The Care and Feeding of Children Part 19

This is frequently due to overeating, to indulgence in some special article of improper food, or to eating heartily when overtired. Acute indigestion often marks the beginning of some acute general illness.

_How should acute indigestion be managed?_

One should bear in mind that for the time being the digestive organs have stopped work altogether. The important thing, therefore, is to clear out from the intestines all undigested food by some active cathartic, such as castor oil. The stomach has usually emptied itself by vomiting. All food should be stopped for from twelve to thirty-six hours, according to the severity of the attack, only water being given.

_At the end of this time is it safe to begin with the former diet?_

No; for such a procedure is almost certain to cause another attack of indigestion. At first only broth, thin gruel, very greatly diluted milk, or whey should be given. The diet may be very slowly but gradually increased as the child's appet.i.te and digestion improve, but in most cases a week or ten days should elapse before the full diet is resumed.

_What are the symptoms of chronic indigestion?_

These, although familiar, are not so easily distinguished and are very often attributed to the wrong cause. There are usually general symptoms such as indisposition, disturbed sleep, grinding of the teeth, fretfulness, languor, loss of weight and anaemia. There are besides local symptoms: flatulence, abdominal pain, abdominal distention, constipation, or looseness of the bowels with mucus in the stools, foul breath, coated tongue, loss of appet.i.te, or an abnormal capricious appet.i.te. Such symptoms are often wrongly ascribed to intestinal worms.

_What are the common causes of chronic indigestion?_

This is generally the result of a bad system of feeding, either the prolonged use of improper food or of improper methods of feeding.

Examples of bad methods of feeding are, coaxing or forcing to eat, rapid eating with insufficient mastication eating between meals, allowing a child to have his own way in selecting his food, as when he lives largely upon a single article of diet. Things to be considered under the head of improper food are, indulgence in sweets, desserts, etc., the use of imperfectly cooked foods, especially cereals and vegetables, and of raw or stale fruits.

_Is it not true that a diet or a special article of food which does not make a child ill is proof that such a diet or such a food is proper for a child?_

By no means; with many people the only guide In feeding children is that the article in question did not make the children sick, therefore it is allowable. This is a very bad principle. A better one is to adopt such a diet as will nourish the child's body with the least possible tax upon his digestive organs; in other words, to exclude articles which experience has shown to be injurious to most children.

_How should chronic indigestion be managed?_

This is a much more difficult matter than the treatment of acute indigestion, for, as it is usually the result of the prolonged use of improper food or of an improper method of feeding, a cure can be accomplished only by a discovery and removal of the cause.

_Is chronic indigestion curable?_

In the vast majority of cases it is so, but only by faithfully observing for a long period the rules for simple feeding laid down elsewhere. One of the greatest' difficulties in the way of recovery is that parents and nurses are unwilling to follow a restricted diet long enough to secure a complete cure, or to change radically their methods of feeding, but expect the child to recover by simply taking medicine.

_For how long a period is it necessary to continue very careful feeding?_

In any case it must be done for several months; with most children for two or three years; with some, throughout childhood, for with them the slightest deviation from established rules is sure to provoke a relapse.

_Is not medicine useful?_

It is undoubtedly of a.s.sistance for the relief of some symptoms, but the essential thing is proper feeding, without which nothing permanent can be accomplished.

GENERAL RULES TO BE OBSERVED IN FEEDING

Bad habits of eating are readily acquired but difficult to break.

Young children should not be allowed to play with their food, nor should the habit be formed of amusing or diverting them while eating, because by these means more food is taken.

Older children should not be permitted to make an entire meal of one thing, no matter how proper this may be.

Children, who are allowed to have their own way in matters of eating are very likely to be badly trained in other respects; while those who have been properly trained in matters of eating can usually be easily trained to do anything else that is important.

Learning to eat proper things in a proper way forms therefore a large part of a child's early education. If careful training in these matters is begun at the outset and continued, the results will well repay the time and effort required.

Whether the child feeds himself or is fed by the nurse, the following rules should be observed:

1. Food at regular hours only; nothing between meals.

2. Plenty of time should be taken. On no account should the child bolt his food.

3. The child must be taught to chew his food. Yet no matter how much pains are taken in this respect, mastication is very imperfectly done by all children; hence up to the seventh year at least, all meats should be very finely cut, all vegetables mashed to a pulp, and all grains cooked very soft.

