Читать книгу The Maternal Management of Children, in Health and Disease - Thomas Bull - Страница 22

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It should be as like the breast-milk as possible. This is obtained by a mixture of cow's milk, water, and sugar, in the following proportions:—

Fresh cow's milk, two thirds;

Boiling water, or thin barley water, one third;

Loaf sugar, a sufficient quantity to sweeten.

This is the best diet that can be used for the first six months, after which some farinaceous food may be combined.

In early infancy, mothers are too much in the habit of giving thick gruel, panada, biscuit-powder, and such matters, thinking that a diet of a lighter kind will not nourish. This is a mistake; for these preparations are much too solid; they overload the stomach, and cause indigestion, flatulence, and griping. These create a necessity for purgative medicines and carminatives, which again weaken digestion, and, by unnatural irritation, perpetuate the evils which render them necessary. Thus many infants are kept in a continual round of repletion, indigestion, and purging, with the administration of cordials and narcotics, who, if their diet were in quantity and quality suited to their digestive powers, would need no aid from physic or physicians.

In preparing this diet, it is highly important to obtain pure milk, not previously skimmed, or mixed with water; and in warm weather just taken from the cow. It should not be mixed with the water or sugar until wanted, and not more made than will be taken by the child at the time, for it must be prepared fresh at every meal. It is best not to heat the milk over the fire, but let the water be in a boiling state when mixed with it, and thus given to the infant tepid or lukewarm.

As the infant advances in age, the proportion of milk may be gradually increased; this is necessary after the second month, when three parts of milk to one of water may be allowed. But there must be no change in the kind of diet if the health of the child is good, and its appearance perceptibly improving. Nothing is more absurd than the notion, that in early life children require a variety of food; only one kind of food is prepared by nature, and it is impossible to transgress this law without marked injury.

If cow's milk disagree with an infant—and this is sometimes unfortunately the case, even from its birth ass's milk—diluted with one third its quantity of water, may be given as a substitute. I am now attending a lady in her fourth confinement, who is unable, from defect in her nipples, to suckle her children. The first child had a healthy wet-nurse, and has grown a fine healthy lad. The second, a girl, was unfortunate in her nurse, she being of a strumous and unhealthy constitution, although to a casual observer bearing the appearance of health. The child lived only three months, and the nurse died of a rapid consumption shortly after. This discouraged the mother from adopting wet-nurse suckling for the third child (a great error); and an artificial diet of cow's milk was resorted to. The third day from commencing this plan, flatulence, griping, purging, and vomiting came on, one symptom quickly following the other; the child wasted, and on the sixth day had several convulsive fits. The diet was immediately changed for ass's milk, and in less than twelve hours the sickness and purging ceased; the flatulence was relieved; the motions, from being green, watery, and passed with great violence and pain, became of a healthy consistence and colour, and the screaming ceased. The symptoms did not return, the child thrived, very soon consuming regularly one quart of the ass's milk daily, and is now a fine healthy girl two years old. A fortnight since the parent was confined with a fourth child. Cow's milk was given to it for two or three days (from the difficulty of obtaining that of the ass), the same train of symptoms, precisely, came on with which the third child had been affected, which again gave way upon following up the same plan of diet—the substitution of the ass's milk for that of the cow. The evident conclusion from this is, that the breast-milk of a healthy woman is incomparably the most suitable diet for the infant; but that, if she be not of a healthy constitution, it may be destructive to the child; and that where this cannot be obtained, and cow's milk is found to disagree, ass's milk may sometimes be resorted to with the happiest results.[FN#8]

[FN#8] An infant will generally consume a quart, or a little more, of ass's milk in the four and twenty hours; and as this quantity is nearly as much as the animal will give, it is best to purchase an ass for the express purpose. The foal must be separated from the mother, and the forage of the latter carefully attended to, or the milk will disagree with the child.

