Book IX.



Important.—The proper management of children is the most important subject that can be brought to the consideration of a parent, and yet it is one that has been greatly neglected. Mothers undertake the management of children without previous instruction, thinking it can be learned by instinct, or by affection. The consequence is they find themselves too often in a condition of uncertainty and trouble, and act not unfrequently directly in opposition to the best physical and mental welfare of their charges.

Before Birth Management.—Undoubtedly the proper management of a child begins even before birth! Prenatal influences and education are of vast importance; yet how greatly neglected and persistently misunderstood! Those who would have healthy children must be themselves healthy. They must obey the laws of nature and morality. They must not expect good fruit from poor soil. Physical strength, good organization, agreeable temper, and nobleness of mind beget their like; drunkenness, debility, debasement of body and mind yield similar characteristics in the progeny. Children who inherit the former start from the highest vantage ground; children with the latter start in the race of life handicapped and at a great disadvantage.


Clothing.—From the earliest moment after conception the mother should pay even more than usual care to her personal health. Her clothing should be loose and comfortable, and adapted to the gradual development of her abdomen and breasts. Tight lacing is injurious to both child and mother, and should be carefully avoided.

Baths.—The judicious use of tepid baths once or twice a week, with a daily sponge bath of lukewarm water, followed by friction with a coarse towel, will be conducive to her welfare.

Exercise.—The mother should also take short, gentle and frequent walks during the whole period of pregnancy. In fact she should spend much of the time in the open air, with mild exercise and occupation, and in this way her general health will be kept in proper tone, the bowels open, and the growing foetus will be nourished and strengthened, and the foundation laid for an easier labor and a good getting up.

Advantage of Toil.—This abundance of air and occupation explains the rapid labors and speedy recoveries of poor women. Such need to work, but in their very toil they are favoring nature's operations, and their compensation is in an easy confinement, unattended with much inconvenience or anxiety. Indolence during pregnancy is enervating to mother and foetus.

Pregnant Women not Invalids.—A pregnant woman is not an invalid. She is not compelled to lie down most of the time. To be with child is a natural physiological process, the fulfilling of the Divine mandate, and the highest crowning act of womanhood.

Diet.—The pregnant woman should exercise some care of her dietary. Meat should be eaten but once a day; rich soups and highly-seasoned foods avoided, and all alcoholic and other stimulants strictly shunned. She should eat rather less during early pregnancy than at ordinary times; for while it is true she has two to provide for, yet she has less drain upon her system, from the fact that she no longer is unwell, and the foetus, up to the third month, is not much larger than an egg. An overloaded stomach also may favor the distressing nausea and morning sickness of early pregnancy. During the latter months of pregnancy the diet should be fuller, for if it is too light it is likely to make the mother a poor nurse for her child, both in the quantity and quality of her milk.

Rest.—A pregnant woman should retire early to rest—at least by ten o'clock—and be up in good time in the morning for her ablution, morning stroll in seasonable weather, and an early breakfast. In short, she should use every means in her power to make and keep herself healthy, not only for the sake of herself and her husband, but also for the sake of her forming child and for the welfare of the human race.

Dangers to the Foetus.—It should be borne in mind that the period of intra-uterine life is one full of danger to the health of the foetus; not only does ill health in the mother react upon the defenceless little creature, but it may be, her thoughts, her mental and moral states, her passions, are reproduced in the child.

Comfort far the Mother.—It is of the utmost importance then that she be surrounded with comfort, cheer and happiness; that no unkindness be shown her by her husband or family; that she have all advantages of mental ease and comfort to implant in the miniature human being qualities good and noble. How readily mothers believe in birth-marks, and yet how ignorant or negligent are they of prenatal impressions affecting health and morals.

Mutual Injuries.—It is to be remembered that during a prolonged period mother and child form together but one living system, and whatever injures the mother's constitution also involves that of her progeny.

It must be borne in mind that the health of the father, at the time of the impregnation, also influences very much the future child's welfare.


While no one is herein advised to usurp the place of a physician or a skilled nurse in the lying-in room, yet, under peculiar circumstances, it may fall to the lot of some member of the family to act in an emergency as a nurse or even as a physician.

What to Do in Absence of Physician.—In such a case after the child has been born care should he exercised that no blood or fluid be drawn into the lungs during efforts to establish breathing. As soon as the child breathes well and cries lustily several times, the cord may be tied and cut in this fashion: Take a piece of strong heavy wrapping cord or a braided silk, a fishing line serves admirably, and tie the cord two fingers' breadth from the belly. Tie again further away and cut the cord between the two strings. Should the child not breath well when born hold it up by the feet. This gives an opportunity for mucus and fluid to run out of its mouth. Spank it gently. If the cord beats feebly cut it and remove the baby from the mother.

To Start Breathing.—If it has not yet begun to breathe souse its body quickly in cold or hot water. Immerse in hot and cold water alternately, frequently hang it head downward. Once the child breathes well or cries well roll it in a warm blanket or woolen shawl, lay it on its right side in a suitable place until the mother has been cared for as described in a previous chapter.

Bathing.—All strong, well-developed infants may be given a thorough cleansing bath soon after birth. If the child is covered by a white cheesy substance it may be thoroughly greased with advantage. For this purpose pure olive oil is superior, although unsalted hog's lard or vaseline makes a good substitute. After rubbing this cheesy substance loose with the grease give a soap and water bath. To give the bath the child should be laid across the lap on a blanket or large soft towel. The bather should wear a rubber apron and should have on a chair by her side a large basin of warm water and a bar of castile soap. A soft wash cloth or bath sponge may be used for the washing process. This completed, wrap the child in the towel and dry the skin by rubbing on the outside of the towel. Dry within all folds of skin very carefully. The entire body may now be dusted with baby powder, lycopodium, talcum or powered[sic] starch.

Caring for the Eyes.—If the eyes are now properly cleansed that condition which mothers so dread, "sore eyes," may be avoided. They are best cleansed by dropping sterile boiled water in them by means of a new clean medicine dropper. A boric acid eye wash may be employed if the eyes seem to be inflamed at birth.

