lessen the quantity of milk. If
he be sick and does _not_ thrive, the mother should notice if the milk
he throws up has a sour smell; if it have, she must first of all look
to her own health; she ought to ascertain if her own stomach be out of
order; for if such be the case, it is impossible for her to make good
milk. She should observe whether in the morning her own tongue be
furred and dry; whether she have a disagreeable taste in her mouth, or
pains at her stomach, or heart-burn, or flatulence. If she have all,
or any of these symptoms, the mystery is explained why he is sick and
does not thrive. She ought then to seek advice, and a medical man will
soon put her stomach into good order; and, by so doing, will, at the
same time, benefit her child.

But if the mother be in the enjoyment of good health, she must then
look to the babe himself, and ascertain if he be cutting his teeth; if
the gums require lancing; if the secretions from the bowels be proper
both in quantity and in quality; and, if he have had _artificial_
food--it being absolutely necessary to give such food--whether it
agree with him.

_What to do_.--In the first place, if the gums be red, hot, and
swollen, let them be lanced; in the second, if the secretion from the
bowels be either unhealthy or scanty, give him a dose of aperient
medicine, such as caster oil, or the following:--Take two or three
grains of powdered Turkey rhubarb, three grains of pure carbonate of
magnesia, and one grain of aromatic powder--Mix. The powder to be
taken at bed-time, mixed in a tea-spoonful of sugar and water, and
which should, if necessary, be repeated the following night. In the
third place, if the food he be taking does not agree with him, change
it (_vide_ answer to question 33). Give it in smaller quantities at a
time, and not so frequently; or what will be better still, if it be
possible, keep him, for a while, entirely to the breast.

_What NOT to do_.--Do not let him overload his stomach either with
breast milk, or with _artificial food_. Let the mother avoid, until
his sickness be relieved, greens, cabbage, and all other green
vegetables.

109. _What are the causes, the symptoms, the prevention, and the cure
of Thrush_?

The thrush is a frequent disease of an infant, and is often brought on
either by stuffing or by giving him improper food. A child brought up
_entirely_, for the first three or four months, on the breast, seldom
suffers from this complaint. The thrush consists of several irregular,
roundish, white specks on the lips, the tongue, the inside and the
angles of the mouth, giving the parts affected the appearance of curds
and whey having been smeared upon them. The mouth is hot and painful,
and he is afraid to suck; the moment the nipple is put to his mouth he
begins to cry. The thrush, sometimes, although but rarely, runs
through the whole of the alimentary canal. It should be borne in mind
that nearly every child, who is sucking, has his or her tongue white
or "frosted," as it is sometimes called. The thrush may be mild or
very severe.

Now with regard to what to do.--As the thrush is generally owing to
improper and to artificial feeding, _if the child be at the breast_,
keep him, for a time, entirely to it. Do not let him be always
sucking, as that will not only fret his month, but will likewise
irritate and make sore the mother's nipple.

_If he be not at the breast_, but has been weaned, then keep him for a
few days entirely to a milk diet--to the milk of ONE cow--either
boiled, if it be hot weather, to keep it sweet; or unboiled, in cool
weather--fresh as it comes from the cow, mixed with warm water.

The best medicine is the old-fashioned one of Borax, a combination of
powdered lump-sugar and borax being a good one for the purpose: the
powdered lump-sugar increases the efficacy, and the cleansing
properties of the borax; it tends, moreover, to make it more
palatable.--

  Take of--Borax, half a drachm;
           Lump Sugar, two scruples;

To be well mixed together, and made into twelve powders. One of the
powders to be put dry on the tongue every four hours.

The best _local_ remedy is Honey of Borax, which ought to be smeared
frequently, by means of the finger, on the parts affected.

Thorough ventilation of the apartment must be observed; and great
cleanliness of the vessels containing the milk should be insisted
upon.

In a bad case of thrush, change of air to the country is most
desirable; the effect is sometimes, in such cases, truly magical.

If the thrush be brought on either by too much or by improper food; in
the first case of course, a mother must lessen the quantity; and, in
the second, she should be more careful in her selection.

