MANAGEMENT OF THE TWO CLASSES.
These two extreme classes of children will differ considerably in their hygienic management.
The Acid Child.–A child that weighs at birth less than seven pounds, or even less than eight, should be placed in the acid list and managed accordingly. It should be remembered that the skin is delicate and thin. The sensory nerves are near the surface and can be irritated by washing by handling and by rough clothing. The skin undergoes at birth an injection of blood. This hyperaemia is necessary to change this surface from a mucous membrane to a thick epidermis. That explains the yellow color that succeeds to the hyperaemic injection. If irritated by soap a true inflammation may follow, giving rise to high fever, stupor and sometimes convulsions. The best bath is, as already indicated, an inunction with oil or lard, that has no salt in it. The oil should be sweet. This will help Nature to put a coat of fat under the skin and cover up the sensitive peripheral nerves.
Feeling is the first wide-awake sense in the newborn.
The subsequent baths will depend upon the age and development of the infant. If very feeble and acid, the oil baths will be best for some time. There may be used warm water with milk in it, with a little salt added. The bath should be warm and then the child wrapped in a soft towel and not rubbed. The delicate skin may be soon irritated by friction. Handle this acid child as little as possible. If it is deficient in animal heat–have cold hands and feet–it should be held in the lap, with the back to the nurse. Remember that the spine of these thin acid babies lacks blood. If the spinal nerve centres are not supplied the functions of the organs in front will not be performed in a proper manner and the child will soon struggle with colic and defective aeration of blood.
The first clothing should be soft and easily taken off and on. In a case of triplets born at the eighth month they were wrapped in cotton and kept near the fire for weeks, or held in the capacious lap of willing old ladies. All of the baby’s clothes should tie and cross in front. The old style of long bands and many garments should be superseded by a flannel night dress and diaper–after the navel heals. The child should be put in bed or crib with plenty beneath so as to keep it warm, and plenty above for the same purpose. The face should be more or less exposed, depending upon the weather. Fresh air breathed aids in warming the body.
The less these acid babies and children are dandled and handled the better. They will be restless enough when awake. The chief trouble is to get them to sleep sufficiently the 22-23 hours out of 24. They are usually hard to manage for the first three months. They must be trained to be regular. This training should be begun before birth. The mother should not encourage wakefulness in herself nor children. The warm bath in the morning usually makes them drowsy, unless the mother or nurse foolishly excites them by rough or reckless handling. It may be better to feed this child before nursing. If possible, wrap it in a blanket and put it to bed to sleep for two hours after the bath, and then it can be dressed and fed and ready for another nap. It should be fed regularly, once in two, not more than once in three hours, and made to go all night without food, except perhaps once. Nervous acid children can not, should not, have to assimilate large quantities of food at a time, but should not be fed too often nor too much at once. The stomach becomes dilated and that leads to permanent acidity. A dandled, frightened child opens its mouth like a young robin. The nurse or mother is supposed to furnish the brains and control the situation for the best interests of the child. The habits and care for the first three months decide the child for rapid or tardy development. The idea should be to make it alkaline. If at birth it weighs 8 pounds the gain should be about 1/2 pound a week, in 6 months to 16-20 pounds, in one year to 24-30 pounds, in 18 months to 28- 36 pounds, in 2 years to 32 pounds minimum, 3 years to 36 1/2 pounds, 4 years to 41 pounds, 5 years to 45 pounds, 6 years to 49 pounds. If it is of a nervous temperament it will be difficult to keep up to these figures.
Alkaline. The child that weighs above 9 pounds may be looked upon as alkaline, and will grow more and more gross if treated as indicated for the underling whose tendency is towards acidity. The first bath may be oil for this fleshy child. The skin is thicker and the nerves are covered with fat, so that handling does not irritate this child as it does the thin baby. It is a different piece of crockery. The water may be cooler and it can stand friction. This alkaline child tends to be stupid and sleepy. The mother should understand this. They are great eaters, and the more fleshy they become the more warmth they crave. They will want to be on the arm and nurse all night and be carried on the arm all day. The warmth of the arm to the spine stimulates digestion inordinately. It grows heavier as it approaches its ninth month, but shows no signs of wanting to walk. It is so heavy that all are afraid it will become “bow- legged”; and it will if not properly managed. Fortunately it wants to eat so that it can be weaned early. Now and before it should be put on the floor on a quilt so that it can learn to use its muscles, roll and creep. It may now be given a cool bath; but this child should not be “soaked” every day (or twice a day as may be done with the thin acid baby with advantage); twice r thrice a week may be sufficient, except soiled parts as face, hands, legs, etc. Cold water can be given both babies, but the fleshy child can take it cold. This will be good for the gastric catarrh that these fleshy babies suffer with.
The clothing should be comfortable. Remember that the infant’s stomach varies by two or three inches before and after meals, so that the clothing should be loose at all times. This child can go out earlier and be benefited thereby even in the coldest of weather. The acid baby is a delicate plant that cannot bear such exposure. Remember acid and cold are the infant destroyers.
This child, tending to grow more and more gross, can be exercised severely and freely. A frolic usually tires it so that it sleeps longer. Massage may be given in twice a day to develop the muscles, especially of the back, and to make it straight and strong. The child may be placed across the knees of the nurse and its back rubbed vigorously. If it kicks and squirms the muscles of the whole body will be strengthened and the fat lessened. This child should be taught early to go three h ours between the times of feeding and to sleep all night with only a drink of water at about midnight. These alkaline babies and children are “so good” that the nurses and mothers are apt to indulge them to their future detriment.
Editor of The United States Medical Investigator. Member of the Chicago Paedological Society. First President of the American Paedological Society Author of: Diseases of infants and children, with their homoeopathic treatment. Published 1878 and Hand book on the diseases of the heart and their homeopathic treatment. by Thomas C. Duncan, M.D. Published 1898