The essential features of this care are as follows:
1. Proper feeding. 2. Fresh air. 3. Regularity in his daily routine. 4. Cleanliness of food, clothing and surroundings. 5. Maintenance of an equable body temperature. 6. Conservation of his forces.
These requirements seem so rational that one might expect them to be met as a matter of course; but the annual sickness and death rate among babies are a constant reminder that they are not.
The nurse should begin by arranging a daily schedule for the baby’s feedings, fresh air, bath, sleep and exercise, and follow it with unfailing regularity. The hours for the nursings, which vary with different doctors, will constitute the greater part of the daily schedule, and for a baby on four hour feedings, for example, some such program as the following may be arranged:
| 6 | a.m. | Feeding. |
| 8 | a.m. | Orange juice (when ordered). |
| 9 | a.m. | Bath. |
| 10 | a.m. | Feeding. |
| 10.30 to 2 | p.m. | Out of doors. |
| 2 | p.m. | Feeding. |
| 2.30 to 4 | p.m. | Out of doors. |
| 4 | p.m. | Orange juice (when ordered). |
| 4 to 5.30 | p.m. | In-door airing and exercise (when ordered). |
| 5.30 | p.m. | Preparation for the night. |
| 6 | p.m. | Feeding. |
| 10 | p.m. | Feeding. |
| 2 | a.m. | Feeding (when ordered). |
The importance of punctuality in the daily routine cannot be stressed too often and it is one aspect of the baby’s care for which the nurse is absolutely responsible. No matter how well the baby is nursed, in other respects, nor how skillfully the doctor directs his care, the baby cannot be expected to progress satisfactorily if his life is irregular.
The Bath. The first office which the nurse usually performs for the new-born baby, and which she repeats daily, is to bathe and dress him. The bath may be given in a tub, under a spray or in the nurse’s lap, according to the wishes of different doctors, while sponge baths are sometimes given with soap and water and sometimes with oil.
The first bath, particularly, is likely to be an olive oil sponge, given immediately after birth, before the baby is taken from the mother’s bedside, and many doctors have the sterile cord dressing and abdominal binder applied at this time. This oil bath is given, not alone for the purpose of removing the vernix caseosa, but also, to lessen the radiation of body heat, which the baby can ill afford to lose. When such a practice is followed it only remains for the nurse to dress the baby and place him in his crib to sleep undisturbed for several hours.
Some doctors have the baby sponged every morning with albolene or olive oil, instead of with soap and water, until the cord separates, when tub bathing is adopted. When the daily bath is given with oil, the baby’s thighs and buttocks are wiped clean with an oil sponge each time that the diaper is changed. Other doctors have the baby’s first bath given in a tub, with soap and water, while still others who fear that the cord may be infected by immersing the baby, have him sponged with soap and water, after the vernix caseosa has been softened with oil.
Sponge bathing is commonly employed for all babies until the cord separates and for frail delicate babies or those suffering from skin trouble. The sponge bath may be given in the nurse’s lap or on a table covered with a pad, either method being satisfactory if the baby is kept warm and comfortable. But one inclines to the idea of having the baby bathed in the nurse’s lap for he seems happier there; more comfortable and less frightened and we cannot be sure that these factors are unimportant.