After the oil bath, the silk and wool shirt (size No. 2), the diaper and stockings are quickly put on to avoid the least danger of chilling. The band having been applied at the time of the dressing of the cord, our baby is now ready for the flannel skirt. This should hang from the shoulders by a yoke of material adapted to the season, cotton yoke without sleeves if a summer baby, and a woolen yoke with woolen sleeves if a winter baby. The outing-flannel night dress completes the outfit and should be the only style of dress worn for the first two weeks. Loosely wrapped in a warm shawl, the baby is about ready for its first nap, save for a drink of cooled, boiled water.
This cooled, boiled, unsweetened water should be given in increasing amounts every two hours until the child is two or three years of age.
It is usually given the child in a nursing bottle. In this way it is taken comfortably, slowly, can be kept clean and warm, and should the babe be robbed of its natural food and transferred to the bottle as a subst.i.tute for mother"s milk, it will already be acquainted with the bottle and thus one-half of a hard battle has already been fought and won.
BABY"S FIRST NAP
The baby"s bed should be separate and apart from the mother"s. It may be a well-padded box, a dresser drawer, a clothes basket, or a large market basket. A folded comfortable slipped in a pillow slip makes a good mattress. A most ideal bed may be made out of a clothes basket; the mattress or pad should come up to within two or three inches of the top, so the baby may breathe good fresh air and not the stale air that is always found in a deeply made bed. Into this individual bed the baby is placed as soon as it is dressed; and a good sleep of four to six hours usually follows.
Frequent observations of the cord dressing should be made as occasionally hemorrhage does take place, much to the detriment of the babe. If bleeding is at any time discovered the cord is retied just below the original tying. By the time baby has finished a six- or eight-hour nap the mother is wondrously refreshed and is ready to receive it to her breast.
PUTTING TO THE BREAST
During the first two days the baby draws from the b.r.e.a.s.t.s little more than a sweetened watery fluid known as the colostrum; but its intake is essential to the child in that it acts as a good laxative which causes the emptying of the alimentary tract of the dark, tarry appearing stools known as the meconium. On the third day this form of stool disappears and there follows a soft, yellow stool two or three times a day.
The child should be put to the breast regularly every four hours; two things being thus encouraged: an abundant supply of milk on the third day and the early shrinking of the uterus. More than once a mother has missed the blessed privilege of suckling her child because some thoughtless person told her "why trouble yourself with nursing the baby every four hours, there"s nothing there, wait until the third day;" and so when the third day came, there was little more than a mere suggestion of a scanty flow of milk, which steadily grew less and less.
THE URINE
The urine of the very young child should be clear, free from odor and should not stain the diaper, nor should it irritate the skin of the babe. Often urination does not take place for several hours, sometimes not at all during the first twenty-four hours. If the infant does not show signs of distress, there is no cause for alarm; the urine should pa.s.s, however, within thirty hours. As a rule there are usually between ten and twenty wet diapers during each twenty-four hours. The following table shows about the amounts of urine at different ages:
Birth to two years 8 to 12 ounces Two to five years 15 to 25 ounces Five to ten years 25 to 35 ounces
GENITALS OF THE MALE CHILD
The foreskin of the male child is often long, tight, and adherent, and is often the direct cause of irritability, nervousness, crying, and too frequent urination. It should be closely examined by both physician and nurse and when the foreskin does not readily slip back over the acorn-like head of the organ, circ.u.mcision is advised early in the second week. This simple operation will start the child out on his career with at least one moral handicap removed and one desirable possibility established--that of being able to keep himself clean.
POST-OPERATIVE CARE OF CIRc.u.mCISION
The dressings that are loosely applied at the time of the operation should remain untouched (especially those next to the skin), unless otherwise directed by the physician, until the seventh or eighth day when the babe is placed in a warm soap bath, at which time the dressings all come off together. Clean sterile gauze is so placed as entirely to protect the inflamed skin from the diaper at all times before this bath, and these same dressings should be continued for at least another week. Sterile vaseline (from a tube) should be applied twice a day after the original dressings are removed in the bath at the end of the first week. There should be little or no bleeding following the operation, neither should the p.e.n.i.s swell markedly; if either complication should occur, the physician should be promptly notified.
CARE OF THE FEMALE GENITALS
The girl baby is often neglected in respect to the proper care of the genitals. The lips of the v.u.l.v.a should be separated and thorough but careful cleaning should be the daily routine. The foreskin or covering of the c.l.i.toris should not be adherent; while the presence of mucus, pus, or blood in the v.u.l.v.a should be at once reported to the physician; in his absence, the application of twenty per cent argyrol should be made daily.
