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to this in very hot weather. In cold weather, however, it is doubtful if any children are benefited by it, particularly in a changeable climate like that of New York. Many delicate children are certainly injured by such attempts at hardening.

What sort of underclothing should be worn during cold weather?

Never the heaviest weight, even in winter. Four grades are usually sold, the next to the heaviest being thick enough for any child.

Do little children require as heavy flannels as older people?

Not as a rule. They usually live in a warm nursery; their circulation is active; and they always perspire easily during their play. When they go out of doors, the addition of coats and leggings renders thick flannels unnecessary.

Are not many little children clothed too thinly for the ordinary house?

Very few. The almost invariable mistake made in city homes is that of excessive clothing and too warm rooms. These two things are among the most frequent reasons for their taking cold so easily.

 

NAPKINS

How should napkins be taken care of?

They should he immediately removed from the nursery when soiled or wet. Soiled napkins should be kept in a receptacle with a tight cover, and washed as soon as possible.

Should napkins which have been only wet be used a second time without washing?

It is no doubt better to use only fresh napkins, but there is no serious objection to using them twice unless there is chafing of the skin. Clean napkins, changed as soon as wet or soiled, are of much importance in keeping the skin healthy.

What are the important things to be observed in washing napkins?

Soiled napkins should not be allowed to dry, but should receive a rough washing at once; they should then be kept in soak in plain water until a convenient time for washing,—at least once every day,—when they should be washed in hot suds and boiled at least fifteen minutes. Afterward they should be very thoroughly rinsed or they may irritate the skin, and ironed without starch or blueing. They should never be used when clamp.

 

NURSERY

What are the essentials in a good nursery?

The furnishings should be very simple, and unnecessary hangings and upholstered furniture should be excluded. As large a room as possible should be selected—one that is well ventilated, and always one in which the sun shines at some part of the day, as it should be remembered that an average child spends here at least three fourths of its time during the first year. The nursery should have dark shades at the windows, but no extra hangings or curtains; about the baby's crib nothing but what can be washed should be allowed. The air should be kept as fresh and as pure as possible. There should be no plumbing no drying of napkins or clothes, no cooking of food, and no gas burning at night. A small wax night-light answers every purpose.

How should a nursery be heated?

Best by an open fire; next to this by a Franklin stove. The ordinary hot-air furnace of cities has many objections, but it is not so bad as steam heat from a radiator in the room. A gas stove is even worse than this, and should never be used, except, perhaps, for a few minutes during the morning bath.

At what temperature should a nursery be kept during the day?

Best, 66° to 68° F., measured by a thermometer hanging three feet from the floor. Never should the temperature be allowed to go above 70° F.

At what temperature during the night?

During the first two or three months, not below 65° F. After three months the temperature may go as low as 55° F. After the first year it may be 50° or even 45° F.

At what age may the window be left open at night?

Usually after the third month, except when the outside temperature is below freezing point.

How often should the nursery be aired?

At least twice a day—in the morning after the child's bath, and again in the evening before the child is put to bed for the night. This should be done thoroughly, and the child should be removed meanwhile to another apartment. It is well to air the nursery whenever the child is out of the room.

What symptoms are seen in a child who is kept in too hot a room?

It becomes pale, loses appetite, shows symptoms of indigestion, occasionally vomits, stops gaining in weight, perspires very much, and takes cold easily because of this and also because of the great difference between the indoor and outdoor temperatures. Its condition may be such as to lead one to suspect very serious illness.

 

AIRING

How early may airing indoors he commenced and how long may it be continued?

Airing in the room may be begun, even in cold weather, when the child is one month old, at first for only fifteen minutes at a time. This period may be gradually lengthened by ten or fifteen minutes each day until it is four or five hours. This airing may be continued in almost all kinds of weather.

Is there not great danger of a young baby's taking cold when aired in this manner?

Not if the period is at first short and the baby accustomed to it gradually. Instead of rendering the child liable to take cold, it is the best means of preventing colds.

How should such an airing be given?

The child should be dressed with bonnet and light coat as if for the street and placed in its crib or carriage which should stand a few feet from the window All the windows are then thrown wide open, but the doors closed to prevent draughts. Screens are unnecessary.

At what age may a child go out of doors?

