New York City’s BABY BOOK A Handbook for Parents Issued by the DEPARTMENT OF HEALTH, CITY OF NEW YORK Israel Weinstein, M.D. Commissioner of Health William O’Dwyer Mayor Copyright 1947 By the City of New York All rights reserved. No part of this book may be reproduced in any form without permis- sion in writing, except by a reviewer who wishes to quote brief passages in connection with a review written for inclusion in a maga- zine or newspaper. City of New York Office of the Mayor New York 7. N . Y. Dear Parents: In behalf of the millions of your fellow-New Yorkers, I welcome your new baby to our ever-growing family. This book on child care is sent as a token of good will. It symbolizes the fact that your city government is deeply interested in your family*s welfare. The staff of your City Health Department, by whom this book was carefully pre- pared, considers the protection of the health of children its most important work. I hope you will enjoy reading "New York City’s Baby Book" and will find it helpful. God bless you and your family. Sincerely yours. /k a y o r / HOW TO USE THIS BOOK Read the table of contents carefully. You will notice that each chapter discusses the baby at different ages in his growth. Some advice is repeated in several places in the book to make it easy for you to find out all about your baby at each age, instead of hunting through the pages for separate bits of information. Let other members of the family read the book, too. It is important that all those who care for your baby do it in much the same way. And, finally, do not hesitate to use your own good common sense. No book can answer every question about every baby. CONTENTS Page Foreword 11 Chapter I. Nature and Your Baby 13 1. Babies Grow According to a Plan of Nature 13 2. Your Baby Is a Person 13 3. Routines for Good Care 14 4. Loving Your Baby Wisely 15 Chapter II. The Little Baby: From Birth to Three Months 18 1. How the Little Baby Grows 18 Your Newborn Baby 18 The Inborn Controls 18 The Mouth Comes First 19 Learning about His World 20 2. The Little Baby’s Day 21 A. The Baby’s First Food 22 The Right Milk for Your Infant 22 A Flexible Routine for Feeding 23 Suggestions for the Mother Who Breast- feeds Her Baby 25 Suggestions for Making Formula and Sterilizing Bottles 27 Water 30 Fish Liver Oil 30 Orange Juice or Substitutes 31 The Baby’s Bowels and Bladder 32 B. Sleep 33 C. Bathing the Baby 36 D. Clothes and Being Dressed 40 5 Contents Page E. Fresh Air and Sunshine 41 F. Exercise, Play and Companionship 42 G. How to Tell That Your Baby Is Well 44 H. Some Things That May Trouble the Little Baby 45 Hiccups 45 Spitting Up and Vomiting 46 Colic 46 Skin Rashes 47 Eye Conditions 48 The Navel 49 Noisy Breathing 49 “Nervous” Babies 49 3. The Clothing and Equipment You Needier Your Little Baby 50 A. Clothes and Bedding 50 B. The Baby’s Bed 51 C. Care of the Baby’s Clothes 51 D. Toilet Articles 52 E. Equipment for Sterilizing Bottles and Making Formula 53 Chapter III. The Big Baby; From Three to Nine Months 54 1. How Your Baby Is Growing! 54 The Desire to Touch Things 54 That Left Hand 54 Turning Over on His Own Power 55 Sitting Up Alone 55 Crawling—in a Dozen Styles 56 New Tricks 57 When the First Tooth Comes 57 2. The Changing Patterns of the Big Baby’s Daily Life 59 A. Naps and Bedtime 59 6 Contents Page B. Now Your Baby Is Ready for Solid Foods 60 How to Begin 60 Cereal or Fruit for Starters 61 Vegetables 62 Eggs 63 A Day’s Meals 63 Happy Mealtimes 64 C. Changing Schedules and Formulas for Milk 65 Increasing Appetite 65 If the Baby Sucks His Thumb 66 D. Elimination 66 E. Clothes and Baths 67 F. Fun for the Baby and the Family 68 G. Protect Your Baby from Disease 70 Chapter IV. The Baby Begins to Get Around: From Nine to Fifteen Months 73 1. How Old Is Your Year-Old Baby? 73 2. Important New Lessons in Your Baby’s Everyday Life 76 A. Eating in a More Grown-up Way 76 Three Meals a Day 76 What to Cook for the Baby’s Meals 77 Trust Your Baby’s Changing Appetite 80 B. Your Baby Is Ready to Help to Wean Himself 80 C. Now Your Baby Is Ready to Control His Bowels 82 D. Now Your Baby Learns to Stand Up 85 E. Playing Is Learning 86 3. When Puzzling Traits Develop 87 A. When the Baby Gets into Everything 87 B. If Your Baby Shows Temper 90 C. If Your Baby Has Trouble Sleeping 91 D. If Your Baby Is Afraid 92 E. If Your Baby Plays with His Genitals 92 F. If Your Baby Continues to Suck His Thumb 93 7 Contents Page Chapter V. The Toddler: From Fifteen Months to Two Years 94 1. The Baby’s Growth in Independence 94 A. Walking, Climbing, Running 94 B. New Skills with His Hands 95 C. Expressing Himself and Talking 95 2. More Grown-up Routines for the Day 96 A. Meals 96 B. Baths and Clothes 99 C. Naps and Bedtime 101 3. Now Your Baby Begins to Learn to Control His Bladder 101 4. New Lessons in Behaving “ ' 104 A. Fitting into Family Life 104 B. Learning from Playmates and Playthings 110 C. How Parents Can Teach Their Children 113 D. When Problems Arise 117 Fears 118 Tantrums 118 Biting, Scratching and Hitting 119 Dirt-Eating 120 Sex Play 120 Chapter VI. What to Do When Your Baby Is Sick 122 1. How to Tell whether Your Baby Is Sick 122 2. How to Choose a Doctor for Your Baby 123 3. What to Do Before the Doctor Comes 124 4. How to Care for Your Baby When He Is Sick 125 A. Follow the Doctor’s Orders Exactly 125 B. Keep the Baby in a Warm, Quiet Room 125 C. How to Take a Baby’s Temperature 126 D. How to Give an Enema When the Doctor Orders It 127 8 Contents Page E. How to Give an Alcohol Sponge Bath 128 F. How to Keep the Air in the Baby’s Room Moist 128 5. If Your Baby Must Go to the Hospital 129 6. When Your Baby Is Getting Better 131 7. A Few Points on Some Common Diseases of Childhood 133 A. Colds 133 B. Croup 133 C. Convulsions 133 D. Chicken Pox 134 E. Measles 134 F. Whooping Cough 134 8. First Aid for Accidents 135 A. Cuts and Scratches 135 B. Swallowing Objects 135 C. Poisons or Pills 135 D. Burns 136 9. Be Careful but Do Not Worry 136 9 FOREWORD Raising a healthy, happy family is a wonderful experience, even though it is not an easy job. Being a good parent requires skill, patience and a sense of humor. There are hur- ried days and sleepless nights, but there is no greater pleasure than watching your children grow to healthy, happy adulthood. All parents want and need help in caring for a baby, espe- cially the first baby. This book is sent to you in the hope that it will help you in many ways. But please use it only as a guide, as a reference book. It was written by doctors and nurses who have specialized in the care of babies, but they have not seen your child. Each baby is an individual. Do not expect your baby to act exactly as your neighbor’s or your sister’s baby. It is important that your baby be seen by a doctor at regular intervals, even though it is apparently well. Many serious ill- nesses of childhood can be prevented if the baby is periodically examined by a physician. Please don’t get the mistaken impres- sion that a person must be seen by a doctor only when he is sick. One of the most important functions of a doctor is the prevention of disease. During the first year of life your baby should be vaccinated against smallpox. He should also be given the necessary injections to protect him against diphtheria and whooping cough. These are serious diseases, especially in very young children. Another reason for bringing your child to the doctor at regular intervals is that he can see if the child is growing normally. If he finds that it is not, he will recommend corrective measures. Your Health Department conducts child health stations throughout the city where parents who cannot afford to pay a private physician may take their babies and other young chil- dren for advice. The inoculations mentioned above are given there. There is no charge for any of the services at these stations. There is another phase of child care, one that maybe over- looked by some parents, namely the development of mind and personality. You want your child to be healthy in mind as 11 Foreword well as in body. Therefore, attention to physical health alone is not sufficient. The molding of personality and character starts in infancy and is continued throughout childhood. Please keep that constantly in mind. Teachers and clergymen may aid in shaping your child’s personality but the chief responsibility is yours. By far the most important influence in the mental and emotional development of a child is the home. Every baby needs the affection and care that is part of a good home. As he grows older, your child must realize that he is but one member of a family and that he must understand and respect the rights of others, just as he is entitled to the recognition of his own rights. The time and care that are given in the formative years of a person’s life, namely in infancy and childhood, are well spent and bring dividends in the form of a healthy, happy adult who is a credit to his family and a worthy citizen of his country. Israel Weinstein, M.D. Commissioner of Health 12 Chapter I NATURE AND YOUR BABY 1. BABIES GROW ACCORDING TO A PLAN OF NATURE Your newborn baby has a lot of growing and learning ahead of him. In the next two years he will grow more, and prob- ably learn more, than he will all the rest of his life. He starts out at birth able to do a lot of important things himself. He grows by himself. Without any instruction he can breathe, eat and digest his food, and sleep. His tiny nervous system has its own way of functioning. The baby’s muscles, bones and nervous system will grow and develop according to nature’s plan. He can see, hear, coo and laugh, use his hands, cut his teeth, and crawl. These and many other abilities develop in a definite way. Generally speak- ing, his muscular development is from the top of his body downward. First he learns to control his mouth and eyes, his head and neck, then his shoulders and arms, next his trunk and lastly his legs. As the baby grows he learns how to sit up, walk, talk, feed himself, control his bowels and bladder and behave as a child of his age is expected to behave. His satisfaction and success in each little thing he learns lead him on to the next step in grow- ing up. All his growth—in body, mind and feelings—is inter- woven. At every age the baby’s patterns of behavior change. It is a usual sign of growth when he naps less often or wants to play at different times in different ways. It is very important to know what to expect your baby to be able to do at the different stages of his growth. This book tells what a baby naturally does as he grows and how his parents can help him. Wise parents respect a child’s natural develop- ment and are guided by it. They try neither to force it nor to hold it back but go along with the baby, helping as much as they can. 2. YOUR BABY IS A PERSON All babies follow the same general patterns of nature, but every baby has its own characteristic way of growing and behav- 13 New York City’s Baby Book ing. Even newborn babies look different, and- act differently, from one another. Each is an individual, a new and different person. The father’s relatives may think the baby takes after their side of the family, while the mother’s folks say he resembles them. The truth is that the baby looks like himself. He won’t look quite like anyone else in the world, and he can’t be ex- pected to feel or behave just like anyone else. No baby grows just the way this book or any other book says. There’s no one “correct weight” for all babies at a certain age, A baby’s weight depends upon a lot of things—how tall and broad his parents are, the kind of food his mother ate dur- ing pregnancy, how well the baby has been, whether he’s a fast grower or a slow one. There’s no one right way of doing any one thing either. One baby may be placid and easy going, sleep for long stretches at a time and get hungry as regularly as the clock strikes. Another baby, who is just as healthy, may take short naps, be extra lively every minute he’s awake, and have a variable appetite. One baby may scoot around the floor on his hands and knees like a little bug at six months. Another may not crawl but just squat until he’s ready to get up and walk. It’s natural for parents to be proud of their children and to want them to be normal or above average. But the parents shouldn’t worry if their baby is thinner than the neighbor’s child, or doesn’t cut his first tooth or say his first word as early as some other baby. What is important is not how your baby compares with another child, but whether he is well and con- tented and growing in his own best possible way. So love your baby for the kind of little boy or girl he or she is. As you study your baby, you will learn to recognize his own particular style of growing and doing things. He’ll grow better and learn faster and be happier if you respect him for what he is. 3. ROUTINES FOR GOOD CARE Good care for a baby includes sensible, healthy ways of doing such things as feeding, bathing and dressing him. It also means protecting your baby from accidents, sickness and unwise things he might do that would harm him. But good care means more than this. It also means helping your baby to do things him- self, little by little to develop self-control, judgment and inde- pendence. 14 Nature and Your Baby There are a great many things to be done for a young baby. At first it’s a full-time job, on all three shifts. Added to this, the child’s mother has other important things to do—homemaking, housekeeping, being a wife and sometimes mothering other children. She needs rest and fun herself. And of course she needs time to enjoy her baby. So a fairly regular routine for the baby is highly desirable if the mother isn’t to wear herself out. A baby needs regular routines, too. His education really be- gins with the orderly pattern of his everyday life. Fairly sys- tematic care is the only way he can comfortably get his food and rest. Besides, the baby thrives better and is more comfortable if he comes to realize that his needs will be met regularly. The feeling that he can depend upon the person who cares for him gives him confidence in others and also in himself. One of the first things to do, therefore, is to plan his day so that it fits in easily with the rest of the family day and at the same time fits him. But making a schedule isn’t everything. Your baby is a hu- man being first of all. He grows and changes from day to day, so that his routines need to be flexible. A mother is human, too, and naturally she can’t always manage to have dinner or a bath ready on the dot. Occasional changes in the daily routine won’t hurt the baby. A few years ago mothers used to be warned to put and keep their babies on an exact, rigid schedule—meals, naps and play- time by the clock, so many minutes to nurse or finish the bottle, and just so many ounces of milk at each feeding. The baby was treated like a kind of machine, too, in the mistaken belief that it was better for him not to be held but to lie alone in his crib and “cry it out” when he wanted attention. In recent years, however, many doctors have1 discovered that a more flexible routine works better for both mother and baby. We believe you will find that your baby is more con- tented arid a better baby if his life is planned upon a stable framework of orderly, flexible routine. This routine should be based on his natural rhythms of doing things. 