Chapter III: Part VII: The Care of the Baby

XXI. CHARACTERISTICS AND DEVELOPMENT OF THE AVERAGE NEW-BORN
BABY 451

XXII. NURSING CARE OF THE AVERAGE NEW-BORN BABY 461

XXIII. COMMON DISORDERS AND ABNORMALITIES OF EARLY INFANCY 518

XXIV. A FINAL WORD 544

LIST OF ILLUSTRATIONS AND CHARTS

ILLUSTRATIONS

ANATOMY AND PHYSIOLOGY.

FIG. PAGE

1 a. Normal female pelvis 21

b. Normal male pelvis 21

2. Diagram of pelvic inlet seen from above 22

3. Diagram of pelvic outlet seen from below 23

4. Sagittal section of the pelvis 24

5. Two types of pelvimeters 25

6. Diagram showing method of measuring distance
between crests, spines and trochanters 26

7. Diagram showing method of measuring Baudelocque’s
diameter 27

8. Diagram showing method of estimating true conjugate 28

9. Diagram showing method of measuring intertuberous
diameter 29

10. Anterior view of external and internal female
generative organs 31

11. Diagrams of sections of virgin and multiparous
uteri 32

12. Sagittal section of female generative tract 35

13. Diagram of external female genitalia 39

14. Sagittal section of breast 42

15. Front view of breast 43

16. Diagram of human ovum 47

DEVELOPMENT OF THE BABY

17. Diagram of human spermatozoa 61

18. Diagram of segmenting rabbit’s ovum 65

19. Ovum about 13 days old embedded in the decidua 66

20. Diagram of developing fetus, cord, membranes and
placenta in utero 69

21. Diagram of structure of placenta 71

22. Photograph of placental vessels 72

23. Maternal surface of the placenta 74

24. Fetal surface of the placenta 75

25. Embryo about 5.5 cm. long in amniotic sac 77

26. Outlines of fetus at different stages 78

27. Full term fetus in utero 81

28. Diagram of fetal circulation 85

29. Diagram of circulation after birth 87

30. Side and top view of fetal skull 90

THE EXPECTANT MOTHER.

31. Height of fundus at different stages of pregnancy 94

32. Contour of abdomen at ninth month 95

33. Contour of abdomen at tenth month 95

34. Front view of home-made abdominal binder 123

35. Side view of same 123

36. Back view of same 123

37. Abdominal binder used in above 124

38. Front view of home-made stocking supporters 124

39. Back view of same 124

40. Patient in right-angled position to relieve
varicose veins 138

41. Elevated Sims position 139

42. Gloves, ready for dry sterilization 160

43. Delivery pad of newspapers and old muslin 161

44. Diagram of centrally implanted placenta prævia 174

45. Partial placenta prævia 175

46. Diagram of marginal placenta prævia 176

47. Champetier de Ribes’ bag inserted in uterus 177

48. Patient in hot pack given with dry blankets 197

49. Method of giving infusion 202

THE BIRTH OF THE BABY.

50. Attitude of fetus in uterus at term 217

51. Illustration from first text-book on obstetrics 218

52. Attitude of fetus in breach presentation 219

53. Attitude of fetus in vertex presentation 220

54. Diagram of six positions in a vertex presentation 222

55. Diagram of six positions in a face presentation 223

56. Diagram of six positions in a breech presentation 223

57. First maneuver in abdominal palpation 225

58. Second maneuver in abdominal palpation 226

59. Third maneuver in abdominal palpation 227

60. Fourth maneuver in abdominal palpation 228

61. Diagrams showing positions of nurse’s hands in four
maneuvers of abdominal palpation 229

62. Ascertaining position of fetus by rectal
examination 230

63, 64, Diagrams showing stages of dilatation and
65, 66. obliteration of cervix 234

67. Characteristic position of patient during first
stage pains 235

68. Diagram indicating rotation and pivoting of head
during birth 236

69. Anterior shoulder being slipped from under
symphysis 237

70. Birth of posterior shoulder 238

71. Diagrams of Duncan and Schultze mechanisms of
placental separation 239

72. Section showing thinness of uterine wall before
birth of fetus 240

73. Section showing thickness of uterine wall
immediately after labor 241

74. Preparing patient for vaginal examination or
delivery 250

75. Patient draped for vaginal examination 251

76. Wrong and right methods of boiling gloves 253

77. Powdering hands before putting on dry gloves 254

78. Successive steps in proper method of putting on
gloves 255

79. Bed and simple equipment ready for normal delivery 258

80. Instruments shown in Fig. 79 260

81. Old prints showing early methods of delivery 261

82. Patient draped with sterile dressings for delivery 262

83. Patient pulling on straps while bearing down during
second stage 264

84. Palpating baby’s head through perineum 265

85. Baby’s head appearing at vulva 266

86. Head farther advanced 267

87. Holding back head at the height of a pain 268

88. External rotation following birth of head 269

89. Wiping mucus from baby’s mouth 270

90. Stroking baby’s back to stimulate respirations 271

91. Two clamps on cord after pulsation has ceased 272

92. Wrong and right method in tying knot in cord
ligature 272

93. Stimulating baby’s respirations 274

94, 95. Stimulating baby’s respirations 275, 276

96, 97. Resuscitating baby by holding under warm water 277, 278

98. Resuscitation by means of direct insufflation 279

99. Delivery of the placenta 280

100. Twisting membranes while withdrawing placenta 281

101. Massaging fundus through abdominal wall 282

102. Showing prolapsed cord between head and pelvic brim 285

103. Giving chloroform for obstetrical anæsthesia 287

104, 105. Giving ether for obstetrical anæsthesia 289, 290

106. Giving ether for complete anæsthesia 293

107. a. Tarnier forceps, b. Simpson forceps 301

108. Patient in position and draped for forceps
operation 302

109. Forceps sheet used in Fig. 108 303

110. Two types of leggings for obstetrical use 304

111. Rubber bougie 311

112. Champetier de Ribes’ bag 311

113. Voorhees’ bag 312

114. Bag held in forceps for introduction into uterus 312

115. Syringe for filling above bags after insertion 312

THE YOUNG MOTHER.

116. Height of fundus on each of first ten days after
delivery 327

117. Patient draped for postpartum dressing 336

118. Equipment in rack used in Fig. 117 337

119. Method of covering nipples with sterile gauze 339

120. Baby nursing through a nipple shield 341

121. Nipple shield used in Fig. 120 342

122. Supporting heavy breasts by means of folded towels 343

123. Ice caps applied to engorged breasts 344

124. Y binder before application 345

125. Y binder applied 346

126. The same seen from the other side 347

127. Indian binder 347

128. Method of stripping 348

129, 130, Bed exercises taken during the puerperium 131, 132, 133, 134, 350 to 135. 353

136. Knee-chest position 354

137. Exercising by walking on all fours 354

138. Position of mother and baby for nursing in bed 359

139. The Nursing Mother (from a painting by Gari
Melchers) 361

140. Baby partially blind as a result of a faulty diet 378

141. Rachitic and normal babies of the same age 381

142. Chest walls of normal and rachitic rats of the same
age 383

143. Interior of specimens in Fig. 142 384

THE MATERNITY PATIENT IN THE COMMUNITY.

144. Baby’s bed improvised from a market basket 415

145. Layette recommended to expectant mothers by
Maternity Centre Association 416

146. Breast tray recommended to expectant mothers by
Maternity Centre Association 417

147. Baby’s toilet tray recommended to expectant mothers
by Maternity Centre Association 417

THE BABY.

148. Diagram of first teeth 456

149. Umbilical cord immediately after birth 457

150. The same four days later 457

151. Umbilicus immediately after separation of cord 458

152. Well healed umbilicus 458

153. Nursery at Manhattan Maternity Hospital 465

154. Bathing the baby 467

155. Preparation for circumcision 468

156. Baby draped with sterile sheet, in above 469

157. Cord dressed with dry sterile gauze 470

158. Abdominal binder applied over cord dressing 471

159. Satisfactory baby clothes 473

160. Diagonally folded diaper applied 474

161. Longitudinally folded diaper applied 474

162. Sutton poncho to protect baby for outdoor sleeping 479

163. Training the baby to use a chamber 481

164. Stiff cuffs to prevent thumb sucking 483

165. Hammer cap to prevent ruminating 484

166. Ruminating cap applied 485

167. Proper method of carrying baby 487

168. Preparing the baby’s milk 493

169. Giving the baby his bottle 496

170. Holding baby upright after feeding 497

171. Dr. Griffith’s table of fat percentages 500

172. Reverse side of above card 501

173. Baby in a basket ready to travel 507

174. Quilted robe with hood for the premature baby 509

175. Premature baby in lined basket, being fed with
Boston feeder 510

176. Bed for premature baby improvised from small
clothes basket 511

177. Putting the baby in a wet pack 521

178. Baby in wet pack 522

179. Diagrams showing successive steps in giving the
baby a pack 522

180. Baby wrapped in blanket preparatory to gavage 523

181. Gavage 524

182. Obtaining a fresh specimen of urine from the baby 526

183. Obtaining a 24–hour specimen of urine from the baby 527

184. Band to hold baby’s legs while obtaining specimens
of urine 527

185. Belt used to hold tube for specimen 528

186. Giving the baby an enema 530

187. Irrigating the eye with a blunt nozzle 536

188. Method of holding baby for treating gonorrhœal
ophthalmia 537

CHARTS.

NO.
1. Showing drop in blood pressure and albumen, after
delivery, in eclampsia 204

2. Showing persistence of high blood pressure and
albumen in the urine, after delivery, in
nephritic toxæmia with convulsions 206

3. Showing temperature curve in streptococcus
infection 397

4. Showing temperature curve in gonorrhœal infection 398

5. Showing normal weekly gain in weight during first
year of life 454

6. Showing normal daily gain in weight during first
two weeks 520

7. Showing loss of weight in inanition fever
contrasted with No. 6 520

8. Showing rise in temperature in inanition fever 520

OBSTETRICAL NURSING

“Can there be any higher work than this?
Can any woman wish for a more womanly work?”
Florence Nightingale