THE CARE OF THE NEW-BORN INFANT.
We simply aim at laying down certain rules which concern the management of the infant during the first few days. Being strongly opposed to artificial feeding, we will speak only of the infant which is nourished by the mother or a wet-nurse.
The cord having been tied, and the infant washed and clothed, it should be placed in its crib, and surrounded, especially in winter, by hot water bottles. Usually, before placing the child in its crib, nurses give it one to two teaspoonsful of sugar water. Without being harmful, this custom is useless. The infant should lie in its crib, on its side, the head slightly elevated, and with its back turned towards the light. It is important to keep it out of any draught. It should never be allowed to sleep in the bed with the mother. Aside from the fact that her rest is thus disturbed, the infant is exposed to inhaling the perspiratory and lochial odors, and this must be harmful. During the first few hours, it is not rare to see mucus flowing from the mouth and nose. This should be removed. The child shortly ceases to cry, and goes to sleep. It should not be rocked, as is customary; this is not only useless, but may, after the ohild has nursed, provoke vomiting. If the cord was large, the ligature may slip, and slight bleeding occur. In such a case, a second ligature must be applied nearer to the navel.
Whether the infant is nursed by mother or wet-nurse, it should not be applied to the breast before twelve to twenty-four hours. [?] A few spoonsful of sugared water or milk and water will suffice until then. When the infant awakens, its napkin should be changed. Although many infants urinate and pass meconium shortly after birth, there are many who do not. In the latter instance nothing is called for; at the end of twelve hours or more, this matter regulates itself.
Every child should be weighed at birth. This is the only way to assure oneself of its gain. Usually, the infant loses a little in weight during the first three to four days, at the end of which period it begins to gain, and at the end of the week nearly all or a little more of the original weight has been regained. From this time forth a healthy and amply nourished infant, ought to gain I to 1 ounce daily.
At the outset, the child should be applied to the breast every two hours, later every two and a half, or three. At night the intervals should be longer—every four hours, at seven, at eleven, at three or four in the morning, at eight or nine. The mother is thus able to sleep in the in tervals, and the infant promptly accustoms itself to regular feeding. If the child obtains sufficient food, it goes to sleep at once at the end of the nursing, and awakens only at the expiration of two to three hours.
Every day the child should be bathed for five or six minutes, and with out waiting for the fall of the cord, which occurs the earlier the stronger the child, from the third to the fifth day in infants at term, from the sixth to the eighth in premature infants. Until the cord separates, the dressing around it should be changed with care, and after separation a flannel or linen abdominal binder should be worn for a time. The infant should never go out until cicatrization is complete.
It is not until the end of the third or the fourth day that the passages con tain no more meconium, that they become yellow, and acquire the normal color and consistency, that of beaten yolk of egg. At this period too, the infant may become yellow, the icterns of the new born. Generally of no import, this icterus, which varies in proportion to the weakness and bad nourishment of the infant, may, in exceptional cases, be grave. The same is true of ophthalmia. While this often yields to simple lo tions, it may become purulent, and requires then energetic care, else the child may lose its sight. [The best treatment of purulent ophthalmia is instillations of a few drops of nitrate of silver solution (gr X to S i) three to four times daily: frequent washing of the conjunctiva with a saturated solution of boracic acid; and cold over the eyes until all inflammatory, acute symptoms have disappeared. A convenient way of applying the cold is by means of little pledgets of cotton, which rest, until needed, on a piece of ice. If one eye is alone affected, the greatest care should be taken against infection of the second, and to prevent this, it is a good plan to seal the sound eye for a few days. The above method depends, for its success, on constant care night and day, and two nurses, or atten dants, are therefore requisite. When we remember, however, that the infant's sight is at stake, the necessity of any amount of care and trouble is apparent. For the method of the prevention of ophthalmia neonato rum, see the section which refers to it.—Ed.] Finally, towards the sixth or the seventh day, the child's breasts swell, and give exit to milk. Manipulation of the breasts should be avoided. The best treatment is flaxseed poultices. [Equable pressure, by means of a miniature bandage, such as has been described as applicable to the female breast, will answer every purpose, and prevent abscess.—Ed.] Sometimes a little abscess forms. We have seen two instances, and in children of the same mother.
Sueh is the care required by the infant during its first few life-days. For further particulars, the reader is referred to treatises on the diseases of children.