By about the sixth month he will usually begin to make an effort to creep, if turned over on his stomach and helped a little, and he may be propped up in the sitting position, in his crib, for a few moments every day. As he gives evidence of having enough energy to creep farther than the size of his crib permits, he may be put into a creeping-pen, or upon the floor under certain conditions. It must be remembered that the floor is likely to be cold, drafty and dusty. The nurse must assure herself, therefore, that the floor is warm; must cut off all drafts and spread a clean sheet or quilt on the floor before the baby is put down to creep. When the sheet is taken up, it is folded with the upper surface inside in order that when it is again put down the baby will play on the clean side and not on the side that has been next the floor.
A creeping-pen or cariole or some such provision is often more satisfactory than the floor, consisting as it does of a railed-in platform raised about six or eight inches from the floor.
The suggestions for exercise, like those for the baby’s airing, must be very general since it must always be adjusted to the powers of the individual baby and under the doctor’s supervision.
TRAINING THE BABY
Bowels. It is possible to train even a very young baby to have regular daily bowel movements; this training should be started when the baby is about a month old. At the same hour each day he may be laid on a padded table, or taken in the nurse’s lap, a small basin being placed against or under the buttocks, and a soap stick introduced an inch or two into the rectum and moved gently in and out. This slight irritation will usually result in the baby’s emptying his bowels almost immediately. Or he may be held on a small chamber on the nurse’s lap, in a comfortable reclining position (Fig. [163]) or with his back supported against her chest, and the desire to empty the bowels stimulated by using the soap stick.
It is of greatest importance that the position and method which are adopted, be employed at exactly the same time each day. If this is done, and the baby is being properly fed, it will usually be found that, before he is many months old, his bowels will move freely and regularly without the stimulation of the soap stick and only when he is resting on the small basin or chamber. This establishment of a regular bowel movement not only simplifies the laundry work but is of great moment to the baby’s health.
Thumb-Sucking. It is scarcely necessary to remind a nurse that the baby must not be allowed to suck on an empty bottle or a pacifier nor be permitted to suck his thumb. The habits are very dirty and help to spread infections. The baby may swallow air while practicing them, with colic as a result, and he may so deform the shape of his upper jaw that, later in life, the upper and lower teeth will not meet as they should when he masticates; his front teeth may protrude in a disfiguring manner; and by narrowing and elongating the roof of his mouth the structure of the air passages is altered, with respiratory troubles and adenoids as a frequent consequence. Thumb-sucking may be prevented by the simple procedure of putting stiff cuffs on the baby’s elbows (Fig. [164]) which make it impossible for him to reach his mouth with his thumb. These cuffs may be made by covering pieces of cardboard with muslin and attaching tapes with which to tie them on the baby’s arms. His hands may be put into celluloid or aluminum mitts, or little bags made of stiff, heavy material, which in turn are tied to his wrists, or his sleeves may be drawn down over his hands and sewed or pinned with safety pins. It should be borne in mind that a baby sometimes sucks his thumb because he is hungry or thirsty and gives up the practice when his food is increased or when he is regularly given water to drink.
Fig. 164.—Stiff cuffs to prevent thumb sucking. (From photograph taken at Johns Hopkins Hospital.)
Ear Pulling is not uncommon among young babies and if allowed to continue a long, misshapen ear may result. This may be prevented by using a thin, close fitting cap which ties under the chin, or by using the same kind of elbow splints as for thumb-sucking.