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by Frank Godfrey, Esq., M.B.
Volume 11, 1900, pgs. 19-27
"A healthy infant requires nothing more than a proper amount of healthy milk from its mother, and on this it will grow and thrive, and all the vital processes will be properly carried out. It is, I consider, the bounden duty of every healthy mother to nurse her baby if she can, and nothing but physical incapacity or the sheer exigencies of life should prevent her from fulfilling that duty."
*Lecture delivered before the Leeds Branch of P.N.E.U., Feb. 16th, 1898
Upon the proper care and nurture of the young plant and animal depend its future health and strength. The tender plant, protected from withering cold, warmed and gladdened by sunshine, and duly watered, will grow into the vigorous shrub or noble tree; but if it be deprived of sunshine, if it be nipped by chilling wind or biting frost, it receives a check from which it may never recover, and which leaves it for life stunted, dwarfed, and ill-developed.
Similarly the young animal which, under favourable conditions of health, thrives and grows into the robust adult, will, under adverse circumstances, be rendered puny and weak, unfit to fight its way among its more study fellows, and it will early fall a prey to enemy, disease, and death. And so with the young of the highest animal: man. His after life, and health, and strength depend very largely upon the care bestowed on him during infancy and childhood; ignorance or neglect of the laws of health on the part of his parents; administration by them of insufficient or improper food; the practical application to his small body of fads, as regards clothing and exposure, which they espouse, may set a seal upon him, which he has to carry with weak and faltering steps through a life of suffering to an early grave. But, on the other hand, the child on whom his parents bestow proper care, and for whom they exercise prudence and common sense, will reward them by growing up to manhood physically and mentally robust and healthy, fit and able to take his place in the battle of life, and to rise, maybe, to greatness and renown.
Think for a moment what this means to those of us who are privileged to be parents, how great is our responsibility, how solemn the charge with which we are entrusted, how sinful would be our betrayal of that trust, and how great may be our reward. We are guardians to our children for their health, we are responsible to them that they be safely piloted through the period of life when they are unable to do for themselves, and launched on the ocean of life in a fit state to face its storms. More than that, we have a national duty entrusted to us as well, for is not the national life and vigour but a compound of its individuals? Let us see, then, very simply and shortly, how we may best endeavour to fulfil these great obligations.
Now, the proper growth and development of the young animal organism depend upon four main external factors--Food, Air, Warmth, and Sunlight, and I propose to sketch for you how these important conditions may be best secured for children.
Firstly, Food. This is, in itself, of sufficient magnitude to form the subject of an entire lecture, and I cannot attempt to deal with it anything like fully to-day. We must clearly realize what food is, and for what purpose food is required. In the human organism, as in all living structures, certain processes are being constantly carried on--growth, development, decay, and repair. Growth, development, and repair are, so to speak, gains from without, and the purpose of food is to supply these gains. In children, not only have the tissues to be kept in repair, but growth and development are also going on apace in the formation and building up of new tissues and organs. It is on the proper building up of these new tissues and organs that the after-life and health of the child depends, and the material which is chiefly concerned in their structure is food. Now, food consists of five great essential elements:--
(1.) The Nitrogenous Elements, so called because their chief constituent is Nitrogen, and these are found chiefly in animal foods, such as albumen, or white of egg, caseine and curd of milk, and the flesh and juice of meat. They are of first importance, for from them are formed muscle, brain, nerve, and most of the other vital tissues.
(2.) The Hydrocarbons or Fats, which take their share in the development on many important structures. These are largely concerned, and please to note this very carefully, in the formation of bones and teeth; they also provide, to a large extent, the fuel from which the body heat is generated and maintained, and in children more especially the maintenance of heat is vital. Indeed the importance of fat in the young animal organisms cannot be over-estimated.
(3.) The Carbo-hydrates, starch and sugar, are fat producers, they aid in the development of the various tissues, and are also consumed as fuel for the generation of heat.
(4.) The Mineral Constituents, such as salts of lime, potash, and iron, help in the formation of the hard tissues of the body, the bones, and teeth; and lastly--
(5.) Water, which is required for the liquefying of the blood, for the conveyance of nutriment to the different parts of the body, for the carrying off of waste products from the system, and for the restoration of tissue.
