“DEFICIENCY OF MILK”

Deficiency of milk may exist even at a very early period after delivery, and yet be removed. This, however, is not to be accomplished by the means too frequently resorted to; for it is the custom with many, two or three weeks after their confinement, if the supply of nourishment for the infant is scanty, to partake largely of malt liquor for its increase. Sooner or later this will be found injurious to the constitution of the mother: but how, then, is this deficiency to be obviated? Let the nurse keep but in good health, and this point gained, the milk, both as to quantity and quality, will be as ample, nutritious, and good, as can be produced by the individual.

I would recommend a plain, generous, and nutritious diet; not one description of food exclusively, but, as is natural, a wholesome, mixed, animal, and vegetable diet, with or without wine or malt liquor, according to former habit; and, occasionally, where malt liquor has never been previously taken, a pint of good sound ale may be taken daily with advantage, if it agree with the stomach.

Regular exercise in the open air is of the greatest importance, as it has an extraordinary influence in promoting the secretion of healthy milk. Early after leaving the lying-in room, carriage exercise, where it can be obtained, is to be preferred, to be exchanged, in a week or so, for horse exercise, or the daily walk. The tepid, or cold salt-water shower bath, should be used every morning; but if it cannot be borne, sponging the body withsalt-water must be substituted.

By adopting with perseverance the foregoing plan, a breast of milk will be obtained as ample in quantity, and good in quality, as the constitution of the parent can produce, as the following case proves:

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“Combating Disease”

The especial province of the mother is the prevention of disease (Combating Disease), not its cure. When disease attacks the child, the mother has then a part to perform, which it is especially important during the epochs of infancy and childhood should be done well. I refer to those duties which constitute the maternal part of the management of disease.

Medical treatment, for its successful issue, is greatly dependent upon a careful, pains-taking, and judicious maternal superintendence. No medical treatment can avail at any time, if directions be only partially carried out, or be negligently attended to; and will most assuredly fail altogether, if counteracted by the erroneous prejudices of ignorant attendants.

But to the affections of infancy and childhood, this remark applies with great force; since, at this period, disease is generally so sudden in its assaults, and rapid in its progress, that unless the measures prescribed are rigidly and promptly administered, their exhibition is soon rendered altogether fruitless.

The amount of suffering, too, may be greatly lessened by the thoughtful and discerning attentions of the mother. The wants and necessities of the young child must be anticipated; the fretfulness produced by disease, soothed by kind and affectionate persuasion; and the possibility of the sick and sensitive child being exposed to harsh and ungentle conduct, carefully provided against.

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“MILK-TEETH”

The first set of teeth, or milk-teeth as they are called, are twenty in number; they usually appear in pairs, and those of the lower jaw generally precede the corresponding ones of the upper. The first of the milk-teeth is generally cut about the sixth or seventh month, and the last of the set at various periods from the twentieth to the thirtieth months.

Thus the whole period occupied by the first dentition may be estimated at from a year and a half to two years. The process varies, however, in different individuals, both as to its whole duration, and as to the periods and order in which the teeth make their appearance. It is unnecessary, however, to add more upon this point.

Their developement is a natural process. It is too frequently, however, rendered a painful and difficult one, by errors in the management of the regimen and health of the infant, previously to the coming of the teeth, and during the process itself.

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“INFANTS ARTIFICIAL DIET”

It should be as like the breast-milk as possible. This is obtained by a mixture of cow’s milk, water, and sugar, in the following proportions.

Fresh cow’s milk, two thirds; Boiling water, or thin barley water, one third; Loaf sugar, a sufficient quantity to sweeten.

This is the best diet that can be used for the first six months, after which some farinaceous food may be combined.

In early infancy, mothers are too much in the habit of giving thick gruel, panada, biscuit-powder, and such matters, thinking that a diet of a lighter kind will not nourish. This is a mistake; for these preparations are much too solid; they overload the stomach, and cause indigestion, flatulence, and griping. These create a necessity for purgative medicines and carminatives, which again weaken digestion, and, by unnatural irritation, perpetuate the evils which render them necessary.

