The Room.—The English nursery should have, wherever possible, a southern aspect, for the sake of catching the sun’s rays to the fullest extent. The prospect from the windows should be cheerful, and there should not be large trees in the immediate vicinity. The sanitary conditions necessary for the house demand extra attention in the nursery, as the young inmates are more prone to suffer from evil influences, and have not the change of air and scene which their elders enjoy. Hence a change of room is very beneficial during the day, and the day room should not be the sleeping room if it can be avoided. A few hours daily in the morning room or drawing room with the parents are productive of both material and moral good. Plenty of houseroom is an excellent rule, too often forgotten in taking seaside lodgings, in the expectation that the children will be out all day, which the state of the weather turns into disappointment. The nursery should be at the top of the house, but not, of course, just under the roof, as such a position is the coldest in winter and hottest in summer. The temperature of both day and night nurseries should be kept as nearly as possible at 60° F., and thermometers should be placed in the rooms for guidance. The height of the room should not exceed 10 ft., or it will be more difficult to keep at an equable temperature. A well ventilated room measuring 15 ft. square and 9 ft. high should suffice for sleeping a nurse and infant and 2 young children. No double-bedded nursery should be less than 15 ft. square. Children between 7 and 10 years may sleep out of the nursery, and above that age the sexes should be separated. A bedroom 14 ft. long and 8 ft. wide will admit a bedstead 4 ft. wide between the wall and door. The fireplace, never absent, should be in the opposite wall beyond the foot of the bedstead. The door should be hung so that when opened it does not admit an indraught of cold air upon the bed. The windows, never quite closed at the top in summer, should have shutters, linen or jute (not woollen) curtains for winter use, and green roller blinds for summer use. The walls are best painted or washed with distemper; if papered, bold patterns and bright colours (especially green) must be avoided, and a coat of varnish should be applied. The ceiling should be tinted sufficiently to destroy glare from the sun or gas. The floor should be stained all over, and varnished under the beds and carpets; the latter, best being Dutch or Kidderminster, should not cover the whole floor, especially under the beds. All furniture and fittings should be free from sharp edges and corners. Clothing.—This is exceedingly important in very young children from their being especially sensitive to cold. They feel changes from warm to cold, and from cold to warm, much more severely than older persons do. The cold of winter and the east winds of spring are very apt to bring on colds and coughs which may end in serious disease; on the other hand, very great heat is equally bad for them, diarrhoea and convulsions always increase as the weather gets hotter. It is a very serious mistake to think that children have great power of resisting cold, and that they are strengthened and hardened by exposure to it; no error is attended with more fatal results. A child’s clothing should keep it warm at all seasons; the extra winter clothing should be put on early in the autumn and continued until late in the spring. The most trying and dangerous time is when the wind is high, particularly when it blows from the north The summer outfit for a young baby would include a binder, small cambric shirt, long flannel petticoat, which, being double over the chest and back, is a great protection from the cold, and keeps the legs very warm; a white washing petticoat and robe, not heavily trimmed, and of fine light material; this is quite sufficient. In winter add a knitted woollen spencer, or, what is prettier, a high long-sleeved merino vest, with a fine white cambric guimpe over, prettily tucked and trimmed, with very narrow lace at neck and sleeves. A short-coated baby requires a merino vest, high in winter, low in summer, cambric shirt, small stays, either quilted or made of jean, on to which the flannel petticoat is sewn, white washing petticoat and frock. In the winter there should be in addition a warm white woollen knitted petticoat and bodice in one, not skimpy, but long and full, and knitted with fine soft wool, not the common heavy sorts. The little stays should also be lined with flannel in the winter, and a high white guimpe worn over the vest, unless the white frocks happen to have been made high. Flannel or merino frocks can of course be substituted for washing ones; but, as long as the child dribbles, the latter are much more suitable, as, even when old, they always look well, and to keep a little child sweet, plenty of clean things are essential. Until a baby can walk, the petticoats and frocks should come over the feet and