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AT HOME.

THE
Physical Training
OF
Children.

By P. H. 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; AUTHOR OF “ADVICE TO A WIFE ON THE MANAGEMENT OF HER OWN HEALTH,” ETC., ETC.

WITH

A Preliminary Dissertation,

By F. H. GETCHELL, M.D.,

CLINICAL LECTURER ON THE DISEASES OF WOMEN AND CHILDREN AT THE JEFFERSON MEDICAL COLLEGE, OBSTETRICIAN TO THE CATHARINE STREET DISPENSARY, FELLOW OF THE COLLEGE OF PHYSICIANS, AND MEMBER OF THE PATHOLOGICAL SOCIETY, PHILADELPHIA; CORRESPONDING MEMBER OF THE GYNŒCOLOGICAL SOCIETY OF BOSTON; AUTHOR OF “THE MATERNAL MANAGEMENT OF INFANCY,” ETC., ETC.

PHILADELPHIA, PA.:

NEW-WORLD PUBLISHING COMPANY,

MIDDLETOWN, CONN.: PARMELEE & CO.

BURLINGTON, IOWA: R. T. ROOT.

1871.

Entered according to Act of Congress, in the year 1871, by

NEW-WORLD PUBLISHING COMPANY,

(John C. Copper.—S. J. Vandersloot,)

In the Office of the Librarian of Congress at Washington, D. C.

CONTENTS.

INTRODUCTION.

Nothing is more to be regretted than the fact that the females of this country grow up to womanhood in entire ignorance of all that relates to their future condition as parents, and the physical and mental development of the young for whose welfare they may yet be so deeply responsible. “It is not to be wondered at that when the young wife finds herself a mother, she is kept in a state of painful alarm and apprehension by the most trifling occurrence, or allows real danger to steal on in a state of the most fatal, because unguarded, security.” The alarming mortality of childhood, amounting to nearly half the children born, before the age of five years is reached, leads us to inquire whether it is an unavoidable fatality of our race, and therefore must be patiently submitted to, or is to a great extent the result of ignorance on the part of those to whom the care of the infant man is intrusted?

The perfection of the human frame, and its admirable adaptation to external nature, together with the fact that the preservation or destruction of life in infancy bears a marked and direct relation to the nature of the treatment to which the young being is subjected, solves the question beyond the possibility of a doubt.

The want of success in the management of the infant cannot be charged to neglect on the part of the parent, for “the kindest feelings flow out instinctively towards a helpless offspring.”

“Morning and evening thou hast watched the bee

Go forth on her errand of industry;

The bee for herself hath gathered and toiled,

But the mother’s toils are for her child.”

The sole cause of the difficulty is that the mother has never been instructed,—no pains has been taken to teach her, and she has neglected to inform herself, and now that she finds the life and welfare of her offspring dependent on her care and management, she applies to her friends for assistance and receives advice of so contradictory a nature that she is ready to give up in despair. It is to relieve mothers from this dilemma, which is one frequently observed by the physician, that the author gives the advice and instruction contained in this volume; and most admirably has he succeeded in his very difficult undertaking to write on a subject so little understood as physical education, and make it perfectly clear to the understanding of all.

J. F. P. Richter says of children: “I would create a world specially for myself and suspend it under the mildest sun; a little world where I would have nothing but little lovely children, and these little things I would never suffer to grow up, but only to play eternally. If a seraph were weary of heaven, or his golden pinions drooped, I would send him to dwell a month upon my happy infant world; and no angel, so long as he saw their innocence, could lose his own.”

The arrangement of the book is in the form of questions and answers. This is an excellent idea, the long experience of the author, as a physician, enabling him to suggest many important questions that would escape the inexperienced mother or nurse.

The first chapter treats of the management of the infant from the moment of its birth; and, although the care of the infant is not intrusted to the mother at this time, it is very important that she should know just how it should be managed, and she will then be able to instruct her nurse, and prevent her carrying into execution many of the hobbies of which old nurses are often very fond. The most of them are founded on error, and may be of the greatest injury to the infant at this tender period of its existence. For instance, the author tells us that the infant should be put to the mother’s breast soon after its birth, and should receive food of no other kind. Now there is the strongest desire on the part of many nurses to feed the child with some one of the many preparations used for this purpose as soon as it is dressed, or, at any rate, before the mother’s milk makes its appearance—forgetting that nature has made no mistake in her affairs here, and will not be interfered with without requiring the poor victim to pay the penalty;—and so we find that if the child’s stomach be filled with pap, gruel, or anything of the kind, the result will be acidity, griping, colic, and vomiting, and you will have made a bad beginning by interfering with nature, instead of a good one by leaving her alone. In very many cases the harm is done by trying to assist nature, and, on account of an ignorance of the natural laws, the intended assistance becomes a positive interference; and it is in view of this fact that the author tells us what not to do, as well as what to do; and whenever the mother is in doubt as to her course, she has only to turn to the chapter treating of the subject under consideration, and her mind is at once relieved.