_What NOT to do_.--Do not use either a calf's teat or wash leather for
the feeding-bottle; fortunately, since the invention of India-rubber
teats, they are now nearly exploded; they were, in olden times,
fruitful causes of thrush. Do not mind the trouble of ascertaining
that the cooking-vessels connected with the baby's food are perfectly
clean and sweet. Do not leave the purity and the goodness of the cow's
milk (it being absolutely necessary to feed him on artificial food) to
be judged either by the milk-man, or by the nurse, but taste and prove
it yourself. Do not keep the milk in a warm place, but either in the
dairy or in the cellar; and, if it be summer time, let the jug holding
the milk be put in a crock containing lumps of ice. Do not use milk
that has been milked longer than twelve hours, but if practicable,
have it milked direct from the cow, and use it _immediately_--let it
be really and truly fresh and genuine milk.

When the disease is _severe_, it may require more active
treatment--such as a dose of calomel; _which medicine must never be
given unless it be either under the direction of a medical man, or
unless it be in an extreme case,--such as dysentery_; [Footnote: See
the Treatment of Dysentery.] therefore, the mother had better seek
advice.

In a _severe_ case of thrush, where the complaint has been brought on
by _artificial_ feeding--the babe not having the advantage of the
mother's milk--it is really surprising how rapidly a wet-nurse--if the
case has not been too long deferred--will effect a cure, where all
other means have been tried and have failed. The effect has been truly
magical! In a severe case of thrush pure air and thorough ventilation
are essential to recovery.

110. _Is anything to be learned from the cry of an infant_?

A babe can only express his wants and his necessities by a cry; he can
only tell his aches and his pains by a cry; it is the only language of
babyhood; it is the most ancient of all languages; it is the language
known by our earliest progenitors; it is, if listened to aright, a
very expressive language, although it is only but the language of a
cry--

  "Soft infancy, that nothing canst but cry."--_Shakspeare_.

There is, then, a language in the cry of an infant, which to a mother
is the most interesting of all languages, and which a thoughtful
medical man can well interpret. The cry of a child, to an experienced
doctor, is, each and all, a distract sound, and is as expressive as
the notes of the gamut. The cry of passion, for instance, is a furious
cry; the cry of sleepiness is a drowsy cry; the cry of grief is a
sobbing cry; the cry of an infant when roused from sleep is a shrill
cry; the cry of hunger is very characteristic,--it is unaccompanied
with tears, and is a wailing cry; the cry of teething is a fretful
cry; the cry of pain tells to the practised ear the part of pain; the
cry of ear-ache is short, sharp, piercing, and decisive, the head
being moved about from side to side, and the little hand being often
put up to the affected side of the head; the cry of bowel-ache is also
expressive,--the cry is not so piercing as from ear-ache, and is an
interrupted, straining cry, accompanied with a drawing-up of the legs
to the belly; the cry of bronchitis is a gruff and phlegmatic cry; the
cry of inflammation of the lungs is more a moan than a cry; the cry of
croup is hoarse, and rough, and ringing, and is so characteristic that
it may truly be called "the croupy cry;" the cry of inflammation of
the membranes of the brain is a piercing shriek--a danger signal--most
painful to hear; the cry of a child recovering from a severe illness
is a cross, and wayward, and tearful cry; he may truly be said to be
in a quarrelsome mood; he bursts out, without rhyme or reason, into a
passionate flood of tears--into "a tempest of tears:" tears are
always, in a severe illness, to be looked upon as a good omen, as a

  "The tears that heal and bless"--_H. Bonar_.

Tears, when a child is dangerously ill, are rarely, if ever, seen; a
cry, at night, for light--a frequent cause of a babe crying--is a
restless cry:--

  "An infant--crying in the night;
   An infant crying for the light:
  And with no language hat a cry."--_Tennyson_.

111. _If an infant be delicate, have you any objection to his having
either veal or mutton broth, to strengthen him_?

Broths seldom agree with a babe at the breast I have known them
produce sickness, disorder the bowels, and create fever. I recommend
you, therefore, not to make the attempt.

Although broth and beef-tea, when taken by the mouth, will seldom
agree with an infant at the breast, yet, when used as an enema, and in
small quantities, so that they may be retained, I have frequently
found them to be of great benefit, they have in some instances
appeared to have snatched delicate children from the brink of the
grave.

112. _My baby's ankles are very weak: what do you advise to strengthen
them_?

