The nursing mother should take sufficient good food, but should not drink all sorts of foods at all hours, under the idea that she will thus make more milk. She is more likely to upset her digestion, and injure the quality of her milk. The secret of good nursing lies in keeping in the best health possible: take plenty of fresh air and rest, and sufficient plain, unstimulating food. Any violent nervous excitement, such as anger, fright, anxiety or grief is sure to affect the child. If the mother’s health remains good, she may continue to nurse her child for about 9 months. If the child is thriving well, and has cut several teeth, and especially if the mother’s health begins to suffer, nursing must be at once given up. Nursing beyond a year does harm to both.
Weaning should take place, then, at or about the tenth month. It must be done earlier (a) If the mother’s health is suffering, or if she is attacked by any acute disease; (b) if she becomes pregnant again while nursing the child; (c) if the child is not sufficiently nourished upon the breast milk, yet refuses to take other food. This happens when the milk is too thin and watery, although it may be in sufficient quantity. Carefully watch the condition of the child, and do not rely too much on dates or teething; wean a child gradually, choosing a time when the child is in good health. Begin by lessening the number of times it is allowed to take the breast; thus giving it time to get used to and to relish other food. Reduce by degrees to one breast meal a day; and after about a week, this too must be given up.
Great mortality is found among infants brought up on the bottle, due to the wrong sort of food being put into the bottle. As to the bottle itself, the old-fashioned kind with a cork on one side is the best, because they are simplest, most easily kept clean and sweet, and when they are used, the child must be held in the proper upright position. However near perfection a bottle may be, it is liable to become a source of disease. Rubber parts absorb milk, or in a crack in the material a small quantity may adhere, and undergo fermentation, and the best-directed efforts to keep the tubing clean may not prevent this happening. In the glass part this does not occur readily, as it can be thoroughly cleansed, and there is no risk of absorption. If 2 bottles are used, one can be in operation while the other one is being cleaned. The manner most likely to prevent bad consequences is to thoroughly wash out the bottle after it has been used in tepid water, and then again wash it with water and soda, then thoroughly dry bottle and tubing, and put them in the open air, as on a window-sill, where they can have both sun and air. Of course, the stopper should be out of the bottle. Another method is to allow the bottle to remain in lime-water till next it requires to be used. In cleaning out tubes a brush attached to a strong wire is needed.
Cow’s milk is the best substitute for a child’s natural food. But in order to make cow’s milk as like the mother’s milk as possible, you must dilute it with water and add some sugar. At first the proportions should be at least equal parts of milk and water, with a small quantity of sugar; if the milk be very poor, a dessert spoonful of cream may be added to each meal with benefit. As cow’s milk soon turns acid, a tablespoonful of lime-water in each bottle is often useful in making it agree better with the child. This is particularly advisable in warm weather. Boil all milk intended for the child’s use as soon as it comes into the house. Where there is any doubt about the purity of the water, boil it too. After the first 6 weeks, the proportions should be ⅔ to ⅓ water; and after the fourth month the milk may be given plain. For at least the first 7 months the child should have no other nourishment whatever. Smell the bottle before you put a fresh meal into it, and if there is the least sourness about either bottle or nipple, wash it until it smells fresh and sweet. Feed at regular hours—every 2 hours during the day, and twice during the night, for the first 6 weeks: after this every 3 hours is often enough, but then the quantity of each meal must be larger. Never give a child a bottle merely to keep it quiet; you damage both stomach and character. The food should be as near the heat of the body as possible, i.e. at or about 98° F. Cold milk delays digestion, and does injury. If the child is allowed to lie on the back, it gets the milk too fast, and indigestion follows. If good cow’s milk cannot be got, Swiss condensed milk is useful, but it must not be given too strong; ½ teaspoonful to a teacup of water is plenty to begin with. For the first 4 months it is an excellent substitute for ordinary milk, and most children thrive on it; but do not continue its use too long. If the child is thriving and has cut several of its front teeth, at the age of 7-8 months, not earlier, farinaceous food may be given once or twice a day. Still, foods which contain much starch are to be avoided, such as arrowroot, sago, corn-flour. The best to begin with is oatmeal gruel, well-boiled and strained, or, as a change, milk thickened with a rusk or well-baked flour; Chapman’s entire wheat flour is excellent, and to be preferred to ordinary wheat flour, as it contains the phosphates of the wheat, and a peculiar ferment which changes starch into sugar.
Cow’s milk and Robinson’s patent barley (prepared by Keen, Robinson, and Bellville) is recommended for use by Dr. Pye Chavasse in his work entitled ‘Advice to a Mother,’ as the best artificial food for infants, stating that “children apparently dying of starvation, soon after taking it, quickly pick up flesh, their bodies fill out, they sleep, they loose all pain,” &c. To a good tablespoonful of the patent barley, mixed with a wineglassful of cold water, add one-and-a-half gills of boiling water, stir this over the fire while boiling for six minutes, and then feed the infant. The same proportion of milk may be used instead of water when the baby is weaned. Alternately with Robinson’s patent barley, Robinson’s patent groats may be used with good results.
