Chapter II: Part 2

Of course, if there be _no_ milk in the breast—the babe having been applied once or twice to determine the fact—then you must wait for a few hours before applying him again to the nipple, that is to say, until the milk be secreted.

An infant who, for two or three days, is kept from the breast, and who is fed upon gruel, generally becomes feeble, and frequently, at the end of that time, will not take the nipple at all. Besides, there is a thick cream (similar to the biestings of a cow), which, if not drawn out by the child, may cause inflammation and gathering of the bosom, and, consequently, great suffering to the mother. Moreover, placing him _early_ to the breast moderates the severity of the mother’s after-pains, and lessens the risk of her flooding. A new-born babe must _not_ have gruel given to him, as it disorders the bowels, causes a disinclination to suck, and thus makes him feeble.

30. _If an infant show any disinclination to suck, or if he appear unable to apply his tongue to the nipple, what ought to be done?_

Immediately call the attention of the medical man to the fact, in order that he may ascertain whether he be tongue-tied. If he be, the simple operation of dividing the bridle of the tongue will remedy the defect, and will cause him to take the nipple with ease and comfort.

31. _Provided there be no milk_ AT FIRST, _what ought then to be done_?

Wait with patience: the child (if the mother has no milk) will not, for at least twelve hours, require artificial food. In the generality of instances, then, artificial food is not at all necessary; but if it should be needed, one-third of new milk and two-thirds of warm water, slightly sweetened with loaf sugar (or with brown sugar, if the babe’s bowels have not been opened), should be given, in small quantities at a time, every four hours, until the milk be secreted, and then it must be discontinued. The infant ought to be put to the nipple every four hours, but not oftener, until he be able to find nourishment.

If, after the application of the child for a few times, he is unable to find nourishment, then it will be necessary to wait until the milk be secreted. As soon as it is secreted, he must be applied, with great regularity, _alternately_ to each breast.

I say _alternately_ to each breast. _This is most important advice._ Sometimes a child, for some inexplicable reason, prefers one breast to the other, and the mother, to save a little contention, concedes the point, and allows him to have his own way. And what is frequently the consequence?—a gathered breast!

We frequently hear of a babe having no notion of sucking. This “no notion” may generally be traced to bad management, to stuffing him with food, and thus giving him a disinclination to take the nipple at all.

32. _How often should a mother suckle her infant?_

A mother generally suckles her baby too often, having him almost constantly at the breast. This practice is injurious both to parent and to child. The stomach requires repose as much as any other part of the body; and how can it have it if it be constantly loaded with breast-milk? For the first month, he ought to be suckled about every hour and a half; for the second month, every two hours,—gradually increasing, as he becomes older, the distance of time between, until at length he has it about every four hours.

If a baby were suckled at stated periods, he would only look for the bosom at those times, and be satisfied. A mother is frequently in the habit of giving the child the breast every time he cries, regardless of the cause. The cause too frequently is, that he has been too often suckled—his stomach has been overloaded; the little fellow is constantly in pain, and he gives utterance to it by cries. How absurd is such a practice! We may as well endeavor to put out a fire by feeding it with fuel. An infant ought to be accustomed to regularity in every thing—in times for suckling, for sleeping, etc. No children thrive so well as those who are thus early taught.

33. _Where the mother is_ MODERATELY _strong, do you advise that the infant should have any other food than the breast_?

Artificial food must not, for the first three or four months, be given, if the parent be _moderately_ strong; of course, if she be feeble, a _little_ food will be necessary. Many delicate women enjoy better health while suckling than at any other period of their lives.

34. _What food is the best substitute for a mother’s milk?_

The food that suits one infant will not agree with another. (1.) The one that I have found the most generally useful, is made as follows: Boil the crumb of bread for two hours in water, taking particular care that it does not burn; then add only a _little_ lump sugar (or _brown_ sugar, if the bowels be costive), to make it palatable. When he is five or six months old, mix a little new milk—the milk of ONE cow—with it, gradually, as he becomes older, increasing the quantity until it be nearly all milk, there being only enough water to boil the bread; the milk should be poured boiling hot on the bread. Sometimes the two milks—the mother’s and the cow’s milk—do not agree; when such is the case, let the milk be left out, both in this and in the foods following, and let the food be made with water instead of with milk and water. In other respects, until the child is weaned, let it be made as above directed; when he is weaned, good fresh cow’s milk MUST, as previously recommended, be used. (2.) Or, cut thin slices of bread into a basin, cover the bread with _cold_ water, place it in an oven for two hours to bake; take it out, beat the bread up with a fork, and then slightly sweeten it. This is an excellent food. (3.) If the above should not agree with the infant (although, if properly made, they almost invariably do), “tous-les-mois” may be given. (4.) Or, Robb’s Biscuit, as it is “among the best bread compounds made out of wheat-flour, and is almost always readily digested.”—_Routh._ “Tous-les-mois” is the starch obtained from the tuberous roots of various species of _canna_; and is imported from the West Indies. It is very similar to arrow-root. I suppose it is called “tous-les-mois,” as it is good to be eaten all the year round.