If his ankles be weak, let them every morning be bathed, after the
completion of his morning's ablution, for fire minutes each time, with
bay-salt and water, a small handful of bay-salt dissolved in a quart
of rain water (with the chill of the water off in the winter, and of
its proper temperature in the summer time); then let them be dried;
after the drying, let the ankles he well rubbed with the following
liniment:--

  Take of--Oil of Rosemary, three drachms;
           Liniment of Camphor, thirteen drachms:

To make a Liniment

Do not let him be put on his feet early; but allow him to crawl, and
sprawl, and kick about the floor, until his body and his ankles become
strong.

Do not, on any account, without having competent advice on the
subject, use iron instruments, or mechanical supports of any kind: the
ankles are generally, by such artificial supports, made worse, in
consequence of the pressure causing a further dwindling away and
enfeebling of the ligaments of the ankles, already wasted and
weakened.

Let him wear shoes with straps over the insteps to keep them on, and
not boots: boots will only, by wasting the ligaments, increase the
weakness of the ankles.

113. _Sometimes there is a difficulty in restraining the bleeding of
leech bites. What is the best method_?

The difficulty in these cases generally arises from the improper
method of performing it. For example--a mother endeavours to stop the
haemorrhage by loading the part with rag; the more the bites discharge,
the more rag she applies. At the same time, the child probably is in a
room with a, large fire, with two or three candles, with the doors
closed, and with perhaps a dozen people in the apartment, whom the
mother has, in her fright, sent for. This practice is strongly
reprehensible.

If the bleeding cannot be stopped,--in the first place, the fire most
be extinguished, the door and windows should be thrown open, and the
room ought to be cleared of persons, with the exception of one, or, at
the most, two; and every rag should be removed. "Stopping of leech
bites.--The simplest and most certain way, till the proper assistance
is obtained, is the pressure of the finger, with nothing
intervening. It _cannot_ bleed through that." [Footnote: Sir Charles
Locock, in a _Letter_ to the Author.]

Many babies, by excessive loss of blood from leech bites, have lost
their lives from a mother not knowing how to act, and also from the
medical man either living at a distance, or not being at
hand. Fortunately for the infantile community, leeches are now very
seldom ordered by doctors.

114. _Supposing a baby to be poorly, have you any advice to give to
his mother as to her own management_?

She must endeavour to calm her feelings or her milk will be
disordered, and she will thus materially increase his illness. If he
be labouring under any inflammatory disorder, she ought to refrain
from the taking of beer, wine, and spirits, and from all stimulating
food; otherwise, she will feed his disease.

Before concluding the first part of my subject--the Management of
Infancy--let me again urge upon you the importance--the paramount
importance--if you wish your babe to be strong and hearty,--of giving
him as little opening physic as possible. The best physic for him is
Nature's physic--fresh air, and exercise, and simplicity of living. A
mother who is herself always drugging her child, can only do good to
two persons--the doctor and the druggist!

If an infant from his birth be properly managed,--if he have an
abundance of fresh air for his lungs,--if he have plenty of exercise
for his muscles (by allowing him to kick and sprawl on the floor),--if
he have a good swilling and sousing of water for his skin,--if, during
the _early_ months of his life, he have nothing but the mother's milk
for his stomach,--he will require very little medicine--the less the
better! He does not want his stomach to be made into a doctor's shop!
The grand thing is not to take every opportunity of administering
physic, but of using every means of with-holding it! And if physic be
necessary, not to doctor him yourself, unless it be in extreme and
urgent cases (which in preceding and succeeding Conversations I either
have or will indicate), but to employ an experienced medical man. A
babe who is always, without rhyme or reason, being physicked, is sure
to be puny, delicate, and unhealthy, and is ready at any moment to
drop into an untimely grave!

I will maintain that a healthy child _never_ requires drugging with
opening physic, and that costiveness is brought on by bad
management. Aperient medicines to a healthy child are so much poison!
_Let me impress the above remarks on every mother's mind;_ for it is a
subject of vital importance. Never, then, give a purgative to a
healthy child; for, if he be properly managed, he will never require
one. If you once begin to give aperients, you will find a difficulty
discontinuing them. Finally, I will only say with _Punch_,--"Don't"


CONCLUDING REMARKS ON INFANCY.