      Boric acid ....................... 1 teaspoonful
      Distilled waiter ................. 6 ounces

Note.—Should the child be very weak or breathe feebly it is well to postpone bathing or simply grease the child and wait until it is stronger before using soap and water.

Care of the Navel (Umbilicus).—Our grandmothers were wiser than they knew when they used singed linen to dress the umbilical cord and umbilicus (navel string and navel). We know that only sterilized dressings should be used about the navel. Among the best is sterile or borated cotton or sterilized gauze. If there cannot be had any piece of soft cloth or linen may be sterilized by baking in an oven for one-half hour and handled only with clean hands. In dressing the cord it should first be washed clean with sterile or boiled water, then dusted with some antiseptic dusting powder. Boric acid is frequently used, although the following formula will be found more frequently used by physicians and obstetric nurses:

      Acetanilid ............................ 1 part
      Powdered starch ....................... 4 parts
          Mix well, and use as a dusting powder.
Rx.---Acetanilidum ......................... (drachms)ij
      Glyceriti Amyli ......................  (ounces)i
Ft. Mix and use as a dusting powder.

Applying the Dressing.—Your cloth or gauze may now be applied, Take a piece about four inches square, cut a hole in its centre, pass the cord through, and lay it upward and toward the left, add more dusting powder and fold in the edges of the dressing. The bandage may now be applied.

Dropping of the Cord.—The stump of the cord usually separates within a week although it may remain longer. The rule is to allow it to drop off of its own accord. At any time when adjusting the bandage if the dressing is blood-stained or if pus is seen about the navel call the physician's attention to it at once.

The Bandage.—The bandage is applied to the infant's body for two reasons: First, to keep in place and to keep clean the dressings on the cord; second, to furnish support to the abdomen, and protect the intestines. During infancy the child uses all of its abdominal muscles at each breath, hence it is important that the bandage be pinned just snugly. If too tight, it will interfere with breathing. It may, too, cause greater than normal pressure in the groins and hernia may result. The bandage should either be knit or should consist of a strip of flannel six inches wide and eighteen inches long. The bandage should be worn from three to six months.

Baby Clothes Prepared Before Birth.—One dozen white gowns for day.

One-half dozen woolen gowns for night.

Six abdominal bandages.

Six woolen undershirts.

One-half dozen knit socks.

One dozen large safety pins.

One dozen small safety pins.

One-half dozen large, soft towels.

Three or four baby wash-cloths.

Powder, powder-box and puff.

Two light, soft shawls.

Two dozen diapers.

Two flannel bathing aprons.

One rubber apron.

The Crib.—A crib is better than a cradle. It should be provided with a cheap mattress and a macintosh, two soft blankets, two pillows, a washable comforter and a counter-pane. A good-sized clothes-basket with a large hair pillow makes an excellent crib for early infant life. It is especially useful when the child is weak, and artificial heat must be supplied. (See Care of Premature Infants.)


Premature Birth.—Fright, accident or disease may cause the pregnant woman to deliver herself of her infant before term. Physical deformity of the mother may make it necessary for the physician to bring on labor some weeks before term. The care of infants born under such circumstances causes parents and nurse great anxiety. The lives of many such infants are sacrificed yearly because the average nurse (untrained) knows nothing of their care.

Incubation.—Every effort must be made to conserve the heat of the prematurely-born infants. To do this successfully, an artificial media must be supplied to take the place of the mother's womb. To speak figuratively, the "hatching" must be completed. Incubators are made for this, purpose, and are for sale or for rent in every large city in this country. These incubators are planned similarly to the incubator in which chicken eggs are hatched. The great advantage of this apparatus is, a uniform high temperature can be obtained, and the moisture of the atmosphere accurately regulated. Feeding can also be done without disturbing the infant, or allowing much heat to escape.

Basket Heat.—Where parents are unable to secure the use of an incubator because of distance, or for financial reasons, a useful method of obtaining heat can be made use of in their own home. Take a large clothes-basket, line it with a double blanket, place on its bottom, and, stand around its sides a row of hot water bottles (beer bottles filled with hot water serve admirably), reline with another blanket, and place a thin pillow over the bottom row of bottles, and you have an improvised incubator that has saved the lives of several infants in the hands of the writer, that otherwise would have perished.

Bathing and Clothing.—Prematurely-born infants must not be given a general bath. The face, if soiled, may be cleansed. The entire body should be greased with olive oil, lard or vaseline. The cheesy substance wiped off with cotton. The entire body, except around the anus and face should then be sheathed in carded lamb's wool or raw cotton, and around the whole, a bandage. A bunch of cotton may be placed over the anus, to receive urine and feces.

Temperature.—The infant must now be provided with a high, even temperature, varying from 95 degrees to 85 degrees Fahrenheit, depending upon how weak it is when born. No other clothing is required, except a blanket cover. This temperature can be accurately maintained with the incubator, or approximately maintained with the basket properly and skillfully manipulated.

Feeding.—The mother's breast should be pumped, and the milk thus gotten kept warm by placing in a cup standing in warm water. It should be given to the infant as soon as possible after being drawn. It is best given by means of a medicine dropper. Where the mother has no milk, milk may be prepared as per formula No. 8, or modified milk, and then dilute it one-half with sterile water. Only a few teaspoonfuls can be given at a feeding. The infant must be kept by its artificial heat, or in the incubator while this is being done. It may even be fed without waking.

General Directions.—Such infants sleep almost continuously, and cry usually when too cold. When too hot they will be seen to be restless, and to breath rapidly. These observations must guide in regulating temperature. Should stimulants be required, the physician will direct the kind of stimulation and dose. The child must not be removed from its "wool" or "cotton" "suit" for a soap and water bath until such time when it would have been at term if unborn, and not then unless it appears to have gained strength.

To remove soiled cotton about anus, do so by turning child on its side; remove cotton, wipe off buttocks with moist cloth; replace fresh cotton, and turn child back as before. Do not drag a prematurely-born child out of the incubator or basket to nurse it or to show it to inquiring friends.

