From earliest girlhood, women have loved their dolls, and one of the greatest joys connected with the adored experience was the make-believe bath and the dressing of the make-believe baby; so now, when we are the happy possessors of real live dolls, we should go about the task with the same lightheartedness of a score of years ago when we hugged, kissed, bathed, and dressed our dolls. There is one big advantage now, the doll won't break; but, we sigh as we stop to think, we can't stick pins into it as we all did into the sawdust bodies of our dolls those years and years ago.

THE FIRST WEEK

In the chapter on "Baby's Early Care," this subject was fully discussed and we only wish to repeat, in passing, that before baby's bath or toilet is undertaken the hands of the mother, nurse, or caretaker must be scrupulously clean. And while the first day's bath usually consists of sweet oil, albolene, or benzoated lard, if the new baby happens to come during the very warm days of July or August and the oil seems to irritate the soft downy skin, as it often does during those hot days, a simple sponge bath may be substituted. The cord dressing remains as the doctor left it, and if there be any interference, let it be subject to his orders.

The cord usually drops off, and the abdomen is entirely healed by the seventh to the tenth day, after which time baby is daily sponged for another week. And now we will describe in detail the simplest, easiest manner of administering an oil bath or a sponge bath.

GIVING THE BATH

A large pillow or a folded soft comfort is placed on a table in a warm room—temperature not below 75 F. On baby's tray near by, and within reaching distance, are the boracic acid solution in a small cup, a medicine dropper, the warm saucer of oil, the toothpick applicators (made by twisting cotton about one end, making sure the sharp end of the pick is well protected), a glass jar of small cotton balls made from sterile absorbent cotton, the castile soap, talcum powder, needle and thread. A vessel of warm water, several old, soft, warmed towels and the clean garments required, complete the layout.

Into the warm, soft blanket on the pillow or comfort we place the partially undressed baby, for the binder, diaper, and socks are not removed until the head-and-face toilet is completed.

The top of the head, behind the ears, the folds of the neck, and the armpits are now gently but thoroughly rubbed with oil, which is then all rubbed off with a soft linen towel. The eyes next receive two or three drops of the boracic acid solution, put in by the aid of the medicine dropper, while, with a separate piece of cotton, the surplus solution is wiped off each eye, rubbing from the nose outward.

Then with the applicator made by wrapping cotton about the end of a toothpick, oil is put into each nostril, all the time exercising the utmost care not to harm the tender mucous membrane. The ears are also carefully cleansed with a squeezed-out dip of boracic acid on the applicator.

Unless there is an inflammation present in the mouth, and the physician in attendance has ordered mouth swabbing, do not touch it; for much harm is done the mucous membrane of the baby's mouth by the forceful manner in which much of the swabbing is done. The face and head are then washed with warm water; very little soap is needed and, when used, must be most thoroughly rinsed off.

THE SECOND WEEK

And now during the second week, we proceed to sponge the baby's body; the hands are washed with soap and rinsed, and, only those who have performed this feat know just how tightly they hold shut their little fists. These hands must be relaxed, and all the lint, dirt, and perspiration be thoroughly washed away. The arms, shoulders, chest, and back are then sponged. All the time the nurse or caretaker is standing while carrying out this most pleasant task. At any time she may quickly cover the babe and stop for this or that with no inconvenience to herself or the child.

After the thorough drying of baby's upper body, a bit of talcum is put under the arms, in the folds of neck, etc., and the shirt is slipped on. Next the band, diaper, and stockings are removed and after first oiling the groin and the folds of the thighs and the buttocks, the same sponging, drying, and powdering is done here as on the upper body.

The band is now applied, and sewed on. The diaper, stockings, booties, and—if a winter baby—the skirt and outing flannel gown (for babies should wear only night dresses for the first two or three weeks) are now slipped over the feet and drawn upward, and baby is ready for nursing or for his nap.

TEMPERATURE OF BATHS

First few weeks, 100 F.; early infancy, 98 F.; after six months, 97 F., cooling down to 90 F.

A wooden bath thermometer may be purchased for twenty-five cents and it should be in every home where babies are bathed. In the absence of a thermometer do not depend upon the hand to determine temperature. Thrust the bared elbow into the water and if it is just comfortable—neither hot or cool—it is probably about the correct temperature for baby. Do not shock the baby by dashes of cold water, for, while it may amuse an onlooker, it unnecessarily frightens your child, and, subconsciously, he learns to dread his bath.