[Ill.u.s.tration: Fig. 6. How to Hold the Baby]
HANDLING THE BABY
Let us thoroughly come to understand the very first day the little one"s life, that it was not sent to us because the family needed something to play with; it is not a ball to toss up, neither is it a variety show. It is a tiny individual, and your responsibilities as parents and caretakers are very great. The child was sent to be fed, clothed, kept warm, dry, and otherwise cared for by you, until such a time as it will become able to care for itself. Remember, what we sow, that shall we also reap. If we sow indulgence we shall reap anger, selfishness, irritability, "unbecomingness"--the spoiled child. At two or three days the baby learns that when it opens its mouth and emits a holler, someone immediately comes. If we do it on the second and third day, why should we object to run, bow, and indulge on the one hundredth and second day?
Handle the baby as little as possible. Turn occasionally from side to side, feed it, change it, keep it warm, and let it alone; crying is absolutely essential to the development of good strong lungs. A baby should cry vigorously several times each day. If the baby is to be handled, support the back carefully (Fig. 6).
THE EARLY BATHS
During the first week the baby is oiled daily over his entire body, with the exception that the cord dressing remains untouched. The face, hands, and b.u.t.tocks are washed in warm water. After the third week the bathroom is thoroughly warmed and the small tub is filled with water at temperature of 100 F. The baby having been stripped and wrapped in a warm turkish towel, is placed on a table protected by a pillow, while the caretaker stands by and vaselines the creases of the neck, armpits, folds of the elbows, knees, thighs, wrists, and genitals; and then, with her own hands, she applies soap suds all over the body--every portion of which is more quickly and readily reached--than by the use of a wash cloth. And now, with the bath at 100 F., with a folded towel on the bottom of the small tub, the soapy child is placed into the water and after a thorough rinsing is lifted out again to a warm fresh towel on the table and the careful drying is quickly begun.
After the bath all the folds and creases are given a light dusting with a good talc.u.m.
During hot weather the bath should be given daily, soap being used twice a week. On the other days there should be the simple dipping of the child into the tub. During the cold weather the full bath is given but twice a week, while on the other days a sponge bath or an oil rub may be administered.
A weak, delicate child should not be exposed to the daily full bath, but rather the semi-weekly sponge bath and the daily oil rub should be administered. We have found the late afternoon hour to be better than the early morning hour for baby"s bath. It requires too much vital resistance to react to an early morning bath, especially when the house is cool.
REGARDING SOAP
The use of soap is very much abused with young babies. I recall one mother who came into the office with her poor little baby which was constantly crying and fretting because of a greatly inflamed body--all a result of the too frequent use of soap. I said, "I am afraid you do not keep your baby clean." "O Doctor!" she replied, "I wash him with soap every time I change him; I am sure he is clean." And come to find out, the poor little fellow"s tender skin had been subjected to soap several times a day. We ordered the use of all soap discontinued, vaseline and talc.u.m powder to be used instead, and the child"s skin got well in a very short time.
CARE OF THE UMBILICUS
Tight bands should not be placed about the babe. If the umbilicus protrudes, do not endeavor to hold it in by a tight band, but consult your physician about the use of a bit of folded cotton and adhesive plaster, and then allow the child the freedom of the knitted bands, with skirts suspended from yokes. The day of tight bands and pinning blankets with their additional and traditional windings is over. After the complete healing of the cord, the need for a snug binder to hold the dressings in place is over. Should the baby cry violently, the umbilicus should be protected in the manner described above--the fold of cotton and the adhesive plaster.
The diaper, stockings, shirt, skirt, and dress with an additional wrapper for cold days completes the outfit at this age.
BIRTH REGISTRATION
"One of the most important services to render the newborn baby is to have his birth promptly and properly registered."
In most states the attending physician or midwife is required by law to report the birth to the proper authority, who will see that the child"s name, the date of his birth, and other particulars are made a matter of public record. Birth registration may be of the greatest importance when the child is older, and parents should make sure this duty is not neglected.
A public health official some time ago epitomized some of the uses of birth registration as follows:
There is hardly a relation in life from the cradle to the grave in which such a record may not prove to be of the greatest value.
For example, in the matter of descent; in the relations of wards and guardians; in the disabilities of minors; in the administration of estates; the settlement of insurance and pensions; the requirements of foreign countries in matters of residence, marriage, and legacies; in marriage in our own country; in voting and in jury and militia service; in the right to admission and practice in the professions and many public offices; in the enforcement of laws relating to education and to child labor, as well as to various matters in the criminal code; the irresponsibility of children under ten for crime or misdemeanor; the determination of the age of consent, etc., etc.
CHAPTER XIII
THE NURSERY
We wish it were possible for every mother who reads this book to have a special baby"s room or nursery. Some of our readers have a separate nursery-room for the little folks, and so we will devote a portion of this chapter to the description of what seems to us a model arrangement for such a room; but, realizing that ninety-five per cent of our readers can only devote a corner of their own bedroom to the oncoming citizen, we have also carefully sought to meet their needs and help them to take what they have and make it just as near like the ideal nursery as possible.
THE SEPARATE NURSERY
The nursery should be a quiet room with a south or southwesterly exposure. The bathroom should adjoin or at least be near. A screened-in porch is very desirable.