Infant Bathing.—An infant should be regularly bathed from head to foot once a day. The water should be tepid—not hot—and barely warm. After the child is three weeks old it may be put into the water and supported with one hand, while it is washed with the other. It is surprising how soon it will learn to enjoy its bath, to splash and play in the water. Never allow it to remain too long in its tub—from ten to twenty minutes is the limit, the latter time being for a healthy child in warm weather. Wet its head before putting it into the bath. This is to guard against congestion. Use white castile soap, and either a very soft sponge or an equally soft flannel or linen cloth. Wipe quickly, and dry with a soft towel, holding the child meanwhile upon a blanket in your lap. See that every little crease is wiped out and powdered with cornstarch or talcum powder. Burnt flour should be used in case of chafing. Be careful to guard against draughts, and bathe the child near an open fire, if possible—if not, the bath should be given in a perfectly warm room. Have the clothing hanging at the fire, well warmed and ready to put on at once. The petticoats should be put one in the other, and the dress over them, so that all three may be slipped on at once. Every little waist should be furnished with buttons or buttonholes and with drawing-strings at top and bottom for drawing to the proper size.

Care of the Mouth.—The mouth of the nursing child should be gently cleansed several times a day with a piece of soft linen dipped in boiled water, or boric acid solution. The mother's or nurse's hands must be clean when washing the baby's mouth. It is particularly important to keep the breast-fed baby's mouth clean, lest the baby infect the mother's nipple, and sore nipples or even breast abscesses result. It is equally important during teething.

Care of the Genital Organs.—It is of the greatest importance to begin in early infancy an intelligent inspection and cleansing of the genital organs. With boys the penis should be examined; the foreskin drawn back over the shaft of the penis; any secretion beneath the skin should be removed with a soft cloth and warm water. The skin should then be drawn forward again as soon as the cleansing has been completed. If this precaution is not observed the penis may become swollen to such an extent that it may become impossible; if the foreskin can not be withdrawn over the penis the boy should be circumcised. Proper cleansing beneath the foreskin will prevent, or often cure, bed-wetting; will prevent premature erections; playing with the penis, and masturbation.

Caring for the vulva and clitoris in girls is equally important, but much simpler to do. It prevents the formation of habits not alone loathsome and disgusting, but augurs for the future health of the child.

Care of the Eyes.—It is well to cleanse the eyes of the new-born infant as directed in giving its first bath. Its eyes may be advantageously cleansed with sterile water, or boric acid solution used from a dropper several times a day for some days after birth. It is not necessary to use medicine or eye washes in the baby's eyes to strengthen them; but during the first three months, when but few tears are secreted, the eyes may be cleansed as above, when dust or dirt of any sort gets into them.

The abominable custom of mothers and nurses taking babies out in carriages without sunshades, allowing the child to lie on its back with the sun beaming on the baby's face, cannot be too strongly condemned.


Quality and Quantity.—The quality and quantity of the child's clothing must be regulated by the means of its parents. Every mother will probably have the best she can afford, but, whether rich or plain, it should be carefully made; all seams felled, and no rough edges left to chafe the tender skin. Six of every garment—three night flannels and three for day—constitute the minimum layette. Twelve diapers may answer, by careful management, but unless they can be washed every day at least eighteen will be required. A flannel cape or a woolen shawl is necessary to throw around the child in passing from one room to another during the first weeks of its existence. Summer and winter, until it is two years old, it should wear a flannel shirt long enough to cover the abdomen.

Warmth Required.—During the early months of the child's life, warmth is peculiarly needful for the infantile system, and where there is any tendency to weakness and imperfect development of animal temperature, flannel clothing is particularly necessary to favor the accumulation of warmth in the infant's body. Benefit may also result from its gentle stimulating action upon the cutaneous surface. In hot weather muslin may be used instead of flannel, but even then a careful mother or nurse will change at once the clothing to suit the varying states of the weather. In summer infants are not infrequently kept too warm by too thick and warm coverlids while sleeping.

The Rubber Diaper.—The rubber diaper has many friends and many foes, and there is much to be said on both sides. If the nurse is careful it will be found a comfort, since it keeps the clothing dry and can do no harm except where it is made an excuse for not changing the child as frequently as is necessary. When it is used there should be two or three, and they should be frequently aired. Wash them always in cold water and wipe on a towel; then hang them in a cool place to dry. When the baby's skin is very delicate their use may cause chafing, unless great care is taken; this is the only valid objection urged against them.

Dress for an Airing.—When the child is sent out for an airing, which may be done in two weeks after birth in summer and in a month's time in winter if the weather is good, and in midday, be sure that it is well wrapped. A knitted worsted spencer, buttoned behind, for wear under the cloak, and a shawl over all if the weather is cool, will protect the little one from harm.

When to Shorten the Clothes.—The proper time for "shortening" the clothes is about the end of three months in summer, or six months in winter. This shortening should be only of the extra length, being still long enough to extend below the feet for nearly a year, to protect the lower parts of the body against changes in temperature. By the end of a year the feet should be entirely free, so as to allow free motion of the legs.

Danger of Wet Clothes.—The child should be kept dry as possible. Wet diapers or stockings, when permitted to remain on the child for some time, give rise to bowel and febrile complaints. They tend to cover excoriations and painful irritation of the skin about the groin and buttocks. Examine frequently the underclothing of a child, and if any part be found wet, immediately replace it by a dry and clean one.


Obstacles to the Mother's Nursing.—Circumstances ofttimes arise when the mother cannot, or should not, nurse her infant. Disease of mother or child, a poor development of breasts or nipples and absence or lack of milk development, or even the premature birth of child may prevent breast feeding. It is always best for mother and child to continue breast feeding at least a few weeks unless forbidden by the physician.

Breast Feeding.—The infant should be applied to the breast six or eight hours after birth, and four or six times a day thereafter, until milk formation is fully established. This accomplished the mother must establish regular hours for feeding. From 6 A. M. to 10 P. M. she should nurse it every two hours, and through the night period every three hours (see special table for maternal feeding). The nipples as well as the child's mouth should be cleansed carefully with a boric acid solution before nursing, and cleansed with pure water afterward. A scarcity of mother's milk must be met with tonics and nourishing food.

Wet-Nursing.—When a mother cannot nurse her child, a competent wet-nurse is most desirable. She should be known to be free from bad habits; to be moral; to be even-tempered; to be clean and free from disease. There ought not to be a period of more than two or three months between the age of her babe and the one to be nursed. The same hours for feeding night and day should be exacted of her that the mother should give.