THE BATHING PLACE

If the bathroom is warm—temperature 75 F.—that is the most logical place for the bath, provided baby has his own tub. Place a couple of strong slats several inches wide across the big tub, six inches apart, and on this place the baby's tub. Of course, care must be exercised to prevent slipping by means of properly fitted cleats on the under surface of the slats. The mother should always stand to bathe her baby and the small tub should be placed at such a height that she neither has to stoop nor bend. Thus the bathing of the baby becomes a pleasure instead of a "job" or an "irksome task."

If the bathroom is not warm then the kitchen table or a small table pulled up near the stove is a place par excellence for the dip.

Many boils seen on young baby's tender skin have been traced to the careless use of the family tub to bathe the baby in. Not until the child is two or three years of age, when his skin has become more toughened, should he be allowed to use the family tub.

FREQUENCY OF BATHS

To begin with, we never bathe either a baby or an adult immediately after a full meal. From one hour to one and one half hours should intervene.

The frequency of baths depends somewhat upon the season of the year, the vitality of the child, and the warmth of the home.

We have seen many infants who were bathed too often. The vitality expended upon the necessary reaction following a tub bath was too much for the little fellow; the daily bath was stopped and a semi-weekly bath substituted, much to the gain of the child. Of course in this instance the hands, face, and buttocks received a daily sponging.

The oil bath may be administered daily. In robust children the tub bath may be a daily affair; while in pale, anemic little folks, the tub bath is perhaps better given twice a week. In hot summer days a sponge bath may be given many times a day.

BEST HOUR FOR BATHING

Again this depends upon several factors; the warmth of the house or apartment, the vitality of the child, and the kind of bath to be administered.

An oil bath may be given any time—often it may be administered entirely under the bed clothes, only care must be taken to keep oil from the blankets.

Many of our mothers prefer to give the tub bath at five o'clock in the afternoon, when the house is thoroughly warm, and the child is thereby prepared for the long night's sleep. Before dressing in the morning an oil bath or rub may be given in such cases.

If the forenoon is selected as the time for bathing the child, then an hour just before the mid forenoon meal is the best. In either event, be regular about it—do it at the same time every day. Let the caretaker attend to her many duties, and, as far as possible, mothers, bathe your baby yourself. The folds of the skin, the creases in the neck, the clenched fists, must all receive particular care, and no one in all the world will ever care as you—the mother—cares.

SOAP AND WATER

Select a soap free from irritants and excess of alkalis. There are few kinds that equal the old-fashioned, white castile soap our grandmothers used.

Very hard water which makes the skin rough and sore may be improved by boiling, but if possible substitute rain water for it. A flannel bag tied over the faucet and changed each day will help to clarify muddy water, provided the stream flows gently through it.

ROUTINE OF THE TUB BATH

Just as we directed the nurse or caretaker to stand while the oil rub or sponge bath was given, so we admonish the mother to stand while the tub bath is given. First, get everything in readiness for the bath as directed for the oil bath, and then the baby's tub setting on the securely cleated slats placed across the top of the family tub may be filled with water by means of a hose attached to the faucet. The temperature should be 100 F. when baby is dipped in to be rinsed.

The head and face toilet are identical with that described before, and with the baby undressed and wrapped in a warm towel placed inside the warm blanket on the pillow or comfort as before mentioned, we proceed with a good lather of castile soap and water to lather the baby's body all over—under the arms, the neck, chest, groins, thighs, buttocks, legs, feet, and between the toes, while the genitals also receive their share of attention. The foreskin of the boy baby is gently pushed back and cleansed thoroughly; while the vulva of the little girl baby, having first been swabbed with boracic acid, is now gently lathered and cleansed. Now grasp the ankles and legs with the right hand and support the upper back and neck and shoulders with the left and gently lower the baby into the water in a semi-reclining position (See Fig. 13). The water should cover the shoulders. Keep a good firm supporting left hand under the head, neck, and shoulders, and with the right, rinse all soap from the body.

After this is thoroughly done, lift the baby out onto a fresh warm towel inside the warm blanket on the pillow, and remain standing, while you gently pat (never rub) the baby dry. All the little folds, creases, and places between fingers and toes, are carefully patted dry, and where any two skin surfaces rub together put on a bit of talcum.

The dressing takes place in the manner already described—first the shirt, then the band (sewed on), the diaper, stockings, skirt, and gown.

Please note that the soap bath is contra-indicated (should not be given) in case of eczema.

BABY'S DAILY RUB

This soap bath should be administered for cleanliness only, and should be given twice a week. If a tub bath is to be given on other days, after the routine head and face toilet, the baby is simply dipped into the water and the soft skin gently rubbed.

If the sponge or tub bath is given in the afternoon just before the long sleep at night, then the oil rub should take place before the mid-forenoon meal; and likewise, if the sponge or tub bath is given during the mid forenoon, then the oil rub or dry hand rub is given before the going-to-bed time. The rub should be a daily procedure for the first two years. Nothing rougher than the soft palm of the hand should be rubbed on baby's soft skin.

