Every mother's handbook : a guide to the management of her children from birth, through infancy, and childhood with instructions for preliminary treatment of accidents and illnesses

Front matter

22501368098

For INFANTS ^ INVALIDS.

Mellin's Food when prepared is similar to Breast Milk.

Introduction

Every thinking person will admit that all young mothers should be carefully and minutely instructed in all that concerns the rearing of their children from birth upwards. The welfare and happiness of the human race depend very largely upon the judicious and enlightened treatment of childhood in its early years. Health is so important for mankind that its foundations should be laid in youth, and who more likely or better designed to do this than the mother. She is the one who nature has appointed to rear the tender child from feeble infancy to strong adult life, and woe betide her and it if she fail in her solemn duty.

It is a well-known fact that many mothers are ignorant of those things which they ought to be acquainted with, such as — the proper feeding, clothing, nursing, and general rearing of a child, and the treatment of those diseases and accidents to which it is liable. This unavoidable want of knowledge may be remedied by reading, and more accurate information may thus be acquired than by asking this person or that.

I have endeavoured in this book to supply in a readable form and in the plainest language, everything that a mother should know, from the smallest detail of

B

INTRODUCTION.

nursing, to the treatment of the severest disease or accident. I wish to remove all uncertainty from her mind, so that she may always do the right thing at the right time.

It must not be thought that I have any desire to make people into complete physicians, as this is impossible without very special training, but I do hold that the essentials of medicine and surgery^ may be taught with advantage to all, and especially to mothers and those who have the care of children. To such, medical and hj'gienic knowledge is of vital importance. It must not be forgotten, however, that in all severe illnesses a medical man should be called in immediately, as no mother should attempt to treat a serious complaint without assistance. All that this book is intended to teach her is — how to act rationallj^ in every emergency, and in what manner to keep her children in the best of health. It is my sincere hope that this work may prove of use to every mother throughout the land, and may lead to a great saving of youthful life.

24, Park Square,

IvEEDS.

January, 1897.

A GUIDE TO THE

Management of her Children.

CHAPTER I. The Management of the Baby immediately after Birth

When a baby is first born, if it is healthy, Birth, it should at once begin to breathe, to cry out loudly, to open its eyes, and to kick its limbs about freely. It may now be immediately separated from its mother. To do this the navel-string or cord must be tied and then cut, a dnty which, in the absence of the doctor, usually devolves upon the nurse.

The navel-string is cut in this manner : — Navel. The nurse takes two pieces of white tape, about half an inch wide, which she damps in luke-warm water. One piece must be tied firmly round the navel-string about two inches from the baby's body, and the other piece about two inches from that again towards the mother, and the space between the tapes must be cut through with scissors. Clean tape is preferable to thread or silk for tying the cord, as it ligatures firmly without cutting into it.

As soon as the child is born and the First cord has been cut, it should be wrapped Attentions, in a piece of warm soft flannel, and put away for half-an-hour or so, till the mother has had necessary attentions paid to her. It

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should be placed near the fire, not directly in front of it, but at one side, and quite out of all draughts. Care must be taken that a little space be left open in the flannel over the baby's face to let in air, otherwise it might be suffocated.

Sometimes a baby is bom in a very feeble Still condition, or even looks to be quite dead. Birth. Its limbs are motionless, its head falls, and its mouth gapes open. This is what is called " still birth." It is quite possible, however, to restore life in this condition. Very energetic treatment must be resorted to at once. The baby's mouth must be cleared of mucus by means of the finger. If its face is blue a tea-spoonful or so of blood should be allowed to flow from the cut navel-string before tying it. Cold water should be sprinkled on the face and chest, the buttocks should be slapped, and a little brandy or whisky rubbed into the chest. This is done to make the baby cry, and so draw air into its lungs. If the baby, however, does not breathe by these means, it should be dipped four or five times, first into a basin of hot, and then into a basin of cold water, or it should be held up by its feet for a few seconds so as to cause the blood to go to its head. If these means of restoring life are still unavailing, it will be necessary to try and make the infant breathe artificially.

Schultze's method of artificial res- Artificial piration is the best and simplest. The Respiration, baby's shoulders must be seized by putting the first finger in each armpit and bending the thumbs over the shoulders so as to touch the ends of the fingers. The whole weight of the child's body thus rests within the rings made by the thumb and first finger of each hand. Hanging perpendicularly in this manner, the infant's ribs are lifted out and its chest expanded, and air is drawn into its lungs. The body of the infant should now be swung forward with some degree of force at arm's length, the arms of the operator being raised a little above a straight line. The motion should be stopped suddenly with a jerk. This causes

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the child's chest to become fixed and its legs to topple over on to its abdomen. In this position the organs in the abdomen press against the muscular floor of the chest, and air is forced out of the lungs. The child's body is now returned to the perpendicular position by a rapid motion. The two motions occupy about eight seconds, and should be repeated about eight times a minute. After practising this method for about five minutes, the infant should be placed in a warm bath for two or three minutes, as the swinging movement causes it to lose some of the heat of its body.

