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Child Care

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What should we do? 

 1. Always keep the baby neat and clean.

 2. Cut the nails properly with utmost care.

 3. Wet nappy should be removed and parts should be cleaned with soap.

 4. Take care of the genitals because fungal infection is common in that area.
    Parts should be kept dry.

 5. Care of the scalp is very important. Fungal infections, dermatitis ect. can be
    prevented by proper cleaning.

 6. Tight dress can cause irritation, hence dress should be loose and should
    allow entry of air.

 7. Room should have sufficient light and ventilation.It should be free from dust
    and insects.

 8. Seperate bed preferably water proof is needed for kids. It should be arranged
    near mother's bed.

 9, Always keep some music making toys near the baby.

10. While carrying the baby support the head with hand. Since the neck muscles
    are weak sudden fall of head can be dangerous.

11. Mothers milk is the best nutrition for the baby, it also gives emotional
    attachment. Breast milk should be given as per the babies need preferably in
    mother sitting position. Proper cleaning of nipple is also necessary. Mother
    should take good nutritious diet throughout lactating period.

12. If there is some contraindication for breast feeding cows milk can be
    given. Feeding bottle should be cleaned with warm water and should be kept 
    dry till next use.

13. Cows milk should be boiled and cooled. Some diseases like bovine
    tuberculosis, brucellosis, ect. spread through raw milk.

14. Some children are allergic to some substances like food, milk, dress, 
    cosmetics ect. Try to find out the material causing allergy and avoid such 

15. Mosquito nets should be used regularly. Diseases like malaria, dengue, 
    filariasis, yellow fever, ect. spread through mosquito bites. Mosquito 
    bite can also produce skin eruptions with some allergic reactions. It also 
    disturbes sound sleep.

16. A calm atmosphere should be maintained for a good sleep. Compared to adults
    infants need more sleep. It is said that growth hormone secretion is 
    activated during sleep.

17. Growth developement, behavioral developement, motor developement,personal
    social developement, language developement, ect. should be noted down in 
    relation to age. However parents need not be over anxious because slight 
    variations are seen from individual to individual.

18. Assessment of growth by measuring height and weight is necessary.

19. In the early months of life infant may defecate after every feed. Proper
    toilet training should be given when the infant grows. The infant can be 
    placed on the toilet seat by the age of ten months.

20. The toilet seat (potty seat) should be cleaned with antiseptic liquid
    before and after use. It should not be shared by other children.

21. If the baby shows some signs of distress like excessive crying, convulsions, 
    fever with rigor, stiffness of neck, frequent vomiting and diarrhoea, bluish 
    discolouration of the body, difficult breathing with grunting, ect. Pay 
    attention and consult your doctor.

22. A first aid box should be kept in the room, which should contain sterile
    cotton, dressing materials, antiseptic lotion and ointment and forceps. 
    Seperate book should be maintained to note down the phone numbers of 
    doctors, ambulance, police, ect.

23. Child's medicines should be kept in seperate box. Information regarding 
    dose and mode of administration should be written in a paper and affixed on 
    the box.

24. While driving keep the baby in seperate seat belt.

25. When you are going out with the baby keep an identity card with your phone
    number and address inside his small pocket.

26. When the infant starts walking always accompany him to prevent a fall and
    injuries thereby.

27. In emergencies take the first aid measures and take the victim to nearby

Choking: The baby may swallow some solid objects and cause obstruction.
Immediately make the baby to lie on the abdomen in head low position and press
the abdomen backwards and towards the chest. Stroking the upper back is also
useful. If no result call a trained person to take the material with the help
of forceps.

Accidental poisoning: Try to takeout the poisonous subatance and induce
vomiting (except kerosine & acids). Wash the body with water to reduce
absorption through skin. Identify the pioson and take the victim to the hospital.

Burns: First of all remove the source of heat and put clean cold water.Burned
cloaths should not be removed immediately. Cover the wound with sterile cotton
and take to nearby hospital.

Wounds: Clean the wound with clean water and stop the bleeding by
compressing, raising the wound above the level of heart or use a tourniquet to
compress blood vessels. Then dress the wound with sterile cotton and bandage
and consult a doctor.

Drowning in bath tub: Take the baby immediately and keep in head low position
,press the abdomen gentely or give a mouth to mouth sucking till the air way is
clear. Give mouth to mouth breathing and cardiac massage and take the victim to
the hospital.

Electric shock: Stop the source of current. Then observe the victim,if no
breathing give mouth to mouth breath along with cardiac massage and take to the

28. And the last but not the least, give your child maximum care, love and
support to make him healthy and happy for ever.

What we should not do? 

 1. Never shake the baby, it can cause damage to the brain.

 2. Don't keep any small articles near the baby.

 3. Sharp pointed articles like pen, pencil, ect. should not be given to kids.

 4. Avoid entry of water in to the ear while giving a bath.

 5. Food should not be given forcibly when the baby is crying or coughing

 6. Should not overfeed the baby.

 7. Articles like mosquito repellents, moth balls, ink, gum, medicines, ect.
    should be kept away.

 8. Avoid tight cloathings.

 9. Should not be placed near the edge of the bed.

10. Should not give the baby to strangers and avoid close contact with others.

11. All electrical instruments should be kept away, and bed should not be
    arranged near electrical sockets and wires.

12. Kitchen is a dangerous place for children. Don't keep them alone in the

13. Water level in the bath tub should be minimum and don't go for any other
    works (to attend phone call or calling bell, ect.) when the baby is in the 

14. Avoid smoking inside the house.

15. Should not allow pet animals to be in very close contact with the kids. 
    (anti rabies injections should be given to pets and cut their nails 

16. When the child starts walking should not be kept alone on the upstairs 
    and should not allow them to climb the steps.

17. Strong light should be avoided in the room.

18. When you are travelling don't give the food articles given by co passengers.

19. Baby should not be allowed to crawl on the soil.

20. If you are sick or someone else is sick be away from the kids.

21. Don't take the baby to hospital wards, crowded market places and polluted
    dusty areas.

22. Table lamp should not be kept near the kids, this will attract insects at
    night and cause problems.

23. Others medicine should not be given to the children.

24. Medicine which has crossed the expiery date should not be used.


During 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 constitution (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

The material and quantity of the clothes should be such as to preserve a
sufficient proportion of warmth to the body, regulated therefore by the season
of the year, and the delicacy or strength of the infant's constitution. In
effecting this, however, the parent must guard against the too common practice
of enveloping the child in innumerable folds of warm clothing, and keeping it
constantly confined to very hot and close rooms; thus running into the opposite
extreme to that to which I have just alluded: for nothing tends so much to
enfeeble the constitution, to induce disease, and render the skin highly
susceptible to the impression of cold; and thus to produce those very ailments
which it is the chief intention to guard against.

