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Title: The Care and Feeding of Children
       A Catechism for the Use of Mothers and Children's Nurses

Author: L. Emmett Holt

Release Date: March 27, 2005 [EBook #15484]

Language: English


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THE CARE AND FEEDING
OF CHILDREN A CATECHISM FOR THE USE OF MOTHERS
AND CHILDREN'S NURSES By L. EMMETT HOLT, M.D., LL.D. PROFESSOR OF DISEASES OF CHILDREN IN THE COLLEGE OF PHYSICIANS AND SURGEONS (COLUMBIA UNIVERSITY) ATTENDING PHYSICIAN TO THE BABIES' HOSPITAL AND THE FOUNDLING HOSPITAL, NEW YORK Fourth Edition, Revised and Enlarged NEW YORK AND LONDON
D. APPLETON AND COMPANY 1907 COPYRIGHT, 1894, 1897, 1903, 1906
By D. APPLETON AND COMPANY

[Transcriber's Note: The text scans did not include a Table of Contents so the following has been added for the convenience of the reader.]

 

CONTENTS I. THE CARE OF CHILDREN Bathing Genital Organs Eyes Mouth Skin Clothing Napkins Nursery Airing Weight, Growth, and Development Dentition II. INFANT FEEDING Nursing Weaning Artificial Feeding Selection and Care of Milk Used for Infant Feeding Modification of Cow's Milk Food for Healthy Infants—The Early Months Food for Healthy Infants—The Later Months General Rules for Guidance in the Use of the Formulas Given Addition of Other Foods to Milk Overfeeding Loss of Appetite Changes in Food Required by Special Symptoms or Conditions Common Mistakes in Milk Modification and Infant Feeding Preparation of Cow's Milk at Home Directions for Feeding Infants Intervals of Feeding Regularity in Feeding Sterilized Milk Modified Milk of the Milk Laboratories Peptonized Milk Feeding During the Second Year Feeding During the Third Year III. THE DIET OF OLDER CHILDREN Milk and Cream Eggs Meats and Fish Vegetables Cereals Broths and Soups Bread, Crackers, and Cakes Desserts Fruits Indigestion in Older Children General Rules to be Observed in Feeding Food Formulas IV. MISCELLANEOUS Bowels Sleep Exercise Cry Lifting Children Temperature Nervousness Toys Kissing Convulsions Foreign Bodies Colic Earache Croup Contagious Diseases Scurvy Constipation Diarrhoea Bad Habits Vaccination Weight Charts

 

THE CARE AND FEEDING OF CHILDREN

 

PART I
THE CARE OF CHILDREN

 

BATHING

At what age may a child be given a full tub bath?

Usually when ten days old; it should not be given before the cord has come off.

How should the bath be given?

It should not be given sooner than one hour after feeding. The room should be warm; if possible there should be an open fire. The head and face should first be washed and dried; then the body should be soaped and the infant placed in the tub with its body well supported by the hand of the nurse. The bath should be given quickly, and the body dried rapidly with a soft towel, but with very little rubbing.

At what temperature should the bath be given?

For the first few weeks at 100° F.; later, during early infancy, at 98° F.; after six months, at 95° F.; during the second year, from 85° to 90° F.

With what should the bath be given?

Soft sponges are useful for bathing the body, limbs and scalp. There should be a separate wash-cloth for the face and another for the buttocks.

What are the objections to bath sponges?

When used frequently, they become very dirty and are liable to cause infection of the eyes, mouth or genital organs.

Under what circumstances should the daily tub bath be omitted?

In the case of very feeble or delicate infants on account of the exposure and fatigue, and in all forms of acute illness except by direction of the physician. In eczema and many other forms of skin disease much harm is often done by bathing with soap and water, or even with water alone.

 

GENITAL ORGANS

How should the genital organs of a female child be cleansed?

Best with fresh absorbent cotton and tepid water, or a solution of boric acid, two teaspoonfuls to the pint. This should be done carefully at least once a day. If any discharge is present, the boric-acid solution should invariably be used twice a day. Great care is necessary at all times to prevent infection which often arises from soiled napkins.

How should the genital organs of a male child be cleansed?

In infancy and early childhood the foreskin should be pushed back at least twice a week while the child is in his bath, and the parts thus exposed washed gently with absorbent cotton and water.

If the foreskin is tightly adherent and cannot readily be pushed back, the physician's attention should be called to it. The nurse or mother should not attempt forcible stretching.

When is circumcision advisable?

Usually, when the foreskin is very long and so tight that it cannot be pushed back without force; always, when this condition is accompanied by evidences of local irritation or difficulty in passing water.