4. LOVING YOUR BABY WISELY Your baby is born with a need to be loved. He learns to love others by being loved himself. He senses his parents’ affection 15 New York City’s Baby Book in the way they hold him while they feed and cuddle him, and in the gentle tones of their voices long before words have any meaning for him. Anyone who has visited an institution for homeless children can plainly see the difference between those lonely little waifs, who get no individual attention, and the baby in his own home, whose parents give him lots of loving care. Babies can be lonely. Wise loving and thoughtful consideration of a baby’s feelings never spoiled him. The “spoiled child” is often the one who has never had a feeling of security, whose normal craving for love hasn’t been satisfied in his everyday life or whose parents don’t really like to take care of him but only want to show him off. Consequently he always wants something that he doesn’t have and cries and whines for it. Babies are born ready to be reasonable and friendly. Once you understand how they grow and why they behave the way they do, you’ll find that they can be trusted a great deal. A baby tries to learn to do things the way grownups do, and he is very anxious to receive the approval of his family. A baby needs both a father and a mother. Naturally the mother is the more important parent at first because of his dependence on her. She takes care' of the baby most of the time and she alone is with him day after day. But even a tiny baby notices his father, and as he grows a little older he learns to listen for his homecoming and greets him happily. In the first weeks, while the mother is re- gaining her strength, the father can help by bringing the baby to the mother to nurse, or by giving an occasional bottle. He can take on the job of making the formula. Sundays and holi- days, or if he gets home early enough at night, giving the child a bath will help father and baby to get acquainted. The time for a father to begin being a com- panion to his child is during babyhood. 16 Nature and Your Baby A child often learns a great deal about family life by observ- ing how his own father and mother get along together. In fact, a child’s attitude toward his home is largely determined by the way his father and mother feel about each other and about him. A child doesn’t need “perfect” parents. But it is very important for him to feel sure that his parents want him even though they may be cross at times. All parents occasionally make mistakes in bringing up their children, but as they try to understand each other and their children better they learn to handle everyday problems more wisely. No book or doctor can tell you everything about the care of your infant. You will become more familiar with the sub- ject, as time goes on, by studying your own baby. 17 Chapter II THE LITTLE BABY; FROM BIRTH TO THREE MONTHS 1. HOW THE LITTLE BABY GROWS Your Newborn Baby You will never forget the first sight of your tiny, helpless new- born baby. Before birth the baby was safe and warm inside his mother’s body. There he was protected from all shock, noise or pain. All his wants were taken care of immediately and without any effort on his part. The new outside world is very different and less comfortable. Hunger causes him pain; cold, noise and sud- den movements bother him. In some ways a baby isn’t fully born until he’s about a month old. It takes that length of time for his body to get to working smoothly and regularly; and it takes time for him to adapt himself to the new routines he finds. It is therefore important to the baby’s well-being and future development that we do everything possible to comfort him and make him feel secure in his new world. He especially needs to be close to his mother, to feel her warmth and tenderness. He needs to be handled gently. His natural wants should be heeded and satisfied. He should not be left alone to scream with the pain of hunger, discomfort or loneliness. He needs to find that he can trust his parents to look after his wants and relieve his distress. Then he will grow in body and mind, in confidence and happiness. Although it is hard to believe that the tiny newborn creature can do anything for himself, he doesn’t start from scratch. He has already been at his job of growing for nine months. His little body is very wise and already knows a lot about what’s good for him. He goes on learning more from the first breath of life. The Inborn Controls The most important parts of the baby’s natural equipment 18 The Little Baby: From Birth to Three Months are the systems that carry on and regulate his vital functions of breathing, eating and digesting, and eliminating. When the baby’s stomach is empty, he feels pains and his cry tells us it’s time for food. He turns his head if we touch his cheek; he roots around, hunting for his dinner. He sucks and swallows, and has a mechanism that tells him when he has had enough food and suck- ing, so that he stops sucking of his own accord when he is satisfied. A baby can do a number of other useful things at birth, too. He can cough and sneeze to get mucus out of his throat and nose. He can also yawn, hiccup and belch. He shivers and his skin turns blue or mottled when he’s cold. If there is a sudden loud noise or a jarring movement, his body stiffens, he stretches out and doubles up his arms and legs, he shrieks and looks pained. If his legs are held so tightly that he can’t move, he cries and struggles to be free. Some babies show their reactions more clearly and intensely than others. Your baby’s behavior will show you what makes him comfortable and what makes him miserable. The Mouth Comes First Nature gives a baby a strong urge to suck in order to get food. Some babies are “good suckers” from the beginning. Some need a little help to learn how to get the nipple into the mouth and swallow. Sucking is an important business for every baby. It enables him to fill his empty stomach, and it is also a very satisfy- ing exercise. Watch how hard and eagerly your baby works for his meal. He wriggles and pushes, gets red and perspires. And how very contented he looks when he has finished! Some babies seem to have a greater desire to use their mouths than they have capacity for milk, and may try to suck their fingers after a meal. This is a normal urge; it is not wrong or harmful. One should not try to prevent a baby from sucking his thumb by pinning his sleeves down or putting splints on his arms or an aluminum mitt on his hands. This naturally makes him angry and does not cure the trouble. He will'probably outgrow the need for extra sucking of his own accord. The cry of the baby when he is born serves a useful purpose in getting air into his lungs and giving his breathing apparatus a first vigorous workout. His later crying has a purpose too, as we shall see. When the baby is a couple of weeks old, the mother may think she sees him smiling in his sleep, but the 19 New York Cjty’s Baby Book first real smile comes when he is about a month or two old, as his parents smile and talk to him. Later he begins to make little mews and throaty sounds and coos. He works very hard at these new accomplishments, moving his mouth, wriggling his hands and toes and making a great effort to get out a tiny squeak or gurgle. Soon he learns to laugh. Then he tries to babble and practices by himself for long periods. His ability to learn how to use words and sentences depends to some extent on his hearing others talk. Learning about His World The newborn baby apparently doesn’t see very much even though he blinks his eyes at a bright light. At first a baby may look cross-eyed; one eye turns in one direction and the other in another. As he grows older he stares vacantly, sometimes for quite a while, at windows, ceilings and walls. Later on he follows a moving light or hand with his eyes; then he turns his eyes in the direction of an unusual sound. Generally, by the time he is two months old, the baby recognizes his mother’s face, her breast, his bottle and other familiar things. At the same time that he is learning to use his eyes, the baby gets impressions of his little world through his ears. Be- fore he is two days old, he is startled by loud sounds. Except for sudden, sharp sounds, however, babies are not likely to be disturbed by ordinary noises and soon become accustomed to the usual household sounds. It is not necessary to tiptoe around the house, but it is well to remember that babies don’t like loud, sharp noises. Before he is a month old, your infant will pay attention when you whisper in his ear and will stop crying to listen. He stares when he hears sounds, and turns his head and eyes to listen. He soon learns to associate the soft voice of his mother with the comforts of being fed, changed and bathed. Long before he understands words, he knows that when she comes to him something pleasant is going to happen. It is a good idea, therefore, to speak to your baby and chat with him when you care for him. The baby can raise his head for a moment when he is lying on his stomach, soon after birth. But his head wobbles so much that care must be taken to support it whenever he is lifted or held. However, he is pretty tough and it won’t hurt him if his head flops back accidentally. Gradually, he finds that he is able 20 The Little Baby: From Birth to Three Months to raise his head for a few more seconds, although three or four months must elapse before it is really steady on his shoulders. He likes to be held up over his mother’s shoulders and to practice raising his head. He turns it from side to side, resting it when he is tired. In the early weeks the baby kicks and waves his arms about in jerky movements. He may push himself to the foot or head of his crib while he is lying on his stomach. At first his hands are clenched most of the time, except after he has been fed, when the fingers may relax. When he is a few weeks old, he seems to feel things that he touches, such as his mother’s breast or his blanket. He begins to clutch at his father’s necktie or his own nightie, but he won’t be able to reach for and grasp objects till he is well over three months old. Meanwhile he throws his arms about like a little windmill. He may be able to get half- way over from his back to his side, in three or four months. The baby smells things early. He soon takes on his parents’ attitudes toward different smells, so don’t wrinkle up your nose in disgust when you offer him fish liver oil. And remember that the sense of taste is closely connected with that of smell. Besides all these special senses, babies are sensitive to touch and to changes in temperature. Little babies like to be snugly wrapped and firmly held, but as they grow they like to be free to kick and wriggle. All in all, your little baby knows a lot about what he needs, how to express himself and how to grow. He knows how to tell you when he is uncomfortable. By the time he is three months old, he is quite at home with his family. His little body has grown into good working order. He has become accustomed to the orderly routines of his day. If he has had good care and plenty of loving, and if his needs and wants have been re- spected, he will be a reasonable little person. He’ll be eager for his meals, enjoy his baths, recognize his father and mother, cry less, and express himself in smiles and coos. He works very hard at learning a lot of new things. He makes steady progress, and his behavior changes as he develops. 2. THE LITTLE BABY’S DAY Your baby is busy all day with the business of growing, and you will be busy a good part of the day taking care of him. If 21 New York City’s Baby Book this is your first baby, you will probably want to know what to feed him and how to prepare it, how much sleep he should get, how to dress him, how much fresh air and sunshine to give him, how much exercise and play he needs, how to tell whether he is cold, and what to do if he seems a little upset. And if you’re experienced with babies, perhaps you’ll like to get some pointers on good ways to manage. The rest of this chapter dis- cusses each of these points of the baby’s daily life in detail. This information will help you to follow your doctor’s instruc- tions in regard to the baby’s care. Remember that your baby must be carefully protected from diseases and infections. Everything that his food comes in con- tact with should be kept clean and sterile. His clothes and bedding should be washed and rinsed thoroughly and fre- quently. It is a good rule to wash your hands well before you pick up your baby or attend to his wants. A. The Baby’s First Food The Right Milk for Your Infant— The right food for your baby is the first essential to his health and good growth. Equally important is the way he is fed and how much he enjoys his meal. Providing satisfying, happy mealtimes, with bottle or breast, is the first and most important way a mother shows that she loves her baby wisely. Nature has established a wonderful plan for the baby’s nourishment which is benefi- cial to both the mother and the baby. The in- fant’s digestive system needs a milk supply that is just right. If you can nurse your ba- by, it is almost certain that your milk will agree with him. 22 The Little Baby: From Birth to Three Months The loving, warm relationship between mother and child first develops at these mealtimes. The nursing mother naturally holds her baby during meals, and the baby feels the warmth and security of her arms; he is cuddled and smiled at, he touches his mother’s soft, living skin and feels she is near him and that she loves him. The wise mother understands how much this experience means to her little one. It is good for her to have these periods to relax and rest and find happiness in her baby. But perhaps you are not able to nurse your baby or, for some other reason, decide not to do so. If you are giving your baby a bottle, you should faithfully follow the doctor’s direc- tions as to the kind of milk mixture required by your infant. The doctor will also tell you when and how to change the formula as the baby grows. Then do all you can to duplicate the great values of breast feeding. Hold your baby in your arms every time you give him a bottle, cuddle him and smile at him. When you are busy, don’t lay him down and prop up the bottle beside him, for the bottle may slip and the baby may suck air in- stead of milk. Give him your full attention at mealtimes. Let him have just as much of your time as you would devote to him if he were at your breast. Let him get all the pleasure he wants from sucking. Make each bottle-feeding period as happy a time as you can. A Flexible Routine for Feeding.