Getting ready to be a mother

by Carolyn Conant Van Blarcom

RELIEVING COLIC, CONSTIPATION AND CONVULSIONS

I have tried to impress upon you, at every step, that it is very unwise for you to delay in sending for the doctor when your baby seems ill, or to attempt to treat him according to your own ideas or those of your neighbors. But if the baby should begin to scream with colic or have a spasm, you would want to know what to do at the moment, and in case of constipation there are a few simple nursing procedures that you may employ to the baby’s advantage.

Colic is always due to indigestion, whether the baby is breast-fed or bottle-fed, because of the food itself being wrong in some respect or because it is not properly given. The milk may contain too much of the material that forms the curd, or so much starch and sugar that fermentation takes place, the pain itself usually being due to undigested food or gas in the intestines. This condition may also result from the baby’s being fed too rapidly or too frequently, or from his swallowing air while sucking on a pacifier or an empty bottle. Colic may be caused, too, by chilling the baby as this is likely to disturb his digestion.

Most babies have colic at some time during the first year, usually before the fifth month. The attacks may occur several times a day, after feeding, or they may not come on until the late afternoon or evening when the baby is tired. Colic is so common that most people are familiar with the symptoms: violent crying and a flushed drawn face; cold hands and feet; tightly clenched fists and a hard, swollen abdomen. As the pain is cramp-like, the baby stops crying every little while, and then suddenly begins again, drawing up his legs, doubling up his body and then straightening out with a jerk.

For immediate relief, you may give the baby a tablespoonful of hot water in which half a soda mint tablet has been dissolved, and an enema of half a pint of water, at 110° F., containing one half teaspoonful of salt, given through a small rubber tube introduced about six inches. This empties the lower bowel and enables the baby to expel a good deal of the gas that is troubling him so. Rub his abdomen with a little oil and apply a compress of several thicknesses of flannel, wrung from hot water, covering this with a larger piece of dry flannel, and change it every three or four minutes for a while. Place a flannel covered hot water bottle (at 125° F.) at his feet, cover him warmly, darken the room and he will almost certainly go to sleep. It is often a good plan to substitute barley water for one or two feedings, after an attack of colic, in order to give the disturbed digestive tract a rest.

Quite naturally, you must tell your doctor if your baby has colic for the cause may lie in the character of his food. But it may lie in some error on your part. Go over all the details of your share of the baby’s care and see if you can discover anything to correct.

With breast-fed babies, prevention is often accomplished by the mother’s nursing her baby more slowly, lengthening the intervals between nursings and by improving her own hygiene, particularly by relieving constipation and increasing her recreation and out-of-door exercise. Nursing mothers who lead sedentary lives and eat rich food very often have colicky babies as do those who are nervous, irritable and inclined to worry.

If the baby is bottle-fed he may be taking his food too fast because of an over-large hole in the nipple; he may not pause often enough during his meal or he may take in air as he nurses because the bottle is not properly held, as shown in Fig. [48].

In any event do not stop until you get at the cause of the trouble for though the colic itself may not necessarily be serious, a continuation of the cause may result in a run down condition or even in malnutrition.

Don’t forget the importance of holding the baby upright over your shoulder after each feeding, to help him bring up gas, and of placing him immediately in his crib to be left quiet and undisturbed. And ask your doctor about drinking water. Very often the tendency toward colic is lessened by increasing the amount of cool boiled water given between meals.

Constipation is very common among babies and may be manifest by the stools being too small, too dry or too infrequent. It is more difficult to cope with than colic, though it, too, may have its origin solely in unsuitable food. In some cases, however, the constipation is due to absence of habit in emptying the bowels regularly; to weakness of the intestinal muscles; to long-continued undernourishment or to some such disease as rickets.

It becomes apparent that the prevention of this troublesome condition is accomplished largely by giving suitable food; constant fresh air; regularity in the daily routine and training the baby to empty his bowels at the same time every day.

When constipation is due to insufficient fat in the food, cod-liver oil is sometimes given, 15 to 30 drops three or four times a day; or a teaspoonful of olive oil two or three times a day. Maltose, malt soup, malted milk, milk of magnesia, mineral oil, oatmeal water and orange juice are all found among the remedies for constipation; while soap sticks, suppositories and enemas of oil or soapsuds sometimes have to be resorted to.

In giving an enema to relieve constipation, the baby should be protected from chilling, laid on a pillow and the bed-pan so placed that he will be comfortable and not inclined to move, and from half a cup to a cup of soapsuds, at 105° F., given with a small hard-rubber nozzle, as in Fig. [64]. When warm olive oil is given at night (2 to 4 tablespoonfuls slowly through a small rubber tube introduced about six inches), it is very often retained until morning when the baby empties his bowels freely with little or no assistance.

Abdominal massage will often relieve constipation by strengthening the intestinal muscles, this in turn tending to make the bowels move. The abdomen should be rubbed with a firm but not hard, circular stroke, beginning in the right groin and working up to the margin of the ribs, across to the left side and down to the groin. This massage is often given for about ten minutes every day, preferably at night, but never just after feeding.

Fig. 64.—Giving the baby an enema. He is well protected, to prevent chilling, and lies comfortably on a pillow which reaches to the bed-pan, the latter being covered with a diaper where he rests upon it.

Constipation is sometimes entirely cured by nothing more than a suitable dietary; an abundance of drinking water; an out-of-door life; massage, and above all, the unceasing effort to establish a regular habit. These are all things which you, yourself, may do for the baby. The longer constipation persists, the harder it is to cure, so do all in your power to prevent it and if it develops, try to end it at once.

Convulsions are a symptom of several disorders of infancy and they may occur unexpectedly. Although at the moment, they are more distressing than serious, you should notify your doctor at once. If he cannot come promptly you may end the seizure by employing measures that will quiet and relax the struggling baby. The room should be darkened, kept absolutely quiet and the baby handled with the utmost gentleness. As a rule the most satisfactory course is to immerse the baby in water at 100° F. and keep him there for five or ten minutes, supporting his head above the level of the water as shown in Fig. [60]. (See p. [209].) Have some member of the household place cloths, wrung from cold or iced water, on the baby’s head and change them frequently. When removed from the bath, the baby should be wrapped in a blanket, kept very quiet and the cold applications to his head continued.

If the baby often has convulsions the doctor may instruct you to give him either a mustard bath or pack whenever he has an attack.

For a bath, one ounce, or six level tablespoonfuls of dry mustard is added to one gallon of water at 105° F. and the baby kept in it for about ten minutes, or until the skin is well reddened. He is then wrapped in a warm blanket and surrounded by hot water bottles, with cold compresses applied to his head. The mustard pack is given in the manner shown in Figs. [61] and 62, with a sheet wrung from mustard water which is possibly a little warmer and stronger than that for the bath, care being taken that the sheet is not cooled before it is wrapped about the baby. He is usually left in the pack for about ten minutes or until his skin is reddened, and then wrapped in warm blankets, with cold compresses to his head.