(5.) Another good food is the following: Take about a pound of flour, put it in a cloth, tie it up tightly, place it in a saucepanful of water, and let it boil for four or five hours; then take it out, peel off the outer rind, and the inside will be found quite dry, which grate. (6.) Another way of preparing an infant’s food, is to bake flour—biscuit flour—in a slow oven, until it be of a light fawn color. (7.) An excellent food for a baby, is baked crumbs of bread. The manner of preparing it is as follows: Crumb some bread on a plate; put it a little distance from the fire to dry. When dry, rub the crumbs in a mortar, and reduce them to a fine powder; then pass them through a sieve. Having done which, put the crumbs of bread into a slow oven, and let them bake until they be of a light fawn color. A small quantity either of the boiled, or of the baked flour, or of the baked crumb of bread, ought to be made into food in the same way as gruel is made, and should then be slightly sweetened, according to the state of the bowels, either with lump or with brown sugar.

(8.) Baked flour sometimes produces constipation; when such is the case, Mr. Appleton of Budleigh Salterton, Devon, wisely recommends a mixture of baked flour and prepared oatmeal, in the proportion of two of the former and one of the latter. He says: “To avoid the constipating effects, I have always had mixed, before baking, one part of prepared oatmeal with two parts of flour; this compound I have found both nourishing, and regulating to the bowels. One tablespoonful of it, mixed with a quarter of a pint of milk, or milk and water, when well boiled, flavored, and sweetened with white sugar, produces a thick, nourishing, and delicious food for infants or invalids.” He goes on to remark: “I know of no food, after repeated trials, that can be so strongly recommended by the profession to all mothers in the rearing of their infants, without or with the aid of the breast, at the same time relieving them of much draining and dragging while nursing with an insufficiency of milk, as baked flour and oatmeal.” If there is any difficulty in obtaining _prepared_ oatmeal, Robertson’s Patent Groats will answer equally as well.

(9.) A ninth food may be made with “Farinaceous Food for Infants, prepared by Hards of Dartford.” If Hards’ Farinaceous Food produces costiveness—as it sometimes does—let it be mixed either with equal parts or with one-third of Robertson’s Patent Groats. The mixture of the two together makes a splendid food for a baby. (10.) A tenth, and an excellent one, may be made with rusks, boiled for an hour in water, which ought then to be well beaten up by means of a fork, and slightly sweetened with lump sugar. Great care should be taken to select good rusks, as few articles vary so much in quality. (11.) An eleventh is—the top crust of a baker’s loaf, boiled for an hour in water, and then moderately sweetened with lump sugar. If, at any time, the child’s bowels should be costive, _raw_ must be substituted for _lump_ sugar. (12.) Another capital food for an infant, is that made by Lemann’s Biscuit Powder. (13.) Or, Brown and Polson’s Patent Corn Flour will be found suitable. The Queen’s cook, in his recent valuable work, gives the following formula for making it: “To one dessertspoonful of Brown & Polson, mixed with a wineglassful of cold water, add half a pint of boiling water; stir over the fire for five minutes; sweeten lightly, and feed the baby; but if the infant is being brought up by the hand, this food should then be mixed with milk—not otherwise.”

(14.) The following is a good and nourishing food for a baby: Soak, for an hour, some _best_ rice in cold water; strain, and add fresh water to the rice; then let it simmer till it will pulp through a sieve; put the pulp and the water in a saucepan, with a lump or two of sugar, and again let it simmer for a quarter of an hour; a portion of this should be mixed with one-third of fresh milk, so as to make it of the consistence of good cream.

When the baby is five or six months old, new milk should be added to any of the above articles of food, in a similar way to that recommended for boiled bread.

(15.) For a delicate infant, lentil powder, better known as Du Barry’s “Revalenta Arabica,” is invaluable. It ought to be made into food, with new milk, in the same way that arrow-root is made, and should be moderately sweetened with loaf sugar. Whatever food is selected ought to be given by means of a nursing-bottle.

If a child’s bowels be relaxed and weak, or if the motions be offensive, the milk _must_ be boiled. The following (16.) is a good food when an infant’s bowels are weak and relaxed: “Into five large spoonfuls of the purest water rub smooth one dessertspoonful of fine flour. Set over the fire five spoonfuls of new milk, and put two bits of sugar into it; the moment it boils, pour it into the flour and water, and stir it over a slow fire twenty minutes.”

Where there is much emaciation, I have found (17.) genuine arrow-root a very valuable article of food for an infant, as it contains a great deal of starch, which starch helps to form fat and to evolve caloric (heat)—both of which a poor, emaciated, chilly child stands so much in need of. It must be made with good fresh milk, and ought to be slightly sweetened with loaf sugar; a small pinch of table salt should be added to it.

I have given you a large and well-tried infant’s dietary to choose from, as it is sometimes difficult to fix on one that will suit; but remember, if you find one of the above to agree, keep to it, as a baby requires a simplicity in food—a child a greater variety.

Let me, in this place, insist upon the necessity of great care and attention being observed in the preparation of any of the above articles of diet. A babe’s stomach is very delicate, and will revolt at either ill-made, or lumpy, or burnt food. Great care ought to be observed as to the cleanliness of the cooking utensils. The above directions require the strict supervision of the mother.

Broths have been recommended, but, for my own part, I think that, for a _young_ infant, they are objectionable; they are apt to turn acid on the stomach, and to cause flatulence and sickness; they sometimes disorder the bowels and induce griping and purging.

Whatever artificial food is used ought to be given by means of a bottle, not only as it is a more natural way than any other of feeding a baby, as it causes him to suck as though he were drawing it from the mother’s breast, but as the act of sucking causes the salivary glands to press out their contents, which materially assists digestion. Moreover, it seems to satisfy and comfort him more than it otherwise would do.

The food ought to be of the consistence of good cream, and should be made fresh and fresh. It ought to be given milk-warm. Attention must be paid to the cleanliness of the vessel, and care should be taken that the milk be that of ONE cow, and that it be new and of good quality; for if not, it will turn acid and sour, and disorder the stomach, and will thus cause either flatulence or looseness of the bowels, or perhaps convulsions. I consider it to be of immense importance to the infant, that the milk be had from ONE cow. A writer in the _Medical Times and Gazette_, speaking on this subject, makes the following sensible remarks: “I do not know if a practice common among French ladies, when they do not nurse, has obtained the attention among ourselves which it seems to me to deserve. When the infant is to be fed with cow milk, that from various cows is submitted to examination by the medical man, and, if possible, tried on some child, and when the milk of any cow has been chosen, no other milk is ever suffered to enter the child’s lips, for a French lady would as soon offer to her infant’s mouth the breasts of half-a-dozen wet-nurses in the day, as mix together the milk of various cows, which must differ even as the animals themselves, in its constituent qualities. Great attention is also paid to the pasture, or other food of the cow thus appropriated.”

The only way to be sure of having it from _one_ cow, is (if you have not a cow of your own) to have the milk from a _respectable_ cow-keeper, and to have it brought to your house in a can of your own (the London milk-cans being the best for the purpose). The better plan is to have two cans and to have the milk fresh, and fresh every night and morning. The cans, after each time of using, ought to be scalded out; and, once a week, the can should be filled with _cold_ water, and the water should be allowed to remain in it until the can be again required.

Very little sugar should be used in the food, as much sugar weakens the digestion. A small pinch of table salt ought to be added to whatever food is given, as “the best savor is salt.” Salt is most wholesome—it strengthens and assists digestion, prevents the formation of worms, and, in small quantities, may with advantage be given (if artificial food be used) to the youngest baby.

35. _Where it is found to be absolutely necessary to give an infant artificial food_ WHILE SUCKLING, _how often ought he to be fed_?

Not oftener than twice during the twenty-four hours, and then only in _small_ quantities at a time, as the stomach requires rest, and at the same time can manage to digest a little food better than it can a great deal.

Let me again urge upon you the importance, if it be at all practicable, of keeping the child _entirely_ to the breast for the first three or four months of his existence. Remember there is no _real_ substitute for a mother’s milk; there is no food so well adapted to his stomach; there is no diet equal to it in developing muscle, in making bone, or in producing that beautiful plump rounded contour of the limbs; there is nothing like a mother’s milk _alone_ in making a child contented and happy, in laying the foundation of a healthy constitution, in preparing the body for a long life, in giving him tone to resist disease, or in causing him to cut his teeth easily and well; in short, _the mother’s milk is the greatest temporal blessing an infant can possess_.

As a general rule, therefore, when the child and the mother are tolerably strong, he is better _without artificial_ food until he has attained the age of three or four months; then it will usually be necessary to feed him twice a day, so as gradually to prepare him to be weaned (if possible) at the end of nine months. The food mentioned in the foregoing conversation will be the best for him, commencing _without_ the cow’s milk, but gradually adding it, as less mother’s milk and more artificial food be given.

36. _When the mother is not able to suckle her infant herself, what ought to be done?_

It must first be ascertained, _beyond all doubt_, that a mother is not able to suckle her own child. Many delicate ladies do suckle their infants with advantage, not only to their offspring, but to themselves. “I will maintain,” says Steele, “that the mother grows stronger by it, and will have her health better than she would have otherwise. She will find it the greatest cure and preservative for the vapors [nervousness] and future miscarriages, much beyond any other remedy whatsoever. Her children will be like giants, whereas otherwise they are but living shadows, and like unripe fruit; and certainly if a woman is strong enough to bring forth a child, she is beyond all doubt strong enough to nurse it afterward.”

Many mothers are never so well as when they are nursing; besides, suckling prevents a lady from becoming pregnant so frequently as she otherwise would. This, if she be delicate, is an important consideration, and more especially if she be subject to miscarry. The effects of a miscarriage are far more weakening than those of suckling.

A hireling, let her be ever so well inclined, can never have the affection and unceasing assiduity of a mother, and, therefore, cannot perform the duties of suckling with equal advantage to the baby.

The number of children who die under five years of age is enormous—many of them from the want of the mother’s milk. There is a regular “parental baby slaughter”—“a massacre of the innocents”—constantly going on in England, in consequence of infants being thus deprived of their proper nutriment and just dues! The mortality from this cause is frightful, chiefly, occurring among rich people who are either too grand, or, from luxury, too delicate, to perform such duties: poor married women, as a rule, nurse their own children, and, in consequence, reap their reward.