Full instruction is given in regard to the clothing of infants. And nothing is more important; for one would suppose we should find deaths from pulmonary complaints, such as pneumonia and bronchitis, more frequent in adult life,—our occupations being of such a nature as to constantly expose us to the vicissitudes of the weather,—but the opposite is the fact, and the mortality from these diseases is far greater during childhood. The sources from which animal heat is derived, are smallest at birth, and increase till the child is full grown; but, instead of realizing this fact, and protecting the child with sufficient clothing, it is supposed to be comfortable when large portions of the body are entirely uncovered, while the parents find much more clothing requisite for both comfort and health—and the result is that many perish, and others are compelled to go on through life with impaired constitutions, for the condition of the pulmonary organs in after life depends, to a very great extent, on the treatment the person received during the tender period of infancy.

“’Tis the work

Of many a dark hour and of many a prayer

To bring the heart back from an infant gone.”—N. P. Willis.

After a few months the child requires other food than that derived from the mother, and it is of great importance that no mistake be made in the kind of food given the child; for, as we have already seen that the condition of the pulmonary organs of the adult depends to a very great extent upon the clothing of the infant, so will the condition of the digestive organs depend upon the selection of the food for the infant at this period of its existence, and if it be of the proper character all will be well, but if, as is too often the case, the food given be of an indigestible nature, the ground-work of dyspepsia is laid, and it will torment the unfortunate creature as long as he lives. In a great majority of cases children are given table-food far too early, and nothing is more common than to be told by the mother that her child grows “thinner and thinner,” though she is giving it all the meat it will eat. Now, our author shows us that the reason the child does not thrive is because its digestive organs are not far enough advanced to extract the nutriment from food of this kind, but that it irritates, and is a positive injury to the infant. And he then explains the important fact that the child does not thrive on that kind of food that contains the most nutriment itself, but on that which is best adapted to the condition of the digestive organs at the time it is given. And then he tells us what that is, and takes us on from step to step, making all the changes necessary in the diet throughout the entire period of infancy and childhood. He also calls our attention to those articles of food that are indigestible at all times, and gives many important directions in regard to the preparation of the food, time for giving it, and the amount that should be given.

Perhaps no part of the work is more important than the instruction given in regard to the raising of children by hand (as it is called); for here the life of the infant may be said to depend, to a very great extent, upon the treatment it receives from those who have it in charge, and it is for this reason that the author has been very explicit in his instructions. He has, in fact, left nothing to be wished for; he gives the minutest directions as to the kind of food, the mode of preparation, the time for feeding, and the general management of the infant who is so unfortunate as to be deprived of the sustenance nature intended for its support. The wet-nurse comes in, also, for her share of attention, and we are told how to select one, and rules are laid down for her diet, exercise, etc. And it is not a matter of indifference whether these rules are attended to or not; for, on the condition of the health of the nurse will depend the character of her milk, and of course we cannot expect a child to be healthy that receives impure milk from its nurse.

Very important instruction is given for our guidance in the management of the child when sick. Everything relating to the sick-room is fully discussed, and the most minute directions given for the assistance of the mother at this critical period of the child’s existence.

Considerable space is taken with prescriptions and the administration of medicine, which is of much value to those not within the reach of the family physician. But if the child is sick the physician should always be notified at once, if it be possible, for much depends upon the early treatment of the disease; and in no case should the limited knowledge of the mother be substituted for that of the experienced physician. It must be remembered that this book is not intended exclusively for those who are always within the reach of a physician, but it is also for the guidance and assistance of whose who are far from, or unable to obtain, medical advice, and to those located on the frontier, and at the missionary stations, this part of the work has proved to be of the greatest advantage.

Sound advice is given in regard to dosing children with many quack cordials, carminatives, and syrups, that fill the shops, all of which are advertised to contain no opium, and yet the busy practitioner hardly passes a month without being called to attend a child dangerously narcotized by some one of these preparations.

It is to induce sleep that these preparations are given, the mother not being aware that if an anodyne be used to-day, a larger dose will be required to-morrow to produce the same effect, and also that by its interference with digestion the habitual use of narcotics always injures the health of the child. For these reasons laudanum, paregoric, or any preparations containing opium in any form, should never be given to the infant, unless under the control of a physician.

