The newborn baby comes into the world in an absolutely helpless condition and completely unconscious of his surroundings. He unconsciously performs certain acts, such as opening his eyes, crying, urination, movement of the bowels, and even nursing of the breast; but there is probably no distinct voluntary action connected with any of these acts. All of his senses at birth are practically dormant, but as the days and weeks go by, they begin to awaken.

SPECIAL SENSES

The baby cries, but the tears do not actually flow over the lids until he is three or four months old, and while the baby may fix his eyes upon objects and distinguish light from darkness, he will not wink nor blink when the finger is brought close to the eye. Vision is probably not complete until the beginning of the third month.

Infants are said to be deaf for the first twenty-four to forty-eight hours after birth, and some authorities hold that they are deaf for several days.

Taste is early developed, as a newborn baby will often repeatedly show a desire to taste sweet things, while if sour or bitter things are put to the tongue, it shows its displeasure.

HAIR AND SCALP

The newborn baby usually comes into the world with a good head of hair, but the end of the first or second week witnesses the falling out of much of this hair, and falling may continue for even another week or two. The hair is often worn off on the back of the head because of constant friction upon the pillow.

Children differ greatly in the growth of hair. Some of them come into the world with heavy hair, and others lose it quickly and remain nearly bald-headed until after the first year.

As the second hair grows in, it is usually lighter than it was at birth and lighter than it will be later in life, as the hair has a tendency to grow darker as the years go by.

The scalp should receive the care already mentioned. As the hair comes in it should be shampooed once in two weeks and brushed often, making it healthy and vigorous.

MISSHAPEN HEADS

It is wise to turn the baby first on one side and then on the other and not allow him to sleep night after night on one side of his head. The newborn head may be misshapen by laying the child constantly on one side, and the ear may be misshapen if it is allowed to curl under or become pressed forward. Markedly protruding ears may be partially corrected by having the child wear a well-ventilated cap made for the purpose.

THE SALIVA

Many mothers think that the presence of drooling or the excessive flow of saliva is associated with teeth cutting. While it may be associated with the teeth, this is not usually the case; it is more probably due to the beginning of a new function of secretion. The newborn baby has only enough saliva to furnish moisture for the mouth, and not until the age of four or five months does saliva really flow, and since the teeth appear a bit later we often confuse the institution of a new secretion with the oncoming teeth.

SENSATIONS AND RECOGNITION

The young baby manifests a number of sensations early in its career. Hunger and satisfaction as well as comfort and discomfort seem to be recognized by the little fellow. He early learns that the approach of someone when he cries usually means that he is to be taken up, and he usually ceases crying as soon as he is taken up. He early manifests a sense of comfort when he is cuddled; there also is early present a manifestation of the desire to sleep, and the satisfying pleasure of a drink of water.

At the age of three months he has recognized many things such as the light or a bright object. He distinctly recognizes his mother and often smiles at her approach. He recognizes his hands at four months, and now begins to recognize other members of the household aside from his mother. Even as early as one month, he may smile at his mother. At two months of age he will often smile at other members of the family. He laughs out loud or chuckles during the fourth or fifth month. But, on the whole, he must be considered as just a little animal whose greatest needs are to have his appetite and thirst satisfied, his little body clothed, and his little nerves put to rest—to sleep.

SITTING ALONE

At four months the normal baby will hold up his head; and if he is supported at the back with a pillow, he will sit erectly—holding his head up—at six months; while at eight months or not later than nine, the normal child should sit alone on the floor with no support. Later in the ninth month he often manifests a desire to bear his weight upon his feet. Care is here urged that the mother protect the little fellow at this time and not allow him to rest his weight upon his feet but a moment or two at a time.

He will reach for a ball suspended from the top of his carriage or bed as early as the fifth month. About this time he discovers his toes while in his bath. He will handle a rattle at six or seven months, and shows delight in such toys.

DENTITION

In both the upper and lower jawbones of the newborn infant there are hidden away in snug little cavities two sets of tiny teeth; the first set, or milk teeth, and the second set, or permanent teeth. These rudimentary teeth grow as the baby grows and push their way up or down from the jawbones until they finally make their appearance through the gums. The milk teeth appear in a definite way and in five definite groups.

There should be no physical disturbance at the appearance of the teeth, which is a physiological process, and it is to be deplored that all of the ills of babyhood are laid upon the teeth with the careless remark: "Oh, its his teeth!" Many, many illnesses are neglected because our inexperienced mother has been told that she can expect "anything to happen when the baby is cutting its teeth." Now, it is true that the babies of many families do have trouble in cutting their teeth, but the majority of babies cut their teeth comfortably and the first knowledge anyone has of it is the appearance of the tooth itself. As the teeth push their way nearer the surface of the gums, there is a broadening and a hardening of the gums themselves, and it is the exception rather than the rule that the baby needs any help in cutting his teeth.

Usually by the time the baby is seven months old it has two central teeth on the lower jaw (the central incisors), which constitute the first group. The second group of teeth to appear is the four upper central teeth which are all through by the time the baby is twelve months old, and are often through at ten months. Then there is a pause of from one to three months before the next teeth appear—the four anterior molars. As these four anterior molars come in, the two lateral incisors appear on the lower jaw, which now gives us, by the time the baby is fourteen or fifteen months old, four central teeth upper, four central teeth lower, and the four anterior molars, which make twelve teeth.

Another pause of two or three months and then we get the four canine, which fill in the space between the first molars and the front teeth. The canine on the upper jaw are commonly known as the eye teeth, while the canine teeth on the lower jaw are spoken of as the stomach teeth. This brings us to the age of eighteen to twenty-four months, when there is still another pause of two or three months, after which time the big teeth or the four posterior molars appear, which completes the first set of twenty teeth—the milk teeth. When baby is twenty months old the milk teeth are often all in. The complete set should appear not later than the thirtieth month.

During the life of the milk teeth the child should be taken to the dentist at least once a year, better once in six months, for all defective teeth must be properly and promptly cared for. Inexpensive but sanitary fillings should be placed in all decayed teeth, for the roots of the first teeth are very soft and infection readily spreads to the jaws and the permanent teeth and serious trouble often begins thus early.

If dentition is seriously delayed, investigation should be started concerning the general condition of the child, for this delay often accompanies ill health.

When the child is six years old, the mother should be watchful, for it is at this time that the first permanent teeth appear just behind the last molar of the milk teeth. They do not replace any of the teeth present, and many times they come through and decay without receiving any attention. It is seldom necessary to assist these milk teeth as they come through the gum, and should the gums become highly colored and swollen it is not wise to lance them, for if the teeth are not ready to come through immediately, the gum only toughens the more and makes the real cutting still more painful.

This is the time to cut down the baby's food as well as to look for other digestive disturbances, for the number of stools may increase and vomiting may occur, and by reducing the quantity and quality of the food and encouraging abundant water drinking, much trouble may be avoided. Under no circumstances urge the baby to eat when he refuses his food, when the gums seem swollen and red during the teething time. You will find that he will enjoy orange juice, pineapple juice, or prune juice. All of these digestive symptoms are simply the result of "feeling bad," and if heavy food of his regular feeding is greatly diminished he will get along much better than if fed his regular allowance of food.

APPEARANCE OF THE TEETH

The normal child has:

Six teeth at one year.
Twelve teeth at one and one-half years.
Sixteen teeth at two years.
Twenty teeth at two and one-half years.

When the child is six years old the first permanent tooth appears just back of the last of the milk teeth. By the time he is seven, the four central teeth, two above and two below, are out and the new ones begin to appear. The order of their appearances is as follows:

DENTAL SUGGESTIONS

A better plan than to lance swollen gums is to rub them gently with ice wrapped in a soft cloth, or to dip the finger in ice water and rub the gums—this often gives the baby much relief.

Often the baby finds comfort in biting on an ivory ring, but the utmost care must be used in keeping it clean and avoiding contamination by allowing it to drop on the floor.

Convulsions are never the symptoms of teething. Consult a physician at once, as such seizures probably spring from causes other than teething.

Cleansing of the teeth should be carried out systematically every morning by means of a piece of cotton which has been dipped in a boric-acid solution or a solution of bicarbonate of soda (common baking soda). A soft brush may be used for cleansing, and when there are particles of food between the teeth they should be removed by strands of waxed floss.

Throughout life, frequent visits should be made to the dentist; during early childhood days he should be on the lookout for symptoms which indicate deformity—narrow jaws and other conditions which affect the permanent teeth. During adolescence and adult life the teeth should be examined every six months and cleansings of the mouth should become a part of the daily toilet.

THE WEIGHT

During the first year, nothing gives us so much information concerning the child's general well-being as the weight. Such a record will not only enlighten the mother concerning the development of the child, but the grown-up child appreciates the record and preserves it along with the other archives of babyhood days. Every Sunday morning, when the father is at home, the baby should be weighed and an accurate record kept. It is important that the baby be weighed each time in the same garments—shirt, band, diaper, and stockings—for every ounce must be accounted for.

Until the baby is five or six months old he should gain from four to eight ounces a week. Anything short of this is not enough and should be reported to the physician. After six months the gain is about a pound each month. This varies somewhat; possibly during the tenth and eleventh month the gain is lessened, but by the close of the first year the baby should have trebled its birth weight.

Dr. Griffith gives us the following very interesting bit of information concerning the weight of boys and girls after the first year, and to him also belongs the credit for the accompanying table showing the growth, height, and weight of the child up to sixteen years of age.

GENERAL DEVELOPMENT

The accompanying illustration (Fig. 14), taken from Dr. Yale, represents the developmental changes at one, five, nine, thirteen, seventeen, and twenty-one years. Each figure is divided into four equal parts, and as we watch the development from the baby who at one year, as Dr. Yale says, is four heads high, at the age of twenty-one the legs and the trunk have much outgrown the growth of the head, so that at this age the head is only two-thirteenths or less of the whole length of the body. The legs have grown more rapidly and equal one-half the entire body length. The trunk has not kept pace with the legs, for as you will see from the diagram the line reaches the navel of the child in one year, while in the adult it is much lower. The rapid growth of the legs is accomplished after nine years of age.

The proportions of the head, chest, and abdomen are exceedingly important in the growing child. At the end of the first year the head, chest, and abdomen are about uniform in circumference. The head may measure one-fourth of an inch more, but the chest and abdomen should both measure eighteen inches in circumference at this time. Should the head or the abdomen be two inches larger than the chest; the attention of the physician should be called to it, for either are indicative of conditions that should be carefully investigated.

NORMAL BREAST WEANING

As a general rule the normal, healthy, breast-fed baby is given a feeding of a bottle each day after he is ten months old. These bottles are increased in number until, by the time the baby is a year old, he is gradually weaned from the breast. Should the ninth month of baby's life arrive in the hot summer months we urge the mothers to continue breast feeding, with possibly the addition of some fruit juices, as noted elsewhere, until early autumn. Under no circumstances should the baby be weaned and compelled to use cow's milk during the season of the year when the risks of contamination are greatest. If the baby is nursed up to the close of his first year he hardly need be trained to use the bottle, but may take his food from a cup. From one to two months should always be consumed in weaning the baby, unless sudden weaning is necessitated by ill health, as noted elsewhere. The baby should have, if possible, from thirty to forty days to accustom himself to cow's milk exclusively.

If the child is weaned slowly there should be no trouble with the breasts, but in the instance of sudden weaning the mother should restrict her liquids, put on a tight breast binder, and for a day or two should take a dose of a saline cathartic, which will assist in taking care of the liquids and thus decrease the secretion of milk.

NORMAL BOTTLE WEANING

If the bottle food is agreeing with the baby he should be allowed to use it up to the end of the first year when he will be given whole milk with possibly the addition of a little lime water. We see no reason why the child should give up his bottle during the second year unless other food is refused—unless he will not accept other food than from his bottle—and if you are convinced that he has formed the "bottle habit," then the milk should be put into a tiny cup or glass, and he should learn to sip it along with his solid foods; but if he takes his other foods without any hesitancy, then we know no reason why he should not take his milk in this comfortable manner from his bottle at least two or three feedings each day.

If you desire to wean him from his bottle, serve the first part of it with a spoon from a cup or glass and then give him the remainder in the bottle. The beautiful picture of a big, robust baby lying on his back, knees flexed, both hands holding his beloved bottle still lingers in my mind as one of the pleasant memories of my lad's babyhood days, and at the close of the second year, when the beloved bottle was left behind, I believe I missed something as well as did the lad.

I recall no difficulty with his taking the food from a cup. The success of all normal weanings is due entirely to the fact that it is done gradually and slowly, and under no circumstances should it be roughly and abruptly attempted—particularly in case of the bottle feeding.

TRAINING THE BOWELS AND BLADDER

Reference is made to this subject in another part of this book—where we went into the detail of keeping the daily record of these physiological occurrences—and it was found that the bowels moved and the bladder was emptied at about the same time each day. Any mother, caretaker, or nurse, who will take the time to keep a daily record of the hours of defecation and urination, will observe the time carefully and will catch the child on nearly every occasion before an accident occurs. Often as early as four months the bowels will move in an infant's chamber at regular times each day. The nurse or mother places this receptacle in her lap and holds the child gently and carefully upon it. A little later it can be made to sit on a special chair prepared for the purpose, and at eight or nine months by careful training the urination can be controlled, and by the end of the first year the diapers ought to be discontinued.

If the child has not learned to control the bladder by the age of two years, medical attention should be called to the fact and remedial measures instituted.

BABY'S SPEECH

The baby should begin to talk at one year. He early learns to say "mamma" and "papa," and gradually adds nouns to his vocabulary, so that at eighteen months the normal child should have a vocabulary of one hundred to one hundred and fifty words. As he nears the two-year mark, he has acquired a few simple verbs and he can possibly put three words together, such as, "Willie wants drink." Pronouns come in late, as we all recall that the young child usually speaks of himself by his own name.

Children are born mimics. If you talk baby talk to them, they will talk baby talk back. For instance, a well known author told us just the other day that for many years no other name was given to the sewing machine in his house but the word "mafinge," and not until he went to school did he correct the word "bewhind," for in the nursery he learned the line "wagging their tails bewhind them." Baby talk is very cunning, and often the adult members of the family pick it up and keep it up for years, and only when they are exposed in public, as one mother was on a suburban platform by her four-year-old lad shouting, "Mamma, too-too tain tumin, too-too tain tumin," do they sense their responsibility and realize how difficult it is to form new habits. This poor mother tried in vain to have her little fellow say, as did another little lad two and one-half years old, "Mother, the train's coming; let's get on."

Many words of our beloved language at best are hard to understand; so let us speak correct English to the little folks and they will reward us by speaking good English in return.

If at two years the child makes no attempt at speech, suspicions should be aroused concerning mutism or other serious nervous defects. Medical advice should be sought.

DEFECTIVE SPEECH

All guttural tones which may be occasioned by adenoids or enlarged tonsils, all lisping, stuttering, or defective speech of all words should be taken in hand at the very start, as they are usually overcome by constant repetition of the correct manner of speaking the particular word in question. Children of defective speech need special training, and should in no way be allowed rapidly to repeat little nursery rhymes, as oftentimes this rapid repetition of rhymes by a child with hereditary nervous defects may occasion stuttering or stammering later on.

CALISTHENICS

Special exercise should not be forced upon young children. Physical culture, along with many other things intended for sedentary adults, should never be forced upon little folks who get all of the exercise they need in the many journeys they take building their blocks, sailing their boats, tearing down imaginary houses, making imaginary journeys—from morning until night the little feet are kept busy—never stopping until the sandman comes at sleepy time. Do not yourself attempt to stimulate a child who seems backward. Consult your physician. You had much better put a child out to grow up in the yard by himself with his sandpile than to force calisthenics or advance physical training upon him.

BOW LEGS AND WALKING

Do not attempt to hasten nature in aiding the child to walk. Let him creep, roll, slide, or even hunch along the floor—wait until he pulls himself to his feet and gradually acquires the art of standing alone. If he is overpersuaded to take "those cute little steps" it may result in bow legs, and then—pity on him when he grows up. Sometimes flat foot is the result of early urging the child to rest the weight of the body upon the undeveloped arch. A defect in the gait or a pigeon toe is hard to bear later on in life. A certain amount of pigeon-toeing is natural and normal. If the baby is heavy he will not attempt to walk at twelve months. He will very likely wait until fourteen or fifteen months. The lighter-weight children sometimes walk as early as eleven months, but they should all be walking at eighteen months, and if not, it is usually indicative of backward mentality.

If the training of the bowels and bladder will replace the diapers with drawers, the baby will attempt to walk sooner than when encumbered with a bunglesome bunch of diaper between the thighs. The little fellow runs alone at sixteen months and thoroughly enjoys it, and the wise mother will pay no attention to the small bumps which are going to come plentifully at this particular time.

SUMMARY OF BABY'S DEVELOPMENT

He discovers his hands at three or four months. At six months he sits alone, plays with simple objects, grasps for objects, and laughs aloud from the third to the fifth month. He says "goo goo" at four or five months. At one year he should stand with support, listen to a watch tick, follow moving objects, know his mother, play little games, such as rolling a ball, should have trebled his birth weight, and have at least six teeth, and should use three words in short sentences. At eighteen months he should say "mamma" spontaneously, walk and run without support, should have quite a vocabulary, should be able to perform small errands like "pick up the book," and should have twelve to sixteen teeth. At two years he should be interested in pictures, able to talk intelligently, and know where his eyes, nose, mouth, hands, and feet are. At three years, he should enumerate the objects in a picture, tell his surname, and repeat a sentence with six words.

In the case of a premature baby or a very delicate child, or as a result of a prolonged illness or a very severe sickness, such as spinal meningitis, the time of these mental and physical developments may all be postponed, while rickets, which will be spoken of later, is often the cause of late sitting, late standing, and late walking.

DIET AFTER THE FIRST YEAR

Milk is the principal article of diet during the second year. It should be given with regularity at distinct intervals of four meals a day. It may be given from the nursing bottle, unless the child has acquired the bottle habit and refuses to eat anything else but the food from his bottle, in which case it should be given from a cup. Beginning with the sixth month, aside from his milk, be it breast milk or bottle milk, he is to be given orange juice once each day as well as the broth from spinach and other vegetables. This is necessary to give the child certain salts which are exceedingly essential to the bottle baby.

At the close of the year when he is taking whole milk he should be given arrowroot cracker, strained apple sauce, prune pulp, fig pulp, mashed ripe banana (mashed with a knife), a baked potato with sauce or gravy (avoiding condiments), and a coddled egg. Fruit juices may be added to the diet, such as grape, pineapple, peach, and pear juice. Later in the second year he may be given stale bread and butter, and for desserts he may have cup custard, slightly sweetened junket, and such fruit desserts as baked apple and baked pear.

We do not think it is necessary to give children much meat or meat juices. We appreciate that there is a diversity of opinion upon this subject, but we do not hesitate to say that in the families where meat is little used, the children seem to grow up in the normal manner with sound healthy bodies, sometimes having never tasted it. When meat is used, it should be well cooked to avoid contamination with such parasites as tapeworm and trichina; it should also be well chewed before swallowing, as many of the intestinal disturbances of the older children are due to the swallowing of unmasticated food such as half-chewed banana, chunks of meat, rinds of fruit, and the skins of baked potatoes.

Let the children's diet be simply planned, well cooked, thoroughly masticated, and above all things have regular meal hours, and no "piecing" between meals; and if the mother begins thus early with her little fellow, she will be rewarded some later day by hearing him say to some well-meaning neighbor, who has just given him a delicious cookie or a bit of candy: "Thank you, I will keep it until meal time." Children learn one of the greatest lessons of self control in following the teaching that nothing should pass the lips between meals but water or a fruit-ade. Children in the second year require four meals a day, one of which is usually only the bottle or a cup of milk. These meals are usually taken at six, ten, two, and six in the evening. Oftentimes this early six o'clock meal is just a bottle or cup of milk, as may also be the evening meal.

CANDY

Now, a word about candy. Pure candy is wholesome and nourishing. It is high in calorific value, and children should be allowed to have it if it does not enter the stomach in solutions stronger than ten or fifteen per cent. We can see at a glance that chocolate creams, bonbons, and other soft candies should never be given to children. Candies that they can suck, such as fruit tablets, stick candy, sunshine candy, and other hard confections that are pure, and free from mineral colorings and other concoctions such as are commonly used in the cheaper candies, may safely be given at the close of the meals—but never between meals.

All such articles as tea, coffee, beer, soft candies, condiments, pastries, and fried foods, should be positively avoided in the case of all children under five and six years of age.

The diet from now on will be considered in the chapter "Diet and Nutrition."