In their make they should be so arranged as to put no restrictions to the free
movements of all parts of the child's body; and so loose and easy as to permit
the insensible perspiration to have a free exit, instead of being confined to
and absorbed by the clothes, and held in contact with the skin, till it gives
rise to irritation.

In their quality they should be such as not to irritate the delicate skin of
the child. In infancy, therefore, flannel is rather too rough, but is desirable
as the child grows older, as it gives a gentle stimulus to the skin, and
maintains health.

In its construction the dress should be so simple as to admit of being quickly
put on, since dressing is irksome to the infant, causing it to cry, and
exciting as much mental irritation as it is capable of feeling. Pins should be
wholly dispensed with, their use being hazardous through the carelessness of
nurses, and even through the ordinary movements of the infant itself.

The clothing must be changed daily. It is eminently conducive to good health
that a complete change of dress should be made every day. If this is not done,
washing will, in a great measure, fail in its object, especially in insuring
freedom from skin diseases.

During childhood. 

The clothing of the child should possess the same properties as that of
infancy. It should afford due warmth, be of such materials as do not irritate
the skin, and so made as to occasion no unnatural constriction.

In reference to due warmth, it may be well again to repeat, that too little
clothing is frequently productive of the most sudden attacks of active disease;
and that children who are thus exposed with thin clothing in a climate so
variable as ours are the frequent subjects of croup, and other dangerous
affections of the air- passages and lungs. On the other hand, it must not be
forgotten, that too warm clothing is a source of disease, sometimes even of the
same diseases which originate in exposure to cold, and often renders the frame
more susceptible of the impressions of cold, especially of cold air taken into
the lungs. Regulate the clothing, then, according to the season; resume the
winter dress early; lay it aside late; for it is in spring and autumn that the
vicissitudes in our climate are greatest, and congestive and inflammatory
complaints most common.

With regard to material (as was before observed), the skin will at this age
bear flannel next to it; and it is now not only proper, but necessary. It may
be put off with advantage during the night, and cotton maybe substituted during
the summer, the flannel being resumed early in the autumn. If from very great
delicacy of constitution it proves too irritating to the skin, fine fleecy
hosiery will in general be easily endured, and will greatly conduce to the
preservation of health.

It is highly important that the clothes of the boy should be so made that no
restraints shall be put on the movements of the body or limbs, nor injurious
pressure made on his waist or chest. All his muscles ought to have full liberty
to act, as their free exercise promotes both their growth and activity, and thus
insures the regularity and efficiency of the several functions to which these
muscles are subservient.

The same remarks apply with equal force to the dress of the girl; and happily,
during childhood, at least, no distinction is made in this matter between the
sexes. Not so, however, when the girl is about to emerge from this period of
life; a system of dress is then adopted which has the most pernicious effects
upon her health, and the development of the body, the employment of tight
stays, which impede the free and full action of the respiratory organs, being
only one of the many restrictions and injurious practices from which in latter
years they are thus doomed to suffer so severely.



Crying is a normal event in the lives of all babies. When a baby comes out of
the woomb 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
doesnot cry then it should be initiated by slightly pinching or gently strocking
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

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: "a 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 sourroundings 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 cloathing: 

Tight cloaths especially during warm climate is intolerable for kids. Tight
elastic of the 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.

 9. Nasal blocking: 

Child may not be able to sleep when there is a cold and go on crying till the
passage is open.

10. Phlegm in throat: 

This also causes difficult breathing resulting in cry. Often a typical sound can
be heard with each breath.

11. General aching: 

Generalised body ache with restlessness is seen in flu and prodromal stages of
some infectious diseases can result in continuous cry.

12. Habitual cry: -Some babies cry without any real cause ending the parents in
agony.Many a times doctor is called for help.

13. Nappy rash: If a tight and wet nappy is kept for a long time results in
this conditon. Rash can also be due to some allergic reaction to the elastic
material of the nappy. When the rash appears it causes soreness and baby become
sleepless and cry. All other skin lesions like eczema, ecthyma, candidiasis, ect.
also causes same problems.

14. Earache: 

Ear infection is common in wet climate. The infection may spread from the
throat.Ear infection can result in rupture of ear drum causing discharge of
pus. Eareache usually becomes worse at night when lying down. Child will become
restless with cry and may not allow you to touch the ear. Some children with
earache rub the affected ear frequently.

15. Colic: 

When the baby cry continuously most of us diagnose it as colic. This roblem is
still a topic for debate because exact cause for colic is not known and
diagnosis is also difficult to confirm. Colic may be associated with rumbling
and distention of abdomen. Child often feels better when lying on abdomen. Some
children may not allow you to touch the abdomen. If the child cries continuously
doctors help is needed.

16. Infections: 

All infections causes some kind of pain or irritation resulting in cry. 
Infection may be anywhere in the body.Usually it is associated with fever,
redness and swelling.

17. Reactions to certain food: 

It is said that one man's food is another man's poison. Some food articles can
produce some allergic reactions. Allergy is manifested in the form of redness,
breathlessness, gastric symptons and continuous cry.

18. Hard stools: 

Constipated babies with hard stools may cry when they get the urge for
stool.Some children hesitate to pass stool because of pain.

19. Gastro esophagial reflex: 

Here baby cries with spilling of food after feeding. If this continues it may 
be due to gastroesophageal reflex. This is due to failure of the lower part of
esophagus to close after food causing regurgitation from the stomach. It is
difficult to diagnose this condition and can be confirmed by giving antireflex

20. Dentition: 

During dentition child becomes restless with crying. Often associated with
gastric troubles and diarrhoea.

Some rare reasons 

1. Bowel obstruction: 

Bowel obstruction is associated with severe pain and vomiting. Abdomen is
distended with rumbling sound. Baby is constipated with absence of flatus.

2. Septicemia: 

Invasion of pathogenic micro organisms in to the blood is called
septicemia. Fever is associated with this condition.

3. Torsion of testes in male kids: 

When a male baby cries continuously his scrotum should be examined. Torsion of
the testes produce severe pain which will be worse by touching the affected
testes. When the testes is pressed upwards pain is releived. If this is not
treated properly it can damage the affected testes due to lack of blood supply.

4. Meningitis: 

Initially there may not be fever, hence crying baby with alternate vacant stare
and irritability should not be ignored. Fontanel is bulging. Neck rigidity and
seizures may appear later.