Mixed Feeding.—Where a mother's milk is not sufficient in quantity it is wise to continue nursing at night and several times during the day. At the other nursing periods give modified cow's milk, or some infant food prepared for a child of the same age, bottle-fed.

Artificial Feeding.—Artificial feeding of infants has undergone such complete changes in recent years that the advice of elderly mothers and grandmothers cannot be depended upon. Now that we know many kinds of germs infect milk as brought from the dairy, sterilization must be insisted upon. Now that many men in every large city devote their time exclusively to infant disease and infant feeding we have gotten out of the rut in which physicians, mothers and nurses formerly trod. Manufacturers of infant food found it necessary to so modify methods of preparation that their finished products would harmonize with proven ideas.

Dr. Holt's Opinion.—One broad assertion made by Dr. Holt in this regard meets with universal present approval. "All students of infant feeding agree that no artificially fed infant can safely be kept upon any permanent diet which does not contain fresh cow's milk."

Modified Cow's Milk.—In the hands of an intelligent mother or nurse the home modification of fresh cow's milk is, next to mother's milk, the best infant food.

The following comparative table will help the better to understand why the various dilutions of milk are made:

Fat .................... 4 per cent.
Sugar .................. 7 "
Proteid ................ 1.5
Ash ....................  .15
Total solids............ 12.65 per cent.
Water......................................................... 87.35 "
Reaction.............................................. Persistently alkaline

Fat .................... 4.04 per cent.
Sugar .................. 4.55 "
Proteid ................ 4.15 "
Ash ....................  .71
Total solids.......... 13.45 per cent.
Water.......................................................... 86.55 "
Reaction.....................................................Feebly acid

What the Above Tables Tell.—From the above tables it will readily be seen why cow's milk alone is not a suitable food for infants. It will be seen that normal cow's milk has about the same proportion of fat as human milk; that it has much less sugar; that it has nearly three times as much proteid substance, and that the percentage of ash, or mineral matter, is far too high. Add to these facts the well-known truth that the proteid of cow's milk is more difficult to digest than that of human milk, and you have sound reasoning for modifying cow's milk, as shall be directed hereafter.

A perusal of the table analysis of colostrum, the first secretion in the human breast, should now be made.

(The breast secretion before milk is formed.)
Fat .................... 1.71 per cent.
Sugar .................. 4.90
Proteid ................ 1.72
Ash ....................  .79
Total solids........... 9.12 per cent.
Water.......................................................... 90.88 "

Meaning of Above Table.—From this table the careful reader will see how little fat the infant gets during its first days after birth. The infant fed artificially should be given such a modified milk that its chemical analysis will approximate first colostrum, later human breast milk, and still later, human breast milk plus its enrichment by the mother eating large quantities of rich, highly nutritious food.

Medical Method.—In large cities, and where families can afford the expense, this is easily done by the physician. He just writes a prescription similar to the above table, adding the amount of food wanted at each feeding and the number of feedings per day. This prescription is then sent to the milk laboratory where it is accurately and scientifically prepared just as medicine is compounded in a pharmacy. This method is expensive and can only be used by those who need not consider cost.

Home Method.—This method may be closely approximated, however, at home by using a list of tables very carefully worked out experimentally. In these tables the cream used has been skimmed cream of a twelve hours rising. No ash or mineral matter allowed for except that in water.

Chemical Formula. Home Formula.
Fat ................... 2   per cent.
Sugar ................. 5      "
Proteid ..............   .75   "
Water ................ 92.25   "
Cream ................. 4 ounces
Milk .................. 0   "
Milk sugar ............ 6 teaspoonfuls
Lime-water ............ 1 ounce
Water ................ 15 ounces

Fat ................ 2.5 per cent.
Sugar .............. 6    "
Proteid ............ 1    "
Water ............. 90.5  "
Cream .............. 5 ounces
Milk ............... 0
Milk sugar ......... 7-1/2 teaspoonfuls
Lime-water ......... 1 ounce
Water ............. 14 ounces

Fat ................ 3.5 per cent.
Sugar .............. 6    "
Proteid ............ 1    "
Water ............. 89.5  "
Cream .............. 6 ounces
Milk ............... 1 ounce
Milk sugar ......... 7-1/2 teaspoonfuls
Lime-water ......... 1 ounce
Water ............. 12 ounces

Fat ................ 3.5 percent.
Sugar............... 6.5    "
Proteid ............ 1.5    "
Water ............. 88.5    "
Cream .............. 7 ounces
Milk ............... 1 ounce
Milk sugar ......... 8-1/2 teaspoonfuls
Lime-water ......... 1 ounce
Water ............. 11 ounces

Fat ................ 4 per cent.
Sugar .............. 7    "
Proteid ............ 1.5  "
Water ............. 87.5  "
Cream .............. 8 ounces
Milk ............... 1 ounce
Milk sugar ......... 9 teaspoonfuls
Lime-water ......... 1 ounce
Water ............. 11 ounces

Fat ................ 4 per cent.
Sugar .............. 7    "
Proteid ............ 2    "
Water ............. 87    "
Cream .............. 8 ounces
Milk ............... 2-1/2 "
Milk sugar ......... 8-1/2 teaspoonfuls
Lime-water ......... 1 ounce
Water .............. 8-1/2 ounces

Fat ................ 4 per cent.
Sugar .............. 7    "
Proteid ............ 2.5  "
Water ............. 86.5  "
Cream............... 8 ounces
Milk ............... 5    "
Milk sugar ......... 7-3/4 teaspoonfuls
Lime-water ......... 1 ounce
Water .............. 6 ounces

Fat ................ 4 per cent.
Sugar .............. 5    "
Proteid ............ 3    "
Water ............. 88    "
Cream .............. 8 ounces
Milk ............... 7-1/2
Milk sugar ......... 6 teaspoonfuls
Lime-water ......... 1 ounce
Water .............. 3-1/2 ounces

Why Lime is Added.—In these mixtures the lime-water is added to preserve the alkalinity of the milk as well as to add lime salts for the food. Where the water used comes from lime rock beds it will not be necessary to add so much lime-water. In such cases, and, indeed, in many cases weak barley-water or arrow-root-water agrees better with the infant than plain water.