Sylvester's method might also be tried. The baby should be laid on its back, with its head and shoulders a little raised. Its arms must be grasped above the elbows, and drawn steadily upwards, and they must be kept so stretched for a few seconds. They must then be brought slowly down again, and firmly pressed against the sides of the chest. These movements must be executed about twelve times a minute.

Marshall Hall's method consists in rolling the infant; first on its face, and then on its back, at regular intervals.

Another way to bring about respiration might be tried. A thin towel is placed over the baby's mouth, and the operator taking a dee*p breath, gently and quickly blows into the child's mouth, and then slowly depresses its chest. In this manner the child's lungs can be filled and emptied of air ten or twelve times a minute. During this operation, the child's nose should be left entirely free.

Either one or the other, or all of the above ways of trying to make a "Still-born" baby breathe artificially, should be persevered with for a couple of hours if necessary, for it is quite possible to restore a child to life as long as a single beat of the heart is to be felt.

Washing mother has been made

the comfortable, the nurse turns her attention Eyes. infant. Her first duty should be

to look to Its eyes. Now, a baby's

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eyes are extremely delicate and soon irritated, and the matter, which is often adhering to the lids and corners at birth, if not soon removed, works its way into the eyes and frequently sets up inflammation, which, in some cases, might terminate in loss of sight. It is essential to clear this matter completely away. The eyes should be very gently washed in perfectly clean water which has just been boiled and allowed to cool down to lukewarm. A piece of clean soft linen rag or a clean new sponge, free from all sand or grit should be used. After using, these should be at once burnt and not used again. The eyelids must be cleaned gently and not rubbed with force, for the eyes of a baby are very soon injured with violence.

After washing and drying the eyes, they should be well bathed with a boric acid lotion. This lotion is easily prepared by mixing a quarter of an ounce of boric acid, (obtained of any chemist,) with half a pint of recently boiled water. The lotion should be used lukewarm.

As soon as the head of the baby is born, it is always well, if opportunity permits, to wash its face' with warm water, and to cleanse and carefully dry its eyes The eyes might also, at this stage, be bathed with the boric acid lotion.

The nurse now proceeds to wash the Washing infant. It must be cleansed from all the impurities by the aid of warm water and Baby. soap. A newly born baby's first bath differs somewhat from those that succeed it during infancy. This arises from the fact, that at birth the skin of the infant has adhering to it, a peculiar tenacious , paste-like substance. This material is secreted by the glands of the infant's skin whilst it is in the womb, and no doubt forms a kind of protective covering or varnish for the skin of the foetus*. After birth, however, if it is allowed to remain long on the skin it becomes dry and hard, and is apt to seriously interfere with the healthy action of the skin, and set up excoriations and eruptions.

• The infant whilst in the womb is called a foetus.

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In order to remove it, every part of the baby's ' body should be smeared with fine hog's lard or with olive oil. This should be gently but thoroughly rubbed in with a small piece of flannel, until the whole of the paste-like substance has been completely softened and loosened. Then all should be washed off with a sponge saturated with warm water and soap, and the washing should be completed by immersing the body in warm water for a couple of minutes. Care must be taken in this first washing of the infant, not to touch the •eyes with the flannel or sponge which has been used to cleanse the, rest of the skin with. The eyelids of an infant must always be washed with perfectly clean water and a separate piece of sponge. The sponge and flannel used for the first washing, must be burnt and ■on no account used a second time.

Warm water must always be used Warm Bath, for the bath of a new-born infant.

The temperature should be ninety-eight degrees Fahrenheit.* It should be remembered that the infant has been suddenly removed from a temperature of ninetj'-eight degrees to a much lower temperature, and this alone should indicate how essential Avarmth is to the life and well-being of a newly-born child. I draw attention to this because there are some people who advocate bathing infants from the first in nearly cold water, with the idea of hardening them. Cough, bronchitis, inflammation of the lungs, and even death are only too likely to follow if the advice of such people is adopted. The duration of the first bath ought not to exceed five minutes.

