The Care and Feeding of Children Part 25

_Why is a cathartic necessary if the movements are already frequent?_

Such movements are nearly always due to an irritation in the bowel, set up by the fermenting food which has not been digested. The diarrhoea is Nature's effort to get rid of the irritant. Nothing to stop the movements should be given until the bowels have been thoroughly cleared by the treatment mentioned.

BAD HABITS

_What are the most common bad habits of young children?_

Sucking, nail-biting, dirt-eating, bed-wetting, and masturbation.

_What do children suck?_

Most frequently the thumbs or fingers, sometimes the clothing or blanket; often the "pacifier" or rubber nipple.

_When is this habit most frequently seen?_

It begins in quite early infancy, and if not broken may last until children are six or seven years old.

_Is the sucking habit a harmful one?_

When persisted in it may produce a misshapen mouth or fingers. It constantly stimulates the flow of saliva and certainly aggravates disturbances of digestion during which the sucking habit is likely to be practised. It may lead to thrush or other forms of infection of the mouth. It is not necessary as a means of quieting a child, though it may in some degree cover up the consequences of bad feeding or bad training. On no account should the habit of sucking the "pacifier" be allowed as a means of putting children to sleep, or of quieting them while restless from dent.i.tion or indigestion.

_How is the sucking habit to be controlled?_

One should be sure in the first place that the constant sucking of fingers is not due to hunger from insufficient food. Sucking of the hands may often be controlled by wearing mittens or fastening the hands to the sides during sleep. In more obstinate cases it may be necessary to confine the elbow by small pasteboard splints to prevent the child from bending the arm so as to get the hand to the mouth.

_When are nail-biting and dirt-eating seen, and how are they to be controlled?_

These habits belong especially to children over three years old. They are seen particularly in those who are excessively nervous or whose general health is below par; sometimes in those who develop serious nervous diseases later in life. Children with such tendencies should be closely watched, and every means used to break up these habits early. Dirt-eating is a morbid craving which is rarely seen in a normal child.

_At what age may a child generally be expected to go without wetting the bed during the night?_

Usually at two and a half years, if it is taken up late in the evening. Some children acquire control of the bladder at night when two years old, and a few not until three years. After three years habitual bed-wetting is abnormal.

_How should a young child addicted to bed-wetting be managed?_

At three or four years of age, punishments are sometimes useful, especially when it seems to depend more upon the child's indifference than anything else. They are of no value in older children, rewards being much more efficacious. In all cases one should give a child plenty of milk and water early in the day, but no fluids after 4 P.M., the supper being always of solid or semi-solid food. The child should be taken up regularly at ten o'clock or thereabouts. It often happens that the formation or continuance of the habit is due to the child being in poor general condition, to some irritation in the urine, or in the genital organs. Unless the simple means mentioned are successful the child should be placed under the charge of a physician.

_What is masturbation?_

It is the habit of rubbing the genital organs with the hands, with the clothing, against the bed, or rubbing the thighs together. Sometimes the child sits upon the floor, crosses its thighs tightly and rocks backward and forward. Many of these things are pa.s.sed over lightly and are regarded for months as simply a "queer trick" of the child. It may be seen at any age, even in those not more than a year old, and in both s.e.xes.

_How should such a child be treated?_

Masturbation is the most injurious of all the bad habits, and should be broken up just as early as possible. Children should especially be watched at the time of going to sleep and on first waking. Punishments and mechanical restraint are of little avail except with infants. With older children they usually make matters worse. Rewards are much more efficacious. It is of the utmost importance to watch the child closely, to keep his confidence, and by all possible means to teach self-control.

Some local cause of irritation is often present, which can be removed.

Medical advice should at once be sought.

VACCINATION

_Nowadays when small-pox occurs so seldom is it necessary to have every child vaccinated?_

It should by all means be done. It is only by the practice of general vaccination that small-pox is kept down. In countries or in communities where vaccination is neglected, frightful outbreaks of small-pox occur every now and then just as in olden times.

_What is the best time for vaccination?_

The time usually selected is from the third to the sixth month. It may be deferred in a very delicate child who is not likely to be exposed to small-pox, or in a child suffering from any form of skin disease.

_Which is preferable for vaccination, the arm or the leg?_

The part which can be most easily protected and kept at rest is to be chosen. In infants who do not yet walk or creep, the leg is to be preferred? in older children, in most circ.u.mstances, the arm. If older children are vaccinated on the leg, they should not be allowed to walk much while the vaccination is active.

_When should vaccination be repeated?_

An unsuccessful vaccination proves nothing and should be repeated in two or three weeks. If success fully vaccinated in infancy, a child should invariably be revaccinated before p.u.b.erty. If exposed or likely to be exposed to small-pox at any time vaccination should be repeated.

[Ill.u.s.tration: Weight chart for the first year; the curved line indicates the average rate of gain.]

[Ill.u.s.tration: Weight chart, one to fourteen years. The upper line indicates the average for boys; the lower (dotted) line that for girls.]