If it be ascertained, _past all doubt_, that a mother cannot suckle her child, then, if the circumstances of the parents will allow—and they ought to strain a point to accomplish it—a healthy wet-nurse should be procured, as, of course, the food which nature has supplied is far, very far superior to any invented by art.

Never bring up a baby, then, if you can possibly avoid it, on _artificial_ food. Remember, as I proved in a former conversation, there is in early infancy no _real_ substitute for either a mother’s or a wet-nurse’s milk. It is impossible to imitate the admirable and subtle chemistry of nature. The law of nature is, that a baby, for the first few months of his existence, shall be brought up by the breast; and nature’s law cannot be broken with impunity. For further reasons why artificial food is not desirable at an early period of infancy, see answer to 35th question. It will be imperatively necessary, then—

“To give to nature what is nature’s due.”

Again, in case of a severe illness occurring during the first nine months of a child’s life, what a comfort either the mother’s or the wet-nurse’s milk is to him! it often determines whether he shall live or die.

But if a wet-nurse cannot fill the place of a mother, then, asses’ milk will be found the best substitute, as it approaches nearer, in composition, than any other animal’s, to human milk; but it is both difficult and expensive to obtain. The next best substitute is goats’ milk. Either the one or the other ought to be milked fresh and fresh, as it is wanted, and should be given by means of a feeding-bottle.

Asses’ milk is more suitable for _delicate_ infants, and goats’ milk for those who are _strong_.

If neither asses’ milk nor goats’ milk can be procured, then the following from the very commencement should be given:

New milk, the produce of ONE _healthy_ cow,
Warm water, of each, equal parts;
Table salt, a few grains;
Lump sugar, a sufficient quantity to slightly sweeten it.

Liebig, the great chemist, asserts that a small quantity of table salt to the food is essential to the health of children. The milk itself ought not to be heated over the fire, but should, as above directed, be warmed by the water; it must, morning and evening, be had fresh and fresh. It now and then happens that if the milk be not boiled, the motions of an infant are offensive; _when such is the case_ let the milk be boiled, but not otherwise. The milk and water should be of the same temperature as the mother’s milk, that is to say, at about ninety to ninety-five degrees Fahrenheit. It ought to be given by means of a feeding-bottle, and care must be taken to _scald_ the bottle out twice a day, for if attention be not paid to this point the delicate stomach of an infant is soon disordered. As he grows older the milk should be gradually increased, and the water decreased, until nearly all milk be given.

There will, in many cases, be quite sufficient nourishment in the above; I have known some robust infants brought up on it alone. But if it should not agree with the child, or if there should not be sufficient nourishment in it, then the food recommended in answer to No. 34 question ought to be given, with this only difference—a little new milk _must_ from the beginning be added, and should be gradually increased, until nearly all milk be used.

The milk, as a general rule, ought to be _unboiled_; but if it purge violently, or if it cause offensive motions—which it sometimes does—then it must be boiled. The moment the milk boils up it should be taken off the fire.

Food ought, for the first month, to be given about every two hours; for the second month, about every three hours; lengthening the space of time as the baby advances in age. A mother must be careful not to over-feed a child, as over-feeding is a prolific source of disease.

Let it be thoroughly understood, and let there be no mistake about it, that a babe, during the first nine months of his life, MUST have—it is absolutely necessary for his very existence—milk of some kind, as the staple and principal article of his diet, either mother’s, or wet-nurse’s, or asses’, or goat’s, or cow’s own milk.

37. _How would you choose a wet-nurse?_

I would inquire particularly into the state of her health; whether she be of a healthy family, or a consumptive habit, or if she or any of her family have labored under “king’s evil;” ascertaining if there be any seams or swellings about her neck; any eruptions or blotches upon her skin; if she has a plentiful breast of milk, and if it be of good quality (which may readily be ascertained by milking a little into a glass. “It should be thin, and of a bluish-white color, sweet to the taste, and when allowed to stand should throw up a considerable quantity of cream.”—_Maunsell and Evertson on the Diseases of Children._) If she has good nipples, sufficiently long for the baby to hold; that they be not sore; and if her own child be of the same or nearly of the same age as the one you wish her to nurse. Ascertain whether she menstruates during suckling; if she does, the milk is not so good and nourishing, and you had better decline taking her. Sir Charles Locock considers that a woman who menstruates during lactation is objectionable as a wet-nurse, and “that as a mother with her first child is more liable to that objection, that a second or a third child’s mother is more eligible than a first.”—_Letter to the Author._ Assure yourself that her own babe is strong and healthy, and that he is free from a sore mouth and from a “breaking-out” of the skin. Indeed, if it be possible to procure such a wet-nurse, she ought to be from the country, of ruddy complexion, of clear skin, and of between twenty and five-and-twenty years of age, as the milk will then be fresh, pure, and nourishing.

I consider it to be of great importance that the infant of the wet-nurse should be, as nearly as possible, of the same age as your own, as the milk varies in quality according to the age of the child. For instance, during the commencement of suckling, the milk is thick and creamy, similar to the biestings of a cow, which, if given to a babe of a few months old, would cause derangement of the stomach and bowels. After the first few days, the appearance of the milk changes; it becomes of a bluish-white color, and contains less nourishment. The milk gradually becomes more and more nourishing as the infant becomes older and requires more support.