Again, some nurses add brandy or Avoid Spirits, other spirits to the water in which a baby is first washed. Or if they don't do this, they wash the baby's head with the brandy, for the purpose they say, of strengthening it. Now, this is decidedly improper, and must never be done, because the spirit evaporates very rapidly, and

* The Regulation of the temperature must uot be trusted to the hand. A nur.sery tliermonieter must always be used.

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quickly produces a sensation of cold, which is both unpleasant and injurious to a newly-born child, by depriving it of some of its natural heat.

A large flat pillow should be ready Drying. prepared, and covered over with two or three large soft warm napkins, on which to lay and dry the baby immediately it is taken from the bath. The pillow should be laid across the nurse's knees. She will thus be enabled to dry the baby in a very short time. Every part must be patted perfectly dry with a soft warm towel — on nO' account scrubbed. The arm-pits, between the thighs, the groins, and the hams, must be entirely freed from all moisture, and the ears must also be well dried. The baby must not be roughly handled during the drying process, as the bones of an infant are so soft as to be incapable of sustaining its own weight, and therefore, it cannot be held up by the hand without inconvenient pressure.

The body of the infant being dried, very gentle rubbing with the naked palm over the whole surface, and. especially on each side of the spine, should be employed till a genial glow is excited.

Directly after the infant is dried all the parts which are likely to chafe should be well powdered with a puff. The best powders to use are either rice powder or finely powdered Fuller's earth, of which latter Matthews's Fuller's Earth (obtained of all Chemists) is preferable for fineness and purity.

The infant having been washed and Attention to dried the next thing to be done is to- Navel = string. attend to the remains of the navel-string.

It should first be washed with the boric acid lotion (as used for the eyes). The ligature should be examined to see that it is holding tight, and that there is no bleeding from the cut ends of the navel-string. All being right the navel-string should now be wrapped up and secured in the following manner: —

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, The nurse should wrap round the navel-string a piece of clean soft linen rag. It should be wrapped round just the same as a rag on a cut finger. The rag should be kept on by tying it with a few rounds of thread. The navel-string thus covered is laid flat on the abdomen of the child, pointing upwards, and is supported in a proper position by means of a flannel belly-band passed twice round the body.

It may be well to mention here that some nurses use singed rag for wrapping up the navel-string. This should not be done as the singed rag often irritates the baby's skin. Perfectly clean white linen rag or cotton wool are the materials to use.

The flannel belly-band should be Belly-band, about five or six inches wide, and it should be a strip cut slant from the piece, so that it may be perfectly elastic. It should be put on sufl&ciently loose to admit of the easy introduction of the finger under it. If the binder is put on too tight it will cause uneasiness, pain, and some difficulty in breathing by interfering with the proper action of the muscles of the abdomen. It also tends from the undue compression to favour the occurrence of rupture, from pressing the bowels downwards when the child crys, coughs, or strains, and forcing them through the natural openings in the sides of the belly. The belly-band should be worn some four or five months, and if the parts about the navel appear weak and ready to yield from the pressure of the bowels, the band should be continued for some months longer. The object of the belly-band is to give general support to the body, and particular support to the navel, it should therefore be applied in such a manner so as to give support in all directions without being tight or uncomfortable. The band should always be fastened with the needle and thread. If, however, pins are used they should be the patent safety-pins.

Bleedinir of Sometimes the navel-string after Navel. being secured will start to bleed.

This usually arises from the fact e;very mother's handbook.

Ihat the vessels of the navel-string, which before were distended with blood, will collapse and the tape ligatu»e will become loose, or it may arise from the cord havin.t^ been carelessly tied. '"^

To arrest the bleeding the baby's clothes and belly-band must be removed, and the wrapping taken from the navel-string. Then a new ligature, composed of five or six strands of strong linen thread, or a length of fresh tape must be tied round the cord thoroughly, but not so tight as to cut the cord. The bleeding being arrested the cord should be fastened up in rag or cotton wool as before and the belly-band re-applied.

The navel-string usually separates Separation of from the infant iii from five days to a Navel-string, week after birth. In some cases, however, it does not drop ofFtill ten, fourteen, or even twenty-one days.

The navel-string must not be pulled at any time, but must be allowed to separate of itself, and the parts about it must be kept dr)- and clean. Meddlesome interference with the navel-string has often caused much suffering to the child and has even lead to the loss of life.

Sometimes, after the cord has fallen off, a kind of growth, about as large as a pea, will appear on the navel with a kind of discharge. This can soon be cured by dusting a little powdered alum over the part and dressing afterwards with some oxide of zinc ointment spread on lint.