These then are the essential elements of food, for infants as well as for adults, and for the former, they are all contained in their proper relative proportions in human milk, which must be taken as the type of infants' food.
The composition of human milk is as follows:--
Nitrogenous Elements . . . 3924
Hydrocarbons or Fats . . . 2666
Carbo-hydrates . . . 4364
Mineral Matters . . . 138
Water . . . . 88908
100000
The Nitrogenous Elements are represented by the caseine or curd; the hydrocarbons by the cream; the Carbo-hydrates by the sugar of milk; the Mineral Matters by salts of lime, potash and iron; and, lastly, there is a large amount of water. A healthy infant requires nothing more than a proper amount of healthy milk from its mother, and on this it will grow and thrive, and all the vital processes will be properly carried out. It is, I consider, the bounden duty of every healthy mother to nurse her baby if she can, and nothing but physical incapacity or the sheer exigencies of life should prevent her from fulfilling that duty. I have no sympathy with the lady of fashion who allows the claims of society, or the attentions of pleasure-seeking, to interfere with her duty to her offspring, and one would fain hope that the recent noble action of a young royal mother, who sturdily took her stand upon her motherhood and set custom at defiance, might awaken a similar instinct in some of the mothers among our better classes. If an infant be not naturally fed, it becomes dependent on artificial substitutes for its natural food, and the moment you begin with these, you open the door to numberless opportunities for evil. I do not for one moment say that a perfectly efficient artificial food is not obtainable; most certainly it is, but that food must resemble human milk in composition, and it must be kept free from decomposition and infectious germs. And how are we to attain this? By giving raw cow's milk diluted largely with water or barley water or other fluid, as is so often done? Most certainly not, unless that dilution be of proper strength and unless elements, reduced by the dilution below their proper standard, be added. Cows' milk diluted with two parts of water, as is usually done in early infancy, is not an efficient food, as you will at once see by a glance at this table.
Cows' milk, diluted with two parts of water:--
Nitrogenous Elements . . . 1'801
Hydrocarbons . . . 1'435
Carbohydrates . . . 1'345
Salts . . . '182
Water . . . 95'237
It is sadly deficient in that very vital element fat, it is also deficient in sugar, and in curd or caseine, the flesh-forming element. It is a food far below the proper standard. Its curd, too, is more dense and hard that that of human milk, and all these defects must be remedied. And how can this be done? We can supply the deficient fat by adding cream, one or two teaspoonfuls to the feed; we can make up the proper amount of sugar by the addition of white sugar, or better still sugar of milk; we can bring the Nitrogenous element up to its proper standard by adding a little raw meat juice. We can further render the curd lighter and more digestible by boiling or sterilizing the milk.
For those of us who can afford it a most excellent and perfect substitute can be obtained from the Aylesbury Dairy Company, or some of the better known dairy companies,--the Humanized Milk.
The vast majority of the patented infants' foods, excellent though they may be in some respects, are deficient in that very vital element fat; and that favourite food with many, condensed milk, is, from a food point of view, a hollow sham; it should never be given, save to tide over a temporary difficulty.
In selecting an artificial food for our babies, we should proceed on proper lines; we should ascertain from some one who knows, or from some written authority, what form of food will best represent the natural one; and even if we have to apply to a doctor for information, it will cost us less than having to call him in to remedy the results of improper feeding.
The great dangers of artificial foods prepared with milk are those of souring, of decomposition, and of the conveyance of disease germs. Souring, as you know, sets in very rapidly, especially in hot or thundery weather, indeed it may be said to commence almost as soon as the milk is drawn from the cow. The germs of some infectious diseases are not at all uncommonly introduced in milk to which they have gained access, germs of typhoid and scarlet fevers, of diphtheria, of cholera, and most deadly of all, of turbercle. This last disease is very common in cattle, often existing before any active evidence of its presence be noticed; and the milk drawn from a turberculous cow may readily produce consumption or other form of tubercle in the child who drinks it.
