Fig. 157.—Cord stump dressed with dry sterile gauze. (From photograph taken at Johns Hopkins Hospital.)
If the first bath is a tub bath the cord is dressed after the baby is dried and powdered. The form and method of cord dressings vary somewhat with different doctors but in practically all instances the dressings are sterile, to prevent infection, and porous in order that air may gain access to the cord and promote the drying, separating process. The dressing itself may consist of dry, sterile gauze or gauze wet with alcohol, applied to the cord in the manner of a finger bandage (Fig. [157]); or it may consist of squares of sterile gauze or muslin with holes in the centres to fit around the cord, and dusted with some such powder as boric acid, bismuth or salicylic acid and starch. These squares are folded about the cord stump which is laid over on the abdomen, being directed upward to prevent its being wet with urine. A gauze sponge is placed over the dressing and the binder applied with firm, even pressure, but not tightly, and sewed on or held in place with safety pins. (Fig. [158].) The cord dressing is not removed until the cord separates, unless it is wet or soiled, but as a rule the band is removed every morning at the time of the bath, or whenever it is soiled.
Fig. 158.—Flannel band applied over cord dressing.
After the band has been applied the warmed shirt, diaper, petticoat and dress are put on, with the fewest possible motions, and the baby’s hair brushed upward from the neck and back from his forehead. He should be wrapped in a small blanket, fed and laid quietly in his crib to sleep. If his hands and feet are cold a hot-water bottle at 125° F. with a flannel cover, may be placed beside him.
When the baby is made ready for the night he may have either a sponge bath or simply have his face and hands sponged with warm water, according to the wishes of the doctor. The clothing which the baby has worn during the day should be replaced by an entirely fresh outfit. The day and night clothing may be worn more than once, if clean and if aired between times, but it is better not to have the baby wear the same clothes day and night.
Clothes. The baby’s clothes may play an important part in promoting his well-being, and to accomplish this they must be warm, light-weight, soft and porous. They should be simple; fit smoothly and be loose enough and short enough to permit the baby to move unhampered. In order that his body may be kept at an even temperature their weight must always be adjusted to the needs of the moment. The general tendency is to dress the baby too warmly, as a result of which he perspires; is listless, pale, fretful; sleeps badly; is susceptible to colds and other infections and has poor recuperative powers. His digestion is likely to be deranged and he may have prickly heat. On the other hand, if the baby is not dressed warmly enough his hands and feet will be cold and his lips blue; he will cry from discomfort and the general result may be lowered vitality and disturbed digestion. If the baby’s clothes are not comfortable, if they pull and drag or have tight bands, he will be fretful and restless, with disturbed sleep and digestion in consequence.
The little wardrobe will be entirely adequate, under ordinary conditions, if it consists of shirts, bands, diapers, flannel petticoats, dresses, flannel wrappers and sacques with a cap and cloak for extra warmth during in- or out-door airing. (Fig. [159].)
The shirts should have long sleeves and high necks; they should open all the way down the front and come well down over the hips. During the cold months they should be of silk, silk and wool or cotton and wool, as all wool shirts are usually too warm, and during the summer months they should be of all cotton and very thin. Size No. 2 is the best size to start with as the smaller size is soon outgrown.