The Maternal Management Of Children, In Health And Disease Part 5

WATER.--This should be the only beverage throughout childhood. Toast- and-water, if the child prefer it, which is rendered slightly more nutritive than the more simple fluid. The water employed in its preparation, however, must be at a boiling temperature, and it ought to be drunk as soon as it has sufficiently cooled; for by being kept, it acquires a mawkish and unpleasant flavour.

WINE, BEER, etc.--The practice of giving wine, or, indeed, any stimulant, to a healthy child, is highly reprehensible; it ought never to be given but medicinally.

The circulation in infancy and childhood is not only more rapid than in the adult, but easily excited to greater vehemence of action; the nervous system, too, is so susceptible, that the slightest causes of irritation produce strong and powerful impressions: the result in either case is diseased action in the frame, productive of fever, convulsions, etc.; wine, accordingly, is detrimental to children.

An experiment made by Dr. Hunter upon two of his children ill.u.s.trates, in a striking manner, the pernicious effects of even a small portion of intoxicating liquors in persons of this tender age. To one of the children he gave, every day after dinner, a full gla.s.s of sherry: the child was five years of age, and unaccustomed to the use of wine. To the other child, of nearly the same age, and equally unused to wine, he gave an orange. In the course of a week, a very marked difference was perceptible in the pulse, urine, and evacuations from the bowels of the two children. The pulse of the first was raised, the urine high coloured, and the evacuations dest.i.tute of their usual quant.i.ty of bile. In the other child, no change whatever was produced. He then reversed the experiment, giving to the first the orange, and to the second the wine, and the results corresponded: the child who had the orange continued well, and the system of the other got straightway into disorder, as in the first experiment.[FN#15]

[FN#15] Marcellin relates an instance of seven children in a family whose bowels became infested with worms, from the use of stimulants.

They were cured by subst.i.tuting water for the pernicious beverage.

In this town, spirits, particularly gin, are given to infants and children to a frightful extent. I have seen an old Irish woman give diluted spirits to the infant just born. A short time since one of those dram-drinking children, about eight years of age, was brought into one of our hospitals. The attendants, from its emaciated appearance, considered the child was dying from mere starvation; which was true enough in a certain sense. Food was accordingly offered and pressed upon it, but the boy would not even put it to his lips. The next day it was discovered that the mother brought the child very nearly a pint of gin, every drop of which before night he had consumed.

It is easy to discover when children have been fed upon spirits: they are always emaciated; have a lean, yellow, haggard look: the eyes sunk, the lips pale, and the teeth discoloured, the cadaverous aspect of the countenance being most fearful. They are continually suffering from bowel complaints and convulsive disorders; which, under these circ.u.mstances, terminate invariably in an early death.

Sect. IV. SLEEP.

DURING INFANCY.--For three or four weeks after birth the infant sleeps more or less, day and night, only waking to satisfy the demands of hunger; at the expiration of this time, however, each interval of wakefulness grows longer, so that it sleeps less frequently, but for longer periods at a time.

This disposition to repose in the early weeks of the infant's life must not be interfered with; but this period having expired, great care is necessary to induce regularity in its hours of sleep, otherwise too much will be taken in the day-time, and restless and disturbed nights will follow. The child should be brought into the habit of sleeping in the middle of the day, before its dinner, and for about two hours, more or less. If put to rest at a later period of the day, it will invariably cause a bad night.

At first the infant should sleep with its parent. The low temperature of its body, and its small power of generating heat, render this necessary. If it should happen, however, that the child has disturbed and restless nights, it must immediately be removed to the bed and care of another female, to be brought to its mother at an early hour in the morning, for the purpose of being nursed. This is necessary for the preservation of the mother's health, which through sleepless nights would of course be soon deranged, and the infant would also suffer from the influence which such deranged health would have upon the milk.

When a month or six weeks has elapsed, the child, if healthy, may sleep alone in a cradle or cot, care being taken that it has a sufficiency of clothing, that the room in which it is placed is sufficiently warm, viz. 60 degrees, and the position of the cot itself is not such as to be exposed to currents of cold air. It is essentially necessary to attend to these points, since the faculty of producing heat, and consequently the power of maintaining the temperature, is less during sleep than at any other time, and therefore exposure to cold is especially injurious. It is but too frequently the case that inflammation of some internal organ will occur under such circ.u.mstances, without the true source of the disease ever being suspected. Here, however, a frequent error must be guarded against,-- that of covering up the infant in its cot with too much clothing throwing over its face the muslin handkerchief--and, last of all, drawing the drapery of the bed closely together. The object is to keep the infant sufficiently warm with pure air; it therefore ought to have free access to its mouth, and the atmosphere of the whole room should be kept sufficiently warm to allow the child to breathe it freely: in winter, therefore, there must always be a fire in the nursery.