In summer, when one week old; in spring and fall, usually at about one month; in winter, when about three months old, on pleasant days, being kept in, the sun and out of the wind.

What are the best hours for airing out of doors?

In summer and early autumn a child may be out almost any time between seven in the morning and sunset; in winter and early spring, a young child only between 10 or 11 A.M. and 3 P.M., although this depends somewhat upon the climate. In New York and along the Atlantic coast the early mornings are apt to be damp and the afternoons raw and cloudy.

On what kind of days should a baby not go out?

In sharp winds, when the ground is covered with melting snow, and when it is extremely cold. A child under four months old should not usually go out if the thermometer is below freezing point; nor one under eight months old if it is below 20° F.

What are the most important things to be attended to when the child is out in its carriage?

To see that the wind never blows in its face, that its feet are properly covered and warm, and that the sun is never allowed to shine directly into its eyes when the child is either asleep or awake.

Of what advantage to the child is going out?

Fresh air is required to renew and purify the blood, and this is just as necessary for health and growth as proper food.

What are the effects produced in infants by fresh air?

The appetite is improved, the digestion is better, the cheeks become red, and all signs of health are seen.

Is there any advantage in having a child take its airing during the first five or six months in the nurse's arms?

None whatever. A child can be made much more comfortable in a baby carriage, and can be equally well protected against exposure by blankets and the carriage umbrella.

What are the objections to an infant's sleeping out of doors?

There are no real objections. It is not true that infants take cold more easily when asleep than awake, while it is almost invariably the case that those who sleep out of doors are stronger children and less prone to take cold than others.

What can be done for children who take cold upon the slightest provocation?

They should be kept in cool rooms, especially when asleep They should not wear such heavy clothing that they are in a perspiration much of the time. Every morning the body, particularly the chest and back, should be sponged with cold water (50° to 60° F.).

How should this cold sponge bath be given?

The child should stand in a tub containing a little warm water, and a large bath sponge filled with cold water should be squeezed two or three times over the body. This should be followed by a vigorous rubbing with a towel until the skin is quite red. This may be used at three years, and often at two years. For infants a little higher temperature (65° to 70°) may be used.

 

WEIGHT, GROWTH, AND DEVELOPMENT

Of what importance is the weight of the child?

Nothing else tells so accurately how well it is thriving.

During the first year a record of the weight is almost indispensable; throughout childhood it is of much interest and is the best guide to the physical condition. It will well repay any mother or nurse to keep such a record.

How frequently should a child be weighed?

Every week during the first six months, and at least once in two weeks during the last six months of the first year. During the second year a child should be weighed at least once a month.

How rapidly should an infant gain in weight during the first year?

There is usually a loss during the first week of from four to eight ounces; after this a healthy child should gain from four to eight ounces a week up to about the sixth month. From six to twelve months the gain is less, usually from two to four ounces a week.

Is it to be expected that bottle-fed infants will gain as rapidly as those who are nursed?

They seldom do so during the first month; after that time under favourable circumstances the gain is usually quite as regular, and during the latter half of the first year it is likely to be more continuous than in a nursing infant, because the latter usually loses weight at the time of weaning.

Why do they not gain so rapidly at first?

It takes a few weeks for the stomach to become accustomed to cow's milk, and until this is accomplished it is necessary to make the milk very weak or the child's digestion will be upset.

For a child of average weight at birth (seven to seven and a half pounds) what should be the weight at the different periods during the first year?

At three months it should be twelve to thirteen pounds; at six months, fifteen to sixteen pounds; at nine months, seventeen to eighteen pounds; at one year, twenty to twenty-two pounds. At five months a healthy child will usually double its weight, and at twelve months it will nearly treble its weight.

Do all healthy infants gain steadily in weight during the first year?

As a rule they do; yet it is seldom the case that one gains every week for the entire year. With most infants there are from time to time periods of a few weeks in which no gain is made. These are more often seen from the seventh to the tenth month and frequently occur when the child is cutting teeth, sometimes during very hot weather.

Is it true that every infant who gains rapidly in weight is thriving normally?

Not invariably. Some who are fed upon prepared infant foods increase rapidly in weight but not in strength, nor in their development in other respects.

Is the weight of as much value in the second year as a guide to the child's condition?

After the first year, the gain in weight is seldom continuous; there are many interruptions, some depend on season, and others often

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