Mother, Nurse and Infant / A Manual Especially Adapted for the Guidance of Mothers and Monthly Nurses, Comprising Full Instruction in Regard To Pregnancy, Preparation for Child-birth, and the Care of Mother and Child, and Designed to Impart so Much Knowledge of Anatomy, Physiology, Midwifery, and the Proper Use of Medicines as Will Serve Intelligently to Direct the Wife, Mother and Nurse in All Emergencies.

by S. P. Sackett

Chafings may be caused by inattention to cleanliness. Fat babies are subject to them, and when there is disorder of the bowels or kidneys they cannot at all times be prevented. Thoroughly sponge the parts with tepid rain water, allowing the water from a well filled sponge to stream over them, then carefully dry with a soft towel, and perhaps dust over them sub-nitrate of bismuth. (F. 202.)

Diarrhœa and DYSENTERY and also COSTIVENESS are among the ailments with which infants may be afflicted. I wish to be particular in giving directions, that these may generally be avoided, but I must again repeat that the nurse should never be influenced by my advice to do any thing contrary to the directions of the attending physician.

To avoid the subsequent necessity of giving medicine you must be very careful in their administration at first. It is indeed necessary that the meconium should be purged off at first, but nature in general provides such physic as is required, and if the child is applied to the mother’s breast, it obtains in the colostrum such medicine as it needs. Where the infant cannot obtain anything from the breast a gentle aperient may be given, and I name the following as being suitable: either molasses and water, raw sugar, a solution of manna in warm water, a teaspoonful of sweet oil, or of simple syrup of rhubarb, or in more obstinate cases, of castor oil, or one-fourth teaspoonful compound licorice powder, (F. 108.) but you must never give a drastic purgative, and you must not repeat the aperient if the discharges become yellow and natural. A young infant ought to have from three to six motions in the twenty-four hours, the color ought to be of a bright yellow or orange, and of the consistency of mustard as ordinarily prepared for the table, and there ought not to be any lumps or curds in its motions. A mother or nurse ought to be very observant of the state of the bladder and bowels—should inspect motions daily and see that they are not slimy, or curdled, or green. If they are she should be very careful, especially in regard to what the mother eats and drinks. If the bowels are costive she must avoid the frequent repetition of opening medicine, however gentle and well selected the aperients may be. They interfere with digestion, often irritate the bowels, and render them more costive. For the sake of the child as well as herself, the mother may vary her diet considerably after the first week, she may eat boiled and stewed, broiled and roast meats, mutton, lamb, and beef, fish, game, and chickens, potatoes, turnips, spinach, celery, peas, beans, figs, bananas, prunes, baked apples, &c. (F. 45 to 60.) The bowels of the child that nurses generally (not always) keep pace with those of the mother, and she must endeavor both for her own sake and that of the child, to keep her bowels loose by means of diet. If necessary she must take physic. (F. 107, 108, 109.)

If the constipated child nurses the mother and the mother constantly pays proper attention to her own health, and especially to her diet, the child will very seldom require physic. Indeed I would not give active physic when the child seemed well, if it did not have a passage oftener than once a week. If it has cow’s milk or other food besides the mother’s milk, do not boil the milk and you can add to the cow’s milk, corn starch, or the following: Make a thin mush by boiling a small quantity at a time of unbolted wheat flour in water and straining it through a sieve while hot. The child may sometimes be fed with this alone, a little sweetened. Molasses may be given freely, or molasses and soda. The child should be watched, and if there is occasional costiveness, and at the time any indisposition, make a suppository of common soap about an inch in length and a quarter of an inch thick, dip it in water and pass it into the rectum. Or give an injection of less than a gill of water with perhaps a teaspoonful of molasses and a pinch of salt. But I would avoid the practice of giving an enema daily, as tending to get up a bad habit in the system. Should the costiveness have provoked fever, induced pain, or excited convulsions, active physic may be given, either castor oil, magnesia, calomel, or F. 108. But be sure that costiveness is not brought on by giving paregoric or other opiates, and let a child drink freely of pure cold and fresh water. The water may be boiled to destroy germs, and then cooled in a refrigerator; it should always be boiled before being used when there is an epidemic of bowel complaint prevailing.

In DYSENTERY there is a specific inflammation and ulceration of the mucous membrane of the colon, especially of the lower part, and of the rectum—there is generally some fever, frequent and bloody stools, tenesmus, and griping pains. Sometimes it attacks an infant or a delicate child, there being at first for several days diarrhœa, the motions being slimy and frothy like frogspawn, afterward entirely mucous and blood. The child is dreadfully griped, strains violently, and screams, and twists about every time it has a motion, and there is vomiting and great prostration.

You should in treating the child at the breast still keep him to it, and give it no other food. If the mother’s milk is not good, procure if possible a healthy wet nurse. If the child must be fed give it cow’s milk from one healthy cow—fresh from the cow—small quantities at a time and frequently, mixed with gum arabic water. In the commencement a warm bath may be used, or as a substitute you may wrap the child in a blanket that has been previously wrung out of hot water; over this put a dry blanket and keep the child thus enveloped for twenty or thirty minutes.

Formula 74 and 99 may be used, but the dose for a young child must be small to accord with its age.

Cholera infantum is more prevalent in the United States than in any other country. The continued heat of summer is a predisposing cause, and improprieties in diet and clothing, worms, premature weaning, and teething are exciting causes.

You may treat this disease in the initial stage by giving F. 80, and also for a child a year old, injections of a gill of warm water in which a teaspoonful of common salt has been dissolved, allowing the patient three or four times a draught of warm water, as much as it desires to drink. Perhaps the drink will be immediately vomited, but it will at least remove irritating matter from the stomach. The injection, too, may operate immediately, but it may bring with it a fecal or bilious discharge, and if several times repeated, its effects will be salutary. A muslin cloth heated almost to scorching and applied once or twice dry to the neck, may stop vomiting, and draughts applied to the extremities may also be of much benefit. After using injections of warm soft water, anodyne injections may be given three or four times a day; but cases of this kind are too serious for any nurse or mother to treat, if the services of a physician can be obtained; and I will only mention one or two things more. When the extremities are cold put the child for a few minutes in a warm bath of mustard water, and then employ friction to the skin.

I have found chicken tea made by boiling the chicken very soon after it is killed, very useful in checking the vomiting and curing the child.