The child up to two years old, at least, should sleep upon a feather bed, for the reasons referred to above. The pillow, however, after the sixth month, should be made of horsehair; for at this time teething commences, and it is highly important that the head should be kept cool.

DURING CHILDHOOD.--Up to the third or fourth year the child should be permitted to sleep for an hour or so before its dinner. After this time it may gradually be discontinued; but it must be recollected, that during the whole period of childhood more sleep is required than in adult age. The child, therefore, should be put to rest every evening between seven and eight; and if it be in health it will sleep soundly until the following morning. No definite rule, however, can be laid down in reference to the number of hours of sleep to be allowed; for one will require more or less than another.[FN#16] Regularity as to the time of going to rest is the chief point to attend to; permit nothing to interfere with it, and then only let the child sleep without disturbance, until it awakes of its own accord on the following morning, and it will have had sufficient rest.

[FN#16] The amount of sleep necessary to preserve health varies according to the state of the body, and the habits of the individual.

As already observed, infants pa.s.s much the greater portion of their time in sleep. Children sleep twelve or fourteen hours. The schoolboy generally ten. In youth, a third part of the twenty-four hours is spent in sleep. Whilst, in advanced age, many do not spend more than four, five, or six hours in sleep.

It is a cruel thing for a mother to sacrifice her child's health that she may indulge her own vanity, and yet how often is this done in reference to sleep. An evening party is to a.s.semble, and the little child is kept up for hours beyond its stated time for retiring to rest, that it may be exhibited, fondled, and admired. Its usual portion of sleep is thus abridged, and, from the previous excitement, what little he does obtain, is broken and unrefreshing, and he rises on the morrow wearied and exhausted.

Once awake, it should not be permitted to lie longer in bed, but should be encouraged to arise immediately. This is the way to bring about the habit of early rising, which prevents many serious evils to which parents are not sufficiently alive, promotes both mental and corporeal health, and of all habits is said to be the most conducive to longevity.

A child should never be suddenly aroused from sleep; it excites the brain, quickens the action of the heart, and, if often repeated, serious consequences would result. The change of sleeping to waking should always be gradual.

The bed on which the child now sleeps should be a mattress: at this age a feather bed is always injurious to children; for the body, sinking deep into the bed, is completely buried in feathers, and the unnatural degree of warmth thus produced relaxes and weakens the system, particularly the skin, and renders the child unusually susceptible to the impressions of cold. Then, instead of the bed being made up in the morning as soon as vacated, and while still saturated with the nocturnal exhalations from the body, the bed-clothes should be thrown over the backs of chairs, the mattress shaken well up, and the window thrown open for several hours, so that the apartment shall be thoroughly ventilated. It is also indispensably requisite not to allow the child to sleep with persons in bad health, or who are far advanced in life; if possible, it should sleep alone.

Sect. V. BATHING AND CLEANLINESS.

DURING INFANCY.--Too much attention cannot be paid to cleanliness; it is essential to the infant's health. The princ.i.p.al points to which especial attention must be paid by the parent for this purpose are the following:--

TEMPERATURE OF THE WATER.--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 const.i.tution (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 pa.s.sed 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. With some children, indeed, there is such extreme delicacy and deficient reaction as to render the cold bath hazardous; no warm glow over the surface takes place when its use inevitably does harm: its effects, therefore, must be carefully watched.

DRYING THE SKIN.--The surface of the skin should always be carefully and thoroughly rubbed dry with flannel,--indeed, more than dry, for the skin should be warmed and stimulated by the a.s.siduous gentle friction made use of. For this process of washing and drying must not be done languidly, but briskly and expeditiously; and will then be found to be one of the most effectual means of strengthening the infant. It is especially necessary carefully to dry the arm-pits, groins, and nates; and if the child is very fat, it will be well to dust over these parts with hair-powder or starch: this prevents excoriations and sores, which are frequently very troublesome. Soap is only required to those parts of the body which are exposed to the reception of dirt.