Now and then the navel excoriates and this inflammatory excoriation extends rapidly to the surrounding skin. Warm water dressings should be applied, or boracic ointment spread on linen rag or lint. If these fail to check the inflammation the doctor's attention must be called to it.

If bleeding takes place from the navel after the separation of the cord (a rare occurrence), the doctor must be sent for immediately, and in the meantime, the point of the finger m'ist be pressed steadily, but gently, over the bleeding part.

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A sort of bleeding growth may appear at the navel. This form of bleeding may be quickly stopped, by winding a piece of very narrow tape closely around the growth, and leaving it undisturbed. In a short time the growth sprouts over the tape, becomes strangulated, and drops oflf.

Whilst speaking of the management Navel Rupture, of the navel, it will be well to mention here Navel ruphtre. The navel-string or. cord by means of which the infant is nourished in the womb, before birth, is composed of several blood vessels, which enter into and depart from the middle of the child's abdomen ; the passage of these vessels renders it necessary that a hole should pass entirely through the covering of the bowels, which generally closes very quickly and soundly, after the separation of the navel-string. Certain circumstances, however, may prevent the natural closing of this hole, and thus a portion of the bowels may be partially forced through this imperfectly closed opening, by any sudden or strong exertion, such as crying, coughing, or sneezing. Great attention must therefore be paid to the condition of the navel. The navel-string should never be pulled to try and get it off, if it is longer in dropping off than usual. It should be left to fall off naturally. Meddlesome interference is a frequent cause of navel-rupture. Constant crying on the part of the child may produce this form of rupture, and the rupture may also cause the infant to cry incessantly. A constantly crying child should therefore have his navel very carefully examined.

Navel-rupture must always be attended to at once. It can only be cured in very early life. It is impossible to cure It in the adult. It can then only be relieved-. In the majority of cases a cure may be effected in a period varying froni one to six month.s, by the application of what is called an umbilical button. This consists of a disc made of either hard rubber, silver or aluminium, hollowed out at one side and rounded at the other. It is placed with its rounded or convex lO EVERY mother' 3 HANDBOOK.

surface over the navel, and is held in position by a broad band of adhesive plaster.

After the navel-string has dropped off, the navel is sometimes a little sore ; in this case apply a small bread or linseed meal poultice every night, and a little boracic ointment spread on lint every morning.

When the child is strong enough, it Dressing, should now be dressed, then laid in the cot, and allowed to go to sleep ; but if it appears to be fatigued by the washing and drying, and is a feeble baby, it is then best to wrap it up loosely in a flannel or blanket, and put it to sleep, the dressing being delayed till it awakes refreshed. The clothing should be warm, light and loose, and not calculated to place thfe slightest restriction upon the movements of the limbs. A cap should not be worn, the baby's head requires to be kept cool. Some mothers have a flannel cap in readiness to put on as soon as the baby is born. This is quite unnecessary and is often hurtful, in some cases producing inflammation of the eyes from over heating the head. The baby's hair is much more likely to grow strong and thick if a cap is not worn.

The use of clothing is to defend from Clothing, cold, the child should therefore be wrapped in soft loose clothing, not of too great a weight. In dressing infants, there ought to be as few pins used as possible, and these should always be the patent safety pins ; tapes and strings should, therefore, supply the place of pins whenever they can be made to answer the purpose. All the clothing of a baby worn next to the skin, should be wool. I shall have more to say in another chapter on the subject of infant clothing.

The napkin or diaper, (which must be The Napkin, worn from the first,) should consist of linen, which is less heating and less liable to cause chafing of the skin when wet than muslin or other material. It must be fastened with safety pins, and folded in such a way as not to cause discomfort by too

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II much pressure on the back or abdomen. " Sanitarytowels," if not too thick, also make good napkins. They are soft and absorbent and do not chafe.

If an infant is feeble at birth, or Feeble Infant, prematurely born, great care will be required for some time to keep it alive. Uniform warmth and breast-milk are indispensable, with constant watchfulness. lyife, in these cases, hangs so feebly in the balance, that it may flicker out in a moment. The doctor should always be consulted when a baby is premature or feeble. It may be necessary to use an incubator.

As soon as the mother is sufl&ciently Putting to refreshed by sleep to suckle her child, Breast. the baby should be put to the breast — some four to eight hours after birth. At this early date no milk can be drawn, but the breasts contain a kind of thin watery fluid called Colostrum, which gives sufficient nourishment to the infant, and which being also of a slightly aperient nature effectually clears out from the child's bowels the greenish or black and viscid matter which has collected in them during its life in the womb. This matter is called the Meconium. The putting of the child early to the breast is of great advantage to the mother as it causes her womb to contract, and thus lessens the chance of "flooding"; it also draws out the nipples and encourages the formation of milk.