5. Retention of urine: 

Children with retention of urine will have agonising pain making them restless.

7. Major injuries: 

Major injury to any parts of the body causes pain. Occasionally children will
fall while arrying and results in head injury. Head injury is associated with
reflex vomiting and convulsions.


Crying is a physiological process in the life of a baby. All normal babies cry
to communicate with others. Since they can't express their feelings in words
crying is the only way for communication. If any uncomfortable feeling comes
they simply cry. Normally babies cry in situations like hunger, wetting, too hot
or cold, tight cloaths, pain, ect. Some kids need the presence of somebody
otherwise will cry simply. Crying without any cause is habitual in some babies.
Eventhough crying is considered as normal it may worry the family members. Since
the reasons for crying ranges from simple causes to serious causes it should not
be ignored and hence exact cause has to be identified and managed accordingly.

The following are some points which should be considered while dealing with a
crying baby.

 1. It is dangerous to shake the baby vigorously.

 2. Tight cloaths can cause irritation hence it should be removed.

 3. If the room is hot put the fan and open the windows.

 4. If the nappy is wet remove it and after cleaning the parts make it dry with 
    a soft towel.

 5. Pat her back or stroke her head slowly and let her here your soothing sound.

 6. Give breast milk and make her quiet.

 7. If the climate is cold cover her in soft towel.

 8. Rock her gently in your arms and walk slowly in the room.

 9. Take a music making doll and let her listen.

10. Try a pacifier or help her for thumb sucking.

11. If no response change her position.

12. Walk outdors with her.

13. Put her on the cradle and rock gently.

14. If no response ask somebody to carry the baby.

Even after all these steps the baby goes on crying see for the following signs.
(Probable cause is given after every sign)

 1. Press her abdomen gently, she may twist or resist you: Colic

 2. Pull her ear gently she may become worse or push your hands away: Earache.

 3. Feel her temperature with the back of your hands: Fever due to any infection.

 4. Examine the skin from head to foot: Eruptive disease, nappy rash, measles, 
    vesicles, allergy, ect.

 5. See the nose for any discharge: Coryza.

 6. Move the head gently to feel any neck stiffness: Meningitis, head injury, ect.

 7. Keep your ear near her chest to hear any rattling sound: Increased mucus in
    wind pipes. (pneumonia, bronchiolitis, asthamatic bronchitis, ect.) 

 8. Examine the anal orifice: Anal erosion, rectal polyp, crawling of worms.

 9. Examine the genitalia: Any discharge or erosion.

10. In male baby see the testicles which may be swollen or tender: Orchitis,
    torsion of testes.

11. Also notice the body movements and see for any convulsions, rigors, vomiting,
    cough,laboured breathing, ect.

If you see the above signs or any other abnormal signs consult your doctor for
proper treatement.


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.

Thus, chiefly in consequence of injudicious management, it is made the most
critical period of childhood. Not that I believe the extent of mortality fairly
traceable to it, is by any means so great as has been stated; for it is rated as
high as one sixth of all the children who undergo it. Still, no one doubts that
first dentition is frequently a period of great danger to the infant. It
therefore becomes a very important question to an anxious and affectionate
mother, how the dangers and difficulties of teething can in any degree be
diminished, or, if possible, altogether prevented. A few hints upon this
subject, then, may be useful. I shall consider, first, the management of the
infant, when teething is accomplished without difficulty; and, secondly, the
management of the infant when it is attended with difficulty.

Management of the infant when teething is without difficulty.

In the child of a healthy constitution, which has been properly, that is,
naturally, fed, upon the milk of its mother alone, the symptoms attending
teething will be of the mildest kind, and the management of the infant most
simple and easy.

Symptoms: The symptoms of natural dentition (which this may be fairly called)
are, an increased flow of saliva, with swelling and heat of the gums, and
occasionally flushing of the cheeks. The child frequently thrusts its fingers,
or any thing within its grasp, into its mouth. Its thirst is increased, and it
takes the breast more frequently, though, from the tender state of the gums,
for shorter periods than usual. It is fretful and restless; and sudden fits of
crying and occasional starting from sleep, with a slight tendency to vomiting,
and even looseness of the bowels, are not uncommon. Many of these symptoms
often precede the appearance of the tooth by several weeks, and indicate that
what is called "breeding the teeth" is going on. In such cases, the symptoms
disappear in a few days, to recur again when the tooth approaches the surface
of the gum.

Treatment: The management of the infant in this case is very simple, and
seldom calls for the interference of the medical attendant. The child ought to
be much in the open air, and well exercised: the bowels should be kept freely
open with castor oil; and be always gently relaxed at this time. Cold sponging
employed daily, and the surface of the body rubbed dry with as rough a flannel
as the delicate skin of the child will bear; friction being very useful. The
breast should be given often, but not for long at a time; the thirst will thus
be allayed, the gums kept moist and relaxed, and their irritation soothed,
without the stomach being overloaded. The mother must also carefully attend, at
this time, to her own health and diet, and avoid all stimulant food or drinks.

From the moment dentition begins, pressure on the gums will be found to be
agreeable to the child, by numbing the sensibility and dulling the pain. For
this purpose coral is usually employed, or a piece of orris-root, or scraped
liquorice root; a flat ivory ring, however, is far safer and better, for there
is no danger of its being thrust into the eyes or nose. Gentle friction of the
gums, also, by the finger of the nurse, is pleasing to the infant; and, as it
seems to have some effect. in allaying irritation, may be frequently resorted
to. In France, it is very much the practice to dip the liquorice-root, and
other substances, into honey, or powdered sugar-candy; and in Germany, a small
bag, containing a mixture of sugar and spices, is given to the infant to suck,
whenever it is fretful and uneasy during teething. The constant use, however,
of sweet and stimulating ingredients must do injury to the stomach, and renders
their employment very objectionable.


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:

I attended a lady twenty-four years of age, a delicate, but healthy woman, in
her first confinement. The labour was good. Every thing went on well for the
first week, except that, although the breasts became enlarged, and promised a
good supply of nourishment for the infant, at its close there was merely a
little oozing from the nipple. During the next fortnight a slight, but very
gradual increase in quantity took place, so that a dessert spoonful only was
obtained about the middle of this period, and perhaps double this quantity at
its expiration. In the mean time the child was necessarily fed upon an
artificial diet, and as a consequence its bowels became deranged, and a severe
diarrhoea followed.

