3. For reasons which may be seen by the last rule, there should be regular seasons for nursing, and these should be adhered to, especially by night. When very young, once in three hours may not be too frequent; I believe that it is seldom proper to nurse a child more frequently than this. But whenever three hours becomes a suitable period by day, once in four hours will be often enough by night. I will not undertake to say at what precise age children should be nursed at intervals of three and four hours each; because some children are older, _const.i.tutionally_, at three months, than others are at four.
There is one grand mistake, however, against which I must caution young mothers; which is, not to indulge the vain expectation that feeble infants will become robust, in proportion to their indulgence. On the contrary, it is the more necessary to be strict with feeble children, _because_ they are feeble. To keep them hanging at the breast to invigorate them, is the very way to counteract our own intentions, and defeat our own purpose. Seasons of entire rest are even more important to their stomachs than to those of other persons.
4. But in order to secure intervals of rest, both to the strong and the feeble, we must avoid the pernicious habit of giving infants pap, and other delicacies, "between meals." Many a child"s health is ruined by this practice. Nothing should be put into their stomachs for many months--if they are in health--but the mother"s milk.
"This," says Dr. Dunglison, "is the sole food of the infant, and is consequently sufficiently nutrient to maintain life, and to minister to the growth, during the earliest periods of existence." [Footnote: Elements of Hygiene, page 271.] In another place, he says, "Milk is an appropriate nourishment at all ages, and is more so the nearer to birth."
SEC. 4. _Quant.i.ty of Food._
"We all know," says Dr. Dewees, "how easily the stomach may be made to demand more food than is absolutely required; first, by the repet.i.tion of aliment, and secondly, by its variety;--therefore both of these causes must be avoided. The stomach, like every other part, can, and unfortunately does, acquire habits highly injurious to itself; and that of demanding an unnecessary quant.i.ty of aliment is not one of the least.
It should, therefore, be constantly borne in mind, that it is not the quant.i.ty of food taken into the stomach, that is available to the proper purposes of the system; but the quant.i.ty which can be digested, and converted into nourishment fit to be applied to such purposes."
There is a great deal of truth in these remarks; and especially in the closing one, that not all which is taken into the stomach is digested.
It is highly probable, that the least quant.i.ty which is usually given to an infant is more than sufficient for the purposes of digestion; and that nearly every child in the arms of its mother, is over-fed.
I know it has been said, by some physicians--and by those who are sensible men, in other respects, too--that the child"s stomach is a pretty correct guide in regard to quant.i.ty. If we give it too much, say they, it will reject it;--as if that were an end of the matter.
But it is not so. It is by no means harmless to fill the child"s stomach as full as is possible without overflowing. Such a process, though it should not create disease directly, would produce a gluttonous habit.
The stomach, being muscular, may be increased in size by use, like all other muscular organs. The hands, the arms, the legs, the feet, the fleshy portions of the face, even, may be disproportionally enlarged by constant use. Thus a sailor, who uses his hands and arms much more than his legs and feet, has the former unusually large; one who is much accustomed to walking, has large feet; and in a tailor, who from childhood uses his lower limbs comparatively little, they are both small and slender. On the same principle, the stomach, by inordinate use, and by carrying unreasonable loads, may be made nearly twice as large as nature intended, and may demand twice as much food. And I have no doubt that the bulk of mankind, young and old, eat about twice as much as nature, unperverted, would require.
If the suggestions of our last section are duly attended to, one of the causes which lead the stomach to demand an unreasonable quant.i.ty of food will be avoided--I mean the too frequent "repet.i.tion of aliment." And if we never depart from the general rule, already laid down, not to give the infant anything but its mother"s milk, we shall escape the evils incident to variety.
SEC. 5. _How long should milk be the only food._
On this point, there is a great diversity of opinion. Perhaps the most approved role, of universal application, is, that the first change should be made in the child"s diet, when the teeth begin to appear.
This period, it is well known, cannot be fixed to any particular age, but varies from the fifth to the twelfth month.
Some mothers, who have borne with me patiently to this place, will probably here object. "What child," they will ask, "would ever have any strength, brought up so?" Not only a little pap and gruel is, in their estimation, necessary, long before this period, but even many choice bits of meat.
Now I am very sure, that these choice bits--whatever they may be--given to a child before it has teeth, not only do no good, but actually do mischief. Indeed, that which does no good in the stomach must do harm, of course; since it is not only in the way, but acts like a foreign body there, producing more or less of irritation.
I ought to state, in this place, that many people--mothers among the rest--have very inadequate ideas of digestion. They appear to have no farther notion of the digestive process than that it consists in reducing to a pulp the substances which are swallowed; and hence, whatever is reduced to a pulp, they regard as being digested. Whereas nothing is better known to the anatomist and physiologist, than that this--the formation of _chyme_ in the stomach--const.i.tutes only a very small part of the digestive process. The chyme must pa.s.s into the duodenum and other portions of intestine beyond the stomach, and be retained there for some time, before it will form perfect chyle.
