Fig. 151.—Appearance of umbilicus immediately after separation of cord.
Fig. 152.—Appearance of a well healed umbilicus.
Cord. Within a few days after birth the stump of the umbilical cord begins to shrivel and turn black, and a red line of demarcation appears at the junction of the cord with the abdomen. By the eighth or tenth day, as a rule, the cord has atrophied to a dry black string, when it drops off and leaves an ulcer, or small granulating area which heals entirely in a few days. (Figs. [149], [150], [151], [152].) Before the days of sepsis, infections of the cord were not uncommon and babies frequently died of tetanus, streptococcus and other infections. But at the present time an infected cord is a rare, and, it may be added, an almost inexcusable occurrence.
Skin. By the end of the first week any lanugo remaining usually disappears and there is frequently a scaling of the superficial layers of the skin which lasts for two or three weeks, while a delicate pink tint replaces the deeper color of the skin in the course of ten days or two weeks. The baby does not perspire until after the first month, as a rule, when insensible perspiration begins, gradually increasing until perspiration is free by the time the baby is a few months old.
Tears. There are no tears at birth and opinions differ as to whether they appear in the course of two or three weeks, or three or four months. The absence of the lachrymal secretion is one explanation for the necessity of bathing the baby’s eyes during the early days and weeks, for if dust or other foreign material gains entrance it is not washed out by the tears as it is later.
General Behavior. During the first few weeks the average baby sleeps most of the time: that is from nineteen to twenty-one hours daily. He gradually sleeps less, as the special senses develop and will sometimes lie quietly for an hour or more with his eyes open, sleeping only sixteen or eighteen hours daily at six months and fourteen to sixteen hours at the end of a year.
The baby begins to make noises and “coo” at about two months and to utter various vowel sounds when about six months old. By the end of a year these indefinite noises and sounds become distinct words. At about the fourth month, he grasps at objects and smiles and very soon even laughs. He holds up his head at about the third or fourth month; sits up and also begins to creep at six or seven months; while sometime between the ninth and twelfth months he will stand by holding to some one’s hand or the furniture, and will begin to walk with assistance.
These degrees of development at different ages are not to be taken as the only measure of normal progress, for many well babies mature more rapidly and others more slowly than at the rate which is found to be the average.