For three or four days it was a question whether the little one would live, for
so greatly had it been reduced by the looseness of the bowels that it had not
strength to grasp the nipple of its nurse; the milk, therefore, was obliged to
be drawn, and the child fed with it from a spoon. After the lapse of a few
days, however, it could obtain the breast-milk for itself; and, to make short
of the case, during the same month, the mother and child returned home, the
former having a very fair proportion of healthy milk in her bosom, and the
child perfectly recovered and evidently thriving fast upon it.

Where, however, there has been an early deficiency in the supply of
nourishment, it will most frequently happen that, before the sixth or seventh
month, the infant's demands will be greater than the mother can meet. The
deficiency must be made up by artificial food, which must be of a kind
generally employed before the sixth month, and given through the bottle.


The especial province of the mother is the prevention of 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.

Again, not only is a firm and strict compliance with medical directions in the
administration of remedies, of regimen, and general measures, necessary, but an
unbiased, faithful, and full report of symptoms to the physician, when he visits
his little patient, is of the first importance. An ignorant servant or nurse,
unless great caution be exercised by the medical attendant, may, by an
unintentional but erroneous report of symptoms, produce a very wrong impression
upon his mind, as to the actual state of the disease. His judgment may, as a
consequence, be biased in a wrong direction, and the result prove seriously
injurious to the welldoing of the patient. The medical man cannot sit hour
after hour watching symptoms; hence the great importance of their being
faithfully reported. This can alone be done by the mother, or some person
equally competent.

There are other weighty considerations which might be adduced here, proving how
much depends upon efficient maternal management in the time of sickness; but
they will be severally dwelt upon, when the diseases with which they are more
particularly connected are spoken of.


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. The mother being a very
healthy woman, it was suspected that some unwholesome article in her diet might
be the cause. The regimen was accordingly carefully inquired into, when it
appeared that porter from a neighbouring publican's had been substituted for
their own for some little time past. This proved to be bad, throwing down, when
left to stand a few hours, a considerable sediment; it was discontinued; good
sound ale taken instead; the infant again put to the breast, upon the milk of
which it flourished, and never had another attack.

In the same way aperient medicine, taken by the mother, will act on the child's
bowels, through the effect. which it produces upon her milk. This, however, is
not the case with all kinds of purgative medicine, nor does the same purgative
produce a like effect, upon all children. It is well, therefore, for a parent to
notice what aperient acts thus through her system upon that of her child, and
what does not, and when an aperient becomes necessary for herself, unless she
desire that the infant's bowels be moved, to avoid the latter; if otherwise,
she may take the former with good effect.

Again; the return of the monthly periods whilst the mother is a nurse always
affects the properties of the milk, more or less, deranging the stomach and
bowels of the infant. It will thus frequently happen, that a few days before
the mother is going to be unwell, the infant will become fretful and uneasy;
its stomach will throw up the milk, and its motions will be frequent, watery,
and greenish. And then, when the period is fully over, the milk will cease to
purge. It is principally in the early months, however, that the infant seems to
be affected by this circumstance; for it will be generally found that although
the milk is certainly impaired by it, being less abundant and nutritious,
still, after the third or fourth month it ceases to affect. the infant. Is then
a mother, because her monthly periods return after her delivery, to give up
nursing? Certainly not, unless the infant's health is seriously affected by it;
for she will generally find that, as the periods come round, by keeping the
infant pretty much from the breast, during its continuance, and feeding him
upon artificial food, she will prevent disorder of the child's health, and be
able in the intervals to nurse her infant with advantage. It must be added,
however, that a wet- nurse is to be resorted to rather than any risk incurred
of injuring the child's health; and that, in every case, partial feeding will
be necessary at a much earlier period than when a mother is not thus affected.

The milk may also be rendered less nutritive, and diminished in quantity, by
the mother again becoming pregnant. In this case, however, the parent's health
will chiefly suffer, if she persevere in nursing; this, however, will again act
prejudicially to the child. It will be wise, therefore, if pregnancy should
occur, and the milk disagree with the infant, to resign the duties of a nurse,
and to put the child upon a suitable artificial diet.

The infant that is constantly at the breast will always be suffering, more or
less, from flatulence, griping, looseness of the bowels, and vomiting. This is
caused by a sufficient interval not being allowed between the meals for
digestion. The milk, therefore, passes on from the stomach into the bowels
undigested, and the effects just alluded to follow. Time must not only be given
for the proper digestion of the milk, but the stomach itself must be allowed a
season of repose. This evil, then, must be avoided most carefully by the mother
strictly adhering to those rules for nursing.

The bowels of the infant at the breast, as well as after it is weaned, are
generally affected by teething. And it is fortunate that this is the case, for
it prevents more serious affections. Indeed, the diarrhoea that occurs during
dentition, except it be violent, must not be subdued; if, however, this is the
case, attention must be paid to it. It will generally be found to be
accompanied by a swollen gum; the freely lancing of which will sometimes alone
put a stop to the looseness: further medical aid may, however, be necessary.

At the period of weaning. 

There is great susceptibility to derangements of the stomach and bowels of the
child at the period when weaning ordinarily takes place, so that great care and
judgment must be exercised in effecting this object. Usually, however, the
bowels are deranged during this process from one of these causes; from weaning
too early, from effecting it too suddenly and abruptly, or from over-feeding
and the use of improper and unsuitable food. There is another cause which also
may give rise to diarrhoea at this time, independently of weaning, viz. the
irritation of difficult teething.

The substitution of artificial food for the breast-milk of the mother, at a
period when the digestive organs of the infant are too delicate for this
change, is a frequent source of the affections now under consideration.

The attempt to wean a delicate child, for instance, when only six months old,
will inevitably be followed by disorder of the stomach and bowels. Unless,
therefore, a mother is obliged to resort to this measure, from becoming
pregnant, or any other unavoidable cause, if she consult the welfare of her
child, she will not give up nursing at this early period.

Depriving the child at once of the breast, and substituting artificial food,
however proper under due regulations such food may be, will invariably cause
bowel complaints. Certain rules and regulations must be adopted to effect
weaning safely, the details of which are given elsewhere.

If too large a quantity of food is given at each meal, or the meals are too
frequently repeated, in both instances the stomach will become oppressed,
wearied, and deranged; part of the food, perhaps, thrown up by vomiting, whilst
the remainder, not having undergone the digestive process, will pass on into the
bowels, irritate its delicate lining membrane, and produce flatulence, with
griping, purging, and perhaps convulsions.

Then, again, improper and unsuitable food will be followed by precisely the
same effects; and unless a judicious alteration be quickly made, remedies will
not only have no influence over the disease, but the cause being continued, the
disease will become most seriously aggravated.