115. In concluding the first part of our subject--Infancy--I beg to
remark: there are four things essentially necessary to a babe's
well-doing, namely, (1) plenty of water for his skin; (2) plenty of
fresh genuine milk mixed with water for his stomach (of course, giving
him ONLY his mother's milk during the first six, eight, or nine
months of his existence); (3) plenty of pure air for his lungs; (4)
plenty of sleep for his brain: these are the four grand essentials for
an infant; without an abundance of one and all of them, perfect health
is utterly impossible! Perfect health! the greatest earthly blessing,
and more to be coveted than ought else beside! There is not a more
charming sight in the universe than the beaming face of a perfectly
healthy babe,--

  "His are the joys of nature, his the smile,
  The cherub smile, of innocence and health."--_Knox._




PART II.

CHILDHOOD.


  _The child is father of the man_.--WORDSWORTH.
  _Bairns are blessings_--SHAKESPEARE.
  _These are MY jewels!_--CORNELLA.


ABLUTION.

116. _At twelve months old, do you still recommend a child to be_ PUT
IN HIS TUB _to be washed_?

Certainly I do, as I have previously recommended at page 6, in order
that his skin may be well and thoroughly cleansed. If it be summer
time, the water should be used cold; if it be winter, a dash of warm
must be added, so that it may be of the temperature of new milk: but
do not, on any account use _very warm_ water. The head must be washed
(but not dried) before he be placed in a tub, then, putting him in the
tub (containing the necessary quantity of water, and washing him as
previously recommended), [Footnote: See Infancy-Ablution, page 6.] a
large sponge should be filled with the water and squeezed over his
head, so that the water may stream over the whole surface of his
body. A jugful of water should, just before taking him out of his
bath, be poured over and down his loins; all this ought rapidly to be
done, and he must be quickly dried with soft towels, and then
expeditiously dressed. For the washing of your child I would recommend
you to use Castile soap in preference to any other; it is more pure,
and less irritating, and hence does not injure the texture of the
skin. Take care that the soap does not get into his eyes, or it might
produce irritation and smarting.

117. _Some mothers object to a child's STANDING in the water._

If the head be wetted before he be placed in the tub, and if he be
washed as above directed, there can be no valid objection to it. He
must not be allowed to remain in his tab more than five minutes.

118. _Does not washing the child's head, every morning, make him more
liable to catch cold, and does it not tend to weaken his sight_?

It does neither the one nor the other; on the contrary, it prevents
cold, and strengthens his sight; it cleanses his scalp, prevents
scurf, and, by that means, causes a more beautiful bead of hair. The
head, after each washing, ought, with a soft brush, to be well
brushed, but should not be combed. The brushing causes a healthy
circulation of the scalp; but combing the hair makes the head scurfy,
and pulls out the hair by the roots.

119. _If the head, notwithstanding the washing, be scurfy, what should
be done_?

After the head has been well dried, let a little cocoa-nut oil be well
rubbed, for five minutes each time, into the roots of the hair, and,
afterwards, let the head be well brushed, but not combed. The
fine-tooth comb will cause a greater accumulation of scurf, and will
scratch and injure the scalp.

120. _Do you recommend a child to be washed_ IN HIS TUB _every night
and morning_?

No; once a day is quite sufficient; in the morning in preference to
the evening; unless he be poorly, then, evening instead of morning;
as, immediately after he has been washed and dried, he can be put to
bed.

121. _Ought a child to be placed in his tub whilst he is in a state of
perspiration_?

Not whilst he is perspiring _violently,_ or the perspiration might he
checked suddenly, and ill consequences would ensue; _nor ought he to
be put in his tub when he is cold,_ or his blood would be chilled, and
would be sent from the skin to some internal vital part, and thus
would be likely to light up inflammation--probably of the lungs. His
skin, when he is placed in his bath, ought to be moderately and
comfortably warm; neither too hot nor too cold.

122. _When the child is a year old, do you recommend cold or warm
water to be used_?

If it be winter, a little warm water ought to be added, so as to raise
the temperature to that of new milk. As the summer advances, less and
less warm water is required, so that, at length, none is needed.

123. _If a child be delicate, do you recommend anything to be added to
the water which may tend to brace and strengthen him_?

