It is surprising how soon even a young and inexperienced mother will learn to distinguish between the pain cry and the plain cry of her baby; for most crying can easily be traced to some physical discomfort which can be relieved, or to some phase of spoiling and indulgence which can be stopped.

NORMAL HEALTHY CRYING

The young baby can neither walk, talk nor engage in gymnastics, except to indulge in those splendid physical exercises connected with a good hearty cry. To be good and healthy, an aggregate of an hour a day should be spent in loud and lusty crying. He should be allowed to kick, throw his arms in the air and get red in the face; for such gymnastics expand the lungs, increase general circulation and promote the general well-being of the normal child. As the child grows older and is able to engage in muscular efforts of various sorts, these "crying exercises" should naturally decrease in frequency and severity. When baby cries, see that the abdominal band is properly applied, that rupture need not be feared.

THE BIRTH CRY

The sound most welcomed by both doctor and nurse is the cry of the newly born child, for it shows that the inactive lungs have opened up and the baby has begun to use them, for all the time baby was living in the uterine room he did not breathe once, the lungs having been in a constant state of collapse; and not until now, the very moment the air comes in contact with his skin, do the lungs begin to functionate as he emits his first lusty holler.

ABNORMAL CRYING

The cry is said to be abnormal when it continues too long or occurs too often. It may be strong and continuous, quieting down when he is approached or taken up; or it may be a worrying, fretful cry, a low moan or a feeble whine. And now as we take up the several cries, their description, cause, and treatment, we desire to say to the young mother: Do not yourself begin to fret and worry about deciding just which class your baby's cry belongs to; for help, knowledge, and wisdom come to every anxious mother who desires to learn and who is willing to be taught by observation and experience.

THE HUNGER CRY

The continuous, fretful cry, accompanied by vigorous sucking of the fists, both of which stop when hunger has been satisfied, is without question the hunger cry.

If this cry is constant with regular feedings, then the quantity of the food must be increased, or the quality improved. The tired, fretful hunger cry must not be neglected; the cause must be removed, for it points to malnutrition.

THE CRY OF THIRST

One day when lecturing at an Iowa chautauqua, I remained in the beautiful park for the noonday meal. It was a warm day and the tables in the well-screened dining tent were filled with mothers who, like myself, preferred the cool shade of the park to the hot ride through the city to the home or hotel dinner. At my table a baby was pitifully crying. The mother had offered the little child seated in a small uncomfortable go-cart, milk, bread, and a piece of cake—all of which were ruthlessly pushed aside. My little son, then only four and a half, said "Mamma, maybe the baby's thirsty," and up he jumped, hurried to the mother's side with his glass of water, saying, "I haven't touched it, maybe the baby's thirsty." The mother brushed the boy aside, saying, "No, I never give the baby water." In spite of the mother's remonstrance, the baby cried on and on, and finally on "trying" the water, the child drank fully one-half the glass and the crying was hushed.

Babies should be given water regularly—many times every day—from birth, in varying amounts from two teaspoons to one-half cup, according to the age of the child. The water should be boiled for the first few months, and longer if there is any suspicion of impurities.

Milk to the nursing infant is like beefsteak and potatoes to the adult; and many times the milk bottle or the breast is just as nauseating to the thirsty babe, as meat would be to the very thirsty adult whose hunger has previously been fully satisfied.

THE FRETFUL CRY

The babe who is wet, soiled, too hot, or is wrapped too tightly, or who has on a tight, uncomfortable belly band, or whose clothing is full of wrinkles, has only one way to tell us of his discomfort, and that is to cry. It is a fretful cry and should command an immediate investigation as to the possible cause. It takes but a moment to discover a wet diaper; to run the hand up the back under the clothes; to sprinkle with talcum if perspiring; to straighten out the wrinkled clothing; to find the unfastened pin that pricks; or to loosen the tight band. Acquire the art of learning to perform these simple tasks easily, and any or all of these services should be rendered without taking the child from its bed.

Let the child early learn to rest happily and quietly in his own bed. The pillow or mattress may be turned or perhaps the mattress be raised nearer the edge of the basinet. One poor youngster instantly stopped his fretful cry when his mattress was raised four or five inches so he could get the air, at the same time taking him out of his hot room to a cooler room with raised windows. Babies like cold air. They cry when the air is hot, or even warm and close. Every day—rain or shine, wind or sleet—babies should nap out of doors on the porch, in a well-sheltered corner. A screen or a blanket protects from the wind, sleet, or rain; and if the baby's finger tips are warm, you can rest assured the feet and body are warm. Scores of babies will sleep out on the porch, on the protected fire escape, or in a room with opened windows, from one bottle or feeding to another; being aroused at the end of the three or four hour interval just enough to nurse, when back they go to their delightful, warm nest in the cool, fresh air to sleep for another period. Babies should never sleep in a room with closed windows.