It is, therefore, of the first importance to the well-doing of the child, that
at this period, when the mother is about to substitute an artificial food for
that of her own breast, she should first ascertain what kind of food suits the
child best, and then the precise quantity which nature demands. Many cases
might be cited, where children have never had a prescription written for them,
simply because, these points having been attended to, their diet has been
managed with judgment and care; whilst, on the other hand, others might be
referred to, whose life has been hazarded, and all but lost, simply from
injudicious dietetic management. Over-feeding, and improper articles of food,
are more frequently productive, in their result, of anxious hours and
distressing scenes to the parent, and of danger and loss of life to the child,
than almost any other causes.

The irritation caused by difficult teething may give rise to diarrhoea at the
period when the infant is weaned, independently of the weaning itself. Such
disorder of the bowels, if it manifestly occur from this cause, is a favourable
circumstance, and should not be interfered with, unless indeed the attack be
severe and aggravated, when medical aid becomes necessary. Slight diarrhoea
then, during weaning, when it is fairly traceable to the cutting of a tooth
(the heated and inflamed state of the gum will at once point to this as the
source of the derangement), is of no consequence, but it must not be mistaken
for disorder arising from other causes. Lancing the gum will at once, then,
remove the cause, and generally cure the bowel complaint.


Exercise is essentially important to the health of the infant. Its first
exercise, of course, will be in the nurse's arms. After a month or two, when it
begins to sleep less during the day, it will delight to roll and kick about on
the sofa: it will thus use its limbs freely; and this, with carrying out into
the open air, is all the exercise it requires at this period. By and by,
however, the child will make its first attempts to walk. Now it is important
that none of the many plans which have been devised to teach a child to walk,
should be adopted the go-cart, leading-strings, etc.; their tendency is
mischievous; and flatness of the chest, confined lungs, distorted spine, and
deformed legs, are so many evils which often originate in such practices. This
is explained by the fact of the bones in infancy being comparatively soft and
pliable, and if prematurely subjected by these contrivances to carry the weight
of the body, they yield just like an elastic stick bending under a weight, and
as a natural consequence become curved and distorted.

It is highly necessary that the young and experienced mother should recollect
this fact, for the early efforts of the little one to walk are naturally viewed
by her with so much delight, that she will be apt to encourage and prolong its
attempts, without any thought of the mischief which they may occasion; thus
many a parent has had to mourn over the deformity which she has herself created.

It may be as well here to remark, that if such distortion is timely noticed, it
is capable of correction, even after evident curvature has taken place. It is to
be remedied by using those means that shall invigorate the frame, and promote
the child's general health (a daily plunge into the cold bath, or sponging with
cold salt water, will be found signally efficacious), and by avoiding the
original cause of the distortion never allowing the child to get upon his feet.
The only way to accomplish the latter intention, is to put both the legs into a
large stocking; this will effectually answer this purpose, while, at the same
time, it does not prevent the free and full exercise of the muscles of the
legs. After some months pursuing this plan, the limbs will be found no longer
deformed, the bones to have acquired firmness and the muscles strength; and the
child may be permitted to get upon his feet again without any hazard of
perpetuating or renewing the evil.

The best mode of teaching a child to walk, is to let it teach itself, and this
it will do readily enough. It will first crawl about: this exercises every
muscle in the body, does not fatigue the child, throws no weight upon the
bones, but imparts vigour and strength, and is thus highly useful. After a
while, having the power, it will wish to do more: it will endeavour to lift
itself upon its feet by the aid of a chair, and though it fail again and again
in its attempts, it will still persevere until it accomplish it. By this it
learns, first, to raise itself from the floor; and secondly, to stand, but not
without keeping hold of the object. on which it has seized. Next it will balance
itself without holding, and will proudly and laughingly show that it can stand
alone. Fearful, however, as yet of moving its limbs without support, it will
seize a chair or anything else near it, when it will dare to advance as far as
the limits of its support will permit. This little adventure will be repeated
day after day with increased exultation; when, after numerous trials, he will
feel confident of his power to balance himself, and he will run alone. Now time
is required for this gradual self-teaching, during which the muscles and bones
become strengthened; and when at last called upon to sustain the weight of the
body, are fully capable of doing so.

Exercise during childhood. 

When the child has acquired sufficient strength to take active exercise, he can
scarcely be too much in the open air; the more he is habituated to this, the
more capable will he be of bearing the vicissitudes of the climate. Children,
too, should always be allowed to amuse themselves at pleasure, for they will
generally take that kind and degree of exercise which is best calculated to
promote the growth and development of the body. In the unrestrained indulgence
of their youthful sports, every muscle of the body comes in for its share of
active exercise; and free growth, vigour, and health are the result.

If, however, a child is delicate and strumous, and too feeble to take
sufficient exercise on foot, and to such a constitution the respiration of a
pure air and exercise are indispensable for the improvement of health, and
without them all other efforts will fail, riding on a donkey or pony forms the
best substitute. This kind of exercise will always be found of infinite service
to delicate children; it amuses the mind, and exercises the muscles of the whole
body, and yet in so gentle a manner as to induce little fatigue.

The exercises of horseback, however, are most particularly useful where there
is a tendency in the constitution to pulmonary consumption, either from
hereditary or accidental causes. It is here beneficial, as well through its
influence on the general health, as more directly on the lungs themselves.
There can be no doubt that the lungs, like the muscles of the body, acquire
power and health of function by exercise. Now during a ride this is obtained,
and without much fatigue to the body. The free and equable expansion of the
lungs by full inspiration, necessarily takes place; this maintains their
healthy structure, by keeping all the air-passages open and pervious; it
prevents congestion in the pulmonary circulation, and at the same time provides
more completely for the necessary chemical action on the blood, by changing, at
each act of respiration, a sufficient proportion of the whole air contained in
the lungs, all objects of great importance, and all capable of being promoted,
more or less, by the means in question.


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

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 circumstances, 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.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.

The amount of sleep necessary to preserve health varies according to the state
of the body, and the habits of the individual. Infants pass 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 assemble, 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.


During infancy. 

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

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.
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.

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 assiduous 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.

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.

A child of a vigorous constitution 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 constitution 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 coarse 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
circumstance, and seabathing should be substituted. 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 constitution, 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.

If a child is of a delicate and strumous constitution, 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 constitution must be particularly watched, for unless
it is succeeded by a glow, a feeling of increased strength, and a keen
appetite, 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 circumstances be obtained,
then cold saltwater 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 substituted.