—It usually takes two or three hours for a little baby’s stomach to di- gest its meal. The stomach then needs a little rest be- fore starting its work again. When it has become empty, it contracts. This is painful to the baby and he cries out, in a sharp, piercing way that you’ll soon learn to recog- nize. This cry is a sign that your baby has a good appe- tite and is ready for his next meal. The baby’s stomach has a natural rhythm, and this is why New York City’s Baby Book doctors advise a three or four-hour feeding schedule. If he is fed only when he cries from hunger, a baby will usually regu- late his appetite to meals at about three or four-hour intervals too. Sometimes, however, it takes an infant several weeks to acquire this habit. Some babies, moreover, need food more often than others. The usual feeding schedule of three or four-hour intervals is partly for the mother’s 'convenience and partly to guard against overworking the baby’s stomach. Meals should be given on a flexible, orderly routine that changes as the baby grows and varies according to his individual requirements. If your baby occasionally wakes up half an hour to an hour earlier than mealtime by the clock, and seems hungry, cries and roots around for food, and isn’t satisfied when you have made him comfortable in other ways, it’s all right to give him his feeding a little early. He’ll probably sleep longer the next time and even if he’s ahead of schedule all day, he’ll get it straightened out at night. If your baby is regularly hungry before the usual time, this is generally a sign that he needs more frequent meals or bigger ones, and you should consult your doctor. If he wakes up and cries between meals, he may have colic instead of being hungry. If the baby sleeps past his regu- lar time, you should let him sleep at least half an hour longer before you disturb his sleep. He will probably wake up of his own accord with a good appetite. During his first few weeks, the baby needs to have meals at the same frequent intervals during the night as during the day. All babies give up their night feedings of their, own accord as soon as they are able to get along on their other meals. Some do this earlier than others. A mother can be sure that between six weeks and three months, if the baby is well and satisfied with his other meals, he will learn to sleep about eight hours at a stretch, ordinarily from the evening feeding at 9 or 10 o’clock until morning. If the baby is hungry in the night, it is cruel to expect him to endure the pain of an empty stomach. Crying will not make him less hungry and may only frighten him and make him spend a restless night. It has been said that every baby has a kind of inside gauge that tells him better than any grownup can when he has had enough to eat. At one meal he may need more milk than an- other time. If you are nursing your baby you can’t see how much milk he drinks but you can soon learn to know when 24 The Little Baby: From Birth to Three Months he has had enough, and usually you let him stop nursing when he seems full. If your baby is bottle-fed, let him help to decide how much he wants at each meal. If he takes only part of the bottle, don’t force him to finish it. If he leaves some, he will probably wake up early and be extra hungry for his next meal. Usually, when the baby has had enough, he will stop sucking, release the nipple of his own accord, and fall asleep with a blissful look on his face. This is the best sign that he has had enough to eat. The wise mother does not try to get him to take another mouthful when he is no longer eager for it. Urg- ing doesn’t do any good anyway, and may make him lose his appetite or even throw up his meal. Often a baby likes to stop for a little rest part way through his meal. He doesn’t need to be hurried but should have all the time he wants to enjoy his meal. Breast-fed babies usually nurse 15 or 20 minutes, sometimes a little longer. If the bottle baby finishes his meal in less than 20 minutes and still wants to suck, try giving him nipples with smaller holes. Part way through the meal, and when the feeding is finished, the baby needs to be “bubbled.” Hold him up on your shoulder and pat his back firmly until he belches up the air in his stomach. It may take a few minutes for him to belch but he will probably feel more comfortable if he does. Some babies are more comfortable if “bubbled” more than once. Lying on his stomach after meals may help him to burp himself. A good appetite begins with a baby’s first meals. Every time the baby’s cry of hunger is heeded and he is com- forted and satisfied and given attention along with his milk, his feeling of well- being and confidence grows. That spells “security” for a baby. Suggestions for the Mother Who Breast-feeds Her Baby — When the newborn baby is a few hours old and he and his mother have had a good rest, he is usually put to the breast to suck for a few minutes. The first fluid that the breasts secrete is a thick, yellowish substance called colostrum. Whether the mother decides to nurse her baby or not, many doctors advise 25 New York City’s Baby Book that the baby get this fluid for two or three days. It contains food that is easily digested. If the mother plans to nurse her baby, the infant’s vigorous, hungry sucking during these first few days stimulates the breasts and helps to produce a good supply of milk after two or three days. By the time the mother gets home from the hospital, she has had a chance to get acquainted with her baby and feels more at ease in nursing him. But she may get tired very soon, the baby may be fussy, and she may wonder whether she has enough milk. The nursing mother should give herself and the baby time to work this out together. The father’s encourage- ment will help too, and for the first few weeks after her return home he can do many things for the mother that will give her a better chance to regain her strength. Changing diapers, bring- ing the baby to the mother to be nursed, and putting him back to bed will give the father a chance to get acquainted with his baby. Breast milk for even a few weeks is worth while. (If you need to change from breast to bottle, see page 80.) The doc- tor will decide whether or when it is necessary to give the baby some bottle milk after the breast feeding. If he advises this additional feeding formula, he will tell you to give the baby the smallest amount needed to satisfy him after each nursing. You will find that at some meals the bottle may not be needed. Sometimes nursing the baby more often, say on a three-hour schedule instead of every four hours, makes an extra feeding unnecessary. As the milk increases, the meals can gradually go back to the longer interval. The milk flow also tends to be increased if the baby is nursed at both breasts at each feeding; ten minutes at each side, unless he stops sooner at the second. The next time, begin with the breast he nursed last. Even though the baby seems to stop sucking at the first breast, he may begin again with renewed vigor when offered the other. The baby gets most of the milk in the breast in the first five minutes, but he needs the extra time to suck, and this helps to empty the breast and stimulate the production of milk for the next meal. If the baby doesn’t let go of the nipple when he falls asleep, draw the corner of his mouth a little to one side, or gently push his two cheeks together. A mother who breast-feeds her baby will be able to lead an ordinary, healthy, social life if she follows a few simple rules 26 The Little Baby: From Birth to Three Months in caring for herself. Regular visits to her doctor and dentist are advisable. Cleanliness in the care of the breasts is neces- sary. Before each nursing, the hands should be washed thoroughly and then the nipples wiped off with a bit of sterile cotton and cool boiled water. If the nipples are cracked or sore or if a red spot appears on the breast, the doctor should be consulted. Eight hours’ sleep at night and at least an hour’s rest during the day are helpful in having a good milk supply. It is important to avoid strain and fatigue as much as possible. A temporary ner- vous upset on the mother’s part may decrease the milk and make the baby fussy but will not make it necessary to wean the infant unless the doctor advises it. It is all right for the baby to continue to be nursed during the mother’s menstrual periods. Often men- struation does not begin until the baby is weaned. The nursing mother’s food, too, is important. She should eat the same nourishing meals that she plans for the rest of the family. Every day she needs from a quart to a quart and a half of milk, some of which may be evaporated or dried milk; for variety, two ounces of American cheese may be substituted for one pint of milk. She should also have plenty of fruit, a large serving of orange juice, grapefruit juice, or three times as much tomato, and one other serving of fresh, canned or dried fruit; at least one green leafy or yellow vegetable; a potato and a raw vegetable; an egg; one or two servings of meat, poultry, fish or dried peas or beans; bread or cereal at every meal with butter or fortified margarine on the bread and in cooking. In addition she requires some form of vitamin D—fish liver oil or concentrate, as directed by the doctor. Laxatives or other drugs should not be taken unless the doctor orders them. If the nursing mother gets sick, she should have her doctor’s advice as to how to protect her baby and whether she needs to give up nursing temporarily. Breast feed- ing actually helps to return the uterus back to normal. Suggestions for Making Formula and Sterilizing Bottles— Bottle feeding can be safe for the baby and easy for the mother if the doctor’s instructions are carefully followed. Only the doctor should decide what formula to give the baby or when to change it. The mother’s job is to keep everything that touches the milk clean and sterilized, and to follow the doc- tor’s directions exactly in making the formula. Before you make the formula, sterilize all the utensils and 27 New York City's Baby Book bottles. An easy way is to rinse each bottle with cold water after using it, and then to fill it with water. This will make it easier TWiuu wiVL » = I CVnd. un$i CSkajn. voale*. to clean the bottles later. Wash them with a bottle brush in clean, warm, soapy water and rinse. Scrub the nipples and caps, and squeeze water through the holes so that no milk remains to clog the nipples. VOjiK. -troiKiA. IruoaJx To sterilize the bottles means to boil them so that all germs are destroyed. To do this, first place the bottles in a large kettle along with the strainer, funnel, caps or corks, jar top, nipple jar, nipples and anything else you use in mak- ing the formula. Put the tongs on top so that you can take them out first to handle the other hot utensils. Fill the ket- tle with water, cover it, and put it on the stove to boil. Let it boil hard for five minutes, then take off the cover. If the cover is flat, place it upside down on the table, to serve as a sterile place to put the funnel and strainer on. Remove the tongs first, taking care not to burn your hands. Use the tongs to remove all the things from the kettle except the nipples. Then empty the water from the nipple jar, pick up the nipples with the tongs, put them in the jar, and cover it. Pour the hot water from the bottles and set them on a tray vjjoKa. Y\»ypU. Jhbbuu 28 The Little Baby: From Birth to Three Months or pan. Place the funnel in the neck of a bottle, hold the strainer over it, and pour in the correct number of ounces of formula. Then cover the bottle with a sterilized cork or cover, and place it in the icebox. Take a sterilized nipple from the nipple jar and put it on the bottle when you use it, taking care not to touch any part of the nipple that goes into the baby’s mouth. Follow your doctor’s orders exactly in making the formula. It’s a good idea to keep part of one shelf in the icebox just for the baby’s bottles. If you have no icebox and are unable to get even a small one, try to arrange with a neighbor to keep the baby’s bottles in her icebox. The most carefully boiled formula will spoil if it isn’t kept at a cold temperature, and your baby may get sick if the milk is spoiled. Some mothers find it easier to put the sterilized nipples on the bottle right after the milk mixture is put in, covering both bottle and nipple with a sterilized bottle cap. The main thing to be sure of is that the bottles, nipples and milk are all sterile (had been boiled well) when the baby gets the bottle. To make holes the proper size in the nipples, stick the blunt end of a medium-sized needle in a cork or piece of cardboard, so that you can hold it without burning your fingers. Hold the pointed end of the needle in a flame till it gets red-hot, then stick it through the top of the nipple. Usually three holes are made in each nipple. After you have put the needle in once, put the nipple on a bottle of water, turn it upside down and watch how fast the water comes out. It should come out drop by drop. If it runs out in a stream, the holes are too big and the baby will get the milk too fast to swallow it comfortably. After nip- ples have been used a few months they got soft and worn, and should be replaced with new ones. When it is time to feed the baby, warm a bottle of milk and ?J10lCSL CJV\ boWjL. Cfrotrs. ‘S'WufijL GaJjp 29 New York City’s Baby Book put a sterilized nipple on it. Then test the milk by shaking a drop on your wrist. It should feel comfortably warm but not hot. Never give the baby a bottle of milk that has been heated without first testing it to see that it is just right. Water.—Babies need a lot of liquids, most of which are sup- plied by the milk. It is a good plan to offer the baby a drink of cooled boiled water, by spoon or bottle, between meals. Some babies will drink several ounces a day but others will not. If the baby fusses between meals, try giving him a drink of water. He may be thirsty. Fish Liver Oil— Children need vitamins A and D from the time they are two or three weeks old through childhood. Vita- min A is necessary for the growth of other tissues. Vitamin D helps to build strong, straight bones and prevents a disease of the bones called rickets. Fish liver oil contains large amounts of these vitamins. For this reason, fish liver oil, either plain or concentrated, is needed for the baby. There are many different brands of fish liver oil on the market. Be sure to get a kind that is labeled U.S.P. Some fish liver oils are sold in a concen- trated form, of which the baby needs only a few drops a day. When plain fish liver oil is given, a couple of teaspoonfuls are the usual dose. Your doc- tor will tell you exactly how much your baby needs. The baby will require only a small amount at first—half a tea- spoonful of the plain oil, or a drop of the concentrate. Then you should increase the amount by half a teaspoonful, or a drop, every two or three days until the baby is getting the full amount the doctor or- dered. It is better to hold the baby up when giving the oil in order to keep him from chok- ing on it. Let him suck it off Tboofej^, 30 The Little Baby: From Birth to Three Months the tip of the spoon. Put it far back in his mouth, or put it in a teaspoon of orange juice, or else put the oil dropper at the side of his mouth while he’s nursing. Don’t try to put it in his bottle. No matter how you dislike the smell and taste of the fish oil, your baby is pretty sure to like it if you give it to him with a smile and let him get used to it gradually. Even if your baby gets lots of sunshine in the summer, it is generally a good idea to continue the oil the year round. Re- member, your baby may suffer very seriously if he doesn’t get oil regularly. Orange Juice or Substitutes.