woollen or silk boots be worn. If a child suffers from the cold, have the little shirt made of silk longcloth, which is warmer than anything of the same weight. Silk boots are warmer than wool, and easily knitted. High merino combinations would be excellent, but they are costly, and apt to be worn soiled. Head flannels are preferable to caps in almost all cases, though some contend that babies who wear caps for the first 2 months are much less liable to colds in the eyes. The greatest safeguard against catching cold out of doors is a large white silk handkerchief, to be worn all the year round, folded crosswise, and put on like an old woman’s shawl, crossed in front and tied behind; if, after the pelisse or jacket is on, you pull this up all round the neck, the child will rarely take cold. Full-skirted pelisses are preferable to jackets for children under 3. When a child is sitting up in a perambulator, a pelisse will pull down all over the feet, whereas a jacket only comes as far as the knees. Nothing equals a merino pelisse lined with flannel, full, and for a small baby long enough to come over the feet about 2 in.; the cape should also be lined with very thin wadding, and have a silk lining. Cashmere or silk hoods, lined with flannel when cold, are better than fur or woollen. In winter, gaiters and flannel knickerbockers must be added, or, for a child that cannot walk, woollen gaiters that end in a bag, to tie up over the diapers. Fur jackets are unhealthy, producing undue heat, thereby weakening the child, and being very uncomfortable and heavy for running in. Unless there is any tendency to weakness in the ankles, strap shoes are best, both indoors and out; where the ankles are weak, very tight boots are better. The time of changing the knitted boots to regular leather shoes, with socks, entirely depends upon whether the child is forward or not. Fat, heavy children should never be put to their feet early, therefore they may wear their first boots longer than light active ones; probably 7-8 months is quite early enough for the change for any child; but in this matter, as in many others, mothers disagree. When out of doors, infants up to 10 months old should wear the hoods already described, and warm woollen overdresses made to fasten at the back, as babies’ arms are Washing.—Never put a child to bed dirty. The whole body should be washed every day. Young babies and infants should be bathed and well washed every morning in warm (96°-98° F.) water, and thoroughly well dried afterwards. As they grow older, the water need not be so warm, but it should not be quite cold during the cold weather. In summer cold water is best. Have a large tub and plenty of water. Beware of a chill from draughts while washing and drying the child. Young infants are best washed after their first meal, older children before breakfast. A clean skin is all important; if not washed away, the perspiration dries and remains on the skin, chokes up the pores and sets up an irritation which frequently ends in some positive skin disease. Dry the skin quickly and thoroughly, rub it briskly, and do not leave off until it is perfectly dry; a half dried skin is sure to be made rough and sore very soon by the wind, and the daily morning wash should be a stimulant and tonic to the whole system, helping to make it vigorous and healthy. Sponges are generally used for washing children, and as long as they are not used for any other purpose, there is no objection; but remember that a sponge is very liable to convey infectious diseases and impurities. Some medical men recommend a piece of fine flannel, instead of a sponge. Use the purest soap. Very young infants should have no soap applied near their eyes, as it is liable to produce severe inflammation in them, not to speak of pain from the irritation of soap. It is particularly necessary to attend to the cleanliness and dryness of the napkins; the discharges from the bowels and bladder of a baby are very irritating, and if a wet and dirty napkin is allowed to remain applied to the skin it soon makes it sore, the skin gets inflamed and peels off, and these sores take a long time and much care to heal. The tender skin is soothed and protected by the use of violet powder after being washed. Some toilet powders are, in a degree, antiseptic. French chalk, white fuller’s earth, Taylor’s Cimolia, and sanitary rose powder (containing borax) are among the best. Iron or wire guards are indispensable to nursery fireplaces. It is well to wash and dress a baby near a fire; but never allow the child’s eyes to be exposed to the glare of the fire or its head to be heated. Air and Exercise.