Thus many infants are kept in a continual round of repletion, indigestion, and purging, with the administration of cordials and narcotics, who, if their diet were in quantity and quality suited to their digestive powers, would need no aid from physic or physicians.

In preparing this diet, it is highly important to obtain pure milk, not previously skimmed, or mixed with water; and in warm weather just taken from the cow. It should not be mixed with the water or sugar until wanted, and not more made than will be taken by the child at the time, for it must be prepared fresh at every meal. It is best not to heat the milk over the fire, but let the water be in a boiling state when mixed with it, and thus given to the infant tepid or lukewarm.

As the infant advances in age, the proportion of milk may be gradually increased; this is necessary after the second month, when three parts of milk to one of water may be allowed. But there must be no change in the kind of diet if the health of the child is good, and its appearance perceptibly improving. Nothing is more absurd than the notion, that in early life children require a variety of food; only one kind of food is prepared by nature, and it is impossible to transgress this law without marked injury.

There are two ways by the spoon, and by the nursing-bottle. The first ought never to be employed at this period, in as much as the power of digestion in infants is very weak, and their food is designed by nature to be taken very slowly into the stomach, being procured from the breast by the act of sucking, in which act a great quantity of saliva is secreted, and being poured into the mouth, mixes with the milk, and is swallowed with it.

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“Infant Cleanliness”

Cleanliness is essential to the infant’s health. The principal points to which especial attention must be paid by the parent for this purpose are the following:

At first the infant should be washed daily with warm water; and a bath every night, for the purpose of thoroughly cleaning the body, is highly necessary. To bathe a delicate infant of a few days or even weeks old in cold water with a view “to harden” the constitution (as it is called), is the most effectual way to undermine its health and entail future disease. By degrees, however, the water with which it is sponged in the morning should be made tepid, the evening bath being continued warm enough to be grateful to the feelings.

A few months having passed by, the temperature of the water may be gradually lowered until cold is employed, with which it may be either sponged or even plunged into it, every morning during summer. If plunged into cold water, however, it must be kept in but a minute; for at this period, especially, the impression of cold continued for any considerable time depresses the vital energies, and prevents that healthy glow on the surface which usually follows the momentary and brief action of cold, and upon which its usefulness depends.

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“CRYING BABY”

Crying is a normal event in the lives of all babies.When a baby comes out of the womb the first thing to do is crying. By the first cry he will take some air in to the lungs for the first time in their life. After delivery if the baby does not cry then it should be initiated by slightly pinching or gently stocking the feet. From this it is clear that the healthy baby should cry and it is a normal physiological event ,still some times it can upset the mother or family members.

We all know that a baby can’t tell his needs or troubles in words. The only way for him to communicate with others is by crying. Babies show some other signs like feet kicking,hand waving and head turning ect. But the best way to take the attention of others is by crying.

Excessive crying may not have a firm definition because the crying habit changes from baby to baby and some babies can be calmed easily but some are difficult to sooth. If crying is distressing for the mother and home nurse it can be called excessive. Many a times baby become quiet by giving breast milk or by carrying with a gentle rocking. Sudden onset of excessive crying means baby is distressed and needs attention. The causes of crying extends from simple reasons to life threatening conditions.Hence crying of a baby should not be ignored.

Most of the time it is difficult to find the cause of the cry . Common causes are discussed here for awareness.

Common reasons for crying:

1. Hunger:
A hungry baby will cry till he gets the milk. Here the old saying comes true’crying baby gets the milk.

2. Wetting:
Urination and defecation causes some discomfort and results in crying till his parts are cleaned and made dry.

3. Company:
Majority of the kids need somebody near. If they feel lonely they cry. When their favourite doll slips away from the grip they cry for help.

4. Tired:
When the baby is tired after a journey and unable to sleep just cry simply.They feel tired in uncomfortable surroundings and due to unhealthy climate.

5. Heat & cold:
If they feel too hot or too cold they become restless and cry. Child is comfortable in a room with good ventilation.