In selecting a wet-nurse for a very small and feeble babe, you must carefully ascertain that the nipples of the wet-nurse are good and soft, and yet not very large: if they be very large, the child’s mouth being very small, he may not be able to hold them. You must note, too, whether the milk flows readily from the nipple into the child’s mouth; if it does not, he may not have strength to draw it, and he would soon die of starvation. The only way of ascertaining whether the infant actually draws the milk from the nipple, can be done by examining the mouth of the child _immediately_ after his taking the breast, and seeing for yourself whether there be actually milk in his mouth.

Very feeble new-born babes sometimes cannot take the bosom, be the nipples and the breasts ever so good. In such a case, cow’s milk and water, sugar and salt, as recommended at page 45, must be given in small quantities at a time—from two to four teaspoonfuls—but frequently; if the child be awake, every hour or every half hour, both night and day, until he be able to take the breast. If, then, a puny, feeble babe is only able to take but little at a time, and that little by teaspoonfuls, he must have little and often, in order that “many a little might make a mickle.”

I have known many puny, delicate children who had not strength to hold the nipple in their mouths, but who could take milk and water (as above recommended) by teaspoonfuls only at a time, with steady perseverance, and giving it every half hour or hour (according to the quantity swallowed), at length be able to take the breast, and eventually become strong and hearty children; but such cases require unwearied watching, perseverance, and care. Bear in mind, then, that the smaller the quantity of the milk and water given at a time, the oftener must it be administered, as, of course, the babe must have a certain quantity of food to sustain life.

38. _What ought to be the diet either of a wet-nurse, or of a mother who is suckling?_

It is a common practice to cram a wet-nurse with food, and to give her strong ale to drink, to make good nourishment and plentiful milk! This practice is absurd; for it either, by making the nurse feverish, makes the milk more sparing than usual, or it causes the milk to be gross and unwholesome. On the other hand, we must not run into an opposite extreme. The mother, or the wet-nurse, by using those means most conducive to her own health, will best advance the interest of her little charge.

A wet-nurse ought to live somewhat in the following way: Let her for breakfast have black tea, with one or two slices of cold meat, if her appetite demand it, but not otherwise. It is customary for a wet-nurse to make a hearty luncheon; of this I do not approve. If she feel either faint or low at eleven o’clock, let her have either a tumbler of porter, or of mild fresh ale, with a piece of dry toast soaked in it. She ought not to dine later than half-past one or two o’clock; she should eat, for dinner, either mutton or beef, with either mealy potatoes, or asparagus, or French beans, or secale, or turnips, or brocoli, or cauliflower, and stale bread. Rich pastry, soups, gravies, high-seasoned dishes, salted meats, greens, and cabbage must one and all be carefully avoided, as they only tend to disorder the stomach, and thus to deteriorate the milk.

It is a common remark, that “a mother who is suckling may eat anything.” I do not agree with this opinion. Can impure or improper food make pure and proper milk, or can impure or improper milk make good blood for an infant, and thus good health?

The wet-nurse ought to take with her dinner a moderate quantity of either sound porter, or of mild (but not old or strong) ale. Tea should be taken at half-past five or six o’clock; supper at nine, which should consist either of a slice or two of cold meat, or of cheese if she prefer it, with half a pint of porter or of mild ale; occasionally, a basin of gruel may with advantage be substituted. Hot and late suppers are prejudicial to the mother or to the wet-nurse, and, consequently, to the child. The wet-nurse ought to be in bed every night by ten o’clock.

It might be said that I have been too minute and particular in my rules for a wet-nurse; but when it is considered of what importance good milk is to the well-doing of an infant, in making him strong and robust, not only now, but as he grows up to manhood, I shall, I trust, be excused for my prolixity.

39. _Have you any more hints to offer with regard to the management of a wet-nurse?_

A wet-nurse is frequently allowed to remain in bed until a late hour in the morning, and during the day to continue in the house, as if she were a fixture! How is it possible that any one, under such treatment, can continue healthy?

A wet-nurse ought to rise early, and, if the weather and season will permit, take a walk, which will give her an appetite for breakfast and will make a good meal for her little charge. This, of course, cannot, during the winter months, be done; but even then, she ought, some part of the day, to take every opportunity of walking out; indeed, in the summer time she should live half the day in the open air.

She ought strictly to avoid crowded rooms; her mind should be kept calm and unruffled, as nothing disorders the milk so much as passion and other violent emotions of the mind; a fretful temper is very injurious, on which account you should, in choosing your wet-nurse, endeavor to procure one of a mild, calm, and placid disposition.

“The child is poisoned.”

“Poisoned! by whom?”

“By you. You have been fretting.”

“Nay, indeed, mother. How can I help fretting?”

“Don’t tell me, Margaret. A nursing mother has no business to fret.
She must turn her mind away from her grief to the comfort that lies in
her lap. Know you not that the child pines if the mother vexes
herself?”—_The Cloister and the Hearth._ By Charles Reade.