—Children should never be kept indoors simply because the weather is cold; if they are properly dressed, the cold will do them no harm, unless they are already out of health. Even drizzling rain is not to be feared, and the children may be taken out in frosty weather, or slight sleet, and even when the snow is thick on the ground, provided their boots are waterproof, falls not to be feared, and garments all changed on returning home. Fogs and high winds, especially east winds, are to be avoided. Let the little ones be out in the air as much as possible. In winter they should go out in the morning from 10.30-12.30, and in the afternoon from 1.45-3 o’clock. In summer they should be out from 8.30-10.45 in the morning and from 4.30-7 o’clock in the afternoon; their meals must be managed so as to leave these hours free. In winter they should have dinner ¼ hour after returning from their morning airing, and should sleep in the afternoon from 3.30-5 o’clock, when they should have another meal. In summer they should have a very light meal on returning Perambulators are a doubtful blessing. A very young child ought to be carried in the arms for the first 6 months; it is so much warmer for one thing. The nurse’s arm, changed at short intervals, should project beyond the baby’s head at the back to protect it from passers by. After 6 months, perambulators may do very well, provided the child is carefully put in, which is very rarely the case. If seated facing forwards, a cold will be the natural result, without taking such care as is beyond the ordinary nursemaid. Every watchfulness must be used to prevent young children getting chills; never let them sit on the grass, nor on a seat which is exposed to the wind in the intervals of play. When they return home warm do not remove their overclothes in a cold room: nothing is more certain to produce ill effects. Once or twice a day an infant should be set free from all hampering binders, &c.; and laid down on a soft rug on the floor to kick and sprawl to its heart’s content. This is the finest exercise, much better than all the jumping and romping, which only makes a baby giddy and over-excited. Do not be in too big a hurry to teach a child to walk; lay it on its back and let it kick about as much as it likes while it is very young. A little later it may crawl and creep about in perfect safety, but when a child is made to stand before its legs are strong enough to bear it, they are very likely to give way and become bent—the body is too heavy for the weak bones of the legs, and they become deformed. As the child advances in age and strength, means of a healthy exercise should be provided in the nursery. Beyond the infantile stage of life, the movements of the child become more and more “purposive.” They are performed for definite purposes, and to effect ends which are clearly mapped out in the child’s mind. Hence, as these movements are of more decided character than those of infancy, “games”—which merely represent play with a purpose—are naturally indulged in. The young child does not “play” aimlessly and listlessly, as is too often supposed. If a child is provided with a ball, nothing delights it more than some defined amusement with that toy. It will aim at effecting some particular plan—as, for example, knocking down an object, or catching the ball in its rebound. Possibly the ball is the best plaything for the child just emerged from its infantile state. Freedom of movement is encouraged in such an exercise, and there is, besides, little danger of fatigue or undue prolongation of this exercise. The child should never be set down to regular exercises, or to any stereotyped course of mild gymnastics, until it has reached its seventh or eighth year. Nursery gymnastics and the use of swinging bars, the trapeze, and allied apparatus will only tend to injure the child if they are used before the age of 7-8. The movements these exercises excite and demand are too severe for young children, whilst, on the contrary, they are well adapted for boys and girls of 8-12 years of age. The same caution applies to the use of “dumb-bells,” which are well adapted for boys and girls of 10-11 and onwards, but are injurious to younger children. Sleep.—Children require much more sleep than adults. They require to be kept very warm when sleeping; the natural warmth of the body is less during sleep than at other times. The hours of sleeping should be made quite regular: this is easy to manage if you begin with a baby at once; they soon acquire regular habits, and in the matter of sleep and feeding, this regularity of habit cannot be begun too soon: a bad habit is difficult to break. For the first few weeks a baby should sleep almost constantly, only awaking at regular intervals to be fed. After the first 2 months it lies awake longer, and is fed less often—it should then be put to sleep for at least 2 hours in the forenoon, from 10-12 or thereabouts, and again in the afternoon for at least an hour. But too much sleep during the day at and after this time spoils the rest at night, which Feeding.