Either a handful of table-salt, or half a handful of bay-salt, or of
Tidman's sea-salt, should be previously dissolved in a quart jug of
_cold_ water; then, just before taking the child out of his morning
bath, let the above be poured over and down the back and loins of the
child--holding the jug, while pouring its contents on the back, a foot
distant from the child, in order that it might act as a kind of douche
bath.

124. _Do you recommend the child, after he has been dried with the
towel, to be rubbed with the hand_?

I do; as friction encourages the cutaneous circulation, and causes the
skin to perform its functions properly, thus preventing the
perspiration (which is one of the impurities of the body) from being
sent inwardly either to the lungs or to other parts. The back, the
chest, the bowels, and the limbs are the parts that ought to be well
rubbed.


CLOTHING

125. _Have you any remarks to make on the clothing of a child_?

Children, boys and girls, especially if they be delicate, ought always
to wear high dresses up to their necks. The exposure of the upper
part of the chest (if the child be weakly) is dangerous. It is in the
_upper_ part of the lungs, in the region of the collar bones, that
consumption first shows itself. The clothing of a child, more
especially about the chest, should be large and full in every part,
and be free from tight strings, so that the circulation of the blood
may not be impeded, and that there may be plenty of room for the fall
development of the rapidly-growing body.

His frock, or tonic, ought to be of woollen material--warm, light, and
porous, in order that the perspiration may rapidly evaporate. The
practice of some mothers in allowing their children to wear tight
bands round their waists, and tight clothes, is truly reprehensible.

_Tight_ bands or _tight_ belts around the waist of a child are very
injurious to health; they crib in the chest, and thus interfere with
the rising and the falling of the ribs--so essential to
breathing. _Tight_ hats ought never to be worn; by interfering with
the circulation they cause headaches. Nature delights in freedom, and
resents interference!

126. _What parts of the body in particular ought to be kept warm_?

The chest, the bowels, and the feet, should be kept comfortably
warm. We must guard against an opposite extreme, and not keep them too
hot. The head alone should be kept cool, on which account I do not
approve either of night or of day caps.

127. _What are the best kinds of hat for a child_?

The best covering for the head, when he is out and about, is a
loose-fitting straw hat, which will allow the perspiration to
escape. It should have a broad rim, to screen the eyes. A sun-shade,
that is to say, a sea-side hat--a hat made of cotton--with a wide brim
to keep off the sun, is also an excellent hat for a child; it is very
light, and allows a free escape of the perspiration. It can be
bought, ready made, at a baby-linen warehouse.

A knitted or crocheted woollen hat, with woollen rosettes to keep the
ears warm, and which may be procured at any baby-linen warehouse,
makes a nice and comfortable winter's hat for a child. It is also a
good hat for him to wear while performing a long journey. The colour
chosen is generally scarlet and white, which, in cold weather, gives
it a warm and comfortable appearance.

It is an abominable practice to cover a child's head with beaver or
with felt, or with any thick impervious material It is a
well-ascertained fact, that beaver and silk hats cause men to suffer
from headache, and to lose their hair--the reason being, that the
perspiration cannot possibly escape through them. Now, if the
perspiration cannot escape, dangerous, or at all events injurious,
consequences must ensue, as it is well known that the skin is a
breathing apparatus, and that it will not with impunity bear
interference.

Neither a child nor any one else should be permitted to be in the
glare of the son without his hat. If he be allowed, he is likely to
have a sun-stroke, which might either at once kill him, or might make
him an idiot for the remainder of his life; which latter would be the
worse alternative of the two.

128. _Have you, any remarks to make on keeping a child's hands and
legs warm when in the winter time he it carried out_?

When a child either walks or is carried out in wintry weather, be sure
and see that both his hands and legs are well protected from the
cold. There is nothing for this purpose like woollen gloves, and
woollen stockings coming up over the knees.

129. _Do you approve of a child wearing a flannel nightgown_?

He frequently throws the clothes off him, and has occasion to be taken
up in the night, and if he have not a flannel gown on, is likely to
catch cold; on which account I recommend it to be worn. The usual
calico night-gown should be worn _under_ it.

130. _Do you advise a child to be LIGHTLY clad, in order that he may
be hardened thereby_?

