The Care and Feeding of Children - L. Emmett Holt (chrysanthemum read aloud .TXT) 📗

id="pgepubid00065">SLEEP

Should a child sleep in the same bed with its mother or nurse?

Under no circumstances, if this can possibly be avoided. Very young infants have often been smothered by their mothers, by overlying during sleep. If the infant sleeps with the mother, there is always the temptation to frequent nursing at night, which is injurious to both mother and child. Older children also should, if possible, have separate beds; many contagious diseases and bad habits are contracted by children sleeping together.

How should an infant's bed be prepared?

The mattress should be firm but soft, the pillow very thin, and the covering not excessive. A baby should not be allowed to sleep always in the same position, but should be changed from side to side. Hair pillows are useful in summer and for children who perspire very much.

How much sleep is natural for a newly born baby?

A baby with a good digestion and proper food will usually sleep at this period about nine tenths of the time.

How much should a baby sleep at six months?

About two thirds of the time.

Up to what age should an older child take a nap during the day?

Always until four years old, and if possible longer.

At what age may an infant go all night without feeding?

At five months a child should not be fed or nursed between 10 P.M. and 6 A.M. At two years a child can easily go from 6 P.M. to 6 A.M. without feeding.

How should a baby be put to sleep?

The room should be darkened and quiet, the child's hunger satisfied, and the child made generally comfortable and laid in its crib while awake.

Is rocking necessary?

By no means. It is a habit easily acquired, but hard to break, and a very useless and sometimes injurious one. The same may be said of sucking a rubber nipple, or "pacifier," and all other devices for putting children to sleep.

What are the principal causes of disturbed sleep?

As quiet peaceful sleep is a sign of perfect health, disorders of sleep may be produced by almost anything which is wrong with the child.

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

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

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

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

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

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

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

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

Do children ever sleep too much?

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

 

EXERCISE

Is exercise important for infants?

It is as necessary for them as for older children.

How is it obtained?

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

 

THE CRY

When is crying useful?

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

How much crying is normal for a very young baby?

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

What is the nature of this cry?

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

When is a cry abnormal?

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

What are the causes of such crying?

Pain, temper, hunger, illness, and habit.

What is the cry of pain?

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

What is the cry of hunger?

It is usually a continuous, fretful cry, rarely strong and lusty.

What is the cry of temper?

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

What is the cry of illness?

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

What is the cry of indulgence or from habit?

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

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

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

What should be done if a baby cries at night?

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

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

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

Is it likely that rupture will be caused from crying?

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

 

LIFTING CHILDREN

How should a young baby be lifted from its bed?

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

What is the advantage of this?

The entire spine is supported, and no undue pressure is made upon the chest or abdomen, as often happens if the baby is grasped around the body or under the arms.

How should a child old enough to run about be lifted?

Always by placing the hands under the child's arms, and never by the wrists.

What injury may be inflicted by lifting the child by the wrists or hands?

Often serious injury is done to the elbow or shoulder joints.

 

THE TEMPERATURE

What is the normal temperature of an infant?

The normal temperature varies more than in adults. In the rectum it usually fluctuates between 98° and 99.5° F.; a rectal temperature of 97.5° F. or of 100.5° F. is of no importance whatever unless it continues.

Where should the temperature of infants and young children be taken?

The rectum is altogether the best place, and next to this the groin. The rectal temperature is from half a degree to a degree higher than that in the groin.

How long should the thermometer be left in place to take the temperature?

Two minutes in the rectum, and five minutes in the groin.

Is the temperature of a young child a good guide as to the severity of its symptoms in illness?

As a rule it is. A temperature of 100° to 102° F. commonly means a mild illness, and one of 104° F. or over a serious one. The duration of the fever is, however, even more important than the height of the temperature. It should be remembered that in all young children slight causes often produce a high temperature which lasts for a few hours; one should not therefore be unduly alarmed unless the temperature continues high, or is accompanied by other important signs of illness.

Is not a high temperature a more serious symptom in a young child than in an adult?

The opposite is rather the case. Young children are extremely sensitive to conditions which produce fever, and the thermometer often gives an exaggerated idea of the severity of the symptoms. A cause which in an adult might produce a temperature of 102° F. or 103° F., in a young child would very likely be accompanied by a temperature of 104° or 105° F.

 

NERVOUSNESS

What are the principal causes of excessive nervousness in infants and young children, and what can be done to prevent this?

The most important cause is the delicate structure of the brain at this time, and its rapid growth. It grows as much during the first year as during all the rest of life. This requires quiet and peaceful surroundings. Infants who are naturally nervous should be left much alone, should see but few people, should be played with very little, and should never be quieted with soothing sirups or the "pacifier."

At what age may playing with babies be begun?

Babies under six months old should never be played with; and the less of it at any time the better for the infant.

What harm is done by playing with very young babies?

They are made nervous and irritable, sleep badly and suffer from indigestion and in many other respects.

When may young children be played with?

If at all, in the morning, or after the midday nap; but never just before bedtime.

 

TOYS

What points should guide one in selecting toys and playthings for