4. Children should not be continually urged to eat if they are disinclined to do so at their regular hours of feeding, or if the appet.i.te is habitually poor, and under no circ.u.mstances should a child be forced to eat.

5. Indigestible food should never be given to tempt the appet.i.te when the ordinary simple food is refused? food should not be allowed between meals because it is refused at meal-time.

6. One serious objection to allowing young children highly seasoned food, entrees, jellies, pastry, sweets, etc., even in such small amounts as not to upset the digestion, is that children thus indulged soon lose appet.i.te for the simple food which previously was taken with relish.

7. If there is any important article of a simple diet such as milk, meat, cereals, or vegetables, which a child habitually refuses, this should always be given first at the meal and other food withheld until it is disposed of. Children so readily form habits of eating only certain things and refusing others that such an inclination should be checked early.

8. If an infant refuses its food altogether, or takes less than usual, the food should be examined to see if this is right. Then the mouth should be inspected to see if it is sore. If neither of these things is the cause, the food should be taken away and not offered again until the next feeding time comes.

9. In any acute illness the amount of food should be much reduced and the food made more dilute than usual. If there is fever, no solid food should be given. If the child is already upon a milk diet, this should be diluted, and in some cases partially peptonized.

10. In very hot weather the same rules hold, to give less food, particularly less solid food, and more water.

FOOD FORMULAS

_Beef Juice._--One pound of rare round steak, cut thick, slightly broiled, and the juice pressed out by a lemon-squeezer, or, better, a meat-press. From two to four ounces of juice can generally be obtained. This, seasoned with salt, may be given cold, or warmed by placing the cup which holds it in warm water. It should not be heated sufficiently to coagulate the alb.u.min which is in solution, and which then appears as flakes of meat floating in the fluid.

_Beef Juice by the Cold Process._--One pound of finely chopped round steak, six ounces of cold water, a pinch of salt; place in a covered jar and stand on ice or in a cold place, five or six hours or overnight. It is well to shake occasionally. This is now strained and all the juice squeezed out by placing the meat in coa.r.s.e muslin and twisting it very hard. It is then seasoned and fed like the above.

Beef juice so made is not quite as palatable as that prepared from broiled steak, but it is even more nutritious, and is more economical, as fully twice as much juice, can be obtained from a given quant.i.ty of meat. Beef juice prepared in either of these ways is greatly to be preferred to the beef extracts sold.

_Mutton Broth._--One pound of finely chopped lean mutton, including some of the bone, one pint cold water, pinch of salt. Cook for three hours over a slow fire down to half a pint, adding water if necessary; strain through muslin, and when cold carefully remove the fat, adding more salt if required. It may be fed warm, or cold in the form of a jelly.

A very nutritious and delicious broth is made by thickening this with cornstarch or arrowroot, cooking for ten minutes and then adding three ounces of milk, or one ounce and a half of thin cream, to a half pint of broth.

_Chicken, Veal, and Beef Broths._--These are made and used in precisely the same manner as mutton broth.

_Meat Pulp._--A rare piece of round or sirloin steak, the outer part having been cut away, is sc.r.a.ped or shredded with a knife; one teaspoonful to one tablespoonful may be given, well salted, to a child of eighteen months. Sc.r.a.ping is much better than cutting the meat fine.

For this on a large scale, as in inst.i.tutions, a Hamburg-steak cutter may be employed.

_Junket, or Curds and Whey._--One pint of fresh cow's milk, warmed; pinch of salt; a teaspoonful of granulated sugar; add two teaspoonfuls of Fairchild's essence of pepsin, or liquid rennet, or one junket tablet dissolved in water; stir for a moment, and then allow it to stand at the temperature of the room for twenty minutes, or until firmly coagulated; place in the ice box until thoroughly cold. For older children this may be seasoned with grated nutmeg.

_Whey._--The coagulated milk prepared as above is broken up with a fork and the whey strained off through muslin. It is best given cold.

If some stimulant is desired, sherry wine in the proportion of one part to twelve, or brandy one part to twenty-four, may be added. Whey is useful in many cases of acute indigestion.

_Barley Jelly from the Grains._--Three tablespoonfuls of pearl barley; soak overnight, then place this in one quart of fresh water; add pinch of salt, and cook in double boiler steadily for four hours down to one pint, adding water from time to time; strain through muslin. When cold this makes a rather thick jelly. If a thinner gruel (barley water) is desired, one half the quant.i.ty of barley should be used.