The maternal management of children, in health and disease

by Thomas Bull

RULES FOR THE USE OF THE WARM BATH.

TEMPERATURE OF THE WATER.—When the warm bath is used as a measure of hygeiene, as a general rule, any degree of temperature may be chosen between 92 degrees and 98 degrees, which appears to be most agreeable to the child; but on no account must 98 degrees be exceeded. When ordered as a remedial measure, the temperature will of course be fixed by the medical attendant.

The same degree of temperature must be kept up during the whole period of immersion. For this purpose the thermometer must be kept in the bath, and additions of warm water made as the temperature is found to decrease. These additions of warm water, however, must be regulated by the indications of the thermometer, and not by the feelings of the child.

PERIOD OF REMAINING IN THE BATH.—This must depend upon circumstances. As a measure of hygeiene, it must be varied according to the age of the child. For the first four or five weeks, the infant should not be kept in beyond three or four minutes; and the duration must afterwards be gradually prolonged as the child advances in age, until it extends to a quarter of an hour, a period which may be allowed after it has attained the age of four years.

When the bath is employed as a remedial agent, the time of immersion must be prolonged; this will be determined by the medical adviser. Speaking generally, a quarter of an hour may be said to be the shortest period, an hour the longest, and half an hour the medium.

When in the bath, care must be taken that the child's body is immersed up to the shoulders or neck, otherwise that part of the body which is out of the bath (the shoulders, arms, and chest), being exposed to the cooler temperature of the air, will be chilled.

When the infant or child is taken out of the bath, the general surface, especially the feet, must be carefully rubbed dry with towels previously warmed; and when one of the objects of the bath is to excite much perspiration, the child should be immediately wrapped in flannel and put to bed. When, however, the object is not to excite perspiration, the child may be dressed in his ordinary clothing, but should not be allowed to expose himself to the open air for at least an hour.

TIME OF USING THE BATH.—When resorted to for sudden illness, the bath must of course be employed at any time needed. When used for any complaint of long standing, or a measure of hygeiene, as a general rule, it should be taken between breakfast and dinner, about two hours after the former, or an hour and a half before the latter. This implies that the infant should never be put into the bath after having been freely nourished at the breast. Neither should it ever be used when the child is in a state of free perspiration from exercise, or on awaking from sleep.

Chap. III.

OF TEETHING, AND HINTS ON THE PERMANENT OR ADULT TEETH.

The infant at birth has no teeth visible: the mouth is toothless. It possesses, however, hidden in the jaw, the rudiments of two sets. The first of these which makes its appearance, are called the Temporary or Milk Teeth; the second, the Permanent or Adult Teeth, and these come up as the former fall out, and so gradually replace them.

Sect. I.—ON TEETHING.

THE MANNER IN WHICH THE TEMPORARY OR MILK-TEETH APPEAR.—The first set of teeth, or milk-teeth as they are called, are twenty in number; they usually appear in pairs, and those of the lower jaw generally precede the corresponding ones of the upper. The first of the milk-teeth is generally cut about the sixth or seventh month, and the last of the set at various periods from the twentieth to the thirtieth months. Thus the whole period occupied by the first dentition may be estimated at from a year and a half to two years. The process varies, however, in different individuals, both as to its whole duration, and as to the periods and order in which the teeth make their appearance. It is unnecessary, however, to add more upon this point.

Their developement is a natural process. It is too frequently, however, rendered a painful and difficult one, by errors in the management of the regimen and health of the infant, previously to the coming of the teeth, and during the process itself.

Thus, chiefly in consequence of injudicious management, it is made the most critical period of childhood. Not that I believe the extent of mortality fairly traceable to it, is by any means so great as has been stated; for it is rated as high as one sixth of all the children who undergo it. Still, no one doubts that first dentition is frequently a period of great danger to the infant. It therefore becomes a very important question to an anxious and affectionate mother, how the dangers and difficulties of teething can in any degree be diminished, or, if possible, altogether prevented. A few hints upon this subject, then, may be useful. I shall consider, first, the management of the infant, when teething is accomplished without difficulty;—and, secondly, the management of the infant when it is attended with difficulty.