One of the incidents that surprised me most in my early work with dispensary babies was the utter misconception of the purpose of the belly band. Invariably it was put on so tightly that I could not slip a finger between it and the babe. It is not a surgical instrument, neither is it a truss. These tight belly bands are a source of much fretting and crying.

THE PAIN CRY

The little pinched look about the face, the drawing up of the legs, the jerking of the head, arms, or legs, associated with a strong, sharp, unceasing or intermittent cry, demands immediate attention Our first work should be to go about quietly, painstakingly, and systematically to locate the cause of this "cry of pain."

There are often some accompanying symptoms to the cry of pain which demand skilled medical advice and attention, such as the arching of the body backward, the drawing of the head strongly to one side, the inability to use one side of the body, or the presence of fever. There may be an earache, an abdominal complication, or a sore throat, any one of which will be detected by the skilled doctor.

Earache frequently occurs in young babies who have been taken out of doors without proper protection to the ears; or, it may be associated with a cold in the head, which is not detected until the mischief has already been done, while the resulting running ear tells the tale of woeful suffering. Earache must always be thought of as a possible cause when the cry of pain accompanies a cold in the head, and if medical aid is secured early, the abscess may be aborted and the deafness of later years entirely avoided. There is only one home remedy for earache, and that is the application of external heat, either by a hot-water bottle or hot-salt bag. Medical advice should be sought before anything whatsoever is dropped into the baby's ear.

In this connection should be mentioned the wild cry at night which so often accompanies tuberculosis of the bone. A careful X-Ray examination will reveal the disease, and proper medical measures should be instituted at once. Other fretful night crying will be mentioned further on.

HABIT CRYING

By the frequent repetition of actions, habits are formed. When the baby is two or three days old, he is so new to us and we have waited for him so long, and it is such a great big world that he has come into, that we jump, dance, and scramble to attend to his every need and adequately to provide for his every want. At this very early, tender age whenever he opens his mouth to cry or even murmur—some fond auntie or some overly indulgent caretaker flies to his side as if she had been shot out of a gun, grabs him up and ootsey tootsey's him about as she endeavors to entertain and quiet him. The next time and the next time and the succeeding time he whimpers—like a flash someone dashes to the side of the basket, and baby soon learns that when he opens his mouth and yells, somebody comes. In less than a week the mischief has been done and baby is badly spoiled. No other factor enters so largely into the sure "spoiled" harvest as picking a new baby up every time he cries. Often in the early days some indulgent parent will say, "Oh, don't turn out the light, something might happen to the dear little thing"—and old Mother Nature sees to it that a constant repetition of "leaving the light on" brings its sure harvest of "he just won't go to sleep without the light." And then, "just once" he had the pacifier—perhaps to prevent his crying disturbing some sick member of the family—and so we go on and on. If a thing is bad, it is bad, and a supposedly good excuse will not lessen the evil when the habit has been thus started and acquired.

The rocking of babies to sleep may be a beautiful portrayal of mother love, but we all pity the child who has to be rocked to sleep as much as we do the mother who sits and rocks, wanting, Oh, so much! to do some work or go for a walk—but she must wait till baby goes to sleep.

THE TEMPER CRY

And so now we come to the temper cry—that lusty, strong outburst of the cry of disappointment when he finds that all of a sudden people have stopped jumping and dancing for his every whim. The baby is not to blame. We began something we could not keep up, and he—the innocent recipient of all our indulgences—is in no sense at fault. It is most cruel to encourage these habits of petty indulgence, which must cause so much future disappointment and suffering on the part of the little fellow as he begins to grow up.

Nobody is particularly attracted to the spoiled baby. After the over-indulgent parent and caretaker have completed their thoughtless work, they themselves are ashamed of it and not infrequently begin to criticise the product of their own making—the formation of these unpleasant bad habits. More than anything else, the spoiled child needs a new environment, new parents, and a new life.

THE SPOILED BABY

Seek to find out if possible—and it usually is possible—just what he is crying for. It may be for the pacifier, for the light, or to be rocked, jolted, carried, taken up and rocked at night, or a host of other trifles; and if he is immediately hushed on getting his soul's desire—then we know he is "spoiled."

The unfortunate thing about it all is that the one who has indulged and spoiled the baby usually does not possess the requisite nerve, grit, and will power to carry out the necessary program for baby's cure. And the pity of it all is that overindulgence in babyhood so often means wrecked nerves and shattered happiness in later life. So, fond, indulgent parents, do your offspring the very great kindness to fight it out with them while they are young, even if it takes all summer, and thus spare them neurasthenia, hysteria, and a host of other evils in later life.

This sort of "spoiled baby crying" can be stopped only through stern discipline—simply let the baby "cry it out." The first lesson may require anywhere from thirty minutes to an hour and thirty minutes. The second lesson requires a much shorter time, and, in normal babies with a balanced nervous system, a third or fourth lesson is not usually required.