I should fear that such a plan, instead of hardening, would be likely
to produce a contrary effect. It is an ascertained fact that more
children of the poor, who are thus lightly clad, die, than of those
who are properly defended from the cold. Again, what holds good with a
young plant is equally applicable to a young child; and we all know
that it is ridiculous to think of unnecessarily exposing a tender
plant to harden it. If it were thus exposed, it would wither and die.

131. _If a child be delicate, if he have a cold body, or a languid
circulation, or if he be predisposed to inflammation of the lungs, do
you approve of his wearing flannel instead of linen shirts_?

I do; as flannel tends to keep the body at an equal temperature, thus
obviating the effects of the sudden changes of the weather, and
promotes by gentle friction the cutaneous circulation, thus warming
the cold body, and giving an impetus to the languid circulation, and
preventing an undue quantity of blood from being sent to the lungs,
either to light up or to feed inflammation _Fine_ flannel, of course,
ought to be worn, which should be changed as frequently as the usual
shirts.

If a child have had an attack either of bronchitis or of inflammation
of the lungs, or if he have just recovered from scarlet fever, by all
means, if he have not previously worn flannel, _instantly_ let him
begin to do so, and let him, _next_ to the skin, wear a flannel
waistcoat. _This is important advice, and ought not to be
disregarded_.

_Scarlet_ flannel is now much used instead of _white_ flannel; and as
scarlet flannel has a more comfortable appearance, and does not shrink
so much in washing, it may be substituted for the white.

132. _Have you any remarks to make on the shoes and stockings of a
child? and on the right way of cutting the toe-nails_?

He ought, daring the winter, to wear lamb's wool stockings that will
reach _above_ the knees, and _thick_ calico drawers that will reach a
few inches _below_ the knees; as it is of the utmost importance to
keep the lower extremities comfortably warm. It is really painful to
see how many mothers expose the bare legs of their little ones to the
frosty air, even in the depths of winter.

Be sure and see that the boots and shoes of your child be sound and
whole; for if they be not so, they will let in the damp, and if the
damp, disease and perhaps death. "If the poor would take better care
of their children's feet half the infantile mortality would
disappear. It only costs twopence to put a piece of thick felt or cork
into the bottom of a boot or shoe, and the difference is often between
that and a doctors bill, with, perhaps, the undertaker's
besides."--_Daily Telegraph_,

Garters ought not to be worn, as they impede the circulation, waste
the muscles, and interfere with walking. The stocking may be secured
in its place by means of a loop and tape, which should be fastened to
a part of the dress.

Let me urge upon you the importance of not allowing your child to wear
_tight_ shoes; they cripple the feet, causing the joints of the toes,
which ought to have free play, and which should assist in walking, to
be, in a manner, useless; they produce corns and bunions, and
interfere with the proper circulation of the foot. A shoe ought to be
made according to the shape of the foot--rights and lefts are
therefore desirable. The toe-part of the shoe must be made broad, so
as to allow plenty of room for the toes to expand, and that one toe
cannot overlap another. Be sure, then, that there be no pinching and
no pressure. In the article of shoes you ought to be particular and
liberal; pay attention to having nicely fitting ones, and let them be
made of soft leather, and throw them on one side the moment they are
too small. It is poor economy, indeed, because a pair of shoes be not
worn out, to run the risk of incurring the above evil consequences.

_Shoes are far preferable to boots:_ boots weaken instead of
strengthen the ankle. The ankle and instep require free play, and
ought not to be hampered by boots. Moreover, boots, by undue
pressure, decidedly waste away the ligaments of the ankle. Boots act
on the ankles in a similar way that stays do on the waist--they do
mischief by pressure. Boots waste away the ligaments of the ankle;
stays waste away the muscles of the back and chest; and thus, in both
cases, do irreparable mischief.

A shoe for a child ought to be made with a narrow strap over the
instep, and with button and button-hole; if it be not made in this
way, the shoe will not keep on the foot.

It is a grievous state of things, that in the nineteenth century there
are but few shoemakers who know how to make a shoe! The shoe is made
not to fit a real foot, but a fashionable imaginary one! The poor
unfortunate toes are in consequence screwed up as in a vice!