Consult the table for intervals of feeding and quantity to feed; for example: a four weeks old baby. It will be seen that nine feedings by day and one feeding by night is advised. Each feeding consists of one and a half to two ounces of food. A glance shows that from fifteen to twenty ounce's are required for twenty-four hours. Make up the food as follows from table fourth to sixth week:

      Cream. ........................... 6     ounces
      Milk ............................. 1     ounce
      Milk sugar ....................... 7-1/2 teaspoonfuls
      Lime-water ....................... 1     ounce
      Water ........................... 12     ounces

Dissolve the milk sugar in the water, add lime-water, milk and cream; mix thoroughly in vessel and divide in ten nursing bottles. Plug each bottle with clean cotton and stand in a kettle of warm water. Place the kettle over the fire, keeping the water boiling twelve to fifteen minutes. Do not allow the food to boil. Remove the nursing bottles and place in a cool place until ready for use. When ready to feed the baby take a bottle, stand in lukewarm water until heated, remove cotton, and place over the bottle a freshly scalded nipple and you have a sweet, clean, sterile infant food.

Nursing Bottles.—Bottles of medium size and round, with flat bottom and small, short necks are best. Rubber nipples which slip over the neck of the bottle are the only safe nipples to use. All nursing bottles having rubber tubes and nipples are dangerous, dirty and should not be used. All bottles must be cleaned as soon as empty and again before refilling they must be cleansed with boiling water. The nipples must be turned, cleansed with soap and water and boiling water and may then be kept in boric acid solution until ready for use.


Age. Interval hours by day. Interval hours by night. Number of day feedings, 6 A.M. 10 P.M. Number of night feedings, 10 P.M. 6 A.M. Number of feedings in 24 hours. Amount at each feeding. Total amount in 24 hours.
1 Week
2   "
4   "
6   "
8   "
3 Months
4   "
5   "
6   "
7   "
8   "
9   "
10  "
11  "
12  "
6 or 5
6 or 5
1 oz.
1 to 1-1/2 " 
1-1-2 to 2 " 
2-1/2 " 
3-1/2 " 
4 " 
4-1/2 " 
5-1/2 " 
6 " 
6-1/2 " 
7 " 
7-1/2 " 
8 or 9-1/2 " 
9-1/2 " 
10 " 
10-11 oz.
11-14  " 
15-20  " 
25  " 
28  " 
28  " 
31  " 
33  " 
36  " 
39  " 
42  " 
45  " 
48  " 
48  " 
50  " 

This table shows equally well the hours and intervals to feed a breast- fed baby.

Condensed Milk.—Condensed milk fattens babies to an abnormal extent, and while they are fat and plump, experience shows that they are too weak to withstand any trifling disease. It is a poor permanent food. It does have a useful place in infant feeding. While traveling or during the night in hot weather, it is an excellent substitute for the regular food. It should be made up for a single feeding at a time. For a child three months old.

      Condensed milk .............. 2-1/2 half-teaspoonfuls
      Water ....................... 2     ounces
      Lime-water .................. 2     teaspoonfuls
      Salt ..........................     a small pinch

This quantity may be increased or decreased according to the age of the child.

Weaning Time.—The age at which a child may be weaned has been suggested to be sometime between the eighth and fourteenth month. Much depends, upon mother, child, surroundings and season. A strong child may be weaned early. It is best to avoid weaning in summer. If the mother or nurse cannot attend personally to preparing the food, and keeping bottles and food scrupulously clean, it is wise to continue nursing even the full fourteen months.

Gradual Weaning.—If the child is weaned early, do it gradually by substituting some artificial food. If late, the mother may stop the breast at once, and the child will experience little difficulty in transferring to some other food. Should the mother again become pregnant, she must wean her infant.


The great increase of sickness and death among young children during the summer months is due largely to ignorance on the part of mothers and nurses. Attention to the following rules would save many a life:

1. Bathe the child once a day in tepid water. If it is feeble, sponge it all over twice a day with tepid water, or with tepid water and vinegar.

2. Avoid all tight bandaging. Make the clothing light and cool, and so loose that the child may have free play for its limbs. At night undress it, sponge it, and put on a slip. In the morning remove the slip, bathe the child, and put it in clean clothes. If this cannot be afforded, thoroughly air the day clothing by hanging it up during the night. Use clean diapers, and change them often.

3. The child should sleep by itself in a cot or cradle. It should be put to bed at regular hours, and be early taught to go to sleep without being nursed in the arms. Without the advice of a physician never give it any spirits, cordials, carminatives, soothing syrups or sleeping drops. Never quiet it by candy or cake; they are the common causes of diarrhoea and of other troubles.

4. Give the child plenty of fresh air. In the cool of the morning and evening send it out to shady places. Whenever it seems to suffer from the heat, let it drink freely of ice water.

5. Keep your house sweet and clean, cool and well aired. In very hot weather let the windows be open day and night. Correct all foul smells by pouring into the sinks and privies carbolic acid or quick-lime, or the chloride of lime, or a strong solution of copperas. These articles can be got from the nearest druggist, who will give the needful directions for their use.

6. Breast milk is the only proper food for infants. If the supply is ample and the child thrives on it, no other kind of food should be given while the hot weather lasts. If the mother has not enough, she must not wean the child, but give it, beside the breast, modified cow's milk, as prepared under Rule 8. Nurse the child once in two or three hours during the day, and as seldom as possible during the night. Always remove the child from the breast as soon as it has fallen asleep. Avoid giving the breast when you are over-fatigued or over-heated.

7. If, unfortunately, the child must be brought up by hand, it should be fed on a milk diet alone—that is, warm milk out of a nursing-bottle, as directed under Rule 8. Modified cow's milk is the best, and next to it Eskay's Albumenized Food mixed up with fresh cow's milk. If the child thrives on this diet, no other kind of food whatever should be given while the hot weather lasts. At all seasons of the year, but especially in summer, there is no safe substitute for milk, if the child has not cut its front teeth. Sago, arrow root, potatoes, corn flour, crackers, bread, every patented food, and every article of diet containing starch, cannot, and must not, be depended on as food for very young infants.