—Babies need orange juice or a substitute as soon as they are two or three weeks old. This is needed for vitamin C, which is good for the baby’s develop- ment and prevents a disease called scurvy. There is very little vitamin C in cow’s milk and only small amounts in mother’s milk. It is a good plan to start the orange juice after the baby is used to fish oil, so that if he gets upset you’ll know what caused it. Your doctor will advise you when to start. Begin with a small amount; a teaspoonful mixed with a teaspoonful of cooled boiled water is enough for the first couple of days. The amount should then be increased by a teaspoonful every other day until the baby is getting two ounces a day of pure orange juice. A small amount of water may be added. To prepare the juice, wash the orange under running water before you cut it, squeeze, then strain the juice, making sure there are no seeds in it. It is best to fix the juice just before using it, as it loses its vitamin C content quickly. It should not be boiled as heat destroys vitamin C. Orange juice can be given to the baby either by spoon or bottle. Of course it tastes strange to him at first, but most babies soon like it. If your baby re- fuses to take it, try substituting tomato juice or grapefruit juice. You will need to give more of some of the other juices. Your baby needs one of the following every day: 2i/2 oz. fresh orange juice (30 mg. of vitamin C) 21/2 oz. canned orange juice (30 mg. of vitamin C) 3 oz, canned grapefruit juice (30 mg. of vitamin C) 3 oz. canned orange and grapefruit juice (30 mg. of vita- min C) 61/2 oz. canned tomato juice (30 mg. of vitamin C) Pineapple, prune and apple juice cannot take the place of orange 31 New York City’s Baby Book juice, though the baby will like their taste and they may later be used for dessert. If your doctor advises a vitamin C pill, called ascorbic acid, he will tell you how much to give the baby daily. The Baby’s Bowels and Bladder The baby’s body takes care of the elimination of waste products naturally and easily. The bladder empties very often daily dur- ing the first months. It sometimes seems as if the little baby were constantly wet. In time his bladder controls develop and then he urinates less often. The bowels, too, move according to a natural system. The waste material collects in the bowel until a movement starts downward. Then, and only then, does a bowel movement take place. The baby may seem to be a little uncomfortable and he will fuss and wriggle until he relieves himself. Breast-fed babies may have several movements a day or only one. The stools are soft, like thick pea soup, and are usually a bright yellow or orange color, and may contain small curds or a little mucus. A baby fed only breast milk very rarely gets constipated. Some babies have a natural pattern of a move- ment only every second or third day. You can trust your baby, if he is breast-fed, to have a movement of his own accord. You’ll find he suffers no distress from skipping a day, although he may have to work a little to get the stool out when it’s so soft. When he begins to eat solid foods, his movements are likely to be more regular. The stools of bottle-fed babies depend on what is in the formula. They are more pasty, vary between dark yellow and light brown in color and may show some curds and mucus. If they get dry, hard and painful to pass, you should tell the doctor, who may adjust the formula. If the baby’s stools are soft, it doesn’t matter if his movements are irregular. Enemas and suppositories should never be given to establish regular bowel movements. There are better ways of helping the baby to eliminate. Besides changing the formula, the doctor may advise giving the baby strained prunes or prune juice. Laxa- tives are almost never necessary and should never be used unless ordered by the physician. Mineral oil may be dangerous to babies, and laxatives for grownups and older children are too strong for them. It is unwise to try to toilet-train the little baby, for reasons that are discussed in Chapter III (see page 66). As long as his stools are normal, his bowel movements 32 The Little Baby: From Birth to Three Months should be left entirely to his own system. When you notice anything unusual, tell your doctor. If the baby has frequent, watery, green stools, he has diarrhea. While this is sometimes the result of a mild upset, it is often a sign of more serious illness. It is therefore wise to call the doctor whenever the baby begins to pass such stools. The doc- tor should also be called if the stools contain blood or look very black or greasy, or if they contain a lot of curds or mucus or have a very bad odor. (See Chapter VI.) B. Sleep Sleep is as necessary to the little baby as food. He needs no training in how to sleep. Later on he will enjoy being awake, but now sleeping is his natural way of life. In his first days the baby seems to be in a doz- ing state most of the time, scarcely sound asleep but not fully awake. He takes a lot of short naps. He stirs, cries and moves often. In a sense he really wakes up only to eat, but he reacts to loud noises, sudden handling, cramps or the discomfort of being wet or cold. When he no longer feels uneasy, he usually dozes off again until the next meal- time. The baby sleeps more com- fortably if he is occasionally turned from one side to the other. Sleeping in one position will not affect his posture. Any slight flattening of the head that does occur will correct itself later on. Many babies seem to like to sleep on their stomachs. It is very important to keep the sheets and covers on the baby’s bed tucked firmly under the mattress, in order that they may not get pulled loose and bunch up around the baby’s face or cover it so he cannot breathe. Do not hang blankets or clothes on the sides of the crib, as they might fall down and 33 New York City’s Baby Book smother the child. Remember, a baby cannot help himself if an accident happens. He can only cry. Usually a baby sleeps better in a fairly quiet room by himself, but the mother should be near enough to hear his cries and should look in on him often to make sure that everything is all right. A room that lets in direct sunlight is best for the baby. The furnishings should be simple and washable so that they can be kept clean. (See page 51 for suggestions about beds.) While the baby is little, it may be more convenient for the mother to 34 The Little Baby: From Birth to Three Months have the crib in her room, but the infant should never sleep with her. Where the family can arrange it, the baby should have a separate room. Parents need privacy, and even young babies very often see and hear more than their parents realize. If a separate room isn’t possible, a screen may be placed around the crib, or the baby’s bed can be moved into another room during the day or night to give the baby quiet and the parents privacy. It is one of the mother’s chief duties to be alert to any cry- ing or fussing, to find out the cause of it, and to remove that cause as promptly as possible. At first all the baby’s cries seem to sound alike, but soon the parents can tell the difference be- tween a hunger cry, fussing when he is uncomfortable or wants attention, and a cry of pain. We can scarcely blame a little baby for crying, for it is the only way he has of telling us that something is the matter. The first few weeks may be pretty stormy because it takes a while for his little body to get in good working order. It will be a comfort to know ahead of time that the crying gradually decreases as the baby gets older. Your child will usually cry less if you respond promptly to his signals. Nor need you be afraid of spoiling him. If he has to endure his pain and is left alone for long periods of time, he may get frantic and continue or resume his crying even after he is finally given attention. While it is true that a few minutes of hard crying will not injure the baby, crying for a long time will do him no good and may make him fearful and fretful. Much of the baby’s future contentment and sense of security will depend on how well you meet these first powerful needs for food, comfort, gentle handling and love. So don’t be afraid to go to your little baby when he cries and try to make him comfortable. During the first month the baby gets about as much com- panionship as he is ready for while he is being bathed, changed and fed. Sometimes he may like a little extra patting and sooth- ing. Between his first and second month he may begin to cry in a new way in the late afternoon or evening. This crying may not be due to hunger or to any pain you can discover, but it is a sign that the baby is ready to stay awake a little longer and wants company. If it comes in the afternoon, a little orange juice combined with a little attention may satisfy him. This is a good time, too, for a family get-together. If the baby cries 35 New York City's Baby Book in the evening after supper, he may be quieted if you pick him up and hold him for a few minutes, or put him on the sofa or in his carriage where he can see and hear the family and look at the lights. After fifteen minutes or half an hour of this, he may be ready to go to sleep in his bed. You need not be afraid of spoiling your baby by this little extra atten- tion when he needs it. Spoiling more often results from a lack of any orderly plan for the baby’s day, from disturbing him when he is asleep to show him off to visitors, or from jiggling and hugging him when the parents just feel like it. Of course it is better for the baby to learn to go to sleep by himself in his bed after his supper, and you can let him fuss for ten or fifteen minutes to see whether he will settle down. By the time the baby is between two and three months old, he no longer wakes up only to eat. He has learned to take naps, to stay awake for short periods, to look around, to exer- cise his arms and voice, to smile and enjoy company. Now he sleeps from 9 or 10 o’clock in the evening until morning, waking anywhere from 5 a.m. to 8 a.m. He babbles to himself hap- pily before breakfast and may play for a few minutes after eating before he falls asleep for a short morning nap. After the second feeding at 10 o’clock, most babies take a long morning nap and, after lunch and playtime, a long afternoon nap. If he has had fresh air and an active play period in the late afternoon, the baby is likely to settle down to sleep right after supper. Remember that all the things a baby does are connected with one another and that his habits keep changing all the time. A comfortable, satisfying routine takes into ac- count the baby’s natural changes as he grows. C. Bathing the Baby A baby needs a daily bath to keep his body clean and help to prevent rashes and infections. Baths can be fun for both the baby and his family. As part of the orderly routine of the baby’s day, the bath should be given at a regular time. It is usually given before a feeding, as it helps to relax and make the baby comfortable and ready for sleep. Some mothers prefer to give the bath in the morning before the 10 o’clock feeding. The late afternoon is also a good time because the baby is then likely to have a wide-awake period. The busy mother should decide which time fits in most conveniently with her 36 The Little Baby: From Birth to Three Months other duties. An occasional change in the time can fit into a flexible schedule. On Sundays or holidays the father may enjoy giving his child a bath. The baby is ready for a tub bath when his navel is healed. Before that he may be given a sponge bath. A large basin or baby’s tub placed on a table or chair, a large kitchen sink lined with a diaper, or a bath table may be used. Any of these arrange- ments will save the mother a backache. Find the arrangement that is comfort- able for the mother as well as the baby and collect all the toilet articles and clean clothes before beginning the bath itself. Choose a warm place for the bath, where the baby can be protected from drafts. If your baby was born in the hospital, you may have had a chance to watch the nurse give him a bath, or you can arrange for a public health nurse to come to your home to show you how to do it. Here are a few simple sug- gestions: First make 37 New York City’s Baby Book sure that the water is warm but not hot. Dip your elbow in the water, and if it feels warm, the temperature is about right. Wash the eyes with pieces of sterile cotton dip- ped in cooled boiled water. The cotton should be wiped across the closed lids gently, from the inside near the nose, outward. Use a fresh piece of cot- ton for each eye. Do not probe in the nose, ears or mouth to clean them. Cotton swabs on sticks or toothpicks may injure the delicate lining of these organs. All babies dislike such poking and fight against it. Natural secre- tions protect these organs. The baby will sneeze or rub out any mucus in his nose, and the wax in the ear will drop out by itself. A corner of the washcloth or a bit of twisted cotton dipped in clean water is sufficient to clean the outside parts of the nostrils and ears. Better leave the mouth alone. If there are any sore spots in it, ask the doctor what to do. Next wash the face with a wet washcloth, without soap, and dry it by patting gently with a soft towel. It is not necessary to wash the head every day; in between times it may be oiled. To wash the head, wet it with water, then make a soap lather with your hand and shampoo the head all over. Be careful not to get soap in the eyes. That hurts and may make the baby dislike his bath. Wash the soft spot on the top of the head gently. The head may be rinsed by holding the baby so that his head, supported by one hand, is above the edge of the tub, and dipping up water in the palm of the other hand, or with a washcloth. The baby’s head should then be dried carefully, A soapy washcloth or your hand may be used to wash the rest of the body, working from the neck downward and taking care to wash in the folds of his neck, arms and legs. If the baby has had a soiled diaper, wipe the genitals and buttocks with clean cotton first, then wash thoroughly. If your baby is a boy and has not been circumcised, push back the foreskin 38 The Little Baby: From Birth to Three Months =-30FT SPOTS oh wm UMBILICUS - —abdomeu VULVA- / REMS -CrLANS TESTICLES ■BUTTOCKS -MUS VULVA- ABDOMEN of the penis until all the glans shows and wash it well with cotton dipped, in clean water, making sure you remove all the substance that may collect at the base of the glans. Be sure to pull the foreskin back down again after washing or it may be- come swollen and sore. With a little girl, wipe the vulva with clean, wet cotton, starting from the front. 