THE CRY OF SERIOUS ILLNESS

The cry of the severely sick child is the saddest cry of all. The low wail or moan strikes terror to the saddened mother-heart. It is often moaned out when the child is ill with "summer complaint" or other intestinal disturbances. Instant help must be secured, and, if medical help is not obtainable, remember, with but one or two exceptions, you are safe in carefully washing out the bowels, in applying external heat and giving warmed, boiled water to drink.

Another cry which demands immediate attention, and the faithful carrying out of the doctor's orders, is the hoarse, "throaty" cry indicative of croup or bronchitis.

THE COLICKY CRY

Perhaps the greatest cause of the most crying during infancy, next to that of over-indulgence, is ordinary colic which—

A colicky baby completely upsets the household and greatly disturbs the mother, who requires both quiet and rest that she may the better produce the life-sustaining stream so much needed for the upbuilding and development of the growing child.

COLIC IN THE BREAST-FED

While colic is so often seen in the bottle-fed babe, it often occurs in the breast-fed child, and is usually traceable to some error in the mother's diet or to some other maternal nutritional disturbance. One mother who was sure she had eaten nothing outside the diet suggestions she had received, was requested to bring to the office a fresh voiding of her own urine which was found to be highly acid. The administration of an alkaline such as simple baking soda or calcined magnesia to the mother, corrected this acidity, and the colic in the baby entirely disappeared. I recall the case of one mother who ate her dinner in the middle of the day, with a light meal in the evening and thereby stopped the colic in her babe.

Another source of colic in the breast-fed baby is the unclean nipple. The nipples should be washed with soap and water and rinsed in boracic acid solution before each nursing. If the mother worries greatly, or thoughtlessly "gets very angry" just before the nursing hour, there is a substance known as "epinephrin" secreted by the glands located just above the kidneys which is thrown into the blood stream and which raises the blood pressure of the mother and often produces not only colic in the babe, but many times throws him into severe convulsions.

COLIC IN BOTTLE-FED BABIES

There are many opportunities for colic in the bottle-fed baby; for instance, dirty bottles, dirty nipples, careless cleansing of utensils used in the preparation of baby's food, improper mixtures, too much flour, the wrong kind of sugar, too much cream or too little water—all these things help to produce wind under pressure in the intestine, which is commonly known as colic. Underfeeding or overfeeding, too rapid feeding or too frequent feeding also contribute their mite in producing colic.

As a rule, the bottle-fed child is fed too often. In the new born, the interval between feeds should be three hours from the start; after six months the interval may be lengthened to four hours.

COLIC AND CHILLINESS

Hiccough—a spasm of the diaphragm—often accompanies colic, and, in the case of infants, is usually due to the swallowing of air or over-filling the stomach; gentle massage, external heat, and a few sips of very warm water usually corrects the condition.

The chilling of the skin very often produces a temporary intestinal congestion with colic as the result. Cold feet, wet diapers, and loitering at bath are all very likely to produce colic; and when it is thus caused by chilling, quickly prepare a bath at 100 F., and after immersing the child for five minutes, wrap up well in warm blankets.

THE TREATMENT OF COLIC

Those of my mother readers who have electric lights in their home, will find the photophore to be a source of great comfort and convenience; for this simple contrivance is usually able to banish colic in a few moments. The photophore is simply radiant heat—heat plus light (See Fig. 3)—and as this heat is applied to legs and buttocks of the crying child the diaper is warmed, the abdomen relaxes, gas is expelled, intestinal contractions relieved, and the baby is soon fast asleep.

Occasionally with the aid of the photophore, and even without it, the warm two-ounce enema containing a level teaspoon of baking soda and a level teaspoon of salt to a pint of water when allowed to flow into the bowel, will soon bring down both gas and feces to the great relief of the baby. Warm water to drink is also very helpful. Putting the feet in very warm water is also quieting to the crying colicky babe.

It is often necessary in cases of repeated and persistent colic, Do not jolt or bounce the baby, do not carry him about, and don't walk the floor with him.

Heat him up inside and outside, warm his clothing and his bedding, and thus bring about relief without sowing seeds for future trouble—the sorrow of a spoiled child.

One very quiet little baby was one day brought to the dispensary whose mother said: "Doctor, I didn't bring him 'cause he's sick, but 'cause he looks so pale; he's as quiet as a mouse; he never cries any more since I got to giving him medicine." On examination of the baby and on inquiring about the medicine, we found that the baby was dead drunk all the time. Some "neighbor friend" had told the tired out mother, "Give him a teaspoon of whiskey at each feeding and that'll fix him all right." If a few more states go dry maybe it will not be so easy for the ignorant mother to dope and drug her helpless baby.

And neither is paregoric to be administered wholesale for colic. It contains an opiate, and should not be given without definite orders from a physician. And so as a parting word on "Why Babies Cry," we ask each mother to run over the following summary of the chapter, and thus seek to find out why her baby cries.

BABY CRIES BECAUSE: