By MRS, OSWALD STEIN Under the Direction ef Ludwig Simon, M, D^ (toss ff rT 3 1 4th to 5th week, $y 2 oz. feedings.. 3 4 23y 2 4 \y 2 6th week to 3rd month, 3 to A T / 2 oz. feedings 3 5 22y 2 4 U/ 2 3rd to 5th month, 4 to Sy 2 oz. feed- ings 5 5 2oy 2 4 \y 2 5th to 6th month, Sy 2 to 6 oz. feed- ings 9 7 22 Sy 2 2 6th to 9th month, 6 to 7 oz. feedings 13 7 18 5^2 9th to 12th month, 8 to 10 oz. feed- ings 24 7 \6y 2 sy 2 2y 2 At three months a weak barley water may be used in place of the plain water; it is made of one teaspoonful of barley flour to 16 ounces of water and cooked for twenty minutes. At six months the barley flour may be increased to one even tablespoonful, cooked in 12 ounces of water. 41 At nine months the barley flour may be increased to three level tablespoonfuls cooked in 8 ounces of water. FOOD, IN ADDITION TO MILK, ALLOWED THE FIRST YEAR In addition to milk a healthy baby may be given fruit juices during the early part of his infancy, and later beef juice. The fruit juice may be given once a day at five or six months, an hour before a feeding, preferably the second. Begin with one teaspoonful and gradually increase the quantity to two tablespoonfuls. After baby is six months old he may have beef juice or broth once a day. This should be given directly before a feeding, preferably before the third, beginning with one tea- spoonful and gradually increasing the quantity to two table- spoonfuls. When baby is ten months old he may have part of a soft egg, a small piece of crisp toast or zweiback, or a crust of bread, to chew on immediately after his feeding. At twelve months he may take his milk undiluted and strained cereal may be given twice a day. He should now have four meals a day: At 6 A. M., 10 A. M., 2 P. M. and 6 P. M. Nothing but water should be allowed between his meals. PATENT OR PROPRIETARY FOODS FOR BABIES These may be generally divided into two classes, those which are to be mixed with water alone, and those to be mixed with milk and water. The patent foods which are prepared with water alone, such as Condensed Milk, etc., lacking im- portant food elements; should not be used except under the advice of a physician, and for a limited period. Babies may gain in weight for a time from the use of this kind of food, 42 but are subject to scurvy, rickets, and digestive troubles, although these symptoms may not appear at once. The use of foods of this class is justified only in certain cases, as in times of emergency, or on journeys when other food cannot be procured or prepared, but they should not be regarded as a complete and permanent nourishment for a baby. In the case of patent foods which are to be mixed with milk it is somewhat different. These vary individually, but usually have too much sugar and often too much starch, a substance nearly always unfit for a very young baby. Of this group the most widely used is the malted milk, which is a mixture of malted milk and grain. Malted food, also greatly used, when diluted and mixed with milk, contains the ele- ments needed in a baby food, although not in quite the proper proportions. Certain babies fed on it should have some fruit juices. Thus, this second class of patent food may often be used to advantage under the physician's advice for a short time during weakness or illness, but as a general food for baby is inferior to modified cow's milk, which is at present believed to be the best substitute that can be found for mother's milk. PREPARATION OF BABY'S FOOD FOR THE DAY MODIFYING COW'S MILK Before preparing the food for the bottles, be sure that your hands and nails are scrupulously clean. Have all the ingredi- ents of which the food is composed in readiness for use; the utensils sterilized and the necessary articles laid out so that there will be no confusion. Have before you the following articles : The written formula for the baby's food. 43 The bottle rack on which are placed as many nursing bottles as there are feedings in one day, with an extra bottle in Case of breakage. The covered glass jar holding the nipples and stoppers for each feeding. THE FOOD INGREDIENTS The milk. Plain water, or barley water if required, which has been previously boiled. Sugar of milk. Lime water, and a kettle of boiling water for use as needed. THE UTENSILS A large saucepan with a cover for holding the milk. A two-quart pitcher for mixing the food. An eight-ounce graduated measuring glass. A tablespoon for mixing or stirring the food. A long handled teaspoon. A piece of sterilized cheese cloth or soft cotton for washing off the top of the milk bottle before opening the same. A