39 New York City’s Baby Book When the baby is completely soaped, he may be rinsed by submerging his body for a couple of minutes in the tub. Put one arm under his back and head, and take a firm hold of his arm with your fingers and thumb. Then your other hand will be free to lift him by the feet or buttocks and to wash him when he is in the water. Take care that water does not get into his ears or mouth. Lower and raise him from the tub slowly, as babies are frightened by sudden movements. Even little babies enjoy the warmth and feel of water. If they are handled gently and spoken to reassuringly, they should have no fear of a bath but show their pleasure. When the baby is a few weeks old, he may be held in the tub for five or ten minutes, free to kick and splash. When the baby is lifted out of the tub, he may be dried with a soft bath towel. Be sure to dry all the creases in his little neck and limbs. Then you may rub a little oil or powder on his skin to prevent chafing. Sometimes oil works better than powder, which may cake; don’t use both together. He may begin to get impatient for his meal, so clean clothes should be ready and put on promptly; then he can be wrapped in a small blanket to protect him from a chill. If you find your baby cry- ing before the bath is finished, next time try giving him a drink of water or orange juice before the bath. It may help to keep him satisfied. A bath, like meals and diaper changes, is an event for the little baby. Talk to your baby as you wash and dress him. Al- though at first he cannot reply, apparently he enjoys listening to your voice. He will smile and coo when you tell him it is time for his bath, that you will wash his face, that now the hand goes in the sleeve, and so on. D. Clothes and Being Dressed A baby’s clothes should be simple, comfortable and washable. Little babies seem to dislike restraint of any kind. It is uncomfortable for them to have garments pulled over their heads, and their arms and legs pushed into sleeves and legs. Because their skins are sensitive, there should be no rough seams or bunches to irritate them. When the room is warm, with the temperature at 68 degrees or above, babies don’t need many garments to keep them warm. For the first couple of months a baby is most comfortable when dressed in a shirt, diaper, and nightgown or linen jacket and wrapped in a blanket. 40 The Little Baby: From Birth to Three Months This is all he needs to wear in the house, with perhaps a sweater for cool days. The little baby’s hands and feet may feel cold when you touch them no matter how well he is covered. You can easily tell when your baby is too warm or too cold. If his neck and chest are perspiring, he is too warm. If these parts feel cold, if his skin is blue or blotchy, if his face loses its color or if he shivers, he is not warm enough. When dressing the baby after his bath, put on the shirt first, slipping it on over his feet, then putting the arms in the sleeves. If the shirt opens down the front, put one arm in, then roll him on his side, put the shirt around his back, and then the other arm in the second sleeve. Next put on his diaper, taking care that it is not too tight around his stomach. Put your fingers under the diaper, next to his body, when you put the pins in and there will be no danger of pricking him. An extra diaper or small pad placed under his nightgown before you wrap him in a blanket will help to protect his clothing and blankets. During the first month or six weeks, little babies seem to mind the discomfort of wet or soiled diapers and fuss until they are changed. Leaving wet diapers on for long periods, or using diapers that have not been thoroughly washed, rinsed and dried usually causes a rash. Whenever the diaper is changed, wash the buttocks and genitals, and dry them. A few drops of light mineral oil or a little powder should be used to prevent chafing. Even little babies are amazingly successful in kicking off their covers. In the first weeks the baby likes to be snugly wrapped, and if the receiving blanket is closely folded around his body, the outer blankets can be simply tucked in the side of the bas- sinet. A sleeping bag may be dangerous; if you use one, make sure that the baby can move around in it and won’t smother or choke. Remember that after the first few weeks the baby dislikes being restrained. His growing muscles need plenty of chance to be used; he likes to turn and wriggle in his sleep as well as when he is awake. It is cruel to pin his sleeves down. E. Fresh Air and Sunshine Your baby needs fresh air and sunshine. He will eat and sleep and grow better if he spends a lot of time outdoors. When the weather is pleasant, the baby should be outdoors a couple of hours every day from the time he is three weeks old. Before 41 New York City’s Baby Book that, or if the day happens to be cold, wet or windy, you can give him an airing indoors. The air in the room in which he lies should be kept fresh by leaving the window open a couple of inches or more at both top and bottom. A window venti- lator, a screen, or a sheet on a chair by the side of the crib will protect the baby from drafts when it is cold or windy. It is better for him to sleep in a cool room. In very cold weather, the room may be aired several times a day by putting the baby in another room and then opening the windows wide for a few minutes. It is a good idea to give the baby an airing outdoors at a fairly regular time every day as far as the weather permits. His bas- sinet or crib may be moved near a window, or placed in a yard or on a walk where you can keep an eye on it. A carriage is a great convenience for a mother, both indoors and out; if there is no one you can leave the baby with, you can take him with you while you do the shopping. Then you will be sure to get the exercise and fresh air you should also have if you take the airing with the baby. No baby of any age should ever be left alone in a house or out of doors. Too many accidents have happened when babies were left alone “just for a few minutes.” Sun baths may be started when a healthy baby is three or four weeks old. His skin is tender, so don’t let him get pink and burned. You may give him the sun bath outdoors or inside in front of an open window where it is not windy. At first let the sun shine on his cheeks and hands for two or three minutes. Turn him so that it won’t shine in his eyes. The next day ex- pose his cheeks and hands five or six minutes. After his cheeks and hands have become accustomed to the sun, expose his arms and then his legs. When the weather is warm enough, take off his shirt and diaper and let him lie naked in the sunshine for two or three minutes. The next day you can expose him five minutes. Continue to increase the time gradually until the baby is sunned all over his body. On hot days when the temperature is above 85 degrees, give the sun bath before 11 a.m. or after 3 p.m. Cover the baby’s head if he is out during the hot part of the day. F. Exercise, Play and Companionship Love is just as necessary to a baby as food, sleep, fresh air and cleanliness. He soon needs a chance to play and to exercise 42 The Little Baby: From Birth to Three Months his growing muscles and he needs sociability. From the be- ginning show your baby that you love him by cuddling and talking to him when you dress, change or play with him. When the infant is about one month old and begins of his own accord to have short wide-awake periods, he will enjoy lying on a big bed or sofa with his clothes off, if the weather is warm enough to permit it. This will leave him free to kick and wave his arms around. He likes to be held or carried or moved to another room where he can look at a new ceiling and walls for ten or fifteen minutes. These are the times when the father, the other children and the relatives, as well as the mother, can play with the baby and laugh at his antics without disturbing his regular habits. When the baby begins to coo and laugh and throw his arms around, he will amuse himself by practicing these new accom- plishments. It is good for him to be left quietly alone part of the time when he is awake, for he has much to do learning to see, to hear, and to use his muscles. But part of the time he needs company. Babies as well as grownups can feel lonely, and even little babies learn much from listening to and watch- ing people. Give your baby the pleasure of your attention some- times when he is happy, not just when he is fussy. The young baby’s rapidly developing senses make him almost hungry to see and hear. He should be given opportunities to look at colored ribbons and toys hanging above or beside his crib or carriage, and to watch lights, and people moving about. A flowered cushion, or a piece of red or orange cloth placed within his view, may quiet a restless infant. A baby reaches for things with his eyes long before he can reach them with his hands. He may grasp a small rattle placed in his palm, but can- not hold it long. When he is about three months old, he will enjoy having small colored objects strung across his crib where he can touch them even if he cannot grasp them. A small spoon, spools, bright buttons strung on a cord, ribbons, a cel- luloid toy or cradle gym will keep his arms and legs flying and his eyes dancing. A young baby enjoys music and rhythm and will listen to soft music and be soothed by lullabies. Between two and three months the baby begins to notice his own arms and legs waving before his eyes, and begins to gain control of his arms and hands. He spends much time kicking and waving and should be free to exercise all he wants. Any healthy baby 43 New York City’s Baby Book who is not held down by too many clothes and covers gives himself all the exercise he needs. G. How to Tell That Your Baby Is Well Most babies are born well and normal. With good care at home and medical supervision the parents as a rule are able to keep their baby well and happy. Take your child to a doctor regularly and telephone him whenever you are in any doubt about youi> baby’s health. You will pro- tect your child’s health, save yourself much worry and also save the doc- tor’s time if you obtain and fol- low his advice about the baby’s care. Parents should also learn the signs of good health and of illness in a baby. You will soon learn to recognize these important details and to sense changes in your child’s condition. A healthy baby is eager for his food and enjoys it. It is normal for his appetite to change from meal to meal and to change as he grows. If your baby, however, drinks a great deal less milk than usual during the day, or turns away from the breast or bottle when it is offered him, it may be a sign of illness. Do not urge or force him to eat, but let him take only as much as he wants. Offer him all the water he will take. A healthy baby establishes his own ways of sleeping, although these change frequently as he grows. If the baby is restless and cries out in his sleep, he may be overtired and need a quieter 44 The Little Baby: From Birth to Three Months day. Or you may need to look for other causes of illness. A healthy baby grows and develops so fast that his parents can see him change from week to week. Some babies gain more rapidly than others who are equally well. The little baby may be expected to gain from three to eight ounces a week, unless he was premature or unusually small at birth. One week he may gain a little more or less than before. Occasionally he may make no gain for a week without anything being the matter, but if he makes no gain for several weeks, the doctor should be consulted. There are many other indications besides gains in weight that your baby is well, so it is not necessary to have baby scales of your own. Indeed, it is better for the parents not to watch the weight too much or to worry about it needlessly. If the baby is weighed once a month when the doctor sees him, that is usually often enough. You can also tell how your baby is growing by watching the things he does. Is he making progress in adapting himself to an orderly routine? Is he learning to use his eyes and ears and exercise his muscles? On the whole, does he behave something like the growing baby described in this chapter? Above all, is he happy and contented? If you have given him the good care and wise loving he needs, he should enjoy his life, be full of smiles and energy, and content to lie alone at times and play with his feet and hands. Of course, every baby will fuss and cry occasionally and have bad days, but he should cry less as he grows older, and when his wants have been attended to, his fussing should be brief. If he is unusually fretful or cries in pain, and the things you generally find helpful do not comfort him, look for signs of one or another of the minor upsets that may trouble the little baby. Also watch for other signs of illness. You can’t expect your baby to be well in every respect every day, for he has many ups and downs in growing. If at times he isn’t hungry or sleepy, it doesn’t necessarily follow that he is ill. Whether he is healthy or getting sick, the calm, reassuring attitude of his mother is essential for his well-beino: or his recovery. H. Some Things That May Trouble the Little Baby Hiccups are common in babies. They are not harmful and usually stop in a few minutes. Sometimes “bubbling” the baby or giving him a drink of warm water helps to stop them. 45 New York City's Baby Book Spitting up and vomiting are common too. The baby may spill or spit out a mouthful of milk after eating or between meals. Occasionally he may throw up part of his feeding. If the baby is otherwise healthy, vomiting once in a while will not harm him and is not a sign of illness. However, if he vomits several times during the day, or after every meal, or throws up with such force that the milk flies several feet, call the doctor promptly. Meanwhile give the baby nothing to eat or drink. Colic is one of the most common and distressing complaints from which little babies may suffer. If your baby cries sharply as if he were in pain, draws up his legs and passes gas, but is not feverish or does not show any other signs of illness, he prob- ably has colic. The attack may last only a few minutes or several hours. He may have colic occasionally or it may occur every day, usually at about the same time and most often in the eve- ning. The causes of this condition are not known, but the baby acts as though he had cramps in his stomach and intestines from gas. In mild cases holding the baby over your shoulder and patting his back so he can belch may relieve him. If this does not help, try giving him a drink of warm water from a bottle. The colicky baby is likely to act as though he were hungry, but it is better not to feed him between meals. Extra food won’t relieve the pain anyway. Sometimes the baby is comforted by being placed on his side with a hot water bottle against his stomach, or with quite warm cloths on his abdomen. Wrap the hot water bottle carefully so that it will not burn him, and test the hot cloths carefully on your own inner arm because his skin is very tender. If your baby gets colic, make sure that he is dressed and covered warmly enough, and give him as much comfort as you can in his distress. Some doctors think colic is more likely to occur in tense, nervous babies and advise mothers to be as calm as possible. They also advise that the baby’s life be quiet and orderly without much stimulation or excitement. It is not advisable to give the baby an enema or insert a rectal thermometer even though he seems to have excessive gas. While this treatment might relieve the pain temporarily, it would probably upset the baby and irritate the rectum. If the colic is severe and persistent, ask your doctor for further suggestions. As far as we know, colic does not injure the child. He con- tinues to gain and, except for the times when he has pain, 46 The Little Baby: From Birth to Three Months seems perfectly well and comfortable. It usually disappears be- tween six weeks and three months of age. It is distressing to the baby while it lasts, though the parents seem* to suffer more than the baby. If your infant is colicky, check over all the things we have mentioned that may upset him. Try the things sug- gested; one of them may help your baby, or none of them may help. This is not very comforting, to be sure, but there is not much more that can be done for colic than to try to make the baby as comfortable as possible. Maybe your baby will be quieter if you walk the floor with him. Perhaps nothing you can do will make him feel better and you will just have to try to ignore his wails until he gets over the colic. It does not help the baby to realize that his mother is upset. Try not to let it get on your nerves, and if you can, get someone else to take care of the baby now and then. Skin Rashes The baby’s skin is very sensitive and may easily become irri- tated and sore. Diaper rash appears on the thighs, buttocks and lower abdo- men. It looks like small red pimples or patches of rough red skin. The rash usually occurs when wet diapers have not been changed promptly or when the skin, which is very tender, has not been washed and dried thoroughly. Chafing may also occur if the diapers have not been well washed and rinsed. When the baby has a diaper rash, do not use soap in bathing his buttocks. Wash gently with clean water, dry well by patting lightly, dust with a little powder or cornstarch, or rub on oil or boric acid ointment. Be sure to change his diapers and bed pads often. Wash the diapers thoroughly and rinse them in a boric acid solution (see page 51). A good treatment is to expose the rash to the air for several hours a day. For a severe rash that does not clear up after being treated a few days, consult your doctor. Do not use any patent medicines except on the doctor’s advice. Prickly heat or heat rash may appear on any part of the body where the baby perspires. It looks like tiny water blisters the size of a pin point. It is a sign that the. baby is too warm and should wear fewer clothes, none in hot weather, and have less covering. Keep him cool, give him sponge baths two or three times a day with cool water to which a little baking soda has been added (4 teaspoonfuls to a quart of water). Do not use 47 New York City’s Baby Book soap in his bath. Dust a little cornstarch on the rash. Orange juice rash. The so-called orange juice rash is usually just a little irritation on the skin from the juice. Very, very few babies get a real rash. Don’t stop the orange juice until your doctor has seen the baby and told you what to do. Even if your infant happens to be one of the few who cannot take orange juice at first, he may be able to take it later. Meanwhile, do not fail to give him a substitute for orange juice (see page 31). Other minor skin rashes. Little babies commonly get a few small white pimples or small red spots on their faces. These do not spread but usually clear up in a short time. If your baby develops a rash that looks different from the kinds described here or that you are not sure about, it is advisable to consult the doctor. Itchy skin, pimples with pus in them or white spots in the mouth need to be treated by the doctor, and the sooner they are attended to, the less severe they become. Rashes with fever. Whenever your baby has a fever with a skin rash, call your doctor immediately. Cradle cap is a common name for a crust that babies often get on their scalps. It looks yellowish and first appears in small patches but may soon spread over the whole head. To relieve it, rub the scalp with a little mineral oil, white petroleum jelly, or boric acid ointment and leave it on the head for two days. At least once a week, wash the scalp thoroughly with warm water and rinse. Rub off the crust with cotton or a clean cloth or comb it gently with a fine tooth comb. It may take a few treatments to clear up and it may reappear and need to be treated again. Cradle cap is not painful to the baby but should not be neglected. Eye Conditions Many babies’ eyes water frequently. A white discharge shows along the edge of the lids or in the corners of the eyes. This is not serious and requires no treatment except washing with cooled water that has been boiled. However, if the white part of the eyeball becomes red or inflamed, you should see the doctor with- out delay. Cross-eyes are common among babies. It may be a year and a half before the child’s eyes focus correctly, so until this age cross-eyes are quite common and are not serious. In most cases they are outgrown and get less noticeable. If the eye muscles, 48 The Little Baby: From Birth to Three Months however, are weak at 18 months, it is very important to consult an eye specialist and get proper treatment. In New York City there are special clinics, including those of the Department of Health, that are equipped to study and treat children with cross- eyes and other eye defects. The Navel If the navel has not healed by the time your baby comes home from the hospital, you can treat it by cleaning it with sterile cotton dipped in alcohol. Then cover it with sterile gauze and wrap a binder or strip of cloth around the baby’s abdomen. If the navel gets red or sore, consult the doctor immediately. If it protrudes, your doctor will advise you what to do about it. The condition is not serious and the baby may be given a tub bath. Noisy Breathing Your doctor will tell you if there is anything unusual about your baby’s breathing. Many infants make a kind of wheezing, snorting or rattling sound when they are perfectly well, and they outgrow it in time. There is no reason for alarm, as all babies change the rhythm of their breathing from time to time. It is a good idea for the mother to notice and get used to the way her child ordinarily breathes when he is asleep. She will then be able to tell when his noisy sounds are different. “Nervous” Babies Some little babies are very restless and are easily startled with- out anything being the matter. It is natural for some infants to be this way. After a while they become less sensitive. Occasionally an infant cries a lot and nothing that is done for him helps much. Like colic, his restlessness is usually out- grown by the time he is three months old. Think over your baby’s routine carefully and try to make any changes that might make him more comfortable and happy. Have a talk with your doctor. If he finds nothing wrong with the child and you are giving him plenty of fresh air, quiet and attention, try to make the best of things until he is a little older. The mother of a crying baby especially needs to get away from him a few times a week. She should not feel that she is neglecting her baby if she asks the father or a friend to take care of him occasionally. 49 New York City’s Baby Book To sum up: The best way to tell whether or not your baby is well is to know your baby—to know how he usually looks and acts. Try to find out what kind of baby he is—whether he is a restless or a calm type, steady or changeable. Remember babies differ in temperament just as grownups do. If your baby suddenly looks different and behaves differently from the way he usually does, if he is feverish or has a running nose, vomits, has diarrhea, is fretful and restless or shows any other signs of illness such as those discussed in Chapter VI, call your doctor at once. 3. THE CLOTHING AND EQUIPMENT YOU NEED FOR YOUR LITTLE BABY Clothes and Bedding Below are listed the clothes and bedding a little baby needs. You probably have some things but may be planning to get others. It is a good idea to buy the first clothes in six months to one year sizes, as babies grow so fast. If your baby is born in the spring or summer, he will need lightweight clothes—sleeve- less shirts, nightgowns and kimonos made of thin material. If he is born in the fall or winter, he should have long-sleeved shirts and cotton knitted or flannelette gowns. Do not buy any clothes with drawstrings or ribbons at the throat, for these may choke the baby. If friends give your baby presents or you can afford extra things, it is fun to let the baby wear pretty clothes on special occasions. But he will look just as sweet in a shirt and diaper or plain gown if his clothes are clean and neat. 3-4 shirts—cotton knit, with ties or buttons 3 - 6 nightgowns—gowns that are open down the back are easier to put on and take off 3 - 4 dozen diapers—bird’s-eye or 3-ply gauze 1 - 2 flannelette jackets or kimonos opening down the front or back with big sleeves 1 - 2 warm sweaters, preferably cotton, as some babies’ skins are irritated by wool 1 cap 1 baby bunting bag or warm hood and coat for winter 2-3 flannel squares or receiving blankets, a yard or more square, to wrap the baby in. They will help to protect the woolen blankets 50 The Little Baby: From Birth to Three Months 6 small sheets or large diapers, big enough to cover the mat- tress. Pillow slips may be used to cover the mattress in a bassinet. 1 or more waterproof sheets or squares to cover the mattress if it is not waterproof. Do not put a rubber sheet under the baby’s head, as it will cause him to perspire; cover the sheet so that it will not be too cold for the child to lie on. 2 diapers folded over a small waterproof square, or small quilted pads, may be used under the baby in order to keep his clothes and bedding dry. 2 soft, lightweight blankets 3 washcloths made of some soft, fine material 2 large, soft bath towels 1 covered diaper pail The Baby’s Bed.—A bassinet, a sturdy clothes basket tied onto two chairs, a dresser drawer or a carriage makes a good bed for a little baby. Any one of them can be easily moved about and will protect the baby from drafts. Something firm and smooth to lie on, whether it is a regular baby mattress or a blanket or pad folded several times, is better than a soft mattress or pillow. The baby needs a straight, flat surface, firm but not too hard. He should not have a pillow. If a bassinet of some kind is used at first, a large crib should be provided by the time the baby is three months old or as soon as his active arms and legs hit the sides. When buying a crib, be sure the slats are close enough together so that the baby cannot possibly get his head between them. Care of the Baby’s Clothes— The baby’s skin is very sensitive, so all his clothes should be washed often and carefully. He will be healthier and more comlortable if his clothes are always clean and dry. If you do your own washing, as most mothers do, you will find it easier to wash every day than to do all the wash at one time. As soon as you remove a wet diaper, put it in a pail or the laundry tub, covered with water. When the diaper is soiled, shake off the bowel movement into the toilet and rinse off as much as you can when you flush the toilet. Then put the diaper to soak in soapy water until you are ready to wash. When you take care of the diapers in this way, it is easier to get them 51 New York City’s Baby Book really clean. Many mothers prefer to boil the diapers before washing by putting them in a large kettle or the diaper pail, covering them with clean water. Let them boil hard for five minutes. Wash the diapers with a mild soap. Remember that washing soda and disinfectants are strong and may irritate the baby’s skin. Be sure to rinse the diapers at least three times in clean water; for the first rinsing, use water as hot as you can stand. When you hang the diapers up to dry, shake them out and pull them straight. Diapers should not be ironed, as it puts harsh folds in them. Just smooth them with your hands as you fold them. The baby may get a rash on his buttocks if the diapers are not thoroughly washed. Never use a diaper a second time without washing it. Always be sure diapers are really dry. Many mothers use one of the diaper laundering services and find it very convenient. If the baby’s skin is sensitive and he gets a diaper rash on his buttocks, thighs or abdomen, take special care to wash, boil and rinse the diapers thoroughly. After they have been rinsed three times, dip them in a boric acid solution made by mixing 4 level tablespoons of boric acid powder for each quart of water. Wring the diapers out and let the boric acid dry on them. Be careful not to leave the boric acid solution where the baby can get at it and drink it. Toilet Articles A tray or large, shallow cardboard box or large cake tin in which you can keep all the baby’s bath articles together A bar of mild soap in a covered dish 1 small covered jar for sterilized cotton. (You can use a small empty mayonnaise jar that can be boiled.) 1 small covered jar for plain mineral oil or baby oil A small box of cornstarch or baby powder. (Do not use tal- cum powder that is made with zinc or magnesium stearate; it may cause pneumonia if the baby breathes it into his lungs.) A package of sterilized gauze or small squares of soft, clean cloth sterilized in the oven A tube of boric acid ointment A small, soft hairbrush 52 The Little Baby: From Birth to Three Months Small covered jars of boiled water and sterile cotton to wash your breasts if you nurse your baby. Boil the jar and the water every day. Something to bathe the baby in—a large dish pan, a baby tub or bathinette Equipment for Sterilizing Bottles and Making Formula A large pan or kettle with a cover OIL / A metal rack to hold bottles is handy and saves much time when boiling bottles; or a wooden one to put on the bottom of the ket- tle. The wooden one can be made by nailing small pieces of wood together. 7 to 9 8-oz. bottles. Get the type that can be thoroughly cleaned inside. 9 nipples 7 to 9 nipple covers or clean squares of waxed paper tied over the mouth of the bottle A covered jar for nipples Tongs or forceps for handling the hot bottles A glass or metal funnel that can be boiled A bottle brush A measuring tablespoon A quart measure Fix a shelf in your cupboard or get a large covered box in which you can keep all the things for making the formula. -CORN 5TAPCH op. POWDER COTTptV hmC ACID / OIMTWE.MT 50AP- 53 Chapter III THE BIG BABY: FROM THREE TO NINE MONTHS HOW YOUR BABY IS GROWING! When your baby is only a few weeks old, visitors are sure to express surprise when they see how tiny he is. But when he is three or four months old, relatives and friends who have seen your baby from time to time will begin to marvel at the way he is growing. In five or six months most babies have about doubled their birth weight. Even more remarkable is the speed with which the infant grows in his ability to do things. In fact, you will probably be aware of interesting changes in your baby every day. The Desire to Touch Things— Now that the baby has learned to hold his head steady on his shoulders, he begins to learn how to manage his hands and arms, to try to sit up and see more of what’s going on in the world around him. He waves his arms, hangs on to the side of his crib or your shoulder, shakes a rattle, takes hold of one hand with the other, stares at his fingers in wonder, turns his wrist and wriggles his fingers. At the age of six months he is able to reach for his toys and has a pretty good sense of direction so that he can get what he sees if it is within reach. In this period he explores and handles everything. His eyes, too, are continually seeing more. He examines everything near him, reaches for it, fingers it, puts it to his mouth and tastes it. He may even try to smell and hear it. Now he wants to touch things, just as earlier he was absorbed in looking at them. By nine months he begins to use his forefinger to poke into things, and he can use his thumb and finger like little pincers to pick up small objects. The baby’s eagerness to touch is a useful part of his natural curiosity and his desire to learn, so he fingers and tastes things. That Left Hand.