 

EYES

How should the eyes of a little baby be cleansed?

With a piece of soft linen or absorbent cotton and a lukewarm solution of salt or boric acid,—one half of an even teaspoonful to one pint of water.

If pus appears in the eyes, what should be done?

They should be cleansed every hour with a solution of boric acid (ten grains to one ounce of water). If the lids stick together, a little vaseline from a tube should be rubbed upon them at night. If the trouble is slight, this treatment will control it; if it is severe, a physician should be called immediately, as delay may result in loss of eyesight.

 

MOUTH

How is an infant's mouth to be cleansed?

An excellent method is by the use of a swab made by twisting a bit of absorbent cotton upon a wooden toothpick. With this the folds between the gums and lips and cheeks may be gently and carefully cleansed twice a day unless the mouth is sore. It is not necessary after every feeding. The finger of the nurse, often employed, is too large and liable to injure the delicate mucous membrane.

What is sprue?

It appears on the lips and inside the cheeks like little white threads or flakes. It is also called thrush. In bad cases it may cover the tongue and the whole of the inside of the mouth.

How should a mouth be cleansed when there is sprue?

It should be washed carefully after every feeding or nursing with a solution of borax or bicarbonate of soda (baking soda), one even teaspoonful to three ounces of water, and four times a day the boric-acid solution mentioned should be used.

 

SKIN

How should the infant's skin be cared for to prevent chafing?

First, not too much nor too strong soap should be used; secondly, careful rinsing of the body; thirdly, not too vigorous rubbing, either during or after the bath; fourthly, the use of dusting powder in all the folds of the skin,—under the arms, behind the ears, about the neck, in the groin, etc. This is of the utmost importance in very fat infants.

If the skin is very sensitive and chafing easily produced, what should be done?

No soap should be used, but bran or salt baths given instead.

How should a bran bath be prepared?

One pint of wheat bran should be placed in a bag of coarse muslin or cheese-cloth, and this put in the bath water. It should then be squeezed for five minutes until the water resembles a thin porridge.

How should a salt bath be prepared?

A teacupful of common salt or sea salt should be used to each two gallons of water.

How should the buttocks be cared for?

This is the most common place for chafing, as the parts are so frequently wet and soiled; hence the utmost pains should be taken that all napkins be removed as soon as they are wet or soiled, and the parts kept scrupulously clean.

If the parts have become chafed, what should be done?

Only bran and salt baths should be used, and in very severe cases even these may have to be omitted for a day or two. The parts may be cleansed with sweet oil and a little absorbent cotton, and the skin kept covered with a dusting powder composed of starch two parts, boric acid one part.

What is prickly heat, and how is it produced?

It consists of fine red pimples, and is caused by excessive perspiration and the irritation of flannel underclothing.

How should it be treated?

Muslin or linen should be put next to the skin; the entire body should be sponged frequently with equal parts of vinegar and water, and plenty of the starch and boric-acid powder mentioned should be used.

 

CLOTHING

What are the most essential things in the clothing of infants?

That the chest shall be covered with soft flannel, the limbs well protected but not confined, and the abdomen supported by a broad flannel band, which should be snug but not too tight. It is important that the clothing should fit the body. If it is too tight it interferes with the free movements of the chest in breathing, and by pressing upon the stomach sometimes causes the infant to vomit soon after swallowing its food. If the clothing is too loose it is soon thrown into deep folds or bunches, which cause much discomfort. No pins should be used, but, instead all bands about the body should be basted. The petticoats should be supported by shoulder straps.

How should the infant be held during dressing and undressing?

Nothing is more awkward than to attempt to dress a young baby in a sitting posture. It should lie upon the nurse's lap until quite old enough to sit alone, the clothing being drawn over the child's feet, not slipped over the head.

Of what use is the band?

It protects the abdomen, but its most important use is to support the abdominal walls in very young infants, and in this way to prevent the occurrence of rupture.

How long is this band required?

The snug flannel band, not usually more than four months. In healthy infants this may then be replaced by the knitted band, which may be worn up to eighteen months. The band is an important article of dress in the case of thin infants whose abdominal organs are not sufficiently protected by fat. With such, or with those prone to diarrhoea, it is often advisable to continue the band until the third year.

What changes are to be made in the clothing of infants in the summer?

Only the thinnest gauze flannel undershirts should be worn, and changes in temperature should be met by changes in the outer garments. The greatest care should be taken that children are not kept too hot in the middle of the day, while extra wraps should be used morning and evening, especially at the seashore or in the mountains.

Should older children be allowed to go with their legs bare?

If strong and well there is no objection