This is a more important part of the work of digestion than even the former. For, suppose the chyme to be perfect, though even this may be mere pulp, rather than chyme, and suppose it pa.s.s quietly along into the duodenum and other small intestines. All this process, thus far, may go on naturally enough, and yet the chyle may not be well formed, and the chymous ma.s.s may find its way out of the system without answering any of the purposes of nutrition. For no matter how well the food is dissolved in the stomach, if it do not become good and proper chyle, the blood which is formed will not be good and perfect blood; or, lastly, if it _seem_ to make good blood, it may still be faulty, so that the particles which should be applied to build up or repair the system, are either not used, or if used, answer the purpose but imperfectly.
We hence see how little prepared a large proportion of the community, are, to judge of the digestibility or fitness of a substance for infants, by their own observation and experience merely; and how much more wisely they act, in contenting themselves with giving them--at least until they have teeth--such food only as the Author of nature seems to have a.s.signed them; especially when thus course, is precisely that which is recommended or sanctioned by nearly every judicious physician, as well as by almost all our writers on health.
SEC. 6. _On Feeding before Teething._
Having laid down the general rule, that until the appearance of teeth, the sole food of an infant should be the milk of its own mother, I proceed to speak of some of the more common exceptions to it.
EXCEPTION 1.--The first of these is when the supply furnished by the mother is scanty. There may be two causes of the scantiness of this supply; 1st, the want of suitable nourishment by the mother; and, 2dly, a feeble const.i.tution, or bad health. In the former case, it should be her first object, as it undoubtedly will be that of her physician, to improve the quality of her diet; and in the latter, to restore her health, or at least invigorate her const.i.tution.
In regard to the proper diet of a _mother_, as such, as well as the general management which her case requires, a volume might be written without exhausting the subject. But I have already said as much on this subject, in another place, as my limits will permit.
But we cannot wait for the mother"s health to improve, and allow the infant to suffer, in the mean time, for a due supply of food. The appropriate question now is, How shall such a supply be furnished?
This should be done by means of an article resembling in its properties, as closely as possible, the mother"s milk. For this purpose, we have only to mix with a suitable quant.i.ty of new cow"s milk, one third of water, and sweeten it a little with loaf sugar. This is to be given to the child, at suitable intervals, and in proper quant.i.ties, by means of a common sucking bottle. It is, indeed, sometimes given with the spoon; but the bottle is better.
To the question, whether the child should be confined to this, till the period of weaning, Dr. Dewees answers, No. I am surprised at this; and my surprise is increased, when I find him, almost in the very next breath, urging with all his might, numerous reasons against the very common notion, that children in early life require a variety of food. He even insists on the importance of confining the child to a single article of food when it is practicable. Yet he has not given us so much as one reason why it is not practicable in the case before us; but has gone on to speak of barley water, gum arabic water, rice water, arrowroot, &c. I venture, therefore, to dissent from him, and to answer the foregoing question in the affirmative. When one good and substantial reason can be given for _change_, the decision will, however, be reconsidered.
I have already stated the general rule for preparing this subst.i.tute for the mother"s milk. But there are several minor directions, which may be useful to those who are wholly without experience on the subject.
If possible, the milk used should not only be just taken from the cow, but should always be from the _same_ cow; for it is well known, that the quality of milk often differs very materially, even among cows feeding in the same pasture, or from the same pile of hay; and the stomach becomes most easily reconciled to the mixture when it is uniform in its qualities. Great care should also be taken to see that the cow whose milk is used is young and healthy.
The mixture should not be prepared any faster than it is wanted, and should always be prepared in vessels perfectly clean and sweet, and given as soon as possible after it is prepared, to prevent any degree of fermentation. It is never so well to heat it by the fire. If taken from the cow just before it is used, and if the water to be added is warm enough, the temperature will hardly need to be raised any higher.
When it is impracticable, in all cases, to take milk for this purpose immediately from the cow, it should be kept, in winter, where it will not freeze; and in summer, where there will be no tendency to acidity.
Some mothers and nurses are addicted to the practice of pa.s.sing the food through their own mouths, before they give it to the child--with a view, no doubt, to see that it is at a proper temperature. This practice is not only wholly unnecessary, but altogether disgusting, and even ridiculous. A thermometer would answer every purpose; and save even the trouble of another disgusting practice--that of blowing it with the breath.
The most proper season for giving the child this preparation, is immediately after it has been nursing. It is better for both mother and child, that the latter should nurse just as often as though the supply of food was adequate to his wants. And when his first supply is exhausted, then let him make up his meal from the sucking bottle. The great advantage of this plan is, that he will not be so likely in this way to be over-fed. If he is really needy, he will accept the bottle, even if he do not like it quite so well; if he refuse it, let him go without till he is hungry enough to receive it.