—Sometimes, as early as six or nine months, a baby shows a definite preference for his right or left hand. More often he uses either one with equal readiness and skill until he is much older. It is best not to try to change the child’s 64 The Big Baby: From Three to Nine Months tendency to use his left hand if he prefers to do so. Being forced to change may confuse him so that later he may stutter or have trouble learning to read. Being left-handed may be a little awkward in some respects, but if a child isn’t made self-conscious about it, he will become just as skillful with his left hand as others are with their right hands. It is a good idea to offer him toys so that he may grasp them easily with either hand. Turning Over on His Own Power.—Most of the time, while your young baby was awake, he lay on his back. Now, at three or four months, he wriggles and tosses and turns himself part way to one side and then to the other. It must be a great satisfaction to the baby to be able presently to turn over alone. Then he can change his position when he feels like it without waiting for someone to do it for him. But now it is very dan- gerous to leave him alone on a table or bed for even an in- stant. Most babies have at least one fall sooner or later. While they are not often seriously hurt, the mother should at all times be very careful to protect her baby from this danger. When the baby is on his stomach, he may raise his head and shoulders and rest on his arms. He quickly gets tired in this position and fusses, but he wants to see more. He loves to be held in a half-sitting position with your arm around him, or to have his mattress slightly raised on one end so that he lies at an angle. Some babies, while they are held, try to rock back and forth a little or else try to bounce up and down. These exercises help to develop a baby’s back muscles and to get him ready for the next step, sitting alone. One should not prop a baby up with soft pillows until his back is strong enough. Sitting Up Alone.—You can tell when your baby is ready to sit up alone. Before that time he slumps forward or folds up like a jackknife with a curved back when you set him down. Somewhere around six or seven months he will sit upright for a moment or so, and then tip or slump backward instead of forward. Do not let him try this too long and get too tired. fljfljL. 'Vvocrr**- 55 New York City’s Baby Book A minute or two at a time is enough at first. Gradually he will be able to sit for five to fifteen minutes by himself. Most babies seven or eight months old can sit up steadily, some not until a month or two later. When he is ready to sit up, he will; don’t hurry him. Crawling—in a Dozen Styles.—About the time that he learns to sit up alone—sometimes earlier and sometimes later—a baby begins to crawl. A few babies never learn how, but go right from sitting to standing and walking. The little baby may make swimming motions when he is on his stomach but he doesn’t get anywhere. Real crawling begins after much practice. He may do it in any one of a dozen different styles—backward, side- ways, forward, on his hands and knees or humping himself along on his haunches. It doesn’t matter much whether or not your baby learns to crawl, but he should have plenty of chance and space to exercise and practice when he feels like it. A blanket or sheet on the floor makes a good place for a young baby to lie and kick and practice rolling over, sitting up or crawling. It is easier for him to sit and crawl on a firm surface than on a soft one. By the time the child is able to crawl well, he will be eager to explore farther and farther in the room. He probably won’t be content to stay in his play-pen all the time. He needs the experience of moving about, so let your baby crawl to his heart’s content. He will want to follow his mother where- ever she goes, and he can be encouraged to go after his own toys. The bits of dirt he may pick up—and try to eat—aren’t likely to hurt him. It is important, however, to make sure that the floor has no splinters and that there are no dangerous ob- jects around, such as electric wires, tacks, pins, buttons, glass toys or bottles. Cigarettes may be fatal to a baby, so keep boxes out of reach and ash trays empty. The baby needs space to move around. It is so important for him to have room to crawl that in small, cramped quarters it is worth while to move the furniture to give him a free 56 The Big Baby: From Three to Nine Months Space. A play-pen provides him with a safe place to move around without getting hurt on the furniture but it is not a necessity. The baby may soon prefer the larger freedom of the floor any- way, and it is better for him not to be cooped up too much in a small space. If you are going to get a play-pen for your baby, get it early, when he is five or six months old. If you have a place where you can put it outdoors, the baby will enjoy watching people going by. Later, when he is ready to practice standing up, the slats will be helpful to hang on to and he can pull himself up by them. When he is older, take one side off the pen, turn it upside down to make a playhouse. New Tricks. —Your big ba- by learns to make new sounds and “talks” to him- self, carries on conversa- tions with his family, laughs, babbles and may learn to say one or two words such as ‘“dada,” “ma- ma,” “bye-bye” or “ta-ta” be- fore he is twelve months old. He watches with great interest everything that goes on and can read many of the gestures and expressions of grownups. If his mother or father feels cross, he knows it just as he knows that their smile means they like having him around. He also understands increasingly what is said to him. He enjoys games like peekaboo and pat-a-cake and begins to imitate the action in these and other games. All these experiences with his family and the little world of things he explores help to make up his day. When the First Tooth Comes— Another big event in the baby’s growth that is likely to occur before he is nine months 57 New York City’s Baby Book old is cutting his first tooth. The baby teeth are all formed under the gums before birth. How good they are depends some- what on the diet of the baby’s mother while she was pregnant and on the food the baby has been eating since he was born. In most infants the first tooth appears when they are about seven or eight months old. Some babies get a tooth as early as four or five months. Occasionally a baby who is healthy in every way does not get any teeth until he is a year or more old. The first two teeth to appear are usually the two lower center ones. By a year the four upper and the four lower center teeth may appear. For months before the first tooth shows, the baby may drool, try to bite on any- thing within reach, and be fretful and fus- sy. Sometimes a child shows no signs of teeth- ing and the mother first dis- covers that a tooth has come when it clinks on his spoon or cup. Although teething is a natural process in babies, it can cause consider- able discom- fort. When you notice signs of teething, give your baby something hard 5 to 9 Tnonthb months 12,io 18 months 18 to 3Ji YnontRs 3.H to 4 S monies -CENTRAL INCISOR. -LATERAL INCISOR "CUSPID -FIRST HOLAR -SECOND MOLAR SECOND MOLAR -FIRST MOLAR -CUSPID -LATERAL INCISOR "CENTRAL INCISOR UPPER LOWER, to chew on 58 The Big Baby: From Three to Nine Months a hard rubber or bone teething ring, a silver teaspoon, a small toy or a piece of cloth. You needn’t worry about germs on such things if they are kept clean by scrubbing. But make sure that the baby does not chew paint off furniture. Paint may contain lead, which is poisonous. If the mother is nursing her baby, she may some day feel a little nibble on her nipples. The baby just likes to feel his teeth and does not realize that he may hurt you. Do not hit or scold him. Draw the breast away gently and he will soon learn not to bite the nipples. If he should get a firm grip and hang on, you can get him to let go by gently holding his nose a minute so that he has to open his mouth to breathe. If your baby wakes up at night and cries out with pain from teething, he may go back to sleep in a few minutes. If he keeps on crying, don’t be afraid to pick him up and comfort him. When the pain is gone, he will willingly go back to sleep. Some- times only a small bottle of milk or a short period of nursing will comfort the teething, wakeful baby. This won’t spoil him or start a habit. A little wise mothering when he needs it will soothe his distress and keep him from getting into a crying habit. Do not use any soothing syrup or rub-on medicine to relieve the baby's pain. THE CHANGING PATTERNS OF THE BIG BABY’S DAILY LIFE Naps and Bedtime The way the baby grows and learns gives his parents the best cues as to how to plan and change the orderly routines of his care. By three months the baby has learned to stay awake part of the day instead of sleeping most of the twenty-four hours. You can begin to count on his regular nap times, although these change often as he grows, older, and babies differ in the num- ber and length of naps they need. The young baby is likely to wake up any time between 5 and 8 a.m., but he will prob- ably not demand his breakfast immediately and may talk to himself for fifteen minutes or so before he fusses. By six months he may enjoy playing with a toy in his crib for a while. After the early breakfast the younger baby may take a short nap before bath time. When he is a little older and is no longer 59 New York City’s Baby Booh sleepy after breakfast, he is likely to play happily by hiths'elf for an hour or two if he gets a different toy now and them When he is able to sit up in his high chair or to crawl around, he will enjoy watching the household activities while his mother cooks in the kitchen or cleans. After the second feeding, whether or not there is a morning bath, most babies take a long morning nap. If the mother can arrange it, this is a good time for the baby to sleep outdoors. As he grows older, he stays awake longer in the afternoon, but nearly all babies under a year still want a short afternoon nap. Drowsy eyes, turning his head from side to side, wriggling, sucking his thumb or fussing may all be signs that the child is sleepy. Your baby may be wakeful after his supper, but you should get him used to going to bed after eating, and most babies will fall asleep after they have talked to themselves a little while. Sometimes your infant may get so keyed up learning new things and playing with his father or with visitors that he will be too excited and restless to go to sleep. The parents should then plan some quieter period before bedtime. If your baby cries and seems unable to go to sleep alone, try letting him stay up half an hour later to see the lights and hear conversa- tion. If he is a restless, fussy baby, a few minutes of extra mothering, being held, gently rocked and sung to, may quiet him until he gets drowsy. He can then be put back in his crib. If the bed coverings are too heavy or wrapped too tightly, the baby can’t sleep comfortably. He needs freedom at night as well as in the daytime. It is very unwise to take the baby into bed with you. He may soon prefer to sleep near you and it will be difficult to get him used to his own bed again. How long the baby is going to need the 10 p.m. feeding will depend largely on his appetite and gains. This is discussed under “Meals.” (See page 65.) Now Your Baby Is Ready for Solid Foods How to Begin.—Remember that anything but liquids is an altogether new experience to your baby. Solid foods taste and feel different to him. He has to learn how to eat all new things. At first he may not like the idea. He may clack his tongue and push the cereal out, look puzzled, and be obviously displeased. 60 The Big Baby: From Three to Nine Months Give him a chance to get used to it and see that his first experi- ence is as pleasant as possible. He is most hungry at the begin- ning of a meal, but some babies prefer to drink their milk first. Do not try to start a new food on a day when the baby is out of sorts or tired. Offer it to him at a mealtime when he is usually most hungry. See that the food is neither too hot nor too cold, and give it to him with a smile. Start with just a little bit on the tip of a small spoon. One taste will be enough for the first day, unless he seems to like it from the beginning. The next day offer him a taste again, but don’t force him to eat it if he doesn’t like it; in- stead, try again in a few days. It may take some weeks before he gets used to the spoon. If his reactions are not respected, he may get balky and begin to re- fuse his bottle, too. So take it easy. If he still dislikes solid food, wait a week or two and then try again. Cereal or Fruit for Starters.—Your doctor will advise you when to start solids and what to begin with. Some babies accept solid food better if they are started on fruit instead of cereal. Try either applesauce or bananas; both are great favorites. You can either use ordinary canned apple- sauce or cook it yourself from ripe apples and put it through a strainer. Sugar may be added if the apples are sour. If you use bananas, be sure they are fully ripened with no green skin; peel and mash fine with a fork, adding a little water or milk if it seems too thick. Cereal is sometimes the first solid food given because it is easy to digest. You can either fix it your- self, by cooking a fine cereal—like farina or cornmeal over a 61 New York City’s Baby Book low heat, or you can use one of the prepared baby cereals with a little milk so that it is rather thin. After a trial of two or three days, when your baby seems to be getting accustomed to fruit or cereal and apparently likes it better, start increasing the amount. Add another teaspoonful every two or three days until the child gets as much as he wants, usually two or three tablespoonfuls. If he has cereal for lunch, give him fruit for supper, and vice versa, beginning with a small amount and increasing gradually. Vegetables— When the baby is about four months old, or after he has begun to take fruit and cereal well, pureed or strained vegetables may be added to the diet. They are usually given at the 2 p.m. feeding. To prepare strained vegetables, first wash them, then peel or scrape only When necessary. Drop immediately into a very little boiling water. Cover the pan and cook a few minutes, until the vegetable is tender when pierced with a fork. Cooking with a small amount of water saves all the food values, especially the minerals and vitamins. Serve the liquid from the vegetables with it, or use it in soups, or gravies for the grownups. Mash the cooked vegetable through a fine sieve, and season with a few grains of salt. It is not neces- sary to boil the dishes and spoons you use for solids. Germs don’t thrive on dry, clean dishes. It is only utensils and bottles for the formula and water that need to be sterilized. The pre- pared vegetables that may be bought in jars or cans are more expensive than those you prepare at home. There are many vegetables suitable for babies. Carrots, peas, spinach and other greens, beets, green beans, tomatoes, squash and asparagus are all good. In fact almost any kind may be given except cabbage, onions, sauerkraut, corn, dried peas and beans. Start offering vegetables as you did cereal and fruit, a little at a time. If your baby dislikes one kind, don’t force him to take it. There are plenty of others you can give him and a month or two later he may like one he refused at first. In- crease the amounts gradually until he gets two or three table- spoonfuls, depending on his appetite. By the time he is used to solids, he is likely to enjoy almost anything offered him on a spoon, and it is a good idea to give him a variety of foods. This develops his sense of taste, helps him to enjoy his food more, and teaches him to eat all kinds of food—something that 62 The Big Baby: From Three to Nine Months will be useful later on. It is best to add only one new food at a time in order that you may be able to tell whether it agrees with him. Eggs.