These dangers which, mark you, are very real ones, may, to a very large extent, be counteracted by boiling or by sterilization, and milk used in the nursery should always be subjected to one or other of these processes directly the milkman leaves it at the house. It matters not very much which process be adopted, boiling is quite efficient, sterilization is more recent and more fashionable, and it has the advantage that milk so treated does not acquire the taste, objectionable to many children, of boiled milk.
There are many forms of Sterilizer now before the public, which can be bought at the cost of a few shillings, and of these, that known as "Aymond's" is, from its simplicity, probably the best.
An infant under four months old has no power of digesting starch, and to give it starch-containing foods such as arrowroot, sopped bread, or gruel is to give it that which it cannot digest and which may do grave harm. I wish this fact were more generally known, specially by self-opinionated old nurses.
Perfect cleanliness in all vessels and bottles in which children's food is kept and given is absolutely essential, and cannot be too carefully supervised; and all glass and rubber tubes, mouth-pieces, etc., which cannot be thoroughly cleansed, must be carefully avoided. Many a grave illness has its origin in a dirty bottle or foul rubber tube. And foul these tubes will get in spite of all one's care; they are the cause of a vast amount of infant illness, and cannot be too strongly condemned.
Children's meals should be regular, simple and ample. Too frequent feeding, stuffing with cake, sweets, or fruit, between meals, the giving of unwholesome food, of jams in excess, curries, or savouries, and the like, will tend to intestinal disorder and ill-health. If a child be plainly, sufficiently, and regularly fed, it will not require food between times. The stomach, like every other organ, requires its periods of rest, and it should have them. Every child should be allowed to eat as much as it wants at meal-times; if the food be wholesome and not hurried over, the child may safely be left to satisfy its appetite without fear of repletion, and to deny a second helping to a hungry child is a cruel mistake.
We are sometimes apt to forget too that children, specially infants, are liable to be thirsty, and to think that milk will satisfy thirst. Milk is a food, not a drink, and water is what they want, pure wholesome water. It is an essential, and it serves an important purpose in the economy. In summer-time a little lime or other fruit juice added to the water is agreeable and advantageous.
It cannot be too strongly insisted upon that children do not require alcohol in health. It is in no sense a food, and it is a powerful drug which is capable of doing irreparable harm. Occasionally it is of great service as a medicine, but only occasionally, and it should never be given except under medical advice.
The public are far too apt to give, and to advise their friends to give, wine and other forms of alcohol to themselves and to their children, in the vain belief that they are feeding and strength-giving, and capable of "building you up," as it is called; and one is apt to be led away by the specious advertisements of the various forms of medicated wines, which their manufacturers would have you believe contain the elixir of life, or something very nearly allied to it. It has become the custom with many people to give these medicated wines to themselves and to their children as a tonic. Even some total abstainers have been known to use them, under the delusion that they are non-alcoholic. There never was a greater mistake. These medicated wines, the demand for which is shewn by the large amount of space they occupy in the advertisement columns of the daily papers, and by the prominence given them in the windows of many grocers and chemists are, I consider, the curse of the age. They are potent intoxicants under the cloak of medicine, and many of them contain strong narcotic poisons in addition to bad alcohol. Of them all, coca wine [akin to cola?] is the chief sinner. Some of the forms of coca wine are made from the coca leaves themselves; others, and I fear the majority, from the drug cocaine, a narcotic quite as insidious and quite as deadly in its effects as morphine. The dangers of such a wine are obvious, more especially if taken when the system is weakened by recent illness, for not only does the patient acquire a liking for alcohol, which is presented in a seductive form, but he soon falls a victim to what has aptly been termed the third scourge of humanity the cocaine habit. It is high time that stringent steps were taken by our legislature to put a restriction on the manufacture and sale of all medicated wines. And may I digress a little further, to condemn the most cruel and wicked practice of supplying alcoholic drinks at children's parties: claret cup, port wine negus and the like. It is done, and it cannot be too strongly denounced. Who knows what poor child may not inherit an inebriate crave, and what dire evil may not result. I do not stand here as a teetotaller to denounce alcohol all around, but I do think strong speaking is necessary in this regard.