6. Tight clothing:
Tight cloths especially during warm climate is intolerable for kids. Tight elastic of the dress can also produce soreness in the hip region.

7. Dark room:
When the baby wakes up from sleep he needs some dim light.If there is darkness he will disturb the sleep of parents by crying. Of course he will be irritated by strong light resulting in cry.

8. Mosquito:
Yes, these creatures disturb the sleep by their blood sucking and make the baby to cry.

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“BREASTFEEDING”

From the first moment the infant is applied to the breast (breastfeeding), it must be nursed upon a certain plan. This is necessary to the well-doing of the child, and will contribute essentially to preserve the health of the parent, who will thus be rendered a good nurse, and her duty at the same time will become a pleasure.

This implies, however, a careful attention on the part of the mother to her own health; for that of her child is essentially dependent upon it. Healthy, nourishing, and digestible milk can be procured only from a healthy parent; and it is against common sense to expect that, if a mother impairs her health and digestion by improper diet, neglect of exercise, and impure air, she can, nevertheless, provide as wholesome and uncontaminated a fluid for her child, as if she were diligently attentive to these important points. Every instance of indisposition in the nurse is liable to affect the infant.

And this leads me to observe, that it is a common mistake to suppose that, because a woman is nursing, she ought therefore to live very fully, and to add an allowance of wine, porter, or other fermented liquor, to her usual diet. The only result of this plan is, to cause an unnatural degree of fulness in the system, which places the nurse on the brink of disease, and which of itself frequently puts a stop to the secretion of the milk, instead of increasing it. The right plan of proceeding is plain enough; only let attention be paid to the ordinary laws of health, and the mother, if she have a sound constitution, will make a better nurse than by any foolish deviation founded on ignorance and caprice.

The following case proves the correctness of this statement:

A young lady, confined with her first child, left the lying-in room at the expiration of the third week, a good nurse, and in perfect health. She had had some slight trouble with her nipples, but this was soon overcome.

The porter system was now commenced, and from a pint to a pint and a half of this beverage was taken in the four and twenty hours. This was resorted to, not because there was any deficiency in the supply of milk, for it was ample, and the infant thriving upon it; but because, having become a nurse, she was told that it was usual and necessary, and that without it her milk and strength would ere long fail.

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“STOMACH AND BOWEL”

Disorder of the stomach and bowels is one of the most fruitful sources of the diseases of infancy. Only prevent their derangement, and, all things being equal, the infant will be healthy and flourish, and need not the aid of physic or physicians.

There are many causes which may give rise to these affections; many of them appertain to the mother’s system, some to that of the infant. All are capable, to a great extent, of being prevented or remedied. It is, therefore, most important that a mother should not be ignorant or misinformed upon this subject. It is the prevention of these affections, however, that will be principally dwelt upon here; for let the mother ever bear in mind, and act upon the principle, that the prevention of disease alone belongs to her; the cure to the physician. For the sake of clearness and reference, these disorders will be spoken of as they occur:

To the infant at the breast

The infant’s stomach and bowels may become deranged from the breast-milk becoming unwholesome. This may arise from the parent getting out of health, a circumstance which will be so manifest to herself, and to those more immediately interested in her welfare, that it is only necessary just to allude to it here. Suffice it to say, that there are many causes of a general kind to which it may owe its origin; but that the most frequent is undue lactation, and the effects both upon mother and child fully dwelt upon.

Anxiety of mind in the mother will cause her milk to be unhealthy in its character, and deficient in quantity, giving rise to flatulence, griping, and sometimes even convulsions in the infant. A fit of passion in the nurse will frequently be followed by a fit of bowel complain in the child. These causes of course are temporary, and when removed the milk becomes a healthy and sufficient for the child as before.

Sudden and great mental disturbance, however, will occasionally drive away the milk altogether, and in a few hours. A Mrs. S., aet. 29, a fine healthy woman, of a blonde complexion, was confined of a boy. She had a good time, and a plentiful supply of milk for the child, which she continued to suckle till the following January, a period of three months, when her milk suddenly disappeared.