It is highly important that a mother should possess such information as will
enable her to detect. disease at its first appearance, and thus insure for her
child timely medical assistance. This knowledge it will not be difficult for
her to obtain. She has only to bear in mind what are the indications which
constitute health, and she will at once see that all deviations from it must
denote the presence of disorder, if not of actual disease. With these changes
she must to a certain extent make herself acquainted.

Signs of health. 

The signs of health are to be found, first, in the healthy performance of the
various functions of the body; the regular demands made for its supply, neither
in excess or deficiency; and a similar regularity in its excretions both in
quantity and appearance.

If the figure of the healthy infant is observed, something may be learnt from
this. There will be perceived such an universal roundness in all parts of the
child's body, that there is no such thing as an angle to be found in the whole
figure; whether the limbs are bent or straight, every line forms a portion of a
circle. The limbs will feel firm and solid, and unless they are bent, the joints
cannot be discovered.

The tongue, even in health, is always white, but it will be free from sores,
the skin cool, the eye bright, the complexion clear, the head cool, and the
abdomen not projecting too far, the breathing regular, and without effort.

When awake, the infant will be cheerful and sprightly, and, loving to be played
with, will often break out into its merry, happy, laugh; whilst, on the other
hand, when asleep, it will appear calm, every feature composed, its countenance
displaying an expression of happiness, and frequently, perhaps, lit up with a

Just in proportion as the above appearances are present and entire, health may
be said to exist; and just in proportion to their partial or total absence
disease will have usurped its place.

We will, however, for the sake of clearness examine the signs of disease as
they are manifested separately by the countenance, the gestures, in sleep, in
the stools, and by the breathing and cough.

Of the countenance. 

In health the countenance of a thild is expressive of serenity in mind and
body; but if the child be unwell, this expression will be changed, and in a
manner which, to a certain extent, will indicate what part of the system is at

The brows will be contracted, if there is pain, and its seat is in the head.
This is frequently the very first outward sign of any thing being wrong, and
will occur at the very onset of disease; if therefore remarked at an early
period, and proper remedies used, its notice may prevent one of the most
fearful of infantile complaints "Water in the Head."

If this sign is passed by unheeded, and the above disease be threatened, soon
the eyes will become fixed and staring, the head hot, and moved uneasily from
side to side upon the pillow, or lie heavily upon the nurse's arm, the child
will start in its sleep, grinding its teeth, and awake alarmed and screaming,
its face will be flushed, particularly the cheeks (as if rouged), its hands
hot, but feet cold, its bowels obstinately costive, or its motions scanty,
dark-coloured, and foul.

If the lips are drawn apart, so as to show the teeth or gums, the seat of the
pain is in the belly. This sign, however, will only be present during the
actual existence of suffering; if, therefore, there be any doubt whether it
exist, press upon the stomach, and watch the eifect. on the expression of the

If the pain arise simply from irritation of the bowels excited from
indigestion, it will be temporary, and the sign will go and come just as the
spasm may occur, and slight remedial measures will give relief.

If, however, the disease be more serious, and inflammation ensue, this sign
will be more constantly present, and soon the countenance will become pale, or
sallow and sunken, the child will dread motion, and lie upon its back with the
knees bent up to the belly, the tongue will be loaded, and in breathing, while
the chest will be seen to heave with more than usual effort, the muscles of the
belly will remain perfectly quiescent.

If the nostrils are drawn upwards and in quick motion, pain exists in the
chest. This sign, however, will generally be the accompaniment of inflammation
of the chest, in which case the countenance will be discoloured, the eyes more
or less staring, and the breathing will be difficult and hurried; and if the
child's mode of respiring be watched, the chest will be observed to be unmoved,
while the belly quickly heaves with every inspiration.

Convulsions are generally preceded by some changes in the countenance. The
upper lip will be drawn up, and is occasionally bluish or livid. Then there may
be slight squinting, or a singular rotation of the eye upon its own axis;
alternate flushing or paleness of the face; and sudden animation followed by

These signs will sometimes manifest themselves many hours, nay days, before the
attack occurs; may be looked upon as premonitory; and if timely noticed, and
suitable medical aid resorted to, the occurrence of a fit may be altogether

The state of the eyes should always be attended to. In health they are clear
and bright, but in disease they become dull, and give a heavy appearance to the
countenance; though after long continued irritation they will assume a degree of
quickness which is very remarkable, and a sort of pearly brightness which is
better known from observation than it can be from description.

The direction of the eyes, too, should be regarded, for from this we may learn
something. When the infant is first brought to the light, both eyes are
scarcely ever directed to the same object: this occurs without any tendency to
disease, and merely proves, that regarding one object. with both eyes is only an
acquired habit. But when the child has come to that age when the eyes are by
habit directed to the same object, and afterwards it loses that power, this
circumstance alone may be looked upon as a frequent prelude to disease
affecting the head.

Of the gestures. 

The gestures of a healthy child are all easy and natural; but in sickness those
deviations occur, which alone will often denote the nature of the disease.

Suppose an infant to have acquired the power to support itself, to hold its
head erect; let sickness come, its head will droop immediately, and this power
will be lost, only to be regained with the return of health; and during the
interval every posture and movement will be that of languor.

The little one that has just taught itself to run alone from chair to chair,
having two or three teeth pressing upon and irritating the gums, will for a
time be completely taken off its feet, and perhaps lie languidly in its cot, or
on its nurse's arm.

The legs being drawn up to the belly, and accompanied by crying, are proofs of
disorder and pain in the bowels. Press upon this part, and your pressure will
increase the pain. Look to the secretions from the bowels themselves, and by
their unhealthy character your suspicions, in reference to the seat of the
disorder, are at once confirmed.

The hands of a child in health are rarely carried above its mouth; but let
there be any thing wrong about the head and pain present, and the little one's
hands will be constantly raised to the head and face.

Sudden starting when awake, as also during sleep, though it occur from trifling
causes, should never be disregarded. It is frequently connected with approaching
disorder of the brain. It may forebode a convulsive fit, and such suspicion is
confirmed, if you find the thumb of the child drawn in and firmly pressed upon
the palm, with the fingers so compressed upon it, that the hand cannot be
forced open without difficulty. The same condition will exist in the toes, but
not to so great a degree; there may also be a puffy state of the back of the
hands and feet, and both foot and wrist bent downwards.