Many children are allowed too long a fast during the night time, and suffer in consequence. It is too long for a young child to go from tea at, say, six until breakfast at eight on the following morning. Infants, of course, are fed in the night. Older children, if awake, are all the better for a little milk at eight or nine at night, and as all children are like the birds, early astir, it is a wise plan to let them have some bread and butter or milk by their bed-side to eat on first waking in the morning.
I have already spoken about the need for fat in infancy and childhood, and I would like again to enforce it. Its importance cannot be over-estimated, and is shewn by the very large proportion of fat contained in human milk. On the fat depends, as I have said, two very important conditions, the maintenance of animal heat and the development of the bones and teeth. Without fat, the body heat falls below its proper standard; without fat, the bones and teeth are ill-developed, and rickets and dental decay ensue. Some years ago a series of very interesting experiments were conducted at the Zoo on the feeding of young carnivorous animals, the result of which was to prove that those from whose food fat was excluded rapidly developed rickets. In infancy, fat may be supplied in the form of cream, in childhood as cream, as butter, as meat fat and as bacon drip. Many children naturally dislike fat, and if so it is cruel to force them to eat it. By carefully mixing it with mashed potato, or by giving it in the form of light suet pudding, it will generally be taken without demur.
Next as to Air. Children require air in abundance, and, deprived of plenty of fresh air, they soon flag and become pale and listless. Witness the children in our crowded centers of population. I am often astonished at the marvelous change in the child from some large inland town, whose home is in a confined neighbourhood, after a week on our Scarborough sands. The pale face, the want of appetite, the lack of "go," the frequent complaint "I am so tired," give place to rosy cheeks, to bright eyes, to a voracious appetite, and to an energy almost untiring. We have all felt the same thing, have we not, when wearied by work and much confinement to the house, we have sought the moors and stretched away over them, rejoicing in our new-found strength and reveling in what poor Lindsay Gordon described as "God's glorious oxygen."
Let your children have as much fresh air as possible, both inside and outside the house. Let your nurseries be large and airy, and airiness should be obtained without draught. In summer, keep the top windows freely open. In winter, suitable methods of ventilation may be arranged; or, where such do not exist, the desired result may be obtained by the well-known plan of putting a board under the raised lower sash of the window, and allowing air to enter the room through the space between the top and bottom sash. The air thus enters high above the occupants' heads and is diffused over the room insensibly. Draughts may be met by putting draught protectors under the door, and by setting suitable screens to, as it were, break them up. This question of ventilation applies to the night nursery probably with even greater force than to the day, for our children spend more time there. After the children leave the night nursery in the morning, the windows should be widely opened, the bed clothes all turned up, and its contents thoroughly flushed with fresh air.
The more children are out of doors, the better; nothing but bad weather should prevent them from getting out for as much of the daytime as lessons and other circumstances will allow. And talking of lessons, do not allow lessons to occupy the best hours of the day. The morning air is best because fresher and purer than any other, and we should get our children out during the morning if possible. Lessons are much better mixed up with periods of recreation than carried on continuously for several hours. In one large public school, justly celebrated for the physical and mental health of its pupils, the boys are turned out for fifteen minutes between each class, and the bulk of the work is done before eleven and after three o'clock. The young brain must not be overstrained by too much study. It is a delicate organ, the brain, though hidden away and intangible; but it is the dominant organ of the whole system, and anything that impairs its health reacts throughout the system. We are, some of us, apt to forget that our hidden and unfelt organs are subject to the same fatigue as those we know more about. We realize muscular fatigue quickly enough, and we rest the tired muscles; we know when the eyes tire with much reading, and we put the book away for a period; when the heart is beating too quickly from over-exertion, we cease the violent exercise. But do we in the same way seek to avoid over-fatigue of the brain, do we give it always the rest and relaxation it so urgently needs? The headache produced by long study; the general feeling of weariness for which we cannot account; are not these evidences of brain fatigue, and should we not so regard them? They should above all be most carefully watched for in childhood, and most carefully guarded against.
(To be continued.)
Health in the Nursery.
By Frank Godfrey, ESQ., M.B.
Volume 11 1900 pg 93-101
(Continued from page 27.)
