The Care and Feeding of Children Part 21

1. Habitual disturbance of sleep in infants is most frequently a.s.sociated with the food or feeding. It may be from the discomfort of chronic indigestion due to improper food. In bottle-fed infants it is often the result of overfeeding; in those who are nursed it is often due to hunger. A common cause is frequent night feeding; an infant who is fed three or four times during the night is almost invariably a bad sleeper.

2. Disturbed sleep or sleeplessness may be due to causes purely nervous. Such are bad habits acquired by faulty training; as when the nursery is lighted and the child taken from its crib whenever it wakes or cries; or when some of the contrivances for inducing sleep have been used. Any excitement or romping play just before bedtime, and fears aroused by pictures or stories, are frequent causes. Children who inherit from their parents a nervous const.i.tution are especially likely to suffer thus.

3. There may be physical discomfort from cold feet, insufficient or too much clothing, or want of fresh air in the sleeping room.

4. Interference with breathing due to obstruction from large tonsils or adenoids. These cause great restlessness and lead a child to a.s.sume many different postures during sleep, often lying upon the face or upon the hands and knees.

5. Chronic pains or frequently recurring night pains may be causes of disordered sleep, when a child wakes with a sudden sharp cry. In infants this is most often due to scurvy, sometimes to syphilis. In older children it may be the earliest symptom of disease of the hip or spine.

6. Sleeplessness and disturbed sleep are frequent whenever the general condition falls much below a healthy standard; e.g., in infants who are not thriving and in children suffering from marked anaemia.

_How are children who sleep too little, or whose sleep is constantly disturbed, to be treated?_

Never by the use of soothing sirups or other medicines. Successful treatment consists in the discovery and removal of the cause.

_Do children ever sleep too much?_

It is doubtful if healthy children ever do. Excessive sleep is an important symptom of some diseases of the brain. Otherwise it seldom if ever occurs unless soothing sirups or other drugs have been given.

EXERCISE

_Is exercise important for infants?_

It is as necessary for them as for older children.

_How is it obtained?_

A young baby gets its exercise by screaming, waving its arms, kicking, etc. The clothing should not be so tight as to make these movements impossible. At least twice a day the infant should be allowed for fifteen or twenty minutes the free use of its limbs by permitting it to lie upon a bed in a warm room, with all clothing except the shirt, stockings, and napkin removed. Later, when in short clothes, the baby may be put upon a thick blanket or quilt laid upon the floor, and be allowed to tumble about at will. A nursery fence two feet high, made to surround a mattress, is an excellent device and makes a convenient box stall for the young animal, where it can learn to use both its arms and legs without the danger of injury. Only by exercise such as this do the muscles have an opportunity to develop properly.

THE CRY

_When is crying useful?_

In the newly born infant the cry expands the lungs, and it is necessary that it should be repeated for a few minutes every day in order to keep them well expanded.

_How much crying is normal for a very young baby?_

From fifteen to thirty minutes a day is not too much.

_What is the nature of this cry?_

It is loud and strong. Infants get red in the face with it; in fact, it is a scream. This is necessary for health. It is the baby's exercise.

_When is a cry abnormal?_

When it is too long or too frequent. The abnormal cry is rarely strong, often it is a moaning or a worrying cry, sometimes only a feeble whine.

_What are the causes of such crying?_

Pain, temper, hunger, illness, and habit.

_What is the cry of pain?_

It is usually strong and sharp, but not generally continuous. It is accompanied by contraction of the features, drawing up of the legs, and other symptoms of distress.

_What is the cry of hunger?_

It is usually a continuous, fretful cry, rarely strong and l.u.s.ty.

_What is the cry of temper?_

It is loud and strong and accompanied by kicking or stiffening of the body, and is usually violent.

_What is the cry of illness?_

There is usually more of fretfulness and moaning than real crying, although crying is excited by very slight causes.

_What is the cry of indulgence or from habit?_

This is often heard even in very young infants, who cry to be rocked, to be carried about, sometimes for a light in the room, for a bottle to suck, or for the continuance of any other bad habit which has been acquired.

_How can we be sure that a child is crying to be indulged?_

If it stops immediately when it gets what it wants, and cries when it is withdrawn or withheld.

_What should be done if a baby cries at night?_

One should get up and see that the child is comfortable--the clothing smooth under the body, the hands and feet warm, and the napkin not wet or soiled. If all these matters are properly adjusted and the child simply crying to be taken up, it should not be further interfered with. If the night cry is habitual some other cause should be sought (see page 121).

_How is an infant to be managed that cries from temper, habit, or to be indulged?_

It should simply be allowed to "cry it out." This often requires an hour, and in extreme cases, two or three hours. A second struggle will seldom last more than ten or fifteen minutes, and a third will rarely be necessary. Such discipline is not to be carried out unless one is sure as to the cause of the habitual crying.

_Is it likely that rupture will be caused from crying?_

Not in young infants if the abdominal band is properly applied, and not after a year under any circ.u.mstances.

LIFTING CHILDREN

_How should a young baby be lifted from its bed?_

The right hand should grasp the clothing below the feet, and the left hand should be slipped beneath the infant's body to its head. It is then raised upon the left arm.

_What is the advantage of this?_