There are other and milder signs threatening convulsions and connected with
gesture, which should be regarded: the head being drawn rigidly backwards, an
arm fixed firmly to the side, or near to it, as also one of the legs drawn
stifly upwards. These signs, as also those enumerated above, are confirmed
beyond all doubt, if there be present certain alterations in the usual habits
of the child: if the sleep is disturbed, if there be frequent fits of crying,
great peevishness of temper, the countenance alternately flushed and pale,
sudden animation followed by as sudden a fit of languor, catchings of the
breath followed by a long and deep inspiration, all so many premonitory
symptoms of an approaching attack.

Of the sleep. 

The sleep of the infant 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

Any deviation, then, from the above characters, is of course a sign of
something wrong; and as a deranged condition of the bowels is frequently the
first indication we have of coming disease, the nurse should daily be directed
to watch the evacuations. Their appearance, colour, and the manner in which
discharged, are the points principally to be looked to. If the stools have a
very curdy appearance, or are too liquid, or green, or dark-coloured, or smell
badly, they are unnatural. And in reference to the manner in which they are
discharged, it should be borne in mind, that, in a healthy child, the motion is
passed with but little wind, and as if squeezed out, but in disease, it will be
thrown out with considerable force, which is a sign of great irritation. The
number, too, of stools passed within the four-and- twenty hours it is important
to note, so that if the child does not have its accustomed relief, (and it must
not be forgotten that children, although in perfect. health, differ as to the
precise number,)

Of the 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

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. More
generally, however, the patient has been for some time in bed and asleep,
before the nature of the disease with which he is threatened is apparent; then,
perhaps, without waking, he gives a very unusual cough, well known to any one
who has witnessed an attack of the croup; it rings as if the child had coughed
through a brazen trumpet; it is truly a tussis clangosa; it penetrates the
walls and floor of the apartment, and startles the experienced mother, 'Oh! I
am afraid our child is taking the croup!' She runs to the nursery, finds her
child sleeping softly, and hopes she may be mistaken. But remaining to tend
him, before long the ringing cough, a single cough, is repeated again and
again; the patient is roused, and then a new symptom is remarked; the sound of
his voice is changed; puling, and as if the throat were swelled, it corresponds
with the cough," etc.

How important that a mother should be acquainted with the above signs of one of
the most terrific complaints to which childhood is subject; for, if she only
send for medical assistance during its first stage, the treatment will be
almost invariably successful; whereas, if this "golden opportunity" is lost,
this disease will seldom yield to the influence of measures, however wisely
chosen or perseveringly employed.


The respiration of a pure air is at all times, and under all circumstances,
indispensable to the health of the infant. The nursery therefore should be
large, well ventilated, in an elevated part of the house, and so situated as to
admit a free supply both of air and light. For the same reasons, the room in
which the infant sleeps should be large, and the air frequently renewed; for
nothing is so prejudicial to its health as sleeping in an impure and heated
atmosphere. The practice, therefore, of drawing thick curtains closely round
the bed is highly pernicious; they only answer a useful purpose when they
defend the infant from any draught of cold air.

The proper time for taking the infant into the open air must, of course, be
determined by the season of the year, and the state of the weather. "A delicate
infant born late in the autumn will not generally derive advantage from being
carried into the open air, in this climate, till the succeeding spring; and if
the rooms in which he is kept are large, often changed, and well ventilated, he
will not suffer from the confinement, while he will, most probably, escape
catarrhal affections, which are so often the consequence of the injudicious
exposure of infants to a cold and humid atmosphere." If, however, the child is
strong and healthy, no opportunity should be lost of taking it into the open
air at stated periods, experience daily proving that it has the most
invigorating and vivifying influence upon the system. Regard, however, must
always be had to the state of the weather; and to a damp condition of the
atmosphere the infant should never be exposed, as it is one of the most
powerful exciting causes of consumptive disease. The nurse-maid, too, should
not be allowed to loiter and linger about, thus exposing the infant
unnecessarily, and for an undue length of time; this is generally the source of
all the evils which accrue from taking the babe into the open air.


From the first moment the infant is applied to the breast, 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

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.

After this plan had been followed for a few days, the mother became drowsy and
disposed to sleep in the daytime; and headach, thirst, a hot skin, in fact,
fever supervened; the milk diminished in quantity, and, for the first time, the
stomach and bowels of the infant became disordered. The porter was ordered to be
left off; remedial measures were prescribed; and all symptoms, both in parent
and child, were after a while removed, and health restored.

Having been accustomed, prior to becoming a mother, to take a glass or two of
wine, and occasionally a tumbler of table beer, she was advised to follow
precisely her former dietetic plan, but with the addition of half a pint of
barley-milk morning and night. Both parent and child continued in excellent
health during the remaining period of suckling, and the latter did not taste
artificial food until the ninth month, the parent's milk being all-sufficient
for its wants.

No one can doubt that the porter was in this case the source of the mischief.
The patient had gone into the lying-in-room in full health, had had a good
time, and came out from her chamber (comparatively) as strong as she entered
it. Her constitution had not been previously worn down by repeated
child-bearing and nursing, she had an ample supply of milk, and was fully
capable, therefore, of performing the duties which now devolved upon her,
without resorting to any unusual stimulant or support. Her previous habits were
totally at variance with the plan which was adopted; her system became too full,
disease was produced, and the result experienced was nothing more than what
might be expected.

The plan to be followed for the first six months. Until the breast- milk is
fully established, which may not be until the second or third day subsequent to
delivery (almost invariably so in a first confinement), the infant must be fed
upon a little thin gruel, or upon one third water and two thirds milk,
sweetened with loaf sugar.

After this time it must obtain its nourishment from the breast alone, and for a
week or ten days the appetite of the infant must be the mother's guide, as to
the frequency in offering the breast. The stomach at birth is feeble, and as
yet unaccustomed to food; its wants, therefore, are easily satisfied, but they
are frequently renewed. An interval, however, sufficient for digesting the
little swallowed, is obtained before the appetite again revives, and a fresh
supply is demanded.

At the expiration of a week or so it is essentially necessary, and with some
children this may be done with safety from the first day of suckling, to nurse
the infant at regular intervals of three or four hours, day and night. This
allows sufficient time for each meal to be digested, and tends to keep the
bowels of the child in order. Such regularity, moreover, will do much to
obviate fretfulness, and that constant cry, which seems as if it could be
allayed only by constantly putting the child to the breast. A young mother very
frequently runs into a serious error in this particular, considering every
expression of uneasiness as an indication of appetite, and whenever the infant
cries offering it the breast, although ten minutes may not have elapsed since
its last meal. This is an injurious and even dangerous practice, for, by
overloading the stomach, the food remains undigested, the child's bowels are
always out of order, it soon becomes restless and feverish, and is, perhaps,
eventually lost; when, by simply attending to the above rules of nursing, the
infant might have become healthy and vigorous.