In these days of keen competition there is an infinite danger of over-straining the young brain, and so doing irreparable harm, which no class honour, however brilliant, can recompense for. How often do we see the bright intelligent child pushed along in his mental work far beyond his powers simply because he is bright and quick, and because his proud parents and masters picture for him a brilliant future. Is that future generally attained? I fear only very seldom. Too often the lad who has given such early promise, and who has gone through a brilliant school career, envied by his class-mates and applauded by his teachers, fails in early manhood, his powers exhausted, his high promise unfulfilled and unattainable; while the boy with less brilliance, who has not been pushed, comes to the front later on in life, and develops mental powers with which no one would ever have credited him. Read that pathetic life history of a clever over-worked child by Marie Corelli, The Mighty Atom, and, as you love your children, protect them from brain strain.
It is easy enough to recognize the brilliant child, and it is generally equally easy to tell the stupid child, but I wish to enter a plea for many children who are supposed to be dull and inattentive, and who are so merely because of unrecognized deafness. We meet with many examples of this in practice, and I would wish that every apparently dull and inattentive child should not be condemned as such until it is made certain that his hearing is not at fault.
Of late years, a new danger has crept into children's lives--I mean the danger of frequent excitement and interference with regular habits liable to be caused by children's parties. Far be it from me to decry or to discourage such a charming and pretty entertainment as a children's party, and I see nothing but good in it if not overdone. But there is a danger of these parties being overdone. They all come together with a rush, and they are, many of them, kept up too late. It cannot be good for any child to be kept in the state of excitement and unrest that frequent parties are bound to produce, especially when these are associated with late hours and rich unaccustomed foods. We should be careful not to allow our children to go to too many parties, and we should be equally careful that they are not allowed to be up much beyond their usual bedtime, or to eat a lot of unwholesome food. The remedy is in the hands of the givers of parties, who should aim at early hours and simple refreshment.
I have wandered, I fear, far from the subject of air, but a train of thought has led me on.
It is not necessary to say much on the subject of sunshine. We all know and appreciate its beneficial properties. It is required of all life, practically, for its exhilarating, cleansing, health-giving effects, and children require it in large measure. The nurseries should be, if possible, on the sunny side of the house, and children should be allowed out in the sunshine as much as possible. It is not very generally known that sunshine is a strong disinfectant and deodorizer. Many disease germs, which, like other malignant spirits, work in the dark, are rapidly killed by exposure to sunlight. This was conclusively proved by some experiments made in America with infected bedding from the berths of a cholera-stricken liner during the Hamburg cholera outbreak. Hence we may realize the importance of admitting sunshine freely and unstintingly to the bedding and furniture in our homes. We all know, too, how potent an effect sunshine has on the spirits and temperament, evidenced by the gay, light-hearted disposition of the inhabitants of Southern Europe as contrasted with those of our less favoured northern latitudes.
Warmth is most essential to the child and must be secured if the child is to be kept well and to grow up to health. Children very readily part with heat and suffer from the lack of it very seriously. Warmth may be obtained by artificial heat, by exercise, by clothing, and by food (which I have already spoken about).
As regards artificial heat, an open fire is much to be preferred to any closed stove or other method of heating. The room is brighter and fresher, and I think healthier, and we should always adopt this method in our nurseries. A fire, too, serves a valuable part in ventilation, though it does, perhaps, tend to increase the draught. The nurseries should, above all things, be warm, as well as airy and dry, and we should never hesitate to light a fire whenever the weather is cold enough or damp enough to require it. Temperature should be the guide, not the almanack. Nothing strikes one as more senseless than to see a fireplace arranged with pretty curled papers or some fancy screen, put there in May and never to be moved till October. There are many days in summer, in this climate, when both we and our children would be all the better for a good fire. It is sad when we allow common sense to be subordinated to fashion.
Children should have abundance of exercise, and preferably in the open air. They need it, and it is natural to them. Watch a baby or a child when awake, the creature is hardly ever still; indeed, if we adults went through the same amount of exercise as a healthy child does in half and hour we would feel as if we had been on the treadmill. In childhood, energy is given off very rapidly, and tissue change is great, and exercise is the natural outcome of these. Exercise, too, produces warmth, and a healthier warmth than any produced by artificial means. A scamper round the garden, or a run with a hoop, will remove blue fingers and a peaky face quicker and better than any fire. When the weather is too bad to allow of their being out of doors, our children should be turned, if possible, into a large room to dance and romp about.