In regard to the water used in the preparation, only one thing needs to be said; which is, that it should be pure. If it is not, it should by all means be boiled. The sugar used should be of the very best kind; and the quant.i.ty not large; since if the preparation be too sweet, it readily becomes acid in the stomach.
There has been, and still is, a controversy going on among medical men, whether sugar is or is not hurtful to the young. "Who shall decide, when doctors disagree?" has often been asked. Without undertaking the task myself, I may perhaps be permitted to say, that I cannot see any reason why a substance so pure, and so highly nutritious as sugar--if given in very small quant.i.ty only--should prove injurious: though I do not regard the reasoning of Dr. Dewees as very conclusive on the subject, when, in reply to Dr. Cadogan, he has the following language--"If sugar be improper, why does it so largely enter into the composition of the early food of all animals? It is in vain that physicians declaim against this article, since it forms between seven and eight per cent of the mother"s milk."--Now with me, the fact that milk and almost all other kinds of food are furnished with a measure of this substance, is the strongest reason I am acquainted with for making no additions. I believe, however, that they may sometimes be made, but not for these reasons.
EXCEPTION 2.--The second striking exception to the general rule that has been laid down, is when the mother is unable to nurse her own child from positive ill health, or when circ.u.mstances exist which render it obviously improper that she should do it. The following are some of the circ.u.mstances which render such a departure from nature indispensable.
1. When the mother is affected strongly with a hereditary disease, such as consumption or scrofula; or when her const.i.tution is tainted, as it were, with venereal disease, or other permanent affections.
2. When nursing produces, uniformly, some very troublesome or dangerous disease in the mother; as cough, colic, &c.
3. There are a few instances in which the milk of the mother, owing to an unknown cause, has been found by experience to disagree with the child. In these circ.u.mstances, it is the unquestionable duty of the mother to resort wholly to feeding.
4. Sometimes the milk, at first abundant, fails suddenly, owing to some accidental or const.i.tutional defect; and this failure becomes habitual.
In all these circ.u.mstances, the proper resort is to a sucking bottle, or a hired nurse. I generally prefer the latter. The cases which seem to me to admit of the former, will be pointed out in the next section.
"When the bottle is used," says Dr. Dewees, "much care is requisite to preserve it sweet and free from all impurities, or the remains of the former food, by which the present may be rendered impure or sour; for which purpose a great deal of caution must be observed."
The business of feeding a child, whether by the bottle or the spoon, should never be hurried: the slower it is, the better. We should stop from time to time, during the process. Nor should the nourishment be given while lying down; it is much more pleasant, as well as more safe, to sit up.
A few thoughts more on the character and condition of the milk which we give to the young, will conclude the second division of this section.
Some are fond of boiling milk for infants; but to this I am decidedly opposed, so long as they are in health. Boiling takes away, or appears to take away, some of the best properties of the milk.
It is true that milk which is boiled does not turn sour so readily in hot weather; but it is quite unnecessary to boil milk in the common manner in order to present its changing, since such a result can be prevented by another process. You have only to put your milk in a kettle, cover it closely, and heat it quickly to the boiling point, and then remove and cool it as speedily as possible. This plan prevents the rising to the surface of that coat or pellicle which contains some of the most valuable properties of the milk.
I have already said that it was as necessary that the stomach should have rest as any other muscular organ. Some writers say that the infant should be kept perfectly quiet, at least half an hour, after each meal.
This is certainly necessary with feeble children, but I question its necessity in the case of those who are strong and robust. I would not recommend, however, nor even tolerate, for one moment, the absurd practice of _jolting_, so common with a few ignorant nurses and, mothers, as if they could jolt down the food in the stomach with just as much safety as they can shake down the contents of a farmer"s bag of produce. Such mothers as these should go and reside among the native tribes of Indians in Guiana, in South America, where they make it a point not only to stuff their children"s stomachs as long as they will hold, but actually to shake it down.
Little less absurd than jolting is the custom of tossing a child high, in quick succession, which is practised not only after meals, but at other times. But on this point, I have treated elsewhere.
Some give the sucking bottle to children as a plaything. This is just about as wise a practice as that of giving them books as playthings.
Both are done, usually, to save the time and trouble of those whose office it is to devote their time to the very purpose of managing and educating their offspring. The evil, however, of suffering the child to have the bottle when it pleases is, that he will thus be tasting food so often as to interfere with and disturb the process of digestion, to his great and lasting injury. For in this way, a part of the food will pa.s.s from the stomach into the bowels unchanged, or at least but imperfectly digested, where it is liable to become sour, and cause disease. It is not to be doubted that many diarrhoeas, as well as, other bowel affections, are produced in this way. Children that are always eating are seldom healthy; and we may hence see the reason.