USE AND ABUSE OF TALCUM

Babies have come to my clinic with cakes of talcum under their arms, and particularly between their thighs and in the crease of the buttocks. Here the well-meaning but thoughtless mother had reasoned, "a little is good; more is better" which is not always the case.

Talcum is not used to replace careful drying, and it should never be found in quantities on the baby's skin any more than you would expect to find quantities of face powder caked in the creases of the neck or behind the ears of an adult. The skin is first cleaned, then patted entirely dry, and, as a finishing touch, a bit of talcum is put on by means of a puff.

TONIC AND MEDICATED BATHS

Tonic baths are usually given to older children when they are able to enter into the sport and frolic of a cool bath. Baths are called tonic because they call forth from the body a reaction—a sort of circulatory rebound. This rebound or reaction brings the blood to the skin, increases the circulation, and tones up the nerves. The room should be properly warmed and, if necessary, some form of exercise be continued after the bath to prevent the chill that sometimes follows a poorly administered bath.

In the case of the anemic child, after six months of age, the mother's hand dipped in cold water may briskly rub the chest and back until it glows or becomes red. The child should enjoy this bath. Never frighten a child by throwing cold water on it or by giving it a too sudden cold plunge; great harm may be permanently done by these efforts to "toughen the baby."

The simple medicated baths may be administered according to the following directions:

Salt. Use half a teacup of common salt or sea salt to each gallon of water. The salt should first be dissolved in a cup of warm water to prevent the sharp particles from pricking the skin. The doctor sometimes orders a salt bath.

Starch. Add a cup of ordinary, cooked laundry starch for every gallon of water in the bath.

Soda. A soda bath requires two tablespoons of ordinary baking soda to a gallon of water, dissolving it in a little water before adding it to the bath.

Bran. Make a cotton bag of cheesecloth or other thin material, six inches square. Fill loosely with bran. Soak the bag in the bath water, squeezing it frequently until the water becomes milky.

Starch, soda, and bran baths are often used in place of the ordinary soap and water bath when the skin is inflamed, as in cases of chafing or prickly heat.

FEAR OF BATHS

Force and harshness are not likely to cause baby to overcome very much of the fear of a tub bath. Patience, perseverance, and purposeful diversion of mind will bring sure results.

In the case of a very young baby, have a helper stretch a towel across the filled baby tub, lay the baby in it, with its head well supported, and then gently lower the towel into the water, keeping the head out. (Most anyone would fear an all-over ducking, if he had ever been completely ducked into water by a careless or mischievous friend).

In the case of older children, celluloid ducks, fish, or boats may float about on the water, and the entire bath be forgotten by the little fellow's enjoyment of "his boats."

OUT OF DOOR BATHING

Although a baby under two years should never be given a sea bath, a word of caution about sea bathing for young children may not be amiss. The cruelty with which well-meaning parents treat young, tender children by forcibly dragging them into the surf, a practice which may be seen at any seaside resort in the summer, can have no justification. The fright and shock that a sensitive child is thus subjected to is more than sufficient to undo any conceivable good resulting from the plunge. On the other hand, a child who is allowed to play on the warm sand and becomes accustomed to the water slowly and naturally will soon learn to take delight in the buffeting of the smaller waves, but he should not be permitted to remain more than a minute or two in the water, and should be thoroughly dried, dressed immediately, and not left to run about the beach in wet clothing.

MILK CRUST

Any roughness on the scalp must receive immediate attention. This roughness, or milk crust, is entirely avoidable; it is the result of accumulated oil and dirt. When it has formed a complete crust or cake, it may quickly become eczematous and require a physician's advice; however, in the beginning, at the first sight of brown patches or roughness, oil the scalp thoroughly at night with vaseline or cold cream, which should be gently rubbed off in the morning.

This vaseline or cold cream should be applied repeatedly, several nights in succession, followed by the morning's gentle rubbing and daily washing of the head. Often the washing with water must be entirely avoided; only sweet oil or vaseline being used in those cases where the crusting seems to be persistent.

THE EYES, EARS, AND NOSE

At birth the eyes are particularly cared for. First, the mucus is gently swabbed off the closed lids from the nose side outward, and then follows the application of one drop of twenty per cent argyrol or two per cent silver nitrate, either of which thoroughly disinfects the eye and prevents the growth or development of any bacteria that may have gotten into the child's eye during the descent of the head through the birth canal. The neglect of this procedure may sometimes result in lifelong blindness.