8. Buy only whole milk known to be of good quality. Prepare either modified cow's milk or artificial foods exactly as directed under infant feeding. Keep bottles of food in a cool place, on ice, or if in the country and without ice lower a basket containing the filled nursing bottles in a well near the surface of the water. It is best to have the milk delivered during the early morning and have it prepared and sterilized before the day becomes hot.

9. If the milk should disagree, one-half to one tablespoonful of lime water may be added to each bottleful. Whenever pure milk cannot be gotten, try the condensed milk, which sometimes answers well. It may be prepared by adding to ten tablespoonfuls of boiling water, without sugar, one tablespoonful or more of the milk, according to the age of the child. Should this disagree, a teaspoonful of arrow root, sago or cornstarch may be cautiously added to a pint of the milk. If milk in any shape cannot be digested, try, for a few days, pure cream, diluted with three-fifths or four-fifths of water—returning to the milk as soon as possible.

10. The nursing-bottle must be kept perfectly clean; otherwise the milk will turn sour and the child will be made ill. After each meal it should be emptied, rinsed out, taken apart and the nipple and bottle cleansed in boiling water and placed in clean water, or in water to which a little soda has been added. It is a good plan to have eight or ten nursing-bottles, and to use them by turns. Then when food is prepared for the day each feeding can be placed in a bottle and kept ready for use in some cool place or in the refrigerator. The best kind is the plain bottle with a rubber nipple and no tube.

11. Do not wean the child just before or during the hot weather, or, as a rule, until after its second summer. If suckling disagrees with the mother she must not wean the child, but feed it, in part, out of a nursing-bottle, on such food as has been directed. However small the supply of breast milk, provided it agrees with the child, the mother should carefully keep it up against sickness; it alone will often save the life of a child when everything else fails. When the child is over six months old, the mother may save her strength by giving it one or two meals a day of modified cow's milk or some prepared infant food put into a nursing-bottle. When from eight months to a year old, it may have also one meal a day of the yolk of a fresh and rare-boiled egg, or one of beef or mutton broth, into which stale bread has been crumbed. When older than this, it can have a little meat finely minced; but even then milk should be its principal food, and not such food as grown people eat.


Mothers, nurses and friends are often badly misinformed as to what constitutes a healthy, normal, full-term child, and often know less about what should be its natural development.

Weight.—The average weight of infants at birth is six and one-half pounds for a girl and seven and one-half pounds for a boy. Of course, great variations from this may occur. Children have weighed at birth but two and three-fourths pounds and have lived to develop into strong manhood, while, on the other hand, children have been born weighing as much as twenty-two pounds. During the first week after birth the infant loses steadily in weight. Sometimes a full pound is lost, usually not more than a half pound. After the first week there should be a steady gain of two to four ounces each week. The baby should frequently be weighed, and if it does not increase in weight some change of food should be made.

Length.—The average baby at birth measures twenty inches in length. At six months it should be twenty-four inches. At birth the trunk is longer in proportion than the body. The first growth is largely in the length of the legs. Growth usually occurs in cycles. While gaining rapidly in weight little is gained in length. While teething, or immediately after, the growth in length is marked.

General Development.—The fat, flabby child, such as we see when bottle-fed with condensed milk, or occasionally when breast-fed, is not a healthy child. An acute illness will be badly borne. Rickets, bow-legs and delayed teething are noted. The healthy child has pink skin, rounded limbs, with firm muscles. It is not necessarily fat. It is always active when awake.

Periods of Development.—For convenience the child's life may be considered as consisting of three periods: The first period extending from birth to the beginning of teething; the second, that of teething (milk teething); the third extends from the first teething to the end of the second teething.

During the first period breast milk is the ideal food. At this time babies cannot digest starchy foods, hence all table food, bread and the like, must be withheld. During the second period saliva is formed in the mouth and occasionally good broths may be given. During the third period the digestive apparatus is prepared for more complex food. See Special Diet Lists.

Exercise and Air.—Almost as important as food and bathing is that of exercise and air for the growing infant. Exercise for its muscular system can be secured by massage after the bath, and by dressing in such a way as to give the child the freedom of its limbs. It is of great importance that the child be taken in the fresh air and sunshine as much as possible. Only in inclement weather should this be neglected. A baby carriage is desirable for this purpose. A sun-bath given with the nude baby on a pillow inside a sunny window in winter and in the fresh air in summer is healthful. Nurseries should be large, airy and well ventilated, and should be located on the sunny side of the home. The heating plant should be so managed as to give an equal temperature of 72 degrees, with fresh outside air entering at all times.


Time of Teething.—The most usual age for an infant to begin teething is from the sixth to the eighth month. This is only a general rule. Bottlefed babies, delicate infants and children with rickets, teethe later than the eighth month. Precocious infants may teethe much earlier. Children are occasionally born with one, two or more teeth; others have no teeth until the eighteenth month.

How the Teeth Come.—The lower central incisors usually appear first, and in a few weeks the four upper incisors follow, from the twelfth to the fourteenth month the remaining lower incisors and the premolars come through. There is a long delay preceding cutting of the incisors. They appear from the eighteenth to the twentieth month. The remaining molars appear about two and a half years of age. The full set of milk teeth numbers twenty, ten in each jaw. The accompanying diagram shows their appearance most graphically. It also shows the full set of teeth and the age at which they appear.

Convulsions.—Dentition is a physiologic process and should cause no serious disturbance to the health of the child. It is true that there may be considerable irritability of temper, and resulting from it some digestive disturbance. The dreaded convulsions of teething are very much overrated.

What to Observe in a Child.—The most important points to be attended to in making up an opinion of a child's condition are the countenance, noting its expression, coloration, wrinkles, etc.; the sleep; the cry; the state of emaciation or fatness; the condition of the skin, as to eruptions, color, temperature, degrees of dryness, swelling, etc.; the pulse; the respiration; the signs furnished by the mouth and throat; the power oŁ sucking; and, finally, the state of the abdomen.