—Every mother should make it her duty, as it is her privilege, to nurse her baby at the breast. The only exceptions to this rule are those cases in which, because of special delicacy or disease, they are forbidden by the doctor to do so. Whenever, from any cause, the child cannot be brought up on the breast, the only food which should be given to it for the first 7-8 months is the milk of the cow or goat. Milk contains all ingredients necessary for the growth and nourishment of the child; and nothing can take its place. A child’s stomach has not for many months the power to digest foods which contain much starch, such as cornflour, arrowroot, sago, and others; these foods irritate the stomach and bowels, while the child is being starved for want of the only food it can digest. Milk may be given either from the breast of the mother, or from the bottle. If from the latter, care must be taken not to give the food when either too hot or too cold. Dollond, of 1, Ludgate Hill, has introduced a good thermometer for this purpose, on which thick black lines indicate the right temperature. Breast milk is infinitely to be preferred. Let the child have as much breast milk as possible, and only make up the deficiencies with the bottle. The child should be put to the breast early, within the first 12 hours. The first milk is different to what comes afterwards, and helps by gently acting on the bowels to prepare the passages to properly digest the fully formed milk. Instead of doing this nurses are far too apt to administer a dose of castor oil, which is quite unnecessary and wrong. If the milk has not yet come sucking will help it; and if the child cries with hunger, a little weak milk and water may be given with a spoon. The child should be put to the breast regularly at stated intervals—every 2 hours during the day, and less often at night. 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 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 ? to ? 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 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 Illness.—Infantile disorders within the range of domestic medicine are chiefly diarrhoea 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. Diarrhoea, 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. Medicines kept should be under lock and key, for obvious reasons. The following may be found useful:—Ipecacuanha wine and powder, say of the former 2 oz. and of the latter 1 dr.; grey powder, 1 dr.; castor oil 6 oz.; antimonial wine, 1 oz.; sulphate of zinc, 1 dr.; fluid magnesia, 6 oz.; lime-water, by the gallon, if the infant is brought up by bottle; laudanum or solution of morphia, 1 oz.; Bow’s liniment, or camphor liniment; spongio-piline, for application of fomentation or as a poultice. Lint, oiled silk, and gutta-percha tissue, with 6 oz. carbolic lotion, strength 1 to 40. These are mostly for use by the medical attendant; amateur doctors should restrict themselves to giving a dose of castor oil or fluid magnesia. Moral Training.—Why do women intrust their young children to the care of low-minded ignorant girls, when least able to take care of themselves, yet exercise so much caution to prevent familiar intercourse with servants and inferiors in later youth? With proper treatment, plenty of well-bred and well-educated girls could be found to take nursemaids’ places, to the great advantage of both children and nurse. Obviously, no girl who is not fit to be a companion, an intimate companion, of the mother, is fit to be the guardian and guide of that mother’s children. The nursemaid should be a girl or woman of culture, and not be expected to do anything menial. Early training of children is of great importance. Be with them as gentle, loving, and patient as you can be, but at the same time be firm. Never deceive a child, and never let it weary you into granting a request you have once refused as injudicious. Teach it from the first to bear and to forbear, to obey at once, and to be courteous; the little wretch who snatches anything he fancies, and howls like a monkey if crossed is a pitiable little object, the victim to his parents’ folly, who were too selfish to give themselves the trouble and vexation of training him. Never allow children to be rude and unceremonious to each other because they are brothers and sisters. Be extra careful of your language and manners before children. Never lose your temper with them, never frighten them, and above all things do not strike a child on the head; there is a certain portion of the body especially intended by nature for receiving castigation. Never flatter nor pet a child, nor allow self-admiration to grow upon it. Reduce children’s parties to sensible hours—3-7 for the little ones, and not later than 9 for the older ones—and provide more sensible amusements One word about foreign nurses. They are often engaged with the object of early commencing the acquirement of a foreign language, generally French. But it must not be forgotten that the class of girl obtainable as a nurse is not likely to be capable of teaching the refined language or accent. These nurses may be engaged through the International Institution, 69 Berners Street, London, W. |