Let me strongly urge you to be particular that the sock, or stocking,
fits nicely--that it is neither too small nor too large; if it be too
small, it binds up the toes unmercifully, and makes one toe to ride
over the other, and thus renders the toes perfectly useless in
walking; if it be too large, it is necessary to lap a portion of the
sock, or stocking, either under or over the toes, which thus presses
unduly upon them, and gives pain and annoyance. It should be borne in
mind, that if the toes have full play, they, as it were, grasp the
ground, and greatly assist in locomotion--which, of course, if they
are cramped up, they cannot possibly do. Be careful, too, that the
toe-part of the sock, or stocking, be not pointed; let it be made
square in order to give room to the toes. "At this helpless period of
life, the delicately feeble, outspreading toes are wedged into a
narrow-toed stocking, often so short as to double in the toes,
diminishing the length of the rapidly growing foot! It is next,
perhaps, tightly laced into a boot of less interior dimensions than
itself; when the poor little creature is left to sprawl about with a
limping, stumping gait, thus learning to walk as it best can, under
circumstances the most cruel and torturing imaginable." [Footnote:
_The Foot and its Covering_, second edition. By James Dowie. London:
1872. I beg to call a mother's especial attention to this valuable
little book: it is written by an earnest intelligent man, by one who
has studied the subject in all its bearings, and by one who is himself
a shoemaker.]

It is impossible for either a stocking, or a shoe, to fit nicely
unless the toe-nails be kept in proper order. Now, in cutting the
toe-nails, there is, as in everything else, a right and a wrong
way. The _right_ way of cutting a toe-nail is to cut it straight--in a
straight line. The _wrong_ way is to cut the corners of the nail--to
round the nail as it is called. This cutting the corners of the nails
often makes work for the surgeon, as I myself can testify; it
frequently produces "growing-in" of the nail, which sometimes
necessitates the removal of either the nail, or a portion of it.

133. _At what time of the year should a child leave off his winter
clothing_?

A mother ought not to leave off her children's winter clothing until
the spring be far advanced: it is far better to be on the safe side,
and to allow the winter clothes to be worn until the end of May. The
old adage is very good, and should be borne in mind:--

  "Button to chin
  Till May be in;
  Ne'er cast a clout
  Till May be out."

134. _Have you any general remarks to make on the present fashion of
dressing children_?

The present fashion is absurd. Children are frequently dressed like
mountebanks, with feathers and furbelows and finery; the boys go
bare-legged; the little girls are dressed like women, with their
stuck-out petticoats, crinolines, and low dresses! Their poor little
waists are drawn in tight, so that they can scarcely breathe; their
dresses are very low and short, the consequence is, that a great part
of the chest is exposed to our variable climate; their legs are bare
down to their thin socks, or if they be clothed, they are only covered
with gossamer drawers; while their feet are encased in tight shoes of
paper thickness! Dress! dress! dress! is made with them, at a tender
age, and when first impressions are the strongest, a most important
consideration. They are thus rendered vain and frivolous, and are
taught to consider dress "as the one thing needful" And if they live
to be women--which the present fashion is likely frequently to
prevent--what are they? Silly, simpering, delicate, lack-a-daisical
nonentities; dress being their amusement, their occupation, their
conversation, their everything, their thoughts by day and their dreams
by night! Truly they are melancholy objects to behold! Let children be
dressed as children, not as men and women. Let them be taught that
dress is quite a secondary consideration. Let health, and not
fashion, be the first, and we shall then have, with God's blessing,
blooming children, who will, in time, be the pride and strength of
dear old England!


DIET.

135. _At TWELVE months old, have you any objection to a child having
any other food besides that you mentioned in answer to the 34th
question_?

There is no objection to his _occasionally_ having, for dinner, either
a mealy, _mashed_ potato and gravy, or a few crumbs of bread and
gravy. Rice-pudding or batter-pudding may, for a change, be given; but
remember, the food recommended in a former Conversation is what, until
he be eighteen months old, must be principally taken. During the early
months of infancy--say, for the first six or seven--if artificial food
be given at all, it should be administered by means of a
feeding-bottle. After that time, either a spoon, or a nursing boat,
will be preferable. The food as he becomes older, ought to be made
more solid.

136. _At_ EIGHTEEN _months old, have you any objection to a child
having meat_?