Some of the more expensive artificial foods are prepared in such a way that the starch is rendered soluble and easily digested, effected mainly by the addition of malt and the employment of heat. But if oatmeal and plain wheaten flour agree with your children use them. These farinaceous meals should be given once, or, at most, twice a day, remembering that the greater part of a child’s nourishment should still be milk.
In those rare cases where milk cannot be taken by a child, often barley-water, mixed in equal quantities with the milk, will make it agree, by lessening and softening the curd; sometimes the whey of the milk, separated from the curd by rennet, and made richer by adding 1 part cream, which contains no curd, to 4 of the whey, makes a digestible food. Sometimes it is necessary to feed for a day or two on rice water, with the boiled rice pounded and mixed in it; but such cases are serious, and demand medical advice.
When a child has cut most of its front teeth—that is to say, towards the end of the first year, it may be given once a day a meal of a meat broth with barley in it, or of gravy and bread crumbs. The broth should be made by cutting up the meat finely and letting it stand for 2-3 hours in cold water and then boiling it. At about the same time, or a little later, a lightly-boiled (much better raw) egg may be used instead of the broth, once or twice a week; or a well-boiled mealy potato, carefully mashed and mixed with good meat gravy. No solid meat food should be given to a child under 2 years of age, nor until it has cut all its teeth, for the simple reason that until its back teeth are ready for use, it is unable to masticate such food so as to prepare it to be digested in the stomach. After this a little meat well-cooked may be given to a child occasionally; but it should not form part of its every-day food. It is a great mistake to give weakly and delicate children much animal food; for the first 3 years, the less they have the better. The best food is not that which contains most nourishment, but which is best adapted to the digestive organs. Whenever animal food is given, it should be minced very fine, or bruised in a mortar, to make up for non-mastication. Bread-and-butter, oatmeal porridge, milk, rice, and light puddings should form the staple diet. Avoid stimulants, tea, cakes, and pastry. The plainer and simpler the food, the stronger and healthier will be the child. Compel children to eat slowly; and only allow them to eat at meal times.
Teething.—The number of first or milk teeth which a child gets is 20; they come in regular order, and at definite intervals; 8 front teeth, 4 above and 4 below, called “incisors”; eye teeth, 2 above and 2 below, called “canines”; and 8 back teeth, 2 above and 2 below on each side, called “molars.” The order in which they ought to come is:—the two lower middle incisors at about the seventh month, seldom earlier; followed in a few weeks by the 2 upper middle incisors; almost immediately afterwards, the other 2 upper incisors, one on each side of the middle ones; a week or two later, the two other incisors in the lower jaw come through, so that all the incisors generally appear before any of the other teeth, and, being smaller than the others, are generally cut without much trouble; by the end of the tenth or eleventh month, after an interval of about 2 months, the first 4 molars appear, and occupy 2 months, more or less, in making their way through the gums; after another interval of 2-3 months, the eye teeth begin, and are fully cut by the end of the eighteenth or twentieth month; this is followed by another period of rest, after which the 4 back molars come, and soon after the end of the second year the first dentition is complete. Teething is a natural process; but the period in which it is going on is a time of change from one mode of living to another, so that when a child is teething, it requires more than ordinary care. Its bowels must be kept in good order, rather too loose than too confined; give it abundance of fresh air, and avoid changes of diet just when the teeth are coming through; cooling drinks of milk and water, or barley water, are useful to allay the thirst, and cool the hot mouth; warm baths at night relieve feverishness which is often present; if the gums are swollen and inflamed, a touch of the lance will be productive of great relief. While the teeth are “breeding” in the gums, the irritation may be reduced by gently rubbing them, or by giving the child a crust or indiarubber pad to bite; but shortly before they break through the gum the mouth is so tender that the child will allow nothing to go near it, and it is just at this time that lancing is of most service.
Illness.—Infantile disorders within the range of domestic medicine are chiefly diarrhœa and constipation. The former, in a suckled child, will probably be due to the condition of the mother, who should carefully regulate her own bowels, taking a simple aperient, like castor oil or rhubarb if necessary. Diarrhœa, with bottle feeding, may arise from sour food: boil the milk, mix it with barley water instead of water, make it weaker, and add 2 tablespoonfuls lime-water or a few grains soda bicarbonate to every ½ pint food. See that cold to feet or body is not the cause. For constipation, generally occurring in bottle-fed infants, reduce the food, omit lime-water, and change one meal a day from milk to thin oatmeal gruel. Avoid medicines, except perhaps 30 gr. manna in 1 tablespoonful distilled water, or 1 tablespoonful fluid magnesia in the food of one meal for a day or two, or castor oil if a severe case. Gentle injection of a little warm water is an excellent thing in stubborn cases. Vaccination is a paramount duty hardly requiring mention. Especially beware of chills during convalescence. Exposure to cold after scarlet fever brings dropsy and kidney diseases, and consumption and bronchitis follow whooping-cough and measles.