One is frequently asked for advice about cycling for children, and it certainly is an important question. Although the wild craze for cycling has passed, the cycle has "come to stay," and has taken a permanent place amongst us as a vehicle of recreation and of utility. Everybody cycles, and thousands of children, and it is well that all should know what, if any, danger attends the exercise. The danger of cycling is the danger of strain to the heart and blood-vascular system, and it is a danger that comparatively few appreciate. Now, the young heart is an organ very liable to yield the strain, and one in which prolonged and oft repeated strain is likely to cause organic disease; and I believe that you may have greater strain thrown on the heart by cycling, with less apparent evidence of it as manifested by breathlessness, than by any other form of exercise. It is difficult to lay down hard and fast rules; but, speaking generally, I should say no child under nine years of age should be allowed on a machine at all, that long distances and riding uphill should be strictly avoided, and all racing prohibited.
And now I come to a very important matter, namely clothing. We have, most of us, some fads about clothing. Some go to one extreme, some to another; some advocate an absurd amount of smothering up, others would, as they call it, "harden" their children by clothing them too thinly. We want to steer between these two extremes, and to do this, we need only remember that children must be warm, and that they must have freedom of movement to allow of their getting the exercise they require. Any clothing which interferes with free movement is harmful, no matter how warm its texture; all clothing which allows the skin to be chilled must be avoided.
It must be remembered that the skin is not merely a kind of leathery covering to the body, as some would suppose. It is an organ, and a very important organ, in which a vast amount of blood is constantly circulating. The skin is the great heat regulator of the body, the blood comes to the skin to get rid of its heat, or, in other words, to be cooled. You can readily understand that, in the skin, the blood can be cooled too much, or, in other words, that it may be chilled, and then return to the important internal organs, cold and devitalized, to injure them and to set up some serious disorder. And, further, it is essential that the blood should circulate freely in the skin, and to enable it to do this, the blood vessels in the skin must be freely open, not narrowed and contracted. Now, cold, as you all know from personal experience, contracts and shrivels up the skin, and, with it, the blood vessels that exist in it. When this happens, less blood is able to circulate in the skin, and, as a result, the lungs, liver, and other internal organs are over gorged and hampered in their work. If this chilling be a sudden occurrence, it may set up an active internal inflammation; but if the skin be kept constantly a little too cold, the blood is kept below its proper temperature, it suffers, as do all the other organs to which it carries life. How, then, are we to arrange to keep the skin and blood warm? By clothing the whole of the surface of the body, save the head and hands, in warm woollen clothing, equally distributed. It is useless to smother up the chest and stomach in many vests, binders, and petticoats, whilst the legs and arms are left bare or but thinly clad in calico or linen. Try to imagine how large a sheet of skin is represented by that covering limbs and you will realize how large a proportion of blood must be chilled if these be not kept warm. Children's clothing must be light, it must be warm, and it must be easily fitting; and I am convinced that suitable warmth can only be obtained in animal wool. The various descriptions of cotton underclothing, though superior to linen, are not so warm as those made from wool, and no amount of puffing and advertisement by their manufacturers will make them so. Woollen clothing, of suitable texture, is the proper clothing for children, and it is as porous as need be. In summer we may, perhaps, put them into cotton or linen, but, to be quite safe, it is better to keep to wool of thinner texture.
In babyhood, we should avoid all the senseless inelastic binders and stays which it is the fashion to use, and which have been used for past generations. I have preached against them till I am tired of it; all I ever get for my trouble is a look of pity from the nurse, and a lofty remark that she never saw a decent baby dressed in any other way. A baby's stomach moves up and down with every breath, and it distends and contracts according as it is full or empty. It cannot, therefore, be right to put round that stomach an inelastic binder, for, in the one case, it must injuriously compress the full stomach, and in the other, it must be so loose as to be useless. A binder is necessary in early infancy to prevent rupture of the navel, but it should be made of some warm elastic material, so as to allow of the movements of the stomach whilst maintaining a constant gentle pressure. Over the binder should be put a little knitted woollen shirt, then a flannel skirt or petticoat which clasps at the wrists and extends below the feet, a linen petticoat next, and over all, the gown. This last should not be too long, and should be so arranged that the baby can kick its legs about freely, and it also should have sleeves reaching to and clasping round the wrists. On the feet should be easily-fitting knitted wool socks. When the baby is shortened, the same style of clothing may be worn, only with the gown and petticoat shortened, and the binder may be discarded. It is not required now, and it, like stays, will do harm by hampering movement. It is generally thought that stays are required to support a baby's back; this is a fallacy, the back is far better left alone to develop naturally. It should not be fixed up in a splint any more than should the limbs.
