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Care Nursling

infant, bath, head, body, skin, covered, water and temperature

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NURSLING, CARE OF.—The new-born, mature infant averages from 49 to 52 centimetres (19'6 to 20'S inches) in length, and weighs, on an average, .3,200 grammes (7 pounds) ; the weight is rarely more than 4,00o grammes (S'S pounds), and only very exceptionally 5,000 grammes (II pounds). The skin of the infant is pinkish-white at birth, and covered with a cheesy smear. Shoulders and face have a close covering of soft, downy hairs (lauugo), which fall out during the first days of life. The head is covered with dark hairs. The nails are hard and fully developed, extending over the tips of the fingers and toes. In boys the testicles can usually he felt in the scrotum. The average circumference of the head is 34 centimetres (13'6 inches).

Immediately after birth the infant cries with a loud voice, and discharges urine and a blackish-green substance, the meconium.

The immature child is smaller and lighter than the mature infant, and usually has the appearance of a little old man. The body is entirely covered with ]anugo, and the nails are imperfectly developed. It cries with a voice which is scarcely audible, and its body-temperature is usually low (95° to 93'2° F.). The pulse can scarcely be felt. Respiration is weak and often greatly or entirely impeded by mucus, which is located in the air passages, and which, owing to the weakness of the infant. cannot be coughed up. If respiration cannot be induced by external irritants (striking the baby's buttocks, dashing it with cold water, or pouring cool water over it while it is in a warm bg.th)', artificial respiration should he practised.

Care of the navel-string is of the greatest importance. When the umbilical cord has been tied and severed, a longer or shorter stump remains suspended from the child's body. This remnant must be treated with the utmost care after every bath, which must he given only in absolutely clean water and in a tub which is used for no other purposes. The cord is dressed with absolutely clean linen or antiseptic gauze, being previously dusted with a dry antiseptic powder. It is then held in place by an abdominal hinder, 2 to 3 inches in width. The umbilical stump soon dries up, and falls off between the third and tenth days, leaving a depression or scar (the navel), which is covered by a thin, delicate skin.

Immediately after the ligature of the umbilical cord, the infant should be given a warm bath, of a temperature of 95° F. This serves to remove

the cheesy, smeary substance, and to cleanse the pores of the skin. Such a bath should be given every day during the first year of life, and should be omitted only in case of sickness or certain insuperable difficulties. The temperature of the bath may be gradually reduced to 85° F., thus aiding in " hardening " the child's body as a protection against colds. Particular attention should be paid to the cleanliness of the hairy part of the head, of the armpits, of the groin, and of the region of the anus. The temperature of the room in which the daily baths and washings (which include also a daily cleansing of the eyes with cotton-tufts and fresh, pure water) are given, should be at least 61° to 63° F. The washings are best made with pieces of clean absorbent cotton, which can be thrown away after use. If a sponge be employed, it must he well cleaned after every use, and should be frequently boiled. A separate sponge must he used for the face. In the bath, and also when being carried, the baby should be held in such a manner that one hand supports the head, the other the buttocks. Any other method of carrying (for instance, holding the infant under the shoulders) is faulty, and harmful to the infant's body (see Figs. 299 to 302). After the bath, the soap which may adhere to the body should be thoroughly rinsed off, whereupon the infant should be dried rapidly and carefully with heated towels.

An examination of the baby with reference to congenital defects or deformities may be conveniently made during its first bath. The mother should not be frightened by the presence of a so-called " head-tumour," which consists of an accumulation of lymph and blood, either under the hairy part of the head or in the face, which may appear greatly distorted thereby. This tumour is caused by the pressure of the head in labour, and disappears in a few days without any interference. Pressure-areas are also occasionally seen on the head, especially upon the parietal bones. They consist of round or oval areas of skin, which are either reddened and slightly depressed, or show a grey discoloration with a red areola. The skin of these areas rarely mortifies. If it does it turns black, a brief suppuration setting in when the mortified parts have fallen off. This condition, however, is easily treated by the physician.

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