NAPKINS.--The frequency of the discharges from the bowels and bladder requires a frequent change of napkins. A nurse cannot be too careful of this duty from the first, so that she may be enabled to discover the periods when those discharges are about to take place, that she may not only antic.i.p.ate them, but teach the child, at a very early age, to give intelligent warning of its necessities. Thus a habit of regularity with regard to those functions will be established, which will continue through life, and tend greatly to the promotion of health. As the child grows older, the system of cleanliness must in no particular be relaxed, and it will be found the best preservative against those eruptive disorders which are so frequent and troublesome during the period of infancy.

DURING CHILDHOOD.--When this period arrives, or shortly after, bathing is but too frequently left off; the hands and face of the child are kept clean, and with this the nurse is satisfied; the daily ablution of the whole body, however, is still necessary, not only for the preservation of cleanliness, but because it promotes in a high degree the health of the child.

PLAN TO BE PURSUED WITH THE VIGOROUS AND HEALTHY.--A child of a vigorous const.i.tution and robust health, as he rises from his bed refreshed and active by his night's repose, should be put into the shower-bath, or, if this excites and alarms him too much, must be sponged from head to foot with salt water. If the weather be very cold, the water may be made slightly tepid, but if his const.i.tution will bear it, the water should be cold throughout the year. Then the body should be speedily dried, and hastily but well rubbed with a somewhat coa.r.s.e towel, and the clothes put on without any unnecessary delay. This should be done every morning of the child's life.

If such a child is at the sea-side, advantage should be taken of this circ.u.mstance, and seabathing should be subst.i.tuted. The best time is two or three hours after breakfast; but he must not be fatigued beforehand, for if so, the cold bath cannot be used without danger.

Care must be taken that he does not remain in too long, as the animal heat will be lowered below the proper degree, which would be most injurious. In boys of a feeble const.i.tution, great mischief is often produced in this way. It is a matter also of great consequence in bathing children that they should not be terrified by the immersion, and every precaution should be taken to prevent this. The healthy and robust boy, too, should early be taught to swim, whenever this is practicable, for it is attended with the most beneficial effects; it is a most invigorating exercise, and the cold bath thus becomes doubly serviceable.

PLAN TO BE PURSUED WITH THE DELICATE AND STRUMOUS.--If a child is of a delicate and strumous const.i.tution, the cold bath during the summer is one of the best tonics that can be employed; and if living on the coast, sea-bathing will be found of singular benefit. The effects, however, of sea-bathing upon such a const.i.tution must be particularly watched, for unless it is succeeded by a glow,--a feeling of increased strength,--and a keen appet.i.te, it will do no good, and ought at once to be abandoned for the warm or tepid bath. The opinion that warm baths generally relax and weaken, is erroneous; for in this case, as in all cases when properly employed, they would give tone and vigour to the whole system; in fact, the tepid bath is to this child what the cold bath is to the more robust.

In conclusion: if the bath in any shape cannot from circ.u.mstances be obtained, then cold salt.w.a.ter sponging must be used daily, and all the year round, so long as the proper reaction or glow follows its use; but when this is not the case, and this will generally occur, if the child is delicate and the weather cold, tepid vinegar and water, or tepid salt water, must be subst.i.tuted.

Sect. VI. CLOTHING.

IN INFANCY.--Infants are very susceptible of the impressions of cold; a proper regard, therefore, to a suitable clothing of the body, is imperative to their enjoyment of health. Unfortunately, an opinion is prevalent in society, that the tender child has naturally a great power of generating heat and resisting cold; and from this popular error has arisen the most fatal results. This opinion has been much strengthened by the insidious manner in which cold operates on the frame, the injurious effects not being always manifest during or immediately after its application, so that but too frequently the fatal result is traced to a wrong source, or the infant sinks under the action of an unknown cause.

The power of generating heat in warm-blooded animals is at its minimum at birth, and increases successively to adult age; young animals, instead of being warmer than adults, are generally a degree or two colder, and part with their heat more readily; facts which cannot be too generally known. They show how absurd must be the folly of that system of "hardening" the const.i.tution (to which reference has been before made), which induces the parent to plunge the tender and delicate child into the cold bath at all seasons of the year, and freely expose it to the cold, cutting currents of an easterly wind, with the lightest clothing.

The principles which ought to guide a parent in clothing her infant are as follows:--