pick or a fork for removing the cap from the bottle (after the bottle is washed). A porcelain or enamel funnel. A dipper for removing the cream or top milk (the Chapin improved dipper is preferred by many). A wire strainer for the barley water (although this latter should have been previously strained and ready for use, when modifying the milk). The articles above enumerated should never be used for any purpose other than the preparation of the baby's food. Measure the milk into the pitcher with the measuring glass, then measure the quantity of plain water or barley 44 water into the saucepan, add the sugar and milk, lime water as directed, and pour this mixture into the feeding bottles. After the bottles have been filled, they should be stoppered with the rubber corks, and placed on their racks in the refrigerator until feeding time. The quantity of food made up should be sufficient for the total number of feedings to be given during the twenty-four hours, so that the milk need not be disturbed from the time of its preparation to the time of feeding. WEANING Weaning : . The time of weaning babies from the breast depends largely upon the condition of the baby and mother. If the baby is not gaining or is not developing properly, he may be weaned at six months, but if he and also the mother are flourishing, the weaning should not be begun until nine months and completed by twelve months. Weaning should, however, be avoided in very hot weather unless the indications for it are very urgent. In beginning the bottle feeding after weaning, it is advisable to consult the physician regarding the food formulae, as great caution must be used. 45 Chapter VI TWELVE O'CLOCK At this time baby is given his noon feeding and should then go to sleep for an hour or two, at least for an hour. This will give the mother time for her luncheon and the needed opportunity for a little rest, which doubtless she will appre- ciate greatly, especially if she is nursing her baby and per- sonally devotes most of her time to its care and well being. 46 Chapter VII TWO O'CLOCK EXERCISE Babies obtain exercise by moving their arms, kicking and crying. It is important that they be permitted free action of their limbs, and from the age of four months onward it is an excellent plan to place the baby at times upon a blanket or mattress in the room which is free from draughts, and so arrange his clothing that he is allowed to make freely all the motions of which he is capable. This gives him a good chance to exercise and is a means of amusement. AMUSEMENT Early in life the baby needs very little diversion. Indeed, up to the age of six months he does not require playthings. It is far more essential that training should commence before amusement. To eat, sleep, and cry a little is about all that a new baby requires. Soon he will begin to see things and find amusement in looking around the room, in following moving objects with his eyes; after a while he will laugh and crow, discover that he has toes and fingers, and delight to play with them. Generally, after four months, he is able to hold his head erect without support, and begins to use his hands much more actively than he has done heretofore. He will often grasp an attractive object, look at it, and probably put it in his mouth, then throw it on the floor and expect some one to pick it up for him. Baby may be played with for a little while each day; but only for a short period, so that his playtime will come to 47 him as a treat, and will be something for him to look forward to, even at this early age. CRYING A certain amount of crying is necessary for a baby, as in this way he exercises his lungs, and also draws attention to his needs, which he is unable to designate in any other manner during the early months of his life. He may be hungry, thirsty or in pain; he may be sleepy or tired, or he may simply want to be played with. By a little experience the young mother will soon learn to distinguish the various shades of crying, for instance, the cry of temper, which should never be given in to, or the mother will have cause to regret her indulgence later. The baby should not be carried or trotted about because he is crying, or rocked to sleep, or given a pacifier, or soothing syrup. When he appears to be crying from habit or temper to be indulged, it is better to leave him alone in his crib. He may even cry for an hour, but the next time he will cry less, and after that, still less or not at all. If the abdominal band is properly adjusted, rup- ture is seldom caused by crying. THE CRY OF HUNGER The cry of hunger is a continuous