PHONE 9571. Established 5o Years.
Rimless Fits-U Sps. Pince-Nez. Bi-focal Sps Krytop Lenses. CrooKe's Tinted Lenses.
REPAIRS PROMPTLY EXECUTED.
so THE SPECULUM. May, 1918.
Diet.—For the first two days, or until the bowels are open, the diet should consist chiefly of fluids such as tea, cocoa, broths, with the addition of toast, bread and butter and milk puddings.
After the bowels are opened, a lightly cooked egg, fish and milk puddings may be given, the next day a grilled chop and well cooked vegetable and fresh fruit of a digestible nature.
The mother should then be able to go back to her ordinary diet, avoiding made over dishes such as stews, curries, and using condiments with moderation, eating nothing likely to disagree with herself and, consequently, her child.
The nursing woman requires a greater amount of fluid, and should have plenty of water between meals.
Should the secretion of milk be insufficient an increased amount of cow's milk may be given to which a pinch of citrate of soda or a little barley water has been added ; a teaspoonful of lactogol given two or three times a clay in drinks may be
found useful.
Bowels.—The bowels should be opened towards the end of the second day after the delivery of the child by an aperient
—Castor oil will be found the best and softest. They should then be opened once daily by an aperient given every other clay, such as liquid cascara 1-2 drachms, liquorice powder, :iss or laxative pills.
Salines are contraindicated in a normal nursing mother as they cause a decrease in the secretion of milk.
Urine.—The mother should he put on a warmed pan and encouraged to pass her urine a few hours after the birth of the child. Should this fail, a hot foment may be placed over the bladder, and the shoulders slightly raised with pillows. She should not remain longer than eight hours without passing urine for the first two days.
Most mothers have little difficulty, but should she be unable to pass urine the catheter must only be used as a last resort, and then the greatest care taken not to carry infection into the bladder.
After the second day the mother may go fourteen to six- teen hours before catherization, if she complains of no dis- comfort.
Involution.—Involution is the process of contraction and retraction by which the uterus regains its normal condition-
Sub-involution is caused by-
1. Retained fragments of placental tissue and membrane.
2. Non-lactation.
3. Over distended bladder.
4. Getting up too early.
5. Lack of tone in the uterine muscles.
Put baby to the breast as early as possible (as soon as the mother is rested), as this favours uterine contraction and lessens the risk of haemorrhage. After the patient has passed urine rub up the fundus, expressing any clot. Let her lie on her abdomen for from half an hour to one hour. This should be clone every morning and evening. The height of the fundus above the symphysis should be measured from the third day.
The uterus should sink at the rate of 3/4 of an inch every 24 hours, and by the tenth day be a pelvic organ.
If involution is slow, raising the head of the bed may be beneficial and douching and aperients may he ordered, as they tend to make the uterus contract and expel any fragments of placenta or membrane which may have been felt in the uterus.
If the lochial discharge is red on the fifth day ergot 3i and quinine gr V. may be ordered to help contractions.
When the uterus has become a pelvic organ and the lochiar discharge practically disappeared the patient may be allowed to sit up in bed, usually about the 7th day. On the eighth day she may sit out of bed, and on the tenth may be allowed to walk a very short distance.
Bath.--Have ready in a cosy corner sheltered from draughts—Baby table, with the following articles :-
Bowl olive oil standing in larger bowl of hot water.
Bowl of sterile boracic lotion.
Argyrol, 10 per cent., and eye dropper, lubricated ther- mometer, bottle of methylated spirit.
Aseptic cotton wool cut about four inches square, and cut from the middle of one side to the centre.
Small jar of sterile swabs.
Small pieces of sterile gauze for mouth wipes.
Tar of starch powder.
Jar of powder, equal parts zinc, starch and boracic for cord.
Soap of non-irritating nature, surh as castile.
Bath thermometer, tape measure, needle and cotton, safety pin.
Grocer's scales, receptacle for used swabs, etc.
Have also low chair.
Suitable bath, with about 4-5 inches of water, Tioo° F.
Warm soft towel and babies clothes, consisting of the fol- lowing-
32 THE SPECULUM. May, 1918.
Soft flannel binder about i yard long and 8 inches wide.
Singlet of soft fine wool.
Napkin of soft flannelette, and not too bulky.
Flannel petticoat.
Washing dress of fine soft cotton material.
Room.—If possible the child should have a room to itself close to the mother.
The room must be bright and airy, with a constant flow of fresh air passing through; the temperature should be about 65°
F. A fire will be necessary if the weather is cold.
Cot.—The cot should be of the open work variety, permit- ting the fresh air to enter on all sides. Made with first a soft woolly blanket large enough to cover the bottom of the cot and drape the sides ; place mattress next, under blanket and piece of mackintosh covered with soft sheet ; the rest of the clothes to be warm and light. Fold over sides of the blanket draping the cot, thus forming a cosy envelope.
Too much warmth will cause a red rash (strophulus).
After the first two days, if the weather is mild, baby may be placed in its cot in a cosy corner of a verandah.
A hot water bottle very well protected with a flannel cover and placed in the cot may be found necessary for the warmth of the child.
The child should lie on its side in order that any mucus that may collect will flow out and the baby should be turned ' on the opposite side when put down next.
Urine.--The child will probably pass urine a few hours after birth and within twelve hours. If it has not passed urine within the first twenty-four hours, examine it thoroughly, as a plug of vernix caseoso may be in the meatus of the uretha.
Put child into warm both too° F., give a few sips of cold water, and hold the hand in front of the child to ascertain if urine is being passed. If unsuccessful report to the doctor in charge at once.
Bowels.—The bowels of a newly born baby should be open within 12 hours of birth; should they fail to do so, gentle massage of the anus may act as a stimulus, or castor oil 5i.
may be given. Often a plug of mucus in the rectum will cause a temporary obstruction. The bowels open two or three times in the twenty-four hours, and no day should pass without their being opened once at least.
Stools should be noted as to frequency, colour, consistency and odour.
Established 30 Years Telephone Central 4298