And, talking of shortening, this process as often carried out is fraught with danger. It is the custom, at all events in certain classes of society, to shorten the baby at a certain age--three months, I think, is the accepted time--by making a great change suddenly in its apparel. The long swaddling clothes, the woollen sleeves and socks, are discarded, and baby is served up to its admiring relatives in a short linen frock, without sleeves, and with pretty coloured bows at the shoulders, with bare neck, bare legs, pretty cotton socks, and dainty shoes. All very sweet and charming, and possibly to be undertaken without great risk in the middle of a hot summer. But think what this means in winter, how great, how sudden the change, and how perilous. I well remember being sent for to see a fine healthy child (whose mother I had specially warned on the subject), the day after it had been shortened for Christmas. The flushed face, the dry skin, the restlessness, and hurried breathing proclaimed only too surely what had happened, and that young life succumbed to pneumonia, a victim to ignorance and to a foolish custom.
When babyhood is past and during childhood, the clothing should be equally warm, simple, and free; a knitted wool vest, a woollen combination with long sleeves, a flannel petticoat of the "rational" type, that is--made like a combination, only with loosely-fitting knickerbockers fastening over and meeting a woollen stocking at the knee; and over this, any dress you like. And in summer the same, only with petticoat of thinner material and possibly with the combination of cellular cloth or soft cotton. So clothed, the child is safe from all ordinary sources of cold, and the skin is kept equally warm.
I cannot too strongly condemn the pernicious and utterly erroneous idea that children can be hardened by clothing them thinly and exposing them to all weathers. One would think that no educated parent could be so foolish; and yet, this idea does exist, as one has had occasion to see.
Some few years back I was asked to see a little girl of six, the child of wealthy parents. Her mother explained that the child was constantly ailing, looked thin and delicate, and required frequent medical care. It was a chill evening in October, and I found a frail half-starved-looking child, pinched and feeble, dressed in a charmingly pretty thin silk dress, with bare throat, bare arms, bare legs, and without one vestige of wool about it save a very thin undervest. Except for a warmer dress, and a jacket, this was the same clothing she had been wearing out of doors during the day. On remonstrating with the mother, and pointing out that want of warm clothing was the cause of the child's ill-health, I was met with an indignant statement that the clothing was ample, and that the mother believed in hardening her children, not coddling them; and my warnings were ignored. And one sees numerous cases such as this, though, perhaps, not so extreme, where ignorance or wrong-headed ideas of hardening are responsible for setting a hopeless blight on young, and what should have been healthy, lives. Is it not too sad? Children's boots and shoes should be made free and easy to fit the individual feet; the foot must not be forced into a boot which cramps and compresses it.
Children need, of course, to be protected from rigorous weather, but we need not fear to send them out in cold weather, provided they are properly clad. Soft cloth gaiters will protect the legs, and a warm cloak, warmed at the fire before being put on, will effectually prevent any danger of chill. Similarly for a baby, it, too, may safely be sent out in its pram if it be well wrapped up in a warm rug, and if the pram itself be warmed by facing it to the fire, or by heating it with a hot-water bottle.