A wet-nurse ought never to be allowed to dose her little charge either with Godfrey’s Cordial, or with Dalby’s Carminative, or with Syrup of White Poppies, or with medicine of any kind whatever. Let her thoroughly understand this, and let there be no mistake in the matter. Do not, for one moment, allow your children’s health to be tampered and trifled with. A baby’s health is too precious to be doctored, to be experimented upon, and to be ruined by an ignorant person.

40. _Have the goodness to state at what age a child ought to be weaned?_

This, of course, must depend both upon the strength of the child and upon the health of the parent; on an average, nine months is the proper time. If the mother be delicate it may be found necessary to wean the infant at six months; or if he be weak, or laboring under any disease, it may be well to continue suckling him for twelve months; but after that time the breast will do him more harm than good, and will, moreover, injure the mother’s health, and may, if she be so predisposed, excite consumption.

41. _How would you recommend a mother to act when she weans her child?_

She ought, as the word signifies, do it gradually—that is to say, she should, by degrees, give him less and less of the breast, and more and more of artificial food; at length she must only suckle him at night; and lastly, it would be well for the mother either to send him away, or to leave him at home, and, for a few days, to go away herself.

A good plan is, for the nurse-maid to have a half-pint bottle of new milk—which has been previously boiled—in the bed, so as to give a little to him in lieu of the breast. The previous boiling of the milk will prevent the warmth of the bed turning the milk sour, which it would otherwise do. The warmth of the body will keep the milk of a proper temperature, and will supersede the use of lamps, of candle-frames, and other troublesome contrivances.

42. _While a mother is weaning her infant, and after she has weaned him, what ought to be his diet?_

Any one of the foods recommended in answer to question 34, page 36.

43. _If a child be suffering severely from “wind,” is there any objection to the addition of a small quantity either of gin or of peppermint to his food to disperse it?_

It is a murderous practice to add either gin or peppermint of the shops (which is oil of peppermint dissolved in spirits) to his food. Many children have, by such a practice, been made puny and delicate, and have gradually dropped into an untimely grave. An infant who is kept, for the first three or four months, _entirely_ to the breast—more especially if the mother be careful in her own diet—seldom suffers from “wind;” those, on the contrary, who have much or improper food, suffer severely. For the first three or four months never, if you can possibly avoid it, give artificial food to an infant who is sucking. There is nothing, in the generality of cases, that agrees, for the first few months, like the mother’s milk _alone_.

Care in feeding, then, is the grand preventive of “wind;” but if, notwithstanding all your precautions, the child be troubled with flatulence, the remedies recommended under the head of Flatulence will generally answer the purpose.

44. _Have you any remarks to make on sugar for sweetening a baby’s food?_

A _small_ quantity of sugar in an infant’s food is requisite, sugar being nourishing and fattening, and making cows’ milk to resemble somewhat in its properties human milk; but, bear in mind, _it must be used sparingly. Much_ sugar cloys the stomach, weakens the digestion, produces acidity, sour belchings, and wind.

If a baby’s bowels be either regular or relaxed, _lump_ sugar is the best for the purpose of sweetening his food; if his bowels are inclined to be costive, _brown_ sugar ought to be substituted for lump sugar, as _brown_ sugar acts on a young babe as an aperient, and, in the generality of cases, is far preferable to physicking him with opening medicine. An infant’s bowels, whenever it be practicable (and it generally is), ought to be regulated by a judicious dietary rather than by physic.

VACCINATION.

45. _Are you an advocate for vaccination?_

Certainly. I consider it to be one of the greatest blessings ever conferred upon mankind. Small-pox, before vaccination was adopted, ravaged the country like a plague, and carried off thousands annually; and those who did escape with their lives were frequently made loathsome and disgusting objects by it. Even inoculation (which is cutting for the small-pox) was attended with danger—more especially to the unprotected—as it caused the disease to spread like wildfire, and thus it carried off immense numbers.

Vaccination is one and an important cause of our increasing population; small-pox, in olden times, decimated the country.

46. _But vaccination does not always protect a child from small-pox?_

I grant you that it does not _always_ protect him, _neither does inoculation_; but when he is vaccinated, if he take the infection, he is seldom pitted, and very rarely dies, and the disease assumes a comparatively mild form. There are a few, very few fatal cases recorded after vaccination, and these may be considered as only exceptions to the general rule; and, possibly some of these may be traced to the arm, when the child was vaccinated, not having taken proper effect.

If children and adults were _revaccinated_,—say every seven years after the first vaccination,—depend upon it, even these rare cases would not occur, and in a short time small-pox would only be known by name.

47. _Do you consider it, then, the imperative duty of a mother in every case to have, after the lapse of every seven years, her children revaccinated?_

I decidedly do; it would be an excellent plan for _every_ person, once every seven years, to be revaccinated, and even oftener, if small-pox be rife in the neighborhood. Vaccination, however frequently performed, can never do the slightest harm, and might do inestimable good. Small-pox is both a pest and a disgrace, and ought to be constantly fought and battled with until it is banished (which it may readily be) the kingdom.

