Fig. 184.—Muslin band with cuffs and tape used to keep the baby from kicking while a specimen of urine is being obtained. The tapes are tied tightly to the sides of the crib and the cuffs fastened around the baby’s ankles with safety pins. See Figs. [182] and [183].
In preparing the soda solution it must be remembered that boiling drives off carbonic acid and forms sodium carbonate and that its reconversion into sodium bicarbonate is a complicated procedure. Howland and Marriott[[16]] say in this connection: “Oscar Schloss has found that sodium bicarbonate in bulk is always sterile. It is probably therefore sufficient to add the bicarbonate with proper precautions to sterile water.”
Since the results of urine tests frequently indicate the treatment in acidosis, it is of very great importance that the nurse be able to obtain specimens from young babies. (Figs. [182], [183], [184] and [185] for methods of obtaining fresh and 24–hour specimens from babies.)
Colic, Constipation, Convulsions and Vomiting so frequently seen in young babies are symptoms rather than diseases.
Colic usually consists of paroxysms of pain in the stomach or intestines, due to distension or to spasmodic, muscular contractions. The indirect cause may be unsuitable food or food given too rapidly; chilling of the surface of the body, excitement or fatigue. The distension may be due to air swallowed by the baby while nursing or gas formed by carbohydrate fermentation. Excess of protein may form an irritating mass in the intestines and cause a cramp.
Fig. 185.—Belt used to hold tube in place while obtaining specimen of urine as indicated in Figs. [182] and [183]. The tube is passed through the hole in the tab and adjusted over penis or between labia; the belt fastened around the waist and straps passed between the thighs and fastened to belt.
While colic frequently accompanies malnutrition and constipation, it is often seen in otherwise well and happy babies, and usually before the fifth month. The attacks are usually sudden and may occur several times a day after feeding, or only in the late afternoon or at night. The baby cries shrilly; his face is drawn and may be flushed, from crying, or cyanotic; his fists are clenched and pressed to his body and his feet and hands are cold. His abdomen is hard and distended and during a pain the baby flexes his thighs upon it and afterward extends them with a jerk. This painful seizure may last only a few moments or it may persist for hours, leaving the baby exhausted.
The chief preventive measures are found in the precautions and attention to detail which have been described, and which should be included in the care of all babies. In a bottle-fed baby it is often found that recurrence of attacks of colic may be averted by a slight change in the milk formula; by giving more water to drink; by lengthening the intervals between feedings; by giving the milk more slowly or by omitting the 2 a.m. feeding, thus giving the baby more digestive rest.
With breast-fed babies, prevention is often accomplished by having the mother nurse her baby more slowly, lengthening the intervals and by improving her own hygiene; particularly by increasing her recreation and out-of-door exercise and relieving constipation. Women who lead sedentary lives and eat rich food very often have colicky babies as do those who are nervous, irritable and inclined to worry. (See chapter on the nursing mother.)