fretful sound after feed- ing or some time before the next meal, accompanied by suck- ing of the fingers. If the child is a nursing baby the supply of milk should be examined by the physician to see if it is strong and plentiful enough to suit the baby's needs. A bottle baby who cries from hunger should have the amount of food made greater or the strength increased, or both. THE CRY OF PAIN OR COLIC If the baby cries from an attack of colic, this cry can be easily distinguished. It is strong and sharp, but not con- 48 tinuous. Baby will scream sharply, draw up his legs, and his abdomen becomes hard and tense. The remedy for this is first to warm his hands and feet, then turn him on his stom- ach, letting him lie on a hot water bottle. Gently pat his back to help him expel the gas, and give him a little warm water to drink, or better still, give him an enema of normal salt solution (common table salt) which will cause a bowel movement and thereby release some of the gas in the intes- tines. Colic is caused by indigestion due to improper feeding, and is common in young babies, generally disappearing by the third or fourth month. When a baby is really sick, his cry is feeble and whining, more like moaning. THUMB SUCKING This habit is sometimes very difficult to break. If the baby sucks his fingers constantly, the mother should ascer- tain whether this is due to hunger. Sucking of the thumb may sometimes be controlled by persistently taking it out of baby's mouth whenever it is found there. Obstinate cases need stronger measures, and fastening the hands to the sides during sleep may prove effective. Aluminum mittens are of great assistance, and are to be recommended; they are per- forated, and allow free use of the baby's arm. They can be had in various sizes at any of the baby shops. 49 Chapter VIII THREE O'CLOCK PERIOD OF WAKING This is baby's period of waking, and after he is dressed and has his three o'clock nursing, he is ready for an afternoon outing, which will be of great benefit to him in various ways. His night's sleep, will be more refreshing, his appetite and digestion improved, and if he is warmly clad in the proper clothing and plenty of covers, there need be no fear of his taking cold. SELECTION OF CARRIAGE The carriage selected for baby's outing should be one that is well built rather than ornamental, one that has good springs, wheels with rubber tires, and a movable hood. In winter the carriage should contain a flat hair mattress laid over the regular pad, and a small flat hair pillow for baby's head. Over this a soft knitted wool blanket should be placed, and in this baby should be carefully wrapped. Another wool blanket should be placed over the baby and tucked in well at the sides and bottom of the vehicle. In very cold weather a fur robe may be put over this, or some other covering of warm material, combining beauty with utility. BABY'S OUTING IN WARM WEATHER In warm weather, simple cotton madras or embroidered linen covers take the place of heavy blankets, but it is advis- able to tuck a padded silk quilt or soft eiderdown cover some- where in the carriage in case of sudden change in the tem- perature. 50 VISITORS When baby returns from his outing he may have visitors, as later in the afternoon it is well to keep him as quiet as possible, instead of being handled and bounced by many admiring friends before he retires. As he grows older and can hold things in his hands, a rubber toy or a soft ball of bright color may be given him for amusement for a little while, if he becomes fretful. Some mothers make the mistake of giving baby numberless toys at this time, of great variety, for which he cares not a jot. As he is surfeited with amuse- ment and company, he soon becomes tired. He is happier with one or two simple objects or toys, and furthermore, a baby who from infancy is constantly amused, whose every wish is gratified, will later lack properly developed resources of his own. 51 Chapter IX FOUR O'CLOCK SHORTENING BABY'S CLOTHES At this time the mother may take the opportunity of looking over baby's wardrobe, as when he reaches the age of four months his clothes may be shortened. This change should not be made in the winter, however, if it can be avoided. The number and material of the garments remain practically the same as before. The shortening may be accom- plished by cutting down the skirts of the long clothes already in use, lengthening the sleeves and letting out the waists if they have been made sufficiently large at first to allow this to be done. Short clothes also necessitate a decided change in the covering