Established 30 Years Telephone Central 4298
54 THE SPECULUM. May, 1918.
The stools of a newly born infant are, for the first two days or three clays, of a dark green, almost black colour and tarry nature, and are practically odourless. Then they become a brigt yellow and more faecal in character, and have a very faint faecal odour. As the stools supply the nurse with much valuable information as regards the baby's capacity for food and its power of digestion, they should be closely observed.
Stools—Abnormalities.—The presence of curds in the stools of the breast-fed child denotes that the milk is too strong, and sterile water, a few drachms, or barley water, given directly before feeding, is indicated. Constipation is caused by too much proteid in the milk, and will probably he corrected by small drinks of water given in between meals.
Green Stools.—Green .stools may be caused by bacteria being carried from cracked or dirty nipples, or from a neglected mouth, and may cause a very serious gastric enteritis. They may also be caused by cold feet. Give castor oil 3i., and with- hold nourishment for 12 hours. Relieve thirst with small drinks of warm sterile water.
Changing of Baby.—Baby should never be handed to the mother for drinks without first making sure it is neither wet nor dirty. Wash buttocks after removing napkin with warm water, in which a little soda bicarb has been dissolved, dry thoroughly, dust between folds of skin with starch powder, and put on clean napkin.
Napkins should not be washed in water containing wash- ing soda or strong soap.
Method of Bathing and Dressin•.—Nurse with flannel apron on takes the child on her knee, first opening the eyelids and dropping one drop of argyrol in each eye, and wiping away the excess with a sterile swab.
Wipe any mucus away that may collect in the mouth with sterile mouth wipe.
Clean the child by wiping the vernix caseosa away with wool swabs which have been dipped in the warm olive oil, taking special care to wipe between the various folds of the skin where it is most liable to collect.
Now lay the child with its head just over the lap and looking upward, supporting it with the left hand.
Wash the head thoroughly, using plenty of soap, and wash- ing it off ; dry well.
Put the child in the bath, grasping it with thumb and fore- finger round the neck, using the remaining fingers to support the hack. With the right hand take the ankles, lifting it into
the bath. Splash and gently massage with the right hand.
Again take the child by ankles and lift on to warm towel and dry thoroughly with a light dabbing movement, dust skin especi- ally between the folds with the starch powder. Examine for abnormalities such as tongue tie; insert thermometer into rec- tum to be certain that the bowel is not imperforate.
Cord.—Wipe cord with a sterile swab clipped in methy- lated spirit, powder base with cord powder, pass cord up through slit of the aseptic wool prepared, again powder, fold in an upward direction, and fold lower half of wool over it.
Apply binder firmly, but not tightly, and secure with a few stitches at the back.
Method of Dressing.—First weigh and measure the child.
Place baby with its back uppermost, slip on singlet, put napkin in position and place petticoat over back.
Turn over on to,back, fasten napkin and petticoat. Raise baby by the feet and slide on dress from below upward.
The bath should be repeated with the exception of the oiling every morning and at the same time.
The bath should be given quickly and efficiently in order that the infant may not lose more bodily heat than necessary.
Mouth.—Baby's mouth should be wiped out with a sterile piece of cotton wool wrapped round the finger and dipped in borax and glycerine once a day, and with a piece of sterile cotton wool dipped in a weak solution of soda bicarb before and after feeding. The mouth will then be kept clean and sweet and thrush is very unlikely to occur.
Care of Eyes.—Every morning before the bath nurse should swab the eyes with weak boracic lotion, using a separate swab each time, with a sweeping movement, and finishinc , one eye before beginning the next. Should they become inflamed report the fact at once.
Swab with corrosive sublimate 1-6000 every four hours and apply one drop of argyrol every hour. If only one eye is infected, treat the good eye first, putting a sterile pad over it while dressing the infected one. Lie child on side of infected eye and place clean cotton cloth under it each time. After using the corrosive sublimate solution, it is necessary to thoroughly wash away all traces of the solution with a solution of Boracic acid 2 per cent.
Food.—The breast is the ideal food for baby, and in a normal mother no other should•be considered.
56 THE SPECULUM. May, 1918.
Baby should be given to its mother every six hours for the first twenty-four hours, every four hours for the second twenty-four hours, then two hourly, missing two feeds alter- nately at night, arranging that the last feed be given at io p.m.
and the first feed for the day at 6 a.m., and making one feed due at 2 a.m.
The mother should be instructed to lie on the side from which the breast is given, holding the breast forward between thumb and fingers, seeing that the baby is able to breathe by keeping nose free.
For the first three days a creamy fluid called colostrum is in the breasts ; it is considered to have a slightly laxative effect, clearing the bowel of the rneconium. If baby is restless and thirsty a little warm sterile water may be given.
The mother has the flow of milk on the third day, and should it prove insufficiet in a clay or so, baby may need its feed supplemented. Humanised milk is best. Top milk in proportion one to two parts water, with half a teaspoonful of lactose.
As the capacity of the child's stomach will be about 31V2 the nurse must take into consideration - the amount likely to have been received from the breast. When supplementary feeds are given it is best to increase the interval between meals to three hours.
Feeds should be given regularly. If necessary, increase the amount given at one feed, never the number of feeds.
If sleeping when feeding is due, the infant must be wakened.
Baby should be weighed every week.
Increase in Weight. —The babe loses in weight for the first five days, or until the cord falls off ; if it is healthy and thriv- ing it will have regained its birth weight by the tenth (lay.
Sleep.—A normal healthy, contented child will sleep about nine-tenths of the time, falling off shortly after it has been fed and changed, and waking up for successive feeds and changes.
Cry.—If baby cries it is probably cold, hungry, in need of being changed, or in pain.
If baby is restless and fretful it is possibly due to cold or wetness ; if cry is loud and insistent, probably hunger; and if
\in pain, loud, sharp and spasmodic.
The healthy, happy baby is firm, pink, and contented.