This circumstance puzzled the medical attendant, for he could not trace it to any physical ailment; but the milk never returned, and a wet-nurse became necessary. In the following spring the husband of this lady failed, an adversity which had been impending since the date when the breast-milk disappeared, upon which day the deranged state of the husband’s affairs was made known to the wife, a fact which at once explained the mysterious disappearance of the milk.

Unwholesome articles of diet will affect the mother’s milk, and derange the infant’s bowels. Once, I was called to see an infant at the breast with diarrhoea. The remedial measures had but little effect so long as the infant was allowed the breast-milk; but this being discontinued, and arrow-root made with water only allowed, the complaint was quickly put a stop to. Believing that the mother’s milk was impaired from some accidental cause which might now be passed, the infant was again allowed the breast. In less than four-and-twenty hours, however, the diarrhoea returned.

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“Breathing and Cough”

The breathing of a child in health is formed of equal inspirations and expirations, and it breathes quietly, regularly, inaudibly, and without effort. But let inflammation of the air-tubes or lungs take place, and the inspiration will become in a few hours so quickened and hurried, and perhaps audible, that the attention has only to be directed to the circumstance to be at once perceived.

Now all changes which occur in the breathing from its healthy standard, however slight the shades of difference may be, it is most important should be noticed early. For many of the complaints in the chest, although very formidable in their character, if only seen early by the medical man, may be arrested in their progress; but otherwise, may be beyond the control of art. A parent, therefore, should make herself familiar with the breathing of her child in health, and she will readily mark any change which may arise.

Whenever a child has the symptoms of a common cold, attended by hoarseness and a rough cough, always look upon it with suspicion, and never neglect seeking a medical opinion. Hoarseness does not usually attend a common cold in the child, and these symptoms may be premonitory of an attack of “croup;” a disease excessively rapid in its progress, and which, from the importance of the parts affected, carrying on, as they do, a function indispensably necessary to life, requires the most prompt and decided treatment.

The following observations of Dr. Cheyne are so strikingly illustrative, and so pertinent to my present purpose, that I cannot refrain inserting them: “In the approach of an attack of croup, which almost always takes place in the evening, probably of a day during which the child has been exposed to the weather, and often after catarrhal symptoms have existed for several days, he may be observed to be excited, in variable spirits, more ready than usual to laugh than to cry, a little flushed, occasionally coughing, the sound of the cough being rough, like that which attends the catarrhal stage of the measles.

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“Child Sleep”

Of the sleep

The sleep of the infant (Child Sleep) in health is quiet, composed, and refreshing. In very early infancy, when not at the breast, it is for the most part asleep in its cot; and although as the months advance it sleeps less, yet when the hour for repose arrives, the child is no sooner laid down to rest, than it drops off into a quiet, peaceful slumber.

Not so, if ill. Frequently it will be unwilling to be put into its cot at all, and the nurse will be obliged to take the infant in her arms; it will then sleep but for a short time, and in a restless and disturbed manner.

If it suffer pain, however slight, the countenance will indicate it; and, as when awake, so now, if there is any thing wrong about the head, the contraction of the eye-brow and grinding of the teeth will appear; if any thing wrong about the belly, the lips will be drawn apart, showing the teeth or gums, and in both instances there will be great restlessness and frequent startings.

Of the stools

In the new-born infant the motions are dark coloured, very much like pitch both in consistence and appearance. The first milk, however, secreted in the mother’s breast, acts as an aperient upon the infant’s bowels, and thus in about four-and-twenty hours it is cleansed away.

From this time, and through the whole of infancy, the stools will be of a lightish yellow colour, the consistence of thin mustard, having little smell, smooth in appearance, and therefore free from lumps or white curded matter, and passed without pain or any considerable quantity of wind. And as long as the child is in health, it will have daily two or three, or even four, of these evacuations. But as it grows older, they will not be quite so frequent; they will become darker in colour, and more solid, though not so much so as in the adult.

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