Fig. 165.—Cap, to prevent ruminating. (Devised by Miss Hammer.)
Crying. It is very easy to allow the baby to develop the crying habit, but very difficult to break it up. A baby who is properly fed, kept dry and warm but not too warm, and whose clothes are comfortable will usually cry very little if wisely handled. But a baby may cry because he is hungry, thirsty, wet, cold, over-heated, sick or in pain or simply because he wants to be taken up and entertained and has learned that the way to realize his wish is to cry. By closely observing the baby’s habits and his condition the nurse will usually be able to ascertain the cause of the crying. Very often a drink of fairly warm, sterile water will quiet him, particularly at night. But both the nurse and the mother should refrain from taking the crying baby up and carrying him or holding him when it is discovered that this attention stops his crying. Persistent crying should always be reported to the doctor, as it may have serious significance.
Ruminating. Some babies have the habit, called “ruminating,” of bringing up food; chewing it; moving it about and finally rolling it out of their mouths. Although this habit has not been recognized until comparatively recently, it is now believed to be of fairly common occurrence and often mistaken for vomiting. It is seen as a rule in precocious babies who take more interest in their surroundings than the average, more placid infant, beginning very early to fix their attention upon light, sounds and moving objects. The ruminator begins by bringing up a small amount of his last nourishment, then a little more and a little more until finally he has brought up nearly or quite all of it, apparently deriving a certain amount of pleasure and satisfaction from the procedure. Quite obviously, a continuation of this practice results in undernourishment, sometimes even starvation, since the baby actually retains very little if any of his food. As liquids come up more easily than fluids, the first step toward breaking up this habit is usually to give the baby more solid and concentrated food than he has been taking and to carry him about, talk to him and entertain him for about an hour after feedings, for if his attention is otherwise engaged, he is not likely to ruminate. Another efficacious measure is the use of a cap (See Fig. [165]) so constructed and tied under his chin that the baby’s jaws are held tightly together and he is unable to make the movements which are necessary to rumination. (Fig. [166].)
Fig. 166.—Ruminating cap applied. (From photograph taken at Johns Hopkins Hospital.)
FEEDING THE BABY
Proper feeding is probably the most decisive single factor in the routine care of the baby.
In order that the food be satisfactory it must be not only suitable in composition for the individual baby, but it must be clean, fresh and at the right temperature; given in suitable amounts and at suitable and regular intervals; it must be given properly—not too fast nor too slowly and it must be given under favorable conditions.
Moreover, the baby himself must be kept in a general condition which will favor the digestion and assimilation of the food that is given to him. Fresh air, suitable clothing, an even body temperature, gentle handling, proper bathing, regular sleep, freedom from excitement, fatigue and irritation, all promote the baby’s ability to use his food to advantage. Reverse influences all work against it.