It is usually the third day after labor Errors in that milk is fully secreted in the breasts. Feeding. The colostrum is, therefore, the only food that the infant requires before that time. How often do ignorant nurses fill a two days' old baby's stomach with gruel, sugar and water, and other mixtures under the idea that it will starve, when nature has provided a suitable food in the first secretion of the mother's breast to supply all the infant's wants for the first three or four days. If the child is put to the mother's breast every two hours whilst she is awake, there need be no fear of starvation. The

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very act of sucking, too, gets the child early into the way.

The giving of gruel to a new-born baby is a thing I must strongly condemn. Babies fed from the first on gruel generally become feeble, have disordered stomachs, and when put at last to the breast often refuse to take it. Besides, if the colostrum is not drawn from the breasts inflammation or abscesses may arise in them with great suflfering to the mother.

Sometimes it is noticed that when Tongue Tie. the baby is put to the breast he refuses to suck, or is unable to apply his tongue properly to the nipple. This usually arises from being tongue-tied. The doctor can remedy this in a moment by dividing the bridle of the tongue with blunt-pointed scissors. This little operation will enable the baby to take the nipple with ease and comfort.

Supposing that after the third day Artificial the breasts should not secrete a supply Food. of milk, it might be well to give the baby a mixture of one third of new milk, and two thirds of warm water slightly sweetened with sugar of milk (or with brown sugar if its bowels have not been opened). It should be given in small quantities every four hours, the baby being put to the breast in the meantime.

On the fourth day the milk is usuall}' secreted, and then the artificial nourishment must be discontinued, and regular suckling commence.

The baby must be applied altcrjiately Application to each breast. One breast mu.st be to Breast. used for one meal, and the other for the next, and so alternately with great regularity. If mothers would always use both breasts in nursing, rarely should we see "a gathered breast."

A healthy baby should be allowed to suck until satisfied, when he will drop the nipple of his own accord, and fall asleep.

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Should the flow of milk be hindered by the nipples being unusually short and small, they should be fomented with a soft sponge dipped in warm water, and the infant be frequently applied to them.

It is advisable always before placing the infant to the breast to wash the nipples with warm water (previously boiled, and allowed to cool sufficiently) ; and again after nursing.

' An ignorant nurse will sometimes Squeezing squeeze the breasts of a newh'-born female Breasts. infant, to " break the nipple-strings " as _ she says, or to press out milk, the ' presence of which is very doubtful. I mention this practice to strongly condemn it, it is barbarous and unnecessary, and often leads to abscess of the breasts, and destruction of their function in maternal life. In any case it gives rise to pain, and feverishness.

It is quite true that at birth or a day or two after, the breasts of an infant ma}- swell, and become hard and painful, and that sometimes there is a kind of oozing of a milky fluid from the nipple. If pressure, however, is made to remove this fluid, inflammation is almost sure to be set up. The best treatment is to let alone. If there is much redness and swelling, and the breasts are hard and tender to the touch, it might be advisable to apply frequent hot water dressings till the swelling goes down.

As I have previously mentioned Baby's Bowels there is found in the bowels of an infant at birth an accumulation of a dark green substance, very similar in appearance to S5'rup of poppies, and hence called meconium. This varies in quantity in different children. Of course if it does not readily pass off" but is retained in the child's bowels, it may be productive of mischief As a rule It comes away early and readily, without having to resort to artificial means. The fluid called colostrum which is contained in the mother's breasts at the time of birth, IS of a slightly aperient quality, and upon the

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first sucking application of the infant, acts on its bowels and brings away the vieconmm. This is one of the advantages to be derived from putting the child to the breast very early, for, if this be neglected until the secretion of perjfect milk takes place, the colostrum becomes too much diluted to act as an aperient, and then other means may have to be resorted to, to expel the meconium from the babj^'s bowels.

If the meconium does not come away naturally in the first day or two after birth, some gentle aperient is indicated. The best artificial aperient for a new-born baby is pure moist sugar as obtained from the grocer. Half a tea-spoonful of this should be mixed with one tea-spoonful of warm water, and given to the baby. If it does not act in four hours, the dose should be repeated. If a stronger aperient is required at this stage of infant life, the medical man should be consulted. I must protest most strongly against indiscriminate dosing of infants with purgatives, which often do more harm than good. Many a child has been injured in health by castor oil, calomel, and other drugs. The simpler and more natural the aperient in early infancy and the better. In fact a healthy baby seldom needs more than what I have indicated. Elsewhere I shall have more to say on this matter.