Under no circumstances should "a mere cold in the eyes" be neglected; it may result in blindness. Call your physician at once, and if he is not at hand, wash out the eye thoroughly every hour with warmed ten per cent boracic acid solution, by means of a medicine dropper, using a separate piece of cotton for each eye, for if the slightest bit of discharge be carried from one eye to the other an inflammation will quickly appear.

From birth, especially during the first week, baby's eyes are very sensitive to light; hence they must be carefully protected. Babies should be so placed during their outings, sleep, or naps, that they do not directly gaze at either the sunlight or sky. The lining of the hood of the carriage should be green, instead of white, as much eye strain is thus prevented.

The daily care of the normal, well eye has been already described, and while it need not be reiterated, we may say, in passing, that if the eyelid be at all inclined to be sticky or adherent, never use force, but instead, gently swab with boracic acid. As a preventive of this condition, a little vaseline from the tube may be rubbed on the edges of the lids at night.

In the toilet of the ears, never attempt to introduce anything beyond the external ear, which may be carefully cleansed with a soft cloth. It is often found necessary to apply oil to the creases behind the ears before the daily bath. There should be no irritation, redness, or roughness present, all such conditions being readily prevented by the use of oil or vaseline before the bath.

With the sharp point removed, make a cotton applicator out of a toothpick, and gently (with no force, whatever) introduce vaseline or oil into the nose. This should be a part of baby's daily toilet. Any stoppage of mucus or snuffiness in the nose should be reported at once to baby's physician. Young babies often have adenoids.

CARE OF THE MOUTH

Leave the well mouth alone until the teeth appear, and then keep the teeth very clean (allowing no particles of milk to accumulate at their bases) with a soft bit of cotton and gentle rubbing. When a child attains the age of two, he should have his own toothbrush; previous to this time all food particles should be removed from between the teeth with waxed silk floss. All decay should be promptly attended to by a competent dentist.

Thrush and ulcers are often caused, not prevented, by the frequent wiping out of baby's tender mouth. The treatment of thrush and other mouth infections will be considered in a later chapter, "The Common Disorders of Infancy."

THE CARE OF THE GENITAL ORGANS

Before the bath, the baby girl's genitals are carefully swabbed between all the folds with boracic acid solution. The foreskin of the boy baby should be pushed well back and washed gently with water. If the foreskin of the male child be long, tight, or adherent, circumcision is advised. See our chapter, "Teaching Truth."

The genitals of both the boy and girl should be kept scrupulously clean every day, with as little handling as possible, and, upon the appearance of the least swelling, discharge, or even redness, the physician's attention should be at once called to it. In a later chapter, the subject of irregularities of sex habits will be taken up.

CARE OF THE BUTTOCKS

Often, because of irritating bowel movements, the buttocks become reddened, chafed, and sometimes raw in places. Some poor little babies are sometimes roughly rubbed—scoured on the buttocks—much like the kitchen sink, many times a day, and it is not surprising that they become reddened, chafed, and very much inflamed.

The buttocks require a gentle swabbing and thoroughgoing "patting dry" after each soiling or wetting of the diaper, but no soap is required in this region but once a day, and even then it should be used sparingly.

When the buttocks are inflamed, after a good cleansing with water and a thorough drying, vaseline or zinc ointment should be applied on a piece of sterile cotton, and this application should be repeated after each changing of the diaper. Wet diapers should be removed at once, for the acidity of the urine causes more chafing. A dusting powder composed of starch two parts, and boracic acid one part, may be dusted on after a cleansing with oil.

Great care should be exercised in the thorough daily rinsing of the diapers as well as in the tri-weekly boil in the laundry. White soap only should be used in their cleansings; no washing sodas or other powders should be used.

OTHER SPECIAL CARE

Under the arms and in the creases of the neck the skin sometimes becomes irritated because of neglect. To prevent such chafing the following program should be carefully carried out:

1. Not too much soap—and no strong soap.
2. Careful rinsing of the skin area.
3. Avoid harsh rubbing, but thoroughly dry.
4. The use of talcum powder in all folds of the skin.

With a fine camel's hair brush the hair should receive its brushing after the cleansing of the scalp. Combs are for just one purpose and that is to part the hair. The brush should be used to do all the smoothing.

While the frequent trimming of the hair has no marked effect upon its growth, yet the comfort the little girls enjoy, especially during the warm-weather months, should not be denied them.

And certainly the boy should become a boy when he puts on trousers and not be made the laughing stock of his mirthful companions just because his "beautiful long curls are much admired by the mother and his aunts."

The finger nails should be trimmed round with the scissors, while all hangnails are properly cared for every day. Toe nails should be cut straight across and the corners never rounded off. Many ingrowing nails may be thus avoided.