The management of the nursery is not overlooked, and very judicious rules for selecting, warming, and ventilating the apartment are given. As the child advances, the teeth begin to make their appearance, and this is always a source of more or less irritation; but, by a little care at this time, the child passes through it with little discomfort, and serious consequences are avoided. The importance of proper regulation of the diet, and the soothing effect of fresh air upon the irritated nervous system at this time, cannot be over-estimated.

The modes of exercising the child are explained, and as the development of the muscular system depends to so great an extent on judicious exercise, no mother should fail to become acquainted with the instruction given on this subject.

The infant man, like the adult one, is a creature of habit, and, with a little systematic training, it is very easy to form good habits, provided you begin early; but, if you delay until bad habits have been formed, it then becomes an entirely different matter. In the simple operation of getting the child to sleep, the difficulty experienced is generally the result of not beginning with it until bad habits have been formed. It is just as easy for the infant to go to sleep at a regular time every day by being placed quietly in the bed, as it is for it to go to sleep after being patted, trotted, and walked about the room for an hour or two; but, if it is walked to-day, of course it will expect it to-morrow. The ill effects of this kind of treatment, together with the way in which it is to be avoided, the author has plainly given us.

Bathing, if properly conducted, is always agreeable, and of advantage to the child, and mothers often ask how often they should bathe their children, and whether in warm or cold water, and, as even the bathing of the child may be done improperly, directions are given which should always be followed. The child may be bathed too often, or not often enough, or in an improper manner. For instance, it may be seated in a bath-tub with the water half way up the body, and then water splashed up over the shoulders, leaving the chest subjected to the chilling effects of evaporation, and material harm may thereby result.

The amusement of the child very properly comes in for a share of the author’s attention. All parents should realize the importance of making the child’s home cheerful, and should not forget that the happiness of the child has much to do with its health and the development of its mental nature. It is astonishing at how small an expense, with a little contrivance, the gloomy, quiet nursery may be converted into a cheerful, happy one, and a small plot of ground into a full-sized farm in the mind of the infant farmer.

“Oh! happy age, when harmless pleasures please,

Gay as the lark, and fickle as the breeze:

Well may we sigh, in after years of pain,

To think that hour will never come again.

How small the grief that dims the sunny eye—

How light the thoughtless tear—how quickly dry;

A toy, a butterfly, thy smiles renew,

As from the flow’r the sunbeams chase the dew.”

Parents are too apt to overlook these, to them, unimportant little things, and it is for this reason that the author calls attention to it, and shows us that rational amusements not only develop the physical, but exert an immense influence on the intellect of the child.

The views of the author in regard to the education of the child are clearly given. In this country children are sent to school far too young. The mind is overtaxed before the body has had time to develop, and a debilitated constitution is too often the result. It is of little consequence whether a child reads at six years or not until it is ten. First develop the physical, then at the proper time the vigorous intellect will climb the hill of knowledge, leaving far behind the student whose constitution was destroyed by overcrowding the brain during the tender age of childhood.

“The main design of nature in early youth, is not the speedy development of the mind,—for she has designedly, as it were, withheld this agent,—but the development and growth of the body, by means of the nutritive functions so carefully provided for the purpose. All the energies of the constitution are then required for the promotion of this object; and if the brain be then cultivated too assiduously, these energies are abstracted from their legitimate purpose, and physical debility, ending most probably in disease and decay is produced. Does it not thus clearly and manifestly appear, that premature and too exclusive mental cultivation is to thwart nature by interfering with her operations in the careful development of the physical constitution of youth?”

It was the opinion of Rosseau “that the chief art of education in childhood is to lose time; that every delay should be considered an advantage, care being taken not to give that instruction to-day which may be deferred, without danger, till to-morrow.” The same writer says: “The most critical interval of human life is that between the hour of birth and twelve years of age. This is the time wherein vice and error take root, without our being possessed of any instrument to destroy them; and when the implement is found they are so deeply grounded that they are no longer to be eradicated.

“If children took a leap from their mother’s breast and at once arrived at the age of reason, the methods of education now usually taken with them would be very proper; but, according to the progress of nature, they require those which are very different. We should not tamper with the mind till it has acquired all its faculties; for it is impossible it should perceive the light we hold out to it while it is blind, or that it should pursue, over an immense plain of ideas, that route which reason hath so slightly traced as to be perceptible only to the sharpest sight.

“The first part of education, therefore, ought to be purely negative. It consists neither in teaching virtue nor truth, but in guarding the heart from vice and the mind from error.”

“Meantime a smiling offspring rises round,

And mingles both their graces. By degrees,

The human blossom blows; and every day,

Soft as it rolls along, shows some new charm—

The father’s luster, and the mother’s bloom.”

Thomson’s Seasons.

After this brief review, the only conclusion that we can come to is, that everything depends upon a proper system of physical training. Without a systematic development of the physical frame, a healthful and vigorous intellectual condition need not be looked for. The mental and the physical parts of education are as inseparable as the action of the mind from that of the bodily organs—they are created for and adapted to each other, and so sympathize as to form an harmonious whole. Now, if the mothers of the land will give their attention to the subject of Physical Education, the mortality of childhood will decrease, the condition of mankind improve, enjoyment be promoted, and, by enabling all to cultivate the higher faculties and affections, the human family will effect the nearest approach to perfection that it is possible to attain on earth.

F. H. GETCHELL,

1432 Spruce Street, Phila.

October, 1870.

INFANCY.

I hardly know so melancholy a reflection, as that Parents are necessarily the sole directors of the management of Children; whether they have, or have not judgment, penetration, or taste, to perform the task.—Greville.

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 favor 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 endeavor 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 quickly 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 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 subject 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 the marring of the man.” Dr. Guthrie justly remarks that—“Moses might never have 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.”

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.”

In the writing of the following pages I have 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.”

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. Lukewarm 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 off the chill.

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 Glycerin soap, instead of the Castile soap, ought to be used.

4. At what age do you recommend a mother to commence washing her infant in the tub or in the nursery-basin?

As soon as the naval-string comes away. 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!

A nursery-basin (Wedgwood’s 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 basin is generally fitted into a wooden frame, which will raise it to a convenient height for the washing of the baby.

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.

5. Which do you prefer—flannel or sponge—to wash a child with?

For the first part of the washing a piece of flannel is 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 child 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, 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 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.

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 afterward 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.

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 armpits, 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 his 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 mothers are in the habit of using white lead; but as this is a poison, it ought on no account to be resorted to. In one case related by Koop (Journ. de Pharm., xx. 603), a child was destroyed by it.

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. 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 preventive 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 napkin in fresh water and then tasting the water; if it be brackish and salt, soda has been employed.” [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 afterward the mother, unless she should happen to have an experienced, sensible, thoughtful nurse, which, unfortunately, is seldom the case. [“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. Bruce. 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 bath-coating—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 is dangerous for him to remain for a long period in his bath; this, of course, holds good in a tenfold degree if the child has either a cold, or a 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, how 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 braces 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 advice, 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 upward, 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 come 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 be quite healed.

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 rupture, 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 center 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 a truss or an elastic bandage; which latter appliances sometimes gall, and do more harm than they do good.

20. If a child has 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 directions of an experienced surgeon) by a skillful 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 skillful 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 insured. 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 run 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 a 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, by all means discontinue 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, etc.) 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 movements 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 hooping-cough while still very young, it is safer to resume the belly-band.” [Communicated by Sir Charles Locock to the Author.]

24. Have you any remarks to make on the clothing of an infant?

A baby’s clothing ought to be light, warm, loose, and free from pins. (1.) It should be light, without being too airy. Many infants’ 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 with a needle and thread every part that requires fastening. They do not even use pins to fasten the baby’s napkins. 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 napkins, 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 baby’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 endeavor 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 the 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 northeast, 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 breast 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 that at so early a period there is no milk in the breast; 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 breast—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 no milk AT FIRST, what ought then to be done?

Wait with patience: the child (if the mother has 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 it 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 constantly in pain, and he gives utterance to it by cries. How absurd is such a practice! We may as well endeavor to put out a fire by feeding it with fuel. An infant ought to be accustomed to regularity in every thing—in times for suckling, for sleeping, etc. 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 three or four 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 while suckling than at any other period of their lives.

34. What food 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 five or six 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. (4.) Or, Robb’s Biscuit, as it is “among the best bread compounds made out of wheat-flour, and is almost always readily digested.”—Routh. “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.

(5.) Another good food is the following: Take about a pound of flour, put it in a cloth, tie it up tightly, place it in 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 color. (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 color. 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, 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 tablespoonful of it, mixed with a quarter of a pint of milk, or milk and water, when well boiled, flavored, 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 breast, at the same time relieving them of much draining and dragging while nursing with an insufficiency of milk, as baked flour and oatmeal.” If there is any difficulty in obtaining prepared oatmeal, Robertson’s Patent Groats will answer equally as well.

(9.) A ninth food may be made with “Farinaceous Food for Infants, prepared by Hards of Dartford.” If Hards’ Farinaceous Food produces costiveness—as it sometimes does—let it be mixed either with equal parts or with one-third of Robertson’s Patent Groats. 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. (13.) Or, Brown and Polson’s Patent Corn Flour will be found suitable. The Queen’s cook, in his recent valuable work, gives the following formula for making it: “To one dessertspoonful of Brown & 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.) 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.

When the baby is five or six 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.

(15.) For a delicate infant, lentil powder, better known as Du Barry’s “Revalenta 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. The following (16.) is a good food when an infant’s bowels are weak and relaxed: “Into five large spoonfuls of the purest water rub smooth one dessertspoonful 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 (17.) genuine arrow-root 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 good fresh milk, and ought to be slightly sweetened with loaf sugar; a small pinch of table salt should be added to it.

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

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, 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. 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.”

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 savor 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 WHILE 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 three or four 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 mother’s 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 has attained the age of three or four months; then it will usually be necessary to feed him 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 be the best for him, commencing without the cow’s milk, but gradually adding it, as less mother’s milk and more artificial food be given.

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 vapors [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 afterward.”

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 a 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. For further reasons why artificial food is not desirable at an early period of infancy, see answer to 35th question. 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, as it is wanted, and should be given by means of a feeding-bottle.

Asses’ milk is more suitable for delicate infants, and goats’ milk for those who are strong.

If neither asses’ milk nor goats’ milk can be procured, then the following from the very commencement should be given:

New milk, the produce of ONE healthy cow,

Warm water, of each, equal parts;

Table salt, a few grains;

Lump sugar, a sufficient quantity to slightly sweeten it.

Liebig, the great chemist, asserts that a small quantity of table salt to the food is essential to the health of children. The milk itself ought not to be heated over the fire, but should, as above directed, be warmed by the water; it must, morning and evening, be had fresh and fresh. 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. The milk and water should be of the same temperature as the mother’s milk, that is to say, at about ninety to ninety-five degrees Fahrenheit. It ought to be given by means of a feeding-bottle, 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. As he grows older the milk should be gradually increased, and the water decreased, until nearly all milk be given.

There will, in many cases, be quite sufficient nourishment in the above; I have known some robust infants brought up on it alone. 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, or wet-nurse’s, or asses’, or goat’s, or cow’s own 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, or a consumptive habit, or if she or any of her family have labored 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 (which may readily be ascertained by milking a little into a glass. “It should be thin, and of a bluish-white color, sweet to the taste, and when allowed to stand should throw up a considerable quantity of cream.”—Maunsell and Evertson on the Diseases of Children.) 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 menstruates during suckling; if she does, the milk is not so good and nourishing, and you had better decline taking her. 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 a third child’s mother is more eligible than a first.”—Letter to the Author. Assure yourself that her own babe is strong and healthy, and that he is 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, as 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 color, 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 actually 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 in his mouth.

Very feeble new-born babes sometimes cannot take the bosom, be the nipples and the breasts ever so good. In such a case, cow’s milk and water, sugar and salt, as recommended at page [45], must be given in small quantities at a time—from two to four teaspoonfuls—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 teaspoonfuls, 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 teaspoonfuls 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 brocoli, 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 or 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 months, 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, endeavor to procure one of a mild, calm, and placid disposition.

“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 laboring 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—in the bed, so as to give a little to him in lieu of the breast. The previous boiling of the milk will prevent the warmth of the bed turning the milk sour, which it would otherwise do. The warmth of the body will keep the milk of a proper temperature, and will supersede the use of lamps, of candle-frames, and other troublesome contrivances.

42. While a mother is weaning her infant, and after she has weaned him, what ought to be his diet?

Any one of the foods recommended in answer to question 34, page [36].

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 three or four 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, suffer severely. For the first three or four 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.

Care in feeding, then, is the grand preventive 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 cows’ 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.

If a baby’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, brown sugar ought to be substituted for lump sugar, as brown 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.

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 revaccinated,—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 only be known 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 revaccinated?

I decidedly do; it would be an excellent plan for every person, once every seven years, to be revaccinated, and even oftener, if small-pox be rife in the neighborhood. 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 is 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 civilized 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 revaccinated once every seven years, or even oftener, if there was an epidemic of small-pox in the neighborhood.

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 tenfold 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 be 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 neighborhood, 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.” Communicated by Sir Charles Locock to the author.

51. Do you consider that the 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 has 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.” 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 neighborhood, 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, and 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 a 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 a 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 in 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 relief and comfort.

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.”

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.”

Act 2, sc, 5.