For the same reason, the infant that sleeps with its parent must not be allowed
to have the nipple remaining in its mouth all night. If nursed as suggested, it
will be found to awaken, as the hour for its meal approaches, with great
regularity. In reference to night-nursing, I would suggest suckling the babe as
late as ten o'clock p. m., and not putting it to the breast again until five
o'clock the next morning. Many mothers have adopted this hint, with great
advantage to their own health, and without the slightest detriment to that of
the child. With the latter it soon becomes a habit; to induce it, however, it
must be taught early.

The foregoing plan, and without variation, must be pursued to the sixth month.

After the sixth month to the time of weaning, if the parent has a large supply
of good and nourishing milk, and her child is healthy and evidently flourishing
upon it, no change in its diet ought to be made. If otherwise, however, (and
this will but too frequently be the case, even before the sixth month) the
child may be fed twice in the course of the day, and that kind of food chosen
which, after a little trial, is found to agree best.


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, inasmuch 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. This process of nature,
then, should be emulated as far as possible; and food (for this purpose) should
be imbibed by suction from a nursing-bottle: it is thus obtained slowly, and the
suction employed secures the mixture of a due quantity of saliva, which has a
highly important influence on digestion. Whatever kind of bottle or teat is
used, however, it must never be forgotten that cleanliness is absolutely
essential to the success of this plan of rearing children.

Te quantity of food to be given at each meal ust be regulated by the age of the
child, and its digestive power. A little experience will soon enable a careful
and observing mother to determine this point. As the child grows older the
quantity of course must be increased.

The chief error in rearing the young is overfeeding; and a most serious one it
is; but which may be easily avoided by the parent pursuing a systematic plan
with regard to the hours of feeding, and then only yielding to the indications
of appetite, and administering the food slowly, in small quantities at a time.
This is the only way effectually to prevent indigestion, and bowel complaints,
and the irritable condition of the nervous system, so common in infancy, and
secure to the infant healthy nutrition, and consequent strength of
constitution. As has been well observed, "Nature never intended the infant's
stomach to be converted into a receptacle for laxatives, carminatives,
antacids, stimulants, and astringents; and when these become necessary, we may
rest assured that there is something faulty in our management, however perfect
it may seem to ourselves."

The frequency of giving food must be determined, as a general rule, by allowing
such an interval between each meal as will insure the digestion of the previous
quantity; and this may be fixed at about every three or four hours. If this
rule be departed from, and the child receives a fresh supply of food every hour
or so, time will not be given for the digestion of the previous quantity, and as
a consequence of this process being interrupted, the food passing on into the
bowel undigested, will there ferment and become sour, will inevitably produce
cholic and purging, and in no way contribute to the nourishment of the child.

The posture of the child when fed: It is important to attend to this. It must
not receive its meals lying; the head should be raised on the nurse's arm, the
most natural position, and one in which there will be no danger of the food
going the wrong way, as it is called. After each meal the little one should be
put into its cot, or repose on its mother's knee, for at least half an hour.
This is essential for the process of digestion, as exercise is important at
other times for the promotion of health.

As soon as the child has got any teeth, and about this period one or two will
make their appearance, solid farinaceous matter boiled in water, beaten through
a sieve, and mixed with a small quantity of milk, may be employed. Or tops and
bottoms, steeped in hot water, with the addition of fresh milk and loaf sugar
to sweeten. And the child may now, for the first time, be fed with a spoon.

When one or two of the large grinding teeth have appeared, the same food may be
continued, but need not be passed through a sieve. Beef tea and chicken broth
may occasionally be added; and, as an introduction to the use of a more
completely animal diet, a portion, now and then, of a soft boiled egg; by and
by a small bread pudding, made with one egg in it, may be taken as the dinner

Nothing is more common than for parents during this period to give their
children animal food. This is a great error. "To feed an infant with animal
food before it has teeth proper for masticating it, shows a total disregard to
the plain indications of nature, in withholding such teeth till the system
requires their assistance to masticate solid food. And the method of grating
and pounding meat, as a substitute for chewing, may be well suited to the
toothless octogenarian, whose stomach is capable of digesting it; but the
stomach of a young child is not adapted to the digestion of such food, and will
be disordered by it.

It cannot reasonably be maintained that a child's mouth without teeth, and that
of an adult, furnished with the teeth of carnivorous and graminivorous animals,
are designed by the Creator for the same sort of food. If the mastication of
solid food, whether animal or vegetable, and a due admixture of saliva, be
necessary for digestion, then solid food cannot be proper, when there is no
power of mastication. If it is swallowed in large masses it cannot be
masticated at all, and will have but a small chance of being digested; and in
an undigested state it will prove injurious to the stomach and to the other
organs concerned in digestion, by forming unnatural compounds. The practice of
giving solid food to a toothless child, is not less absurd, than to expect. corn
to be ground where there is no apparatus for grinding it. That which would be
considered as an evidence of idiotism or insanity in the last instance, is
defended and practised in the former. If, on the other hand, to obviate this
evil, the solid matter, whether animal or vegetable, be previously broken into
small masses, the infant will instantly swallow it, but it will be unmixed with
saliva. Yet in every day's observation it will be seen, that children are so fed
in their most tender age; and it is not wonderful that present evils are by this
means produced, and the foundation laid for future disease."

The diet pointed out, then, is to be continued until the second year. Great
care, however, is necessary in its management; for this period of infancy is
ushered in by the process of teething, which is commonly connected with more or
less of disorder of the system. Any error, therefore, in diet or regimen is now
to be most carefully avoided. 'Tis true that the infant, who is of a sound and
healthy constitution, in whom, therefore, the powers of life are energetic, and
who up to this time has been nursed upon the breast of its parent, and now
commences an artificial diet for the first time, disorder is scarcely
perceptible, unless from the operation of very efficient causes. Not so,
however, with the child who from the first hour of its birth has been nourished
upon artificial food. Teething under such circumstances is always attended with
more or less of disturbance of the frame, and disease of the most dangerous
character but too frequently ensues. It is at this age, too, that all
infectious and eruptive fevers are most prevalent; worms often begin to form,
and diarrhoea, thrush, rickets, cutaneous eruptions, etc. manifest themselves,
and the foundation of strumous disease is originated or developed. A judicious
management of diet will prevent some of these complaints, and mitigate the
violence of others when they occur.

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