of the feet and legs, as when baby wears short dresses, he may then put on shoes, although these are not actually necessary until he begins to creep or stand; gen- erally about the ninth or the tenth month. Moccasins of chamois or kid leather may be used at first, and when real shoes are worn they should be made of soft kid, with thin soles and without heels. The'ir shape is of great importance, as the soft tissues of baby's feet are easily deformed by improperly fitting shoes. They should follow the natural shape of the foot, with broad toes and straight soles. LIST OF SHORT CLOTHES The following list may be convenient as a guide in select- ing baby's short clothes : 4 knitted binders, 4 dozen diapers, 6 shirts, 4 flannel petticoats or Gertrude slips, 4 cambric petti- 52 coats for extra use, if desired; 8 to 12 slips or dresses, 8 pairs of stockings, 2 pairs of shoes, 3 cashmere sacks or wrappers, 6 nightgowns, 2 creeping aprons, to cover the white slips or dresses; 6 bibs, 1 cloak and hood, leggings, veil, and mittens for outdoor wear. 53 Chapter X FIVE O'CLOCK GIVING BABY A SPONGE BATH— GETTING READY FOR BED At about five o'clock baby should be given a sponge bath, all his day clothes should be removed, and a fresh warm night- gown put on. The night clothes should be a complete change from those worn in the day time. During the winter months the gown should be made of flannel and closed at the bottom with a draw string. In hot weather the ordinary muslin night- gowns may be used; they are not closed at the bottom. HOW TO GIVE BABY A SPONGE BATH This simply means washing the baby, using warm water, pure soap and a piece of soft old linen as a wash cloth. The room should be warm and free from draughts and the baby kept covered with a blanket during the procedure. 54 Chapter XI SIX O'CLOCK PUTTING BABY TO SLEEP After the six o'clock feeding, baby should be made com- fortable, the room darkened, and all the equipment necessary for his convenience adjusted, so that he may secure the full benefit of an undisturbed night's rest. He should then be left to sleep in a bed of his own, in his own room, and not in a bed which his mother or any one else will share. He should not be rocked to sleep, nor allowed to suck a rubber nipple, or pacifier. If these habits are commenced they are difficult to break, and unless there is some real cause for a baby's wakefulness at this time, he should be trained from the start to quietly and naturally begin his night's period of unbroken rest. If this is done, he will be less apt to turn night into day, and a short term of such training will result in comfort for the entire family. There are times, however, when baby's sleep is disturbed from causes arising from many different sources, and the treatment, of course, varies accordingly. Fatigue and excite- ment, indigestion and overfeeding, are prolific grounds for disturbed sleep. A baby nursed too frequently during the day may show the force of habit by desiring to be fed often during the night, although not actually hungry. Or when a baby begins to fret as though sleepy, and yet will not sleep, it is fair to presume that he has been overfatigued. He is really "too tired" to sleep, and prevention of this condition is the cure in such a case. With some babies, especially if they are inclined to nervousness, and there seems to be no 55 apparent cause for sleeplessness except an individual pecu- liarity, it is often a good plan to give the daily bath at night instead of in the morning, making it slightly warmer than usual, in order to obtain its soothing action, and simply sponge him in the morning. Sometimes putting baby later to bed than is usual is of service. Other causes of disturbed sleep are self-evident, and it therefore behooves the mother to make an effort to eliminate the direct sources of the trouble. Baby may be restless be- cause he has had too exciting play before bedtime, his room may be too hot or too cold, a bright light or penetrating noises may disturb him, his bed may not be properly made up, and therefore uncomfortable, or he may have been put to bed too early. A baby six months old should sleep about sixteen hours out of the twenty-four ; when a year old, about fourteen hours. 