Perhaps some of you may smile at these precautions, and think that they savour of coddling. It is not coddling at all, and I abhor real coddling as much as any of you. There is a good and sound reason for thus warming the out-of-door garments which any of you can test personally. If you put on a cold cloak, what happens? There is a rush of animal heat from your body into the cloak, and if you go out at once into a keen frosty air or chill east wind, you are parting with heat just at the very time you most need to retain it. You lose heat which you many never regain till you return to a warm room, or take some violent exercise. Whereas by putting on a warmed cloak, this loss of heat is avoided, and you remain cosy, warm, and comfortable during your outing. If any one doubt this, I would only say, try the experiment, and he will doubt no longer. Similarly with the bed. How cold the sheets strike us when we get into them on a winter's night, how long it is before we feel warm, how often do our feet remain cold all night through. By warming the bed, and nothing is better for this purpose than the old-fashioned warming pan, all this discomfort may be prevented. In winter I hold that our children's beds should always be warmed, and there should be a fire in the night nursery. A flannel nightdress is the proper garment. If these precautions against cold are necessary in health, how much more necessary are they after illness, or in inherited delicacy. We are careful enough during and after severe illness, but it is my common experience to meet with lamentable want of care after slight ailments.
The common cold is often changed into a severe bronchitis or pneumonia by want of care. Those two diseases, which are popularly regarded as simple, measles and whooping cough, are very often the predisposing causes of grave lung trouble. It is a common thing to hear that children have "only" got the measles; it is common to hear of children with whooping cough being sent out in the depths of winter to breathe the air at the gas works, or the fumes from the lime kilns, in the belief that these agents will cure them. Some coal tar products are, I admit, excellent remedies for whooping cough, but they should not be administered out of doors on a winter's day. Measles and whooping cough are often, in themselves, but simple complaints, requiring nothing more than bed for a few days, warmth and care, but these they must have. No diseases are so liable to grave complications, and though the doctor may not often be required for their treatment, he may be very badly needed for their results if care be not taken.
A well-known proverb says that "Cleanliness is next to Godliness," and we must be scrupulously clean in our nurseries, and in our children's persons and food. The nurseries should be well scrubbed once or twice a week; all dust carefully removed daily, cooking utensils, cups, plates, etc, most thoroughly cleansed after use, and bed and body clothes changed sufficiently often. Children should be fully bathed every evening before going to bed in warm water, and washed in warm water every morning. Cold baths are not permissible, except to very robust children in summer. Soap should be of good quality, and what is known as over-fatted--that is, with a minimum amount of alkali. Sea-bathing, on this east coast at all events, is, I think, not safely to be undertaken, except in the height of summer; and prolonged paddling, especially when the wind is cold, is dangerous.
Probably the keynote of success in the management of children is regularity--regularity in rising and in going to bed, regularity in meals, regularity in all things. And remember, too, that children require a sufficiency of rest. The day is too long for the young child, and up to seven or eight years of age a child should be put to bed for an hour at least at about mid-day.
So far, I have spoken of physical health. Will I be going beyond my subject, or boring you, if I speak for a moment of Moral Health! By this I do not mean religious training, on which subject others are better qualified to speak, but I mean the healthy moral tone that should prevail in the nursery; I mean obedience, discipline, cheerfulness. Our children must be and should be happy. They cannot be happy if we spoil them, nor can we. Children are quick to take impressions, they are creatures of habit; they very soon learn where, how, and from whom, they can get their own way. They like getting their own way (we all do), but they must not have it. A spoilt child is an abomination, and its parents most blameworthy. If they would only see it, they are doing their child an irreparable wrong by spoiling it, they are really treating it cruelly, though they fancy they are kind; they are training it up in habits which will swamp its better nature and perhaps wreck its future.
The training cannot be begun too early. The infant who gets the bottle, or is lifted from its crib every time it cries, develops into the child who screams the house down until it gets the toy it wants, who is a plague to its parents, a terror to its nurse, and a nuisance to everybody, and who passes from an odious boy into a selfish, willful man. Such words as "won't" and "shan't" should never be heard in the nursery. The parent's word must be law, which the child obeys cheerfully, and of course, there must be no curbing of spirits, and the desired result may be readily attained without harshness, without punishment, without any tears, if the training be only begun early enough, and if it be systematically adhered to. The child then obeys, not because it is afraid to disobey, but because it does not know what disobedience is. To the child so trained, punishments will be almost unknown, frowns and tears will be but seldom seen, and its young life will be, as it should be, bright and happy.
Proofread July 2011, LNL
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