Читать книгу Mother, Nurse and Infant - S. P. Sackett - Страница 14

The food of the child, if it is necessary to feed it at first, may be one-third of new milk and two-thirds of warm water, slightly sweetened. It is not necessary that it should be fed for at least eight hours after birth, and at first the quantity fed it must be small. Except in rare cases the milk furnished by the mother will come soon enough, and in sufficient quantity to supply the wants of the child, and it is best for both that the child should draw it when secreted. For the instruction of the mother, as well as the nurse, I here quote a paragraph upon the nourishment and feeding of the child, not only of the new-born, but also of the subsequent months:

“No form of artificial nourishment can compare with that furnished by the mother. Women should know and consider the probability of disease and death occurring from any other mode, and the difficulties and annoyances to be encountered in the use of artificial food. As a further inducement to her to nurse her own child, she should know that her offspring is sure to imbibe with its milk, deep, earnest affection. The mother who can nurse her own offspring should commence within eight hours after delivery, and in the mean time no trash should be put in its mouth to still its cries, or for any other reason; if it has not been surfeited, it will be disposed to take the breast. It should be placed to the breast before they are gorged with milk, for at that later time the flow is less easy, the parts are more irritable, and the child sucking with greater power, we are more likely to have, as the result, irritated nipples. Nature prompts all animals to suck their mother soon after they are born; we are less liable to have sore, irritated, cracked nipples, and there is less liability to infantile colics, etc., if we follow the guidance of nature and instinct.”

As soon as possible accustom the child to the habit of nursing every two hours. If there is a proper interval between the times of nursing, the child draws with more avidity, actually empties the breast, and obtains that part that contains the most cream. Endeavor also to have the intervals longer at night, so that, from 10 P. M. to 6 A. M., it nurses but once or twice. Still, if it wakes every two or three hours, demands its supply of nourishment, and you cannot otherwise quiet the child, you must indulge it. Do not accustom the child to sleeping on the mother’s breast. If it sleep in its own crib or bed, properly clothed and protected, it is less liable to have its rest disturbed. Avoid the custom of having a young child sleep with old and sickly persons, and also of having them sleep in ill-ventilated rooms, and of covering the child’s face as it sleeps. There is danger that a child may die from want of pure fresh air, from having its face pressed tightly in the embrace of the person with whom it sleeps, from the multiplicity of its clothes, and from the mass of bedclothing used by the mother, as well as from improper food. A child should never be covered to sweat by reason of the warmth of its clothing, or of that of the apartment.

If the mother does not enjoy good health, it may be better for her not to nurse the child at night, but to have it fed once or twice with a little diluted cow’s milk at night, and to nurse it during the day.

The following have been named as CAUSES WHY THE MOTHER CANNOT PROPERLY NURSE THE CHILD:

1. When she cannot have a sufficient quantity of milk.

2. When the supply falls off from some defect which is not remediable.

3. When there is a strong venereal or scrofulous taint in the constitution.

4. When suckling produces an active or painful disease in the mother, as colic, etc.

5. When the mother is subject to great nervous debility; possesses an irascible temperament, and cannot avoid grief and sorrow; and also when she is suffering from certain hereditary chronic diseases.

When a mother cannot suckle her child, if circumstances will allow, a healthy wet-nurse should be procured. Choose one that is of a healthy family; ascertain that there are no eruptions on her skin, or if there be other disease; if she have a plentiful breast of milk, and if it be of a good quality; if she has good nipples, and if her child is born near the time that the one was that she is to nurse. Do not get a nurse that menstruates during suckling, nor one that has a child which is unhealthy, or has a sore mouth or blotches upon the skin.

Very feeble new-born babes cannot take the breast sometimes. In such cases cow’s milk, water and sugar (F. 1) may be given in small quantities at a time, but frequently repeated. If it takes only a teaspoonful at a time it should be repeated every half hour.

Many mothers are unable to obtain the services of a wet-nurse. The milk of a cow is the best substitute, and when this is of ordinary richness, it may be diluted with an equal quantity of water, or thin barley water.

The following are leading principles to guide in giving infant food:

1. Aliment should always be presented to the infant stomach in a fluid form.

2. Bread and other farinaceous substances are generally indigestible in the infant stomach, and may better be excluded from infant feeding.

3. Cow’s or goat’s milk, when pure and modified so as to resemble as much as possible human milk, will generally be found sufficient without any other help to nourish the new-born infant.

4. If cow’s milk is used at first, diluted with twice as much water and slightly sweetened, the proportion of water must be gradually lessened, until after six months the milk may be given undiluted.

5. When good milk from one cow cannot be obtained, and the child does not thrive upon the milk used, condensed milk may properly be substituted.

6. There are various forms of infant food referred to in F. 1, 2, 3, 4, 11, 28, 45, 49, and if one of these is tried and proves satisfactory, it will not be advisable to try new kinds of infant food which are at the present time offered for sale. Milk should be the basis of all infantile food; neither starch, dextrine or glucose sufficiently nourishes without it; but we may use one of these foods without milk for one or two days, in unsettled state of the stomach, with good results. (F. 61.)

Thoroughly wash the babe every morning from head to foot, using a large wash bowl or nursing basin, half filled with water. First wet the head, then immediately put the body in the bath, and with a sponge or piece of flannel, cleanse the whole body, particularly the armpits, groins, and between the thighs. The skin, after being thus cleansed, must be quickly and thoroughly dried with soft towels, and the parts liable to become sore, powdered; then all parts of the body and limbs should be gently rubbed. During all the time, when the child is but a few days old, it should not be exposed at all to the cold. The water for its bath should be slightly warmer than new milk, and the time occupied in the bathing should be short. Each time, after a passage from the bowels, the parts should be washed with warm water, and if there is any chafing the calamine powder should be applied.

The naval string should receive the attention of the nurse; within an hour of the time it is at first tied, she should examine the dressing to see if there has been any bleeding. If it bleeds, and the doctor is not at hand, retie with a stout cord, drawing it quite tight. Each morning, when the child is bathed, lift up the naval string with the rag dressing and insert a little nice fresh tallow under it. When it is loose remove it, but use no means to cause the separation. The naval is sometimes a little sore, but seldom needs any dressing more than simply vaseline or tallow.

At night a child should be entirely undressed, and its clothing replaced by other garments, those that are loose, light, and sufficiently warm for it while it is under the bedclothes. For a very young child the proper night-dress is a loose slip; when older, a pair of drawers, fitting up well around the neck and covering the body and limbs, is a good article. The clothing worn during the day should not be worn at night, and the clothing when soiled should be immediately changed. Whenever the child seems disposed to sleep, this should be encouraged. Never arouse a child suddenly from its sleep. Be careful that there is no unnecessary noises to disturb its sleeping. Time the bathing and dressing so that the little one may not be unnecessarily disturbed. But never give soothing syrups, anodynes for infants, or other nostrums to induce them to sleep. If the child is restless, endeavor to ascertain if there is not some cause that can be removed, such as tight clothing, etc.

Premature infants may, under favorable circumstances and assiduous care, live and thrive. Immediately after birth the child should be placed in a warm bath, and then wrapped in cotton. The baths should be warmer than usual, and must be frequently repeated. Awaken the child every one or two hours to feed it. Milk (woman’s milk is the best) must be given it by a teaspoon. With a view to the better development of the lungs, it may be excited to cry by a slight irritation. Do not bring such children into the open air for several months after the birth, as their passages are readily affected.