Sometimes the mother's breast, and every description of milk, is rejected by the child; in which case recourse must be had to veal or weak mutton broth, or beef tea, clear and free from fat, mixed with a very small quantity of farinaceous food, carefully passed through a sieve before it is poured into the sucking-bottle.

THE MODE OF ADMINISTERING IT.—There are two ways—by the spoon, and by the nursing-bottle. The first ought never to be employed at this period, inasmuch as the power of digestion in infants is very weak, and their food is designed by nature to be taken very slowly into the stomach, being procured from the breast by the act of sucking, in which act a great quantity of saliva is secreted, and being poured into the mouth, mixes with the milk, and is swallowed with it. This process of nature, then, should be emulated as far as possible; and food (for this purpose) should be imbibed by suction from a nursing-bottle: it is thus obtained slowly, and the suction employed secures the mixture of a due quantity of saliva, which has a highly important influence on digestion.

Too much care cannot be taken to keep the bottle perfectly sweet. For this purpose there should always be two in the nursery, to be used alternately; and, if any food remain after a meal, it must be emptied out. The bottle must always be scalded out after use. The flat glass nursing-bottle itself is too well known to need description; it may be well, however, to say a word about the teat that covers its narrow neck, and through which the infant sucks the food. If the artificial or prepared cow's teat is made use of, it should be so attached to the bottle that its extremity does not extend beyond its apex more than half or three quarters of an inch; for if it projects more than this, the child will get the sides of the teat so firmly pressed together between its gums, that there will be no channel for the milk to flow through. This remark applies equally to the teat made of soft wash- leather, which many ladies prefer to that of the cow, and it is a good substitute; but then a fresh piece of leather must be made use of daily, otherwise the food will be tainted, and the child's bowels deranged. It is also necessary that both of these, when used, should have a small conical piece of sponge inclosed.

The most cleanly and convenient apparatus is a cork nipple, upon the plan of M. Darbo, of Paris, fixed in the sucking-bottle.[FN#9] The cork, being of a particularly fine texture, is supple and elastic, yielding to the infant's lips while sucking, and is much more durable than the teats ordinarily used.

[FN#9] Sold by Weiss et Son, 62. Strand,

Whatever kind of bottle or teat is used, however, it must never be forgotten that cleanliness is absolutely essential to the success of this plan of rearing children.

THE QUANTITY OF FOOD TO BE GIVEN AT EACH MEAL.—This must be regulated by the age of the child, and its digestive power. A little experience will soon enable a careful and observing mother to determine this point.—As the child grows older the quantity of course must be increased.

The chief error in rearing the young is overfeeding; and a most serious one it is; but which may be easily avoided by the parent pursuing a systematic plan with regard to the hours of feeding, and then only yielding to the indications of appetite, and administering the food slowly, in small quantities at a time. This is the only way effectually to prevent indigestion, and bowel complaints, and the irritable condition of the nervous system, so common in infancy, and secure to the infant healthy nutrition, and consequent strength of constitution. As has been well observed, "Nature never intended the infant's stomach to be converted into a receptacle for laxatives, carminatives, antacids, stimulants, and astringents; and when these become necessary, we may rest assured that there is something faulty in our management, however perfect it may seem to ourselves."

THE FREQUENCY OF GIVING FOOD.—This must be determined, as a general rule, by allowing such an interval between each meal as will insure the digestion of the previous quantity; and this may be fixed at about every three or four hours. If this rule be departed from, and the child receives a fresh supply of food every hour or so, time will not be given for the digestion of the previous quantity, and as a consequence of this process being interrupted, the food passing on into the bowel undigested, will there ferment and become sour, will inevitably produce cholic and purging, and in no way contribute to the nourishment of the child.

THE POSTURE OF THE CHILD WHEN FED.—It is important to attend to this. It must not receive its meals lying; the head should be raised on the nurse's arm, the most natural position, and one in which there will be no danger of the food going the wrong way, as it is called. After each meal the little one should be put into its cot, or repose on its mother's knee, for at least half an hour. This is essential for the process of digestion, as exercise is important at other times for the promotion of health.