I say that small-pox is a pest; it is worse than the plague, for if not kept in subjection it is more general—sparing neither young nor old, rich nor poor, and commits greater ravages than the plague ever did. Small-pox is a disgrace; it is a disgrace to any civilized land, as there is no necessity for its presence: if cow-pox were properly and frequently performed, small-pox would be unknown. Cow-pox is a weapon to conquer small-pox, and to drive it ignominiously from the field.

My firm belief then is, that if _every_ person were, _every seven years_, duly and properly vaccinated, small-pox might be utterly exterminated; but as long as there are such lax notions on the subject, and such gross negligence, the disease will always be rampant, for the poison of small-pox never slumbers nor sleeps, but requires the utmost diligence to eradicate it. The great Dr. Jenner, the discoverer of cow-pox as a preventative of small-pox, strongly advocated the absolute necessity of _every_ person being revaccinated once every seven years, or even oftener, if there was an epidemic of small-pox in the neighborhood.

48. _Are you not likely to catch not only the cow-pox, but any other disease that the child has from whom the matter is taken?_

The same objection holds good in cutting for small-pox (inoculation)—only in a tenfold degree—small-pox being such a disgusting complaint. Inoculated small-pox frequently produced and left behind inveterate “breakings-out,” scars, cicatrices, and indentations of the skin, sore eyes, blindness, loss of eyelashes, scrofula, deafness—indeed, a long catalogue of loathsome diseases. A medical man, of course, will be careful to take the cow-pox matter from a healthy child.

49. _Would it not be well to take the matter direct from the cow?_

If a doctor be careful—which, of course, he will be—to take the matter from a healthy child, and from a well-formed vesicle, I consider it better than taking it _direct_ from the cow, for the following reasons: The cow-pox lymph, taken direct from the cow, produces much more violent symptoms than after it has passed through several persons; indeed, in some cases, it has produced effects as severe as cutting for the small-pox; besides, it has caused, in many cases, violent inflammation and even sloughing of the arm. There are also several kinds of _spurious_ cow-pox to which the cow is subject, and which would be likely to be mistaken for the _real_ lymph. Again, if even the _genuine_ matter were not taken from the cow _exactly_ at the proper time, it would be deprived of its protecting power.

50. _At what age do you recommend an infant to be first vaccinated?_

When he is two months old, as the sooner he is protected the better. Moreover, the older he is the greater will be the difficulty in making him submit to the operation, and in preventing his arm from being rubbed, thus endangering the breaking of the vesicles, and thereby interfering with its effects. If small-pox be prevalent in the neighborhood, he may, with perfect safety, be vaccinated at the month’s end; indeed, if the small-pox be near at hand, he _must_ be vaccinated, regardless of his age and regardless of everything else, for small-pox spares neither the young nor the old, and if a new-born babe should unfortunately catch the disease, he will most likely die, as at his tender age he would not have strength to battle with such a formidable enemy. “A case in the General Lying-in-Hospital, Lambeth, of small-pox occurred in a woman a few days after her admission and the birth of her child. Her own child was vaccinated when only four days old, and all the other infants in the house, varying from one day to a fortnight and more. All took the vaccination; and the woman’s own child, which suckled her and slept with her; and all escaped the small-pox.” Communicated by Sir Charles Locock to the author.

51. _Do you consider that the taking of matter from a child’s arm weakens the effect of vaccination on the system?_

Certainly not, provided it has taken effect in more than one place. The arm is frequently much inflamed, and vaccinating other children from it abates the inflammation, and thus affords relief. _It is always well to leave one vesicle undisturbed?_

52. _If the infant has any “breaking-out” upon the skin, ought that to be a reason for deferring the vaccination?_

It should, as two skin diseases cannot well go on together; hence the cow-pox might not take, or, if it did, might not have its proper effect in preventing small-pox. “It is essential that the vaccine bud or germ have a congenial soil, uncontaminated by another poison, which, like a weed, might choke its healthy growth.” The moment the skin be free from the breaking-out, he must be vaccinated. A trifling skin affection, like red gum, unless it be severe, ought not, at the proper age, to prevent vaccination. If small-pox be rife in the neighborhood, the child _must_ be vaccinated, regardless of _any_ “breaking-out” on the skin.

53. _Does vaccination make a child poorly?_

At about the fifth day after vaccination, and for three or four days, he is generally a little feverish; the mouth is slightly hot, and he delights to have the nipple in his mouth. He does not rest so well at night; he is rather cross and irritable; and, sometimes, has a slight bowel complaint. The arm, about the ninth or tenth day, is usually much inflamed—that is to say, it is, for an inch or two or more around the vesicles, red, hot, and swollen, and continues in this state for a day or two, at the end of which time the inflammation gradually subsides. It might be well to state that the above slight symptoms are desirable, as it proves that the vaccination has had a proper effect on his system, and that, consequently, he is more likely to be thoroughly protected from any risk of catching small-pox.

54. _Do you approve, either during or after vaccination, of giving medicine, more especially if he be a little feverish?_

No; as it would be likely to work off some of its effects, and thus would rob the cow-pox of its efficacy on the system. I do not like to interfere with vaccination _in any way whatever_ (except, at the proper time, to take a little matter from the arm), but to allow the pock to have full power upon his constitution.