56 Chapter XII TEN O'CLOCK Baby's day is practically over at six o'clock, but the ten o'clock feeding is given most babies until they are six months old. Sometimes emergencies arise with which a young mother must deal immediately; for instance, in cases of croup, con- vulsions, earache, etc., and it is necessary that she should know how to apply simple remedies until the arrival of the physician. CROUP Sometimes a child will awaken suddenly during the night with an attack of croup which seems very alarming, but spasmodic or catarrhal croup is rarely fatal. The symptoms are known to almost everyone, a dry, barking cough, with more or less difficulty in breathing. Although it is certainly distressing, it can be easily relieved. Wring out pieces of flannel in hot water and put them around baby's throat as hot as can be borne, changing them from time to time as they grow cold. If the attack is severe, make a tent over the baby's bed by means of an open umbrella, over which a large sheet is spread, then place the tea kettle close to the crib, directing the steam most effectively in this manner. The hot, moist atmosphere will soon cause relief, and an electric stove is very convenient to keep the kettle boiling. CONVULSIONS Give the baby an injection of warm, soapy water, then place him in a hot bath, about 110 degrees, and rub his legs, 57 arms and body. Keep ice on his head. Then wrap him in warm blankets and send for the physician. EARACHE If the baby places his hand to his ear constantly and cries sharply it is safe to infer that he is suffering from earache. Ordinarily this condition can be relieved by dropping a little warm olive oil or glycerine (about four drops) into his ear and placing a warm cloth or hot water bag next to the affected part. WOUNDS AND CUTS Cleanliness is the first and most important part of the treatment of all wounds of the skin. Therefore, wash with pure water, but if there is much bleeding, apply a firm band- age by means of strips of pure sterilized gauze and bring the parts and edges of the affected skin together as well as can be done until the physician arrives. RECIPES OF FOOD FOR YOUNG BABIES Barley Water: Stir one level tablespoonful of Robinson's patent barley or prepared barley flour into a little cold water and add to one pint of boiling water. Boil twenty minutes in a double boiler, strain, and add enough boiling water to bring the quantity up to a pint. Oatmeal Water: Use one tablespoonful of ordinary oat- meal and add to one pint of boiling water, cook in a double boiler for one hour, adding water as it evaporates. Strain and add enough boiling water to make a pint. Rice water may be prepared in the same way. Gruels: A gruel of barley, oatmeal or rice is made by following the previous directions for barley water, as gruel differs from the water or jelly only in thickness or consist- 58 ency. For instance, use twice as much of the barley or flour to the same amount of water, boil for several hours or until the portion has cooked down to the desired thickness, and strain. ALBUMIN WATER Beat the white of one egg in half a pint of cold boiled water, add a pinch of salt and strain through gauze or cheese- cloth. This is effective in case of vomiting. BROTHS Chicken, Beef, or Mutton Broth: Use a pint of water to each pound of meat. Put the meat on in cold water and allow it to come to a boil, then lower the fire so that it will just simmer for three or four hours. Strain through cheese- cloth or muslin and set away to cool. When cold, the fat may be removed in a solid piece, leaving a clear liquid or jelly. When ready to use, the portion desired should be seasoned with a little salt. This may be made very palatable and nutritious by thickening with a little arrowroot or corn- starch, cooking for ten minutes and adding three ounces of milk to half a pint of broth. MEATS Scraped Beef: Broil round steak slightly over a brisk fire. Split the steak and scrape out the pulp with a silver knife. Season ever so slightly with a little salt and butter. Beef Juice: To make beef juice, take one pound of thick round steak, broil slightly, press the juice out of it by means of a meat press or lemon squeezer; add a pinch of salt and give the proportion desired to baby when it is still warm. This juice should not be cooked, as it will curdle if heated too much. 59 Preparing Beef Juice by the Cold Process : Beef juice may also be prepared by using the cold process, that is, without cooking the meat at all. This is accomplished by soaking the meat in cold water. Use a pound of chopped round of beef and place in a glass jar with one-fourth as much cold water (six ounces). Season with a little salt and allow the meat to soak over night or for several hours, keeping it on ice. Turn the jar upside down and shake occasionally. In the morning empty the entire contents into a muslin bag and squeeze out the juice. This can be done by twisting it very hard. THE END. 60 LIBRARY OF CONGRESS 021 064 207 9