He ought not to have meat until he have several teeth to chew it
with. If he has most of his teeth--which he very likely at this age
will have--there is no objection to his taking a small slice either of
mutton, or occasionally of roast beef, which should be well cut into
very small pieces, and mixed with a mealy _mashed_ potato, and a few
crumbs of bread and gravy; either _every_ day, if he be delicate, or
every _other_ day, if he be a gross or a fast-feeding child. It may be
well, in the generality of cases, for the first few months to give him
meat _every other_ day, and either potato or gravy, or rice or
suet-pudding or batter-pudding on the alternate days; indeed, I think
so highly of rice, of suet, and of batter-puddings, and of other
farinaceous puddings, that I should advise you to let him have either
the one or the other even on those days that he has meat--giving it
him _after_ his meat. But remember, if he have meat _and_ pudding, the
meat ought to be given sparingly. If he be gorged with food, it makes
him irritable, cross, and stupid; at one time, clogging up his bowels,
and producing constipation; at another, disordering his liver, and
causing either clay-coloured stools--denoting a _deficiency_ of bile,
or dark and offensive motions--telling of _vitiated_ bile; while, in a
third case, cramming him with food might bring on convulsions.

137. _As you are to partial to puddings for a child, which do you
consider the best for him_?

He ought, every day, to have a pudding for his dinner--either rice,
arrow-root, sago, tapioca, suet-pudding, batter-pudding, or
Yorkshire-pudding, mixed with crumbs of bread and gravy--free from
grease. A well boiled suet-pudding, with plenty of suet in it, is one
of the best puddings he can have; it is, in point of fact, meat and
farinaceous food combined, and is equal to, and will oftentimes
prevent the giving of, cod-liver oil; before cod-liver oil came into
vogue, suet boiled in milk was _the_ remedy for a delicate child. He
may, occasionally, have fruit-pudding, provided the pastry be both
plain and light.

The objection to fruit pies and puddings is, that the pastry is often
too rich for the delicate stomach of a child; there is so objection,
certainly not, to the fruit--cooked fruit being, for a child, most
wholesome; if, therefore, fruit puddings and pies be eaten, the pastry
part ought to be quite plain. There is, in "Murray's Modern Cookery
Book," an excellent suggestion, which I will take the liberty of
quoting, and of strongly urging my fair reader to carry into
practice:--"_To prepare fruit for children, a far more wholesome way
than in pies and puddings_, is to put apples sliced, or plums,
currants, gooseberries, &c., into a stone jar; and sprinkle among them
as much Lisbon sugar as necessary. Set the jar on an oven or on a
hearth, with a tea-cupful of water to prevent the fruit from burning;
or put the jar into a saucepan of water, till its contents be
perfectly done. Slices of bread or some rice may be put into the jar,
to eat with the fruit."

_Jam_--such as strawberry, raspberry, gooseberry--_is most wholesome
for a child_, and ought occasionally to be given, in lieu of sugar,
with the rice, with the batter, and with the other puddings.
Marmalade, too, is very wholesome.

Puddings ought to be given _after_ and not _before_ his meat and
vegetables; if you give him pudding before his meat, he might refuse
to eat meat altogether. By adopting the plan of giving puddings
_every_ day, your child will require _less_ animal food; _much_ meat
is injurious to a young child. But do not run into an opposite
extreme: a _little_ meat ought, every day, to be given, _provided he
has cut the whole of his first set of teeth_; until then, meat every
_other_ day will be often enough.

138. _As soon as a child has cut the whole of his first set of teeth,
what ought to be his diet?--What should be his breakfast_?

He can, then, have nothing better, where it agrees, than scalding hot
new milk poured on sliced bread, with a slice or two of bread and
butter to eat with it. Butter, in moderation, is nourishing,
fattening, and wholesome. Moreover, butter tends to keep the bowels
regular. These facts should be borne in mind, as some mothers
foolishly keep their children from butter, declaring it to be too rich
for their children's stomachs! New milk should be used in preference
either to cream or to skim-milk. Cream, as a rule, is too rich for
the delicate stomach of a child, and skim-milk is too poor when robbed
of the butter which the cream contains. But give cream and water,
where new milk (as is _occasionally_ the case) does not agree; but
never give skim-milk. _Skim_-milk (among other evils) produces
costiveness, and necessitates the frequent administration of
aperients. Cream, on the other hand, regul

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