What do you give the medicine for? If the matter that is put into the arm be healthy, what need is there of physic? And if the matter be not of a good quality, I am quite sure that no physic will make it so! Look, therefore, at the case in whatever way you like, physic after vaccination is _not_ necessary; but, on the contrary, hurtful. If the vaccination produce a slight feverish attack it will, without the administration of a particle of medicine, subside in two or three days.

55. _Have you any directions to give respecting the arm_ AFTER _vaccination_?

The only precaution necessary, is to take care that the arm be not rubbed; otherwise the vesicles may be prematurely broken, and the efficacy of the vaccination may be lessened. The sleeve, in vaccination, ought to be large and soft, and should _not_ be tied up. The tying up of a sleeve makes it hard, and is much more likely to rub the vesicles than if it were put on in the usual way.

56. _If the arm_, AFTER _vaccination, be much inflamed, what ought to be done_?

Smear frequently, by means of a feather or a camel’s-hair brush, a little cream on the inflamed part. This simple remedy will afford great relief and comfort.

57. _Have the goodness to describe the proper appearance, after the falling off of the scab, of the arm?_

It might be well to remark that the scabs ought always to be allowed to fall off of themselves. They must not, on any account, be picked or meddled with. With regard to the proper appearance of the arm after the falling off of the scab, “a perfect vaccine scar should be of small size, circular, and marked with radiations and indentations.”

DENTITION.

58. _At what time does dentition commence?_

The period at which it commences is uncertain. It may, as a rule, be said that a babe begins to cut his teeth at seven months old. Some have cut teeth at three months; indeed, there are instances on record of infants having been born with teeth. King Richard the Third is said to have been an example. Shakspeare notices it thus:

“YORK.—Marry, they say my uncle grew so fast
That he could gnaw a crust at two hours old;
’Twas full two years ere I could get a tooth.
Grandam, this would have been a biting jest.”
_Act 2, sc, 5._

When a babe is born with teeth they generally drop out. On the other hand, teething in some children does not commence until they are a year and a half or two years old, and, in rare cases, not until they are three years old. There are cases recorded of adults who have never cut any teeth. An instance of the kind came under my own observation.

Dentition has been known to occur in old age. A case is recorded by M. Carre, in the _Gazette Medicale de Paris_ (Sept. 15, 1860), of an old lady, aged eighty-five, who cut several teeth after attaining that age!

59. _What is the number of the_ FIRST _set of teeth, and in what order do they generally appear_?

The first or temporary set consists of twenty. The first set of teeth are usually cut in pairs. “I may say that nearly invariably the order is—1st, the lower front incisors [cutting-teeth], then the upper front, then the _upper_ two lateral incisors, and that not uncommonly a double tooth is cut before the two _lower_ laterals; but at all events the lower laterals come 7th and 8th, and not 5th and 6th, as nearly all books on the subject testify.” [Sir Charles Locock, in a _Letter_ to the Author.] Then the first grinders in the lower jaw, afterward the first upper grinders, then the lower corner pointed or canine teeth, after which the upper corner or eye-teeth, then the second grinders in the lower jaw, and lastly, the second grinders of the upper jaw. They do not, of course, always appear in this rotation. Nothing is more uncertain than the order of teething. A child seldom cuts his second grinders until after he is two years old. _He is usually, from the time they first appear, two years in cutting his first set of teeth._ As a rule, therefore, a child of two years old has sixteen, and one of two years and a half old, twenty teeth.

60. _If an infant be either feverish or irritable, or otherwise poorly, and if the gums be hot, swollen, and tender, are you an advocate for their being lanced?_

Certainly; by doing so he will, in the generality of instances, be almost instantly relieved.

61. _But it has been stated that lancing the gums hardens them?_

This is a mistake—it has a contrary effect. It is a well-known fact that a part which has been divided gives way much more readily than one which has not been cut. Again, the tooth is bound down by a tight membrane, which, if not released by lancing, frequently brings on convulsions. If the symptoms be urgent, it may be necessary from time to time to repeat the lancing.

It would, of course, be the height of folly to lance the gums unless they be hot and swollen, and unless the tooth or the teeth be near at hand. It is not to be considered a panacea for every baby’s ill, although, in those cases where the lancing of the gums is indicated, the beneficial effect is sometimes almost magical.

62. _How ought the lancing of a child’s gums to be performed?_

The proper person, of course, to lance his gums is a medical man. But, if perchance you should be miles away and be out of the reach of one, it would be well for you to know how the operation ought to be performed. Well, then, let him lie on the nurse’s lap upon his back, and let the nurse take hold of his hands, in order that he may not interfere with the operation.

Then, _if it be the upper gum_ that requires lancing, you ought to go to the head of the child, looking over, as it were, and into his mouth, and should steady the gum with the index finger of your left hand; then you should take hold of the gum-lancet with your right hand—holding it as if it were a table-knife at dinner—and cut firmly along the inflamed and swollen gum and down to the tooth, until the edge of the gum-lancet grates on the tooth. Each incision ought to extend along the ridge of the gum to about the extent of each expected tooth.

_If it be the lower gum_ that requires lancing, you must go to the side of the child, and should steady the outside of the jaw with the fingers of the left hand, and the gum with the left thumb, and then you should perform the operation as before directed.