Pulse Rate of Children.—

        Young infants ................ 100 to 102.
        First year ....................115.
        Second year .................. 118.
        Second to sixth, year......... Sleeping, 76; waking, 92.
        Sixth to ninth year........... Sleeping, 73; waking, 90.
        Ninth to twelfth year......... Sleeping, 72; waking, 80.
        Twelfth to fifteenth year..... Sleeping, 70; waking, 72.
          In girls the rate is about five beats higher.

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Temperature of Children.—1. The daily range of temperature is greater in the healthy child than that recorded in healthy adults, amounting to 1, 2 or 3 degrees.

2. There is invariably a fall of temperature in the evening, amounting from 1 degree to 3 degrees Fahrenheit.

3. This fall may take place before sleep begins.

4. The greatest fall is usually between 7 and 9 P.M.

5. The minimum temperature is usually observed at or before 2 A.M.

6. Between 2 and 4 A.M. the temperature usually begins to rise, such rise being independent of food being taken.

7. The fluctuations between breakfast and tea time are usually trifling in amount.

8. There seems to be no very definite relationship between the frequency of the pulse and respirations and the amount of the temperature, the former being subject to many disturbing influences.

Respiration in Children.—The average frequency of the breathing in new-born children and during the first week of life is thirty-nine times per minute. It may rise, however, upon very slight disturbances, to fifty, sixty or eighty. In perfectly healthy infants, during sleep the respiration may fall to twenty-five per minute.

Between 2 months and 2 years the average number of respirations per minute is 35.

Between 2 years and 6 years the average number of respirations per minute is 23.

Between 6 years and 12 years the average number of respirations per minute is 22.

Between 12 years and 15 years the average number of respirations per minute is 20.

Evacuations of a Child.—The healthy motion varies from a light orange yellow to a greenish yellow, and in number from two to four times daily.

Smell should never be offensive. Slimy, mucus-like, jelly motions indicate worms. Offensive, acid, pale-green motions indicate a disordered stomach. Dark-green evacuations indicate acid secretions and more serious stomach or bowel disorder.

Fetid, dark-brown stools are present in chronic diarrhoea. Putty-like, pasty passages are due to acidity curdling the milk or to torpid liver.

Amount of Sleep Required Each Day.—

    At 4 months..........................20     hours of sleep is required.
    At 6 months..........................18     hours of sleep is required.
    At 1 year............................15     hours of sleep is required.
    At 2 years...........................13     hours of sleep is required.
    At 4 years...........................12     hours of sleep is required.
    At 7 years...........................11     hours of sleep is required.
    At 9 years...........................10-1/2 hours of sleep is required.
    At 14 years..........................10     hours of sleep is required.

Infant Exercise.—Exposure of infants to pure air should begin in a very few weeks after birth; an hour or two a day at first, but daily whenever the weather permits. They soon evince a strong desire for the open air. When yet carried by the nurse they point to the door; when crawling' they try to approach it; when walking they attempt to escape from the house to the air without. This, however, must not be construed into advice to carry out the child in unfavorable weather or for a long time, "with an idea of hardening it. Catarrhal inflammations are easily produced in children.

Out-Door Playing.—When old enough to play and romp, the dress should not be so fine as to require an order of good care. Nothing affords more real enjoyment to children, and at the same time tends more decidedly to give them a sound and active tone of mind and body than a liberal indulgence in exercise and their innocent sports out of doors.

General Signs of Health.—"Rotundity is the beauty of youth." Dr. Meigs says of a healthful child: "Its tissues are firm and solid; its surface of a cool and pleasant temperature; its coloration of clear and exquisite white, firmly tempered with a faint rosy tint in a warm atmosphere, or slightly marbled with light bluish spots in a colder air. Few marks more certainly indicate a healthful temper of the constitution than the clear and exquisitely tinted pink color of the palmar and plantar surface of the hands and feet of a young child. Nothing indeed can be more beautiful or perfect in shape and contour than the figure of a fine, hearty young child; nothing more pleasing to the eye than its delicate but vivid coloring; and nothing more expressive of the fullness of health than its whole appearance." The movements and gestures of a child give a clue to its condition. Healthy children, when awake, are in almost constant motion, or at constant play.

Care of Older Children.—Skene has aptly said: "To begin life well, one must be born of parents who are sound in body and mind. After birth and throughout childhood, or to make them better or worse than themselves, according to the kind of care and culture bestowed."

Diet.—"Food is the primary necessity in raising children; the character, quantity and time of administration should each have the scrupulous attention of all those who are responsible for the welfare of children." Dr. A. Jacobi says: "Children not only eat to live, but eat to grow also." Children need to be fed oftener than adults. The growing boy and girl each require a relatively greater quantity of food than the adult. The best results are to be gotten by a mixed animal and vegetable diet.

The following is a useful summary (taken in part from Holt) of


1. Allow time for meals.

2. See that the food is thoroughly masticated.

3. Do not allow nibbling between meals.

4. Do not tempt the child with the sight of rich and indigestible food.

5. Do not force the child to eat against its will, but examine the mouth, which may be sore from erupting teeth; and examine the food, which may not be properly cooked or flavored. If good food is refused from peevishness merely, remove it and do not offer it again before the next meal time.

6. In acute illness reduce and dilute the food at once.

7. In very hot weather give about one-fourth or one-third less food and offer more water.


The following diet lists are from Thompson's Dietetics, with slight modifications, and from Starr's and Holt's tables:


7 A.M.—Stale bread soaked in a breakfastcup of new milk.

10 A.M.—Milk, six ounces, and soda biscuit, or a thin slice of buttered bread.

2 P.M.—Beef tea, six ounces, bread and a tablespoonful of rice and milk pudding.

6 P.M.—Same as first meal.

10 P.M.—A tablespoonful of Eskay's food in eight ounces of milk.

In alternation a lightly boiled egg, with bread crumbs and six ounces of milk may be given at 7 A.M., and at 2 P.M. a mashed baked potato moistened with four tablespoonfuls of beef tea; two tablespoonfuls of junket.


7 A.M.—New milk, eight ounces; the yolk of an egg lightly boiled; two thin slices of bread and butter, or else milk, and two tablespoonfuls of well-cooked oatmeal or wheaten grits, with sugar and cream.

