When the baby awakes from the profound sleep into which it invariably falls after its first bath, it will cry. This cry is the sign to give it its first meal. At this time the mother should not listen to the advice offered by grandmothers, aunts, and other women, concerning syrups, teas, and sugared water ; but she should put the infant to her breast on the first day. After a few drops of milk have been pressed out, the baby will soon suck vigorously at the nipple placed in its mouth, unless it suffers from con genital defects of mouth or nose which render sucking impossible. Follow ing the first, usually unsatisfactory meal, it may be necessary to give the infant a little sweetened water, With regard to manner and frequency of feeding, see NURSING. When the infant has nursed for from 15 to 20 minutes it should be placed carefully upon its back in order to avoid eructations (often mistakably induced), as well as the inclination to vomit. Spitting or vomiting of food immediately after nursing is usually a sign of over-feeding.
The bowel movements of a healthy infant will number from two to five daily during the first few weeks after birth, if it has been nourished regularly. Later there will be from one to three movements a day. The excrements of healthy children form thick, adhesive, pulpy masses. In children who are fed on mother's milk they are yellowish in colour, and have a sour smell ; whereas they are clay-coloured (greyish-yellow) and slightly malodorous in babies fed on cows' milk.
Disturbances of digestion often give rise to an accumulation of gases in the baby's intestine. If the infant be healthy, these gases will readily escape through the anus ; otherwise they may cause flatulence, distention of the abdomen, and colic. The baby then cries incessantly, distorts its face, beats with its arms, and draws its little legs up to the abdomen (so called " internal spasms "). To remove these winds the baby should be placed on its back with the buttocks raised (sec Pig. 303), and given an injection of warm water (.1 to A of a pint of water at 05° F., and one table spoonful of oil)• Very small infants may be placed with the abdomen upon the palm of the hand, which slightly presses the abdominal walls, causing the gases to escape. Constipation (absence of bowel movements) not infrequently occurs during the first weeks of an infant's life ; in some cases even during the first clays. The feces are then discharged only every second or third day, or still more rarely. They consist usually of hard, round balls, which are bright-yellow in very young nurslings ; darker in babies that are several weeks old. An infant suffering from constipation has a hard, distended belly, which is painful even to the slightest touch ; and the skin is usually hot. If the infant remain constipated for some time, urina
tion becomes disturbed, and high fever sets in, accompanied by involuntary twitchings and even by fatal spasms. Insufficient fat (cream) in the milk, and painful fissures of the anus, are sometimes causes of such constipation in infants.
In breast-fed children constipation may result from insufficient food. An infant which is always constipated should receive food containing more fat, and a physician should be consulted as early as possible. If the stools are a little slower than usual, injections of warm water may be given with safety. They should not be given too often, however. Massage is a reliable remedy for babies inclined to constipation. The baby is placed upon its back, and its abdomen greased with vaseline, lanoline, or other clean fats, whereupon rotary rubbing movements are made under slight pressure in a direction from the right groin to the arch of the ribs, thence transversely toward the left, and from the left costal arch downward to the left groin, thence completing the circle toward the right groin. These manipulations should be continued for from three to five minutes. It is advisable to have a physician show how to perform the massage.
The amount of urine passed soon after birth (provided no deformities of the external genitals be present) depends upon the quantity of food taken, and increases rapidly during the first ten days. At first it is dark and cloudy, but soon becomes clear and straw-coloured.
Urinary disturbances, especially painful pressing or complete retention, may be caused by marked flatulence, or may be due to a growing together of the glans penis and the foreskin. Other causes of disturbances are narrowing of the prepuce in boys, adhesion of the small labia in girls, inflammation of the interior surface of the prepuce, vesical catarrh, and stones of the bladder. In cases of urinary retention the infant cries incessantly, perspires profusely, and draws its legs up to the belly. When flatulence is the cause of the condition, a warm bath of 95' F. is usually sufficient to give relief ; or towels heated to 104° F., and frequently changed, may be advantageously applied to the region of the bladder. If these measures be not followed by the discharge of urine, a physician should be summoned without delay, as prolonged retention of urine may give rise to severe spasms and general systemic poisoning. If there is narrowing of the prepuce, or if the glans penis and the prepuce have grown together, the physician should treat this condition as early as possible See FORESKIN, DISEASES or. If this be not done, the continued violent pressing may cause inguinal or umbilical rupture, prolapse of the rectum, or HYDROCELF (which see).