The binder should be of a breadth suitable to the patient, extending from just below the edge of the haunch-bones to just below the breasts, and sufficiently long to go comfortably once round the patient. It should be fixed, as tightly as is pleasant to the patient, by means of safety-pins. It is customary to place a square pad of gamgee or a folded towel in front, just over the contracted womb.
It is the fashion to decry the value of the pad and binder. There is certainly little value in the pad, but the binder adds greatly to the comfort of the mother, by holding her together, so to speak, if it is properly put on.
The clothing and bed-clothes are now ad justed, and the patient left to rest, the head being low.
Soon after the mother has been made com fortable she may have a warm drink, cup of warm tea or such simple drink, but no stimu lant. It is well as soon as the child is dressed to put it to the breast, if the mother is not too tired, for a few minutes. The contact of the child's mouth with the breast gently stimulates the contraction of the womb, and tends to pre vent relaxation of the womb and bleeding. Regularly every third hour thereafter the child must be replaced at the breast (see p. 560) whether there be milk or not. The effort at sucking promotes the production of milk.
The of the nurse should now return to the infant. Having brought a child's bath in front of the fire, and placed at hand soap, sponge, towels, dusting powder, a square of gamgee, a little olive-oil, and the child's clothing, and a low chair or stool to sit on, she proceeds to bathe and clothe the child.
First of all, the child lying on her lap, she should carefully scrutinize it all over, head, ears, eyes, limbs, fingers and toes, back, chest, and abdomen, to note any irregularity of any kind. In the case of a male child she should see if each testicle is down in the pouch of the scrotum, and whether the foreskin can be easily pulled over the point of the penis. Very frequently the opening of the foreskin is a mere pin-point. If this too-small opening be not enlarged by circumcision, or by some other method, trouble will certainly result.
A cross, ill-natured child is quite often the consequence of a narrow foreskin, which re tains drops of urine, permitting inflammation to occur between the under surface of the fore skin and the upper surface of the penis.
This, therefore, if present, should be noted for the doctor's attention.
The outlet of the bowel should also be looked to, as in rare cases it is imperfect The possibility of rupture (p. 606) must not
be overlooked in this scrutiny, and the con dition of the coml. If there be auy oozing of blood a fresh thread should be tied nearer to the child than the original one. The child is now quickly washed, the eyes being first bathed, then the head, and then the rest of the body.
Especially must the child's limbs be gently stretched from the body to permit the folds of skin to be thoroughly cleansed.
Sometimes parts, or the whole of the body, are covered with a white material which soap and water do not remove. Such parts should be rubbed with the olive-oil, or vaseline, or lard, or butte:, till a kind of lather is produced, which washing wi'd then readily remove.
The child must be carefully dried, and then lightly dusted. Note that careful drying is necessary before dusting. It dusting-powder be laid on damp skin it forms a which will rapidly excoriate the infant's tender skin. in no place is the powder to be laid on thickly, else the same thing will happen with the natural moisture of the part.
The stump of the cord must now be dressed. It should be bathed with clean lysol solution, dried with gamgee, and then folded in a fresh piece. In the centre of the square piece of gamgee is made a small slit; through this pass the cord, then fold the gamgee over upon it. It Is then lightly secured by the binder. If properly put ou, the gamgee may remain un disturbed for a day or two, when it should be replaced by a fresh piece, without pulling ou the cord. The stump usually drops off about the fourth or sixth day. The raw surface should be bathed by lysol solution or boric solution, dried with gamgee, and protected by a fresh piece till it is no longer raw. Infection may reach the child by this route, and erysipe iaz and peritonitis arise if care be not taken The clothing suitable for the chiid is given in detail on p. 549, and its food on p 560. It should get no sugar ann water, nor anything but the breast milk or bottle food.
It should, immediately after Messed, be put for a brief period to the mothers breast (see p. 645k The first breast milk of the mother is of a peculiar character, called colos trum, which acts upon the child's bowels. The first material from the child's bowels is of a very dark brown colour. It ie called meco nium, and it is not infrequently forced out of the bowel by the pressure on the child at birth.
The child should sleep in its own cot, and never in the same bed with the mother.
The further management of the child is given in detail in the preceding section.