11 A.M.—Milk, six ounces, with a soda biscuit or bread and butter.

2 P.M.—One tablespoonful of rare mutton pounded to a paste, bread and butter, or mashed potatoes moistened with good dish gravy, a saucer of junket; or else a breakfastcupful of beef tea or mutton, or chicken broth, a thin slice of stale bread, a saucer of rice and milk pudding.

6.30 P.M.—A breakfastcupful of milk, with bread and butter, or soft milk toast.

TWO AND A HALF TO THREE AND A HALF YEARS—i. e., for Children Who Have Cut Their Milk Teeth (Starr).

7 A.M.—One or two tumblers of milk, a saucer of thoroughly cooked oatmeal or wheaten grits, a slice of bread and butter.

11 A.M.—If hungry, a tumbler of milk or a teacupful of beef tea, with a biscuit.

2 P.M.—A slice of underdone roast beef or mutton, or a bit of roast chicken or turkey, minced as fine as possible; a mashed baked potato moistened with dish gravy, a slice of bread and butter, a saucer of junket or rice and milk pudding.

7 P.M—A tumblerful of milk and a slice or two of soft milk toast.


Breakfast.—Every day: Milk, porridge and cream, bread and butter. One dish only each day: Fresh fish, eggs lightly boiled, eggs poached; eggs scrambled, eggs (plain omelet), chicken hash, stewed kidney, stewed liver.

Sound fruits may be allowed before and after the meal, according to taste, as oranges without pulp, grapes (seeds not to be swallowed), peaches, thoroughly ripe pears and cantaloupes.

Dinner.—Every day: Clear soup, meat roasted or broiled and cut into small pieces, bread and butter. Two dishes each day: Potatoes baked, potatoes mashed, spinach, stewed celery, cauliflower, hominy, macaroni (plain), peas, string beans (young), green corn (grated).

Junket, rice and milk or other light puddings and occasionally ice cream may be allowed for dessert.

Supper.—Every day: Milk, milk toast or bread and butter, stewed fruit.

From the third to the fifth year the child has twenty teeth, and often three meals a day suffice, although from the third to the fourth year four may be given.

When the second set of teeth begin to replace the deciduous or milk teeth, which gradually decay, digestion is sometimes interfered with temporarily from lack of ability to masticate thoroughly, and the food should be thoroughly subdivided before it is offered to the child.

Cereal Food.—Bread, rice, oatmeal and other cereal foods should always enter largely into the dietary of healthy children after they are able to digest them. Their fats should be derived chiefly from butter and cream. The best fruits for them are oranges, cooked apples and stewed prunes.

Holt's Sample Diet.—Children between three and four years of age should be fed when in health four times a day—at 7 A.M., 10.30 A.M., 1.30 P.M. and 6 P.M.

The following is "Holt's Sample Diet for a Child Four Years Old:"

First Meal.—Half an orange, one and a half teaspoonfuls of oatmeal or hominy, well salted, with two tablespoonfuls of cream, but no sugar, and one glass of milk.

Second Meal.—A glass of milk or cup of broth and one slice of stale bread.

Third Meal.—Meat—either steak, chop or chicken—one green vegetable (e. g., spinach), one starchy vegetable (e. g., potato), water to drink, stewed prunes for dessert.

Fourth Meal.—Bread and milk or milk toast.


Indigestible Foods.—The following articles are particularly indigestible for children, and should not be allowed them under four years of age, and most of them should not be given under seven or eight years: Fried food of all kinds, game, salt food, the flesh of swine in all forms (pickles, salads, condiments, except salt), "stews," the "dressing" of fowl, sauces, visceral foods (such as liver, kidneys, tripe, etc), all raw vegetables, potatoes (except baked), tomatoes in any form; the coarser vegetables, such as beets, turnips, cabbage, and so forth; fancy bread, cake and pastry; griddle cakes, canned food of all kinds; fancy confectionery, sweets and preserves; cheese, rich soups, jellies, dried or unripe and overripe fruits (bananas, so often given to young children, are very bad for them), nuts, fruits with large seeds, such as grapes, the skin of all poultry, fruits or vegetables.

Good Cooking.—All food should be plainly and thoroughly cooked. No greasy or highly seasoned dishes are permissible, and, as a rule, twice cooked meats are indigestible.

Forbidden Drinks.—Tea, coffee and alcohol in every form must be withheld. The two former beverages interfere with digestion and make the child nervous, and the latter lays the foundation for a permanent alcohol habit. Soda water with syrups should not be given. Too much water should not be allowed with meals, and what is given should not be ice-cold.

Regular Meals.—Children, as they grow up, should continue to observe regularity in the hours for taking meals, and the habit of perpetually nibbling at cake, crackers and confectionery between meals should not be tolerated. It is best for young children not to be put to sleep immediately after their most substantial meal of the day. As they require a nap in the early afternoon, many advise giving this meal at 4 P. M.

When to Enter School.—The age at which any given child may enter school must be decided for that child alone. The individual must be considered. As a rule children are sent to school too early. Strong, robust children may be sent to school at six or seven years of age. They may even have spent two years in the kindergarten before reaching that age. On the other hand a delicate child had better be kept in the open air and sunshine until nine or ten years of age, or even later. It is far more important to every child to have a sound body than for it to have an educated brain.

Development of Puberty.—Puberty is that time of life in a boy or girl when they emerge from boyhood or girlhood into manhood or womanhood. It is a time in the life of most individuals fraught with danger. To the boy approaching puberty, little care need be given except to surround him with good influence and moral companions. The father had best perhaps tell him something of the change which will occur, and teachers should be patient in cultivating the voice. Singing should not be indulged in until the "new voice" is well established. The boy should be watched so that no bad habits are formed. This period is reached in the average boy in from the fourteenth to the sixteenth year.

Puberty in Girls.—In girls, puberty is reached about the fifteenth year. At this time the mother must seek the girl's closest and strictest confidence. It is well in some cases that the mother should tell the girl something of this change which will occur. She must do no severe mental work at this time, neither shall she indulge in violent exercise. When weary and languid, encourage rest in a reclining posture, with short walks in sunshine and fresh air daily. Many girls are better removed from school. The health and future usefulness of many girls are endangered, some even ruined, by injudicious care at this period. Moral companions must be secured at this period of life.

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