How often are newly born infants taken into a cold room in which, from the arrangement of the doors, a draft sweeps through whenever a person goes out or comes in? How the child is laid bare in readiness for the ordeal of a thorough cleaning! The child is generally first rubbed with oil and afterwards put into a bath tub or some other vessel of sufficient capacity to drown several babies at once. It is now treated to a soaping process, after which, by means of a cloth indifferently selected, the child is scrubbed with an ambition which would have been laudable if applied to the nurse’s own person, but why this little innocent should be the object of such abuse has been a standing wonder to me from the time I witnessed the first outrage. By the time the nurse gets through bathing the child, it is shivering and blue from cold. I had not been practicing medicine very long before I became appalled by this barbarous procedure, nor had I practiced very long before I was called upon to sign a number of death certificates of infants who contracted colds that resulted in bronchitis, pneumonia and congestion of the lungs, which caused their death.
There is no sense in this dousing and soaping of a newborn child, and aside from its danger by undue exposure, it is absolutely useless. But habit is often so thoroughly intrenched that the good judgment which persons exercise in most of their duties may become entirely suspended, when this force of habit has established a custom that is well-nigh universal.
My method of directing the first toilet of the baby is without the possible dangers to which I have referred, for it has for its object not only to clean the child, but to dress it as quickly as possible and again wrap it in flannel. Warmth is the life of the newborn babe; it does not require much food, if any, the first twenty-four or forty-eight hours of its life, but it requires to be kept warm. The room in which the child is to be cleansed must be warm and free from draft, and if there is a fire in the chamber where the mother is, the toilet of the child had better be made here under her eyes and those of the physician. The nurse or person delegated to dress the baby provides herself with a vase or bowl of warm water and a saucerful of warm olive oil or vaseline and a few soft cloths. She then seats herself in a low chair, and by means of a small piece of flannel she applies the oil all over the baby’s body, rubbing in an extra quantity in the armpits, groins and other places where the cheesy substance is thickest. When the oil has softened the sebaceous material, take a soft muslin cloth, provided for the purpose, and beginning on the head the oil is wiped off again; where there are blood stains left, wash these off with a soft flannel cloth; at the same time the eyes are to be bathed and the mouth washed out. I have not mentioned the use of soap, for the reason that it is not at all necessary and very often injurious. The oil removes all the caseous matter and what oil remains is rather an advantage than otherwise; it preserves the warmth of the child and protects its skin. If the soap comes in contact with the eyes of the infant it often becomes a fruitful source of that annoying and often dangerous disease of the eyes that is technically termed purulent ophthalmia.
Never apply oil or any other greasy substance to the cord before it comes off, for this will prevent its drying and delay its falling off. When the cord has come off, you simply keep the navel clean by washing it daily with a little warm borax water and afterwards apply a small compress on which has been smeared a little zinc ointment. Always see to it that the baby is lying dry and use dusting powder freely; the precipitated chalk is the best and cheapest infant powder that can be used. The child that is nursed on its mother’s breasts has little to fear from overfeeding, yet it should not be allowed to hang on the nipple too long or sleep with the nipple in its mouth. Nurse the child every two hours during the day and awaken it if it should sleep to give it its nourishment, but at night allow it to sleep as long as it wants to; this will cultivate regular habits in the child and it will thrive much better. If the baby cries and is restless between times do not imagine that it is always hungry, but rather colicky, for which there is nothing better than the old German domestic remedy, fennel seed tea; of this give the baby all it will drink every day and until it is a year old.
Sore nipples are a great annoyance to a mother and often very obstinate to treatment. The skin covering the nipple is made exceedingly tender by the sucking of the child’s mouth and in a few days it cracks and becomes fissured. Sometimes, the pain that the mother endures whenever the infant nurses is excruciating, for every time the child is put to the breasts the cracks open anew. The most fruitful cause of this condition is to allow the child to hold the nipple in its mouth when it does not nurse or perhaps to allow it to retain the nipple in its mouth while it sleeps.
This practice must be at once discontinued, and the child must be at once removed from the breast as soon as it is satisfied. The nipples should be washed with borax water, and then a salve should be made by mixing the yellow of one egg with half an ounce of Peruvian balsam. This is to be applied by means of a camel’s hair brush to the sore nipple every time after the child is through nursing. Should the nipple be too sensitive and the suction of the child too painful, then a breast pump had better be used for a few days and the child not applied until the teat has sufficiently improved.
Abscess of the breast constitutes a distressing complication of the puerperal condition, inflicting upon the patient intense suffering, and very often leading to a long delay in recovery. It may be due to cold, and in one case it developed from this cause two months before confinement, but this is an exception. Sore nipples are a fruitful cause, for the soreness of nursing makes the mother reluctant to have the child draw all the milk out, hence, the breast cakes and hardens with the above result. It also is due to neglect in not having the nipple properly drawn out; or to a foolish custom, derived from remote ancestry not to allow the infant to be put to the breast for two or three days after its birth. In this way the milk ducts become greatly distended, inflammation sets in, which, if not properly arrested will terminate in an abscess. If gentle friction of camphorated oil and hot, moist compresses or poultices do not enable the child to draw out the secretion, a young pup should be obtained, for he draws with a gentleness and activity which surpasses the most perfect machine. The patient must drink sparingly of fluids and properly support the breasts by means of handkerchiefs placed under them and made to cross the shoulders, and the bowels should be thoroughly opened. Should an abscess form it should be opened by a free incision, and the poultice discontinued, but instead a wad of absorbent cotton should be applied and the breast tightly bandaged with the handkerchief.