A robust baby who has been gradually accustomed to being out-of-doors during the day will usually be much benefited by sleeping out at night. But he must be protected from winds and his clothing so arranged that he cannot be chilled. Knitted or flannel sleeping garments or sleeping bags (See Fig. [159]) are valuable and in addition, the blankets which cover the baby should be securely pinned to the mattress with safety pins and tucked well under it at the sides and foot. The baby should wear a warm cap and the bed should be warmed before he is put into it. Or better still, he may be dressed for the night, put to bed in a warm room and the crib then moved out on the sleeping-porch.
Fig. 162.—Sutton poncho which keeps the baby warm by covering all but his head. The insert shows slit for his head. The regular bedding is temporarily turned back in this picture. (From photograph taken at Bellevue Hospital.)
An excellent device for protecting the baby’s arms and chest and keeping him generally well covered is the poncho (Fig. [162]) devised by Dr. Lucy Porter Sutton of Bellevue Hospital. The poncho is a rectangle made of flannel, outing flannel or an old blanket and cut large enough to tuck well under the head and sides of the mattress and extend below the baby’s feet. The baby’s head slips through an opening, which is almost a right-angled slit, near the centre of the poncho and about 20 inches from the top. The slit is firmly bound and provided with tapes to tie it together after the baby is put in. The poncho should be put on loosely enough to permit the baby to move about at will beneath it. After it is adjusted the bed is made up as usual with additional blankets.
Under all conditions the baby’s airings must be increased gradually, both as to lowering the temperature and lengthening the time, and always adjusted to the vigor and reaction of the individual baby. He must be warm, but not too warm; he must be protected from wind and dust, and his eyes shielded from glare and from flickering light such as may be caused by a tree in a light breeze.
Exercise. Although the baby should not be handled unnecessarily nor tossed about and played with by friends and relatives, it is important that his muscular development be promoted by regular and carefully planned exercise. It is usually considered best for the baby to lie quiet and undisturbed in his crib most of the time during the first three or four weeks. Dr. Griffith begins the baby’s exercise about that time by having the nurse take him in her arms on a pillow and carry him about for a few moments, several times daily. After a week or two of this form of exercise, the nurse carries the baby without a pillow but supports his head and back.
The position of the baby’s body is changed by being carried about in this way, while the movement of the nurse as she walks about causes a certain amount of motion of the baby’s muscles, constituting a gentle exercise.
This exercise, in the form of picking up and carrying about is regarded by many pediatricians as of great importance. There is a possibility that lack of this form of “mothering” is one reason why babies in hospital practice sometimes fail to progress as they should. Certainly lying too long in one position is harmful. The nurse should carry the baby first on one arm and then on the other in order that both sides of his body may be equally exercised. By the third or fourth month he sits up in her arms as she carries him about, and he may be placed on the outside of his crib coverings for a little while every day, to kick and struggle at will. His skirts should be rolled up under his shoulders, or removed entirely, to leave his legs quite free, care being taken that the room is warm and that he has on stockings.
Fig. 163.—A comfortable position for the baby being trained to use chamber.