-Arqund four to six months, depending on the doctor’s advice, egg yolk may be given the baby. The yolk is the most valuable part of the egg for him and should be started first. The white may be added later, when he is taking the yolk well. The egg may be hard-boiled and the yolk mashed with a fork or put through a strainer, then mixed with a little milk or butter. Or the egg may be soft-cooked by putting it in cold water, bringing to a boil, then turning off the heat and letting the egg stay in the water three minutes. Or the egg yolk may be cooked separately. Put it in a cup, place in water, and heat from three to five minutes. Offer the baby a half teaspoon with a feeding and increase gradually. When egg is added, make sure you are not adding another new food at the same time in case it should upset the baby. A Day’s Meals.—By seven, eight or nine months most big babies have meals something like this: Milk at about 6 a.m. Orange, grapefruit or tomato juice, fish liver oil at 9 a.m. Cereal, milk and fruit at 10 a.m. Vegetables at 2 p.m. plus milk. Simple milk puddings in custard form may be added if the baby takes them after he has had as much as he likes of his other foods. Cereal, fruit and milk for supper. If the baby’s bowel move- ments tend to be a little hard, pureed prunes or prune juice every night may help. Zwieback or plain crackers may be given at the end of the meal or after a nap. A healthy baby’s appetite is the best measure of how much food he needs. If he is offered a good diet and both his eager- ness to eat and his signs of when he has had enough are re- spected, there is usually nothing to worry about in connection with his eating. A baby’s inside system seems to tell him how much he needs. If he is not urged to eat when he does* not feel like it or has had enough, and if the mother watches for the few changes that may come, he is pretty sure to enjoy his food. And learning to like to eat is an important lesson for a baby. 63 New York City’s Baby Book Happy Mealtimes— Remember that your baby is learning to use his hands and likes to hold things. A piece of hard toast or plain cracker will give him something to hold and put in his mouth. It satisfies his urge to bite on something hard when he is teething and helps him to learn how to chew. About the eighth month the baby may also get a peeled apple to chew and exercise his gums and jaws on. He will enjoy playing with a spoon during meals, and though it will be some time before he can feed himself with it, it is good practice for him to play with it. He is learning to pick up things with his fingers, too, and may be given a few peas or small pieces of cooked carrot on his tray. At this stage he should start feeding himself with his fingers and learning how to chew lumps of food. Around five or six months it is a very good idea to begin giving your baby a sip or two of milk from a cup at mealtimes. He will get used to drinking it this way and will have some advance preparation for weaning. He will soon try to hold his bottle, and while the full bottle will be too heavy for him to handle alone, if you let him put his hands on it, he will man- age it when it is partly empty. Around eight or nine months he will be interested in handling a small cup or plastic glass and may try to give himself a drink. Then put a little milk in the bottom, and soon he will like to drink milk in this new, grown-up way. Thus the intelligent mother can assist her baby in learning how to feed himself by giving him oppor- tunities as soon as his muscles are ready for them. When the baby is first given solids, it is well for the mother to hold him in a half-sitting position on her lap in order that he may not choke. When he can sit up steadily by himself, he will enjoy sitting in a high chair for his meals. In his eager- ness to learn all about his new food, he will surely put his hands in the cereal bowl and his fingers in his mouth and try to feed himself. This is bound to be messy, but if the mother can bear it, her baby may learn more quickly how to get along without her constant help at mealtimes. You can put a bib on the baby, an apron on yourself, and newspapers or a piece of oilcloth under his chair. You should also keep a dishcloth handy to wipe up the spilled food. When your child can sit by himself, you can show him how to feed himself by sitting or standing behind him and directing the hand holding the 64 The Big Baby: From Three to Nine Months spoon toward his mouth. Let him use either his right or his left hand; in this connection he should be allowed to follow his own inclination. One of the first signs of ill- ness or upset is often a decrease in appetite. When your baby be- gins to refuse food, he may be temporarily upset by teething or may be coming down with a cold. His lack of appetite should warn you to watch him with extra care. Do not urge him to eat but let him take only as much food as ne wants, vvnen ne reels better, he will make up for what he has missed. Changing Schedules and Formulas for Milk Increasing Appetite—It your baby gets a formula, it will need to be changed from time to time as he grows. Your doc- tor is the only one who should make these changes. The baby may get seriously upset if you try to change the formula your- self or use the one a neighbor has. Every time you take the infant for a regular check-up, discuss with the doctor the baby’s appetite, how long it takes him to finish his bottle, how eager or satisfied he seems to be with his meals, and how the new foods agree with him. When he is about six months old or a little older, your baby may be ready to pass up the 10 p.m. feeding and sleep through the night. Some babies are ready for this change sooner than others. Your baby may begin to sleep past 10 o’clock and then wake up hungry at 11 or 12. It is all right not to be too strict about this feeding. You can wake the baby at 10 p.m. or whenever you go to bed yourself, or you can wait until he wakes up. It is much better not to try to hurry him in giving up this meal because if he is hungry, he will naturally not be able to sleep well. On the contrary, he will be restless and fussy and both his sleep and his appetite may be affected. After you have had to wake him several weeks to give him this feeding, try letting him sleep through the night without disturbing him. If you breast-feed your baby, you will usually find that the amount of milk you have adjusts itself to his increasing appe- 65 New York City’s Baby Book tite. If the breasts become uncomfortably full when the baby first sleeps all night, you may use a breast pump or squeeze out some of the milk by hand to give yourself some relief. As a rule the breasts accommodate themselves to the changed schedule, and you should be able to enjoy an unbroken night’s sleep, as your baby does. But if you happen to wake up occa- sionally from habit, peek in and make sure that the baby is covered. Take care, however, not to wake him up. In most cases, babies are not ready to give up the bottle or breast until they are nine months old or so. If it is necessary to change your baby from breast to bottle, you can follow the suggestions for weaning (see page 80). Give the baby a bottle instead of a cup of milk. If the Baby Sucks His Thumb.—Although your child gets a great deal of satisfaction from his new, grown-up way of eating solid foods, he may want to suck a lot and should be allowed to do so. This is the thumb-sucking age, and if your baby sucks his thumb a few minutes before mealtime, it is only because he is hungry. If he sucks it after feeding or between meals, it may be a sign that he is not getting enough sucking at meal- times. If he is breast-fed, let him nurse longer at one breast before offering him the other. If he is a bottle baby, get new nipples with smaller holes. The thumb-sucking baby may need more time to suck at meals, so the 10 p.m. feedings should be continued until he refuses them. The parents might also consider whether the baby seems contented and happy. More time outdoors, more freedom and toys to play with, or a little extra attention and fondling will sometimes give the baby more enjoyment. Should you try to stop him by direct methods? Well, it doesn’t do any good. Pin- ning his sleeves down or putting mittens on makes a baby angry, and it will not cure him. If you have followed these suggestions and your baby still sucks his thumb, you need not worry. Your efforts will have made him better satisfied in other ways, and he will probably be ready to give it up earlier than he would have done other- wise. It is no disgrace to a baby or his parents if he sucks his thumb. Elimination As the baby grows older, his bowel movements are likely to 66 The Big Baby: From Three to Nine Months be less frequent than they were in the first months. The addi- tion of solid foods to the diet usually changes the consistency and color of his stools. You may see bits of color or lumps of vegetables in the stool, but this does not mean that anything is wrong. Prune juice or pulp given at supper will generally help to soften hard movements. If the stools are hard and un- comfortable to pass, your doctor will advise you what to do. Enemas and suppositories are rarely necessary or advisable. It is much better to treat any tendency toward constipation by correcting the cause through the diet. A few years ago it was considered a good idea to try to train babies to a pot from a very early age. Now we know that while a mother can sometimes catch the movement in the chamber, a very young baby cannot be really trained. His nerves and muscles at the bowel opening are not developed enough for him to be able to control himself. It is much better and easier in the long run to wait until the baby is a year or fifteen months old. Then he will be ready to start training himself. (See page 82.) Clothes and Baths When the baby begins to crawl, he may need a sponge or tub bath before his supper, for he is sure to get dirty even in the cleanest of homes. Getting dirty is as much a part of crawl- ing as getting clean is a part of bathing. When he can sit up steadily alone for ten minutes, he will enjoy part of his bath sitting up in the deep laundry tub or in the sink; or else he may lie in the big tub, where he can splash and try to swim. A floating toy, or clothespins, or an unbreakable cup will give him fun in the bath. Most babies try to suck the washcloth, drink the bath water and eat soap. A little of this, which is bound to happen anyway, will not hurt them. The baby should never be left alone in the bath even for a moment. He might slip and be drowned in only a couple of inches of water. All babies love to play in water, and unless the room is cold, you may safely let your infant play in the tub 15 or 20 minutes. In hot weather a second bath or sponge bath every day will help to keep him comfortable, and a dip in the washbasin when his diaper is changed is useful in preventing prickly heat and diaper rash. As the baby grows, he is awake more of the day and less 67 New York City’s Baby Book disturbed by being handled than he was when he was little. The mother may now enjoy dressing her little boy or girl in rompers or dresses. Cotton, corduroy or jersey overalls are very practical for the crawler. They protect the legs from scratches and bruises and are easy to wash. In hot weather the baby needs nothing but diapers or a sun suit. In cold weather pajamas with feet will help to keep a lively kicker warm. If a sleeping bag is continued, the baby may get so used to it that he will be unhappy if a change is made later. Booties look pretty but do not stay on long because babies like to pull or kick them off. The same applies to socks. Your baby will begin to help a bit with dressing, holding out his arms for sleeves or tugging at his cap. Let him do as much as he can. He learns that way and has fun in addition. Fun for the Baby and the Family The baby’s development suggests the kind of play and exer- cise he needs and enjoys. Each month he sleeps less and gets more interested in things around him. By the time he is three months old, play becomes as important to his growth as sleep. He likes a change of scene, a shift from the crib to his car- riage or the sofa or the floor. Even when he can sit up alone, he will enjoy lying on his back part of the time, kicking, wav- ing his arms, talking, turning over, looking around, raising himself up. A play-pen and especially a high chair give him a better view of the household. He loves a ride in his carriage, tries to look over the sides, smiles at people who stop to talk to him, plays with a toy or spoon. When he becomes more active, he will need a strap around him to keep him from falling. Now he really begins to play with toys. Simple, inexpensive playthings or household objects are as much fun as anything. Paper to crinkle, empty cereal boxes, a small soft ball, stuffed animals, a stout string of empty spools, a set of colored plastic measuring spoons, a wooden mushroom darner or any small object that has no sharp edges and cannot be swallowed will give him great pleasure. Clothespins make wonderful toys that will be played with for months. They are easy to wash, not too heavy to hold, good to bite on, float in the bath, and can be thrown or carried around. The baby will especially like things to bang, and a small saucepan and lid will give him 68 The Big Baby: From Three to Nine Months much amusement. When he can crawl, his mother might fix a low shelf in one of her cupboards with pans, empty boxes, nested measuring cups and similar objects. He will be happy playing with these things while she does her housework. When he is about nine months old, your baby will enjoy play- ing little games. He likes to have someone roll a ball to him, to crawl after it and to push it. You may be able to teach him pat- a-cake and he will re- spond to the attention and admiration his new tricks win. He soon learns the fun of throw- ing down his toys and watching you pick them up for him. This game really means something to the baby, for after he has learned how to take hold of things, he still has to learn how to let go of them, and he practices dropping and throwing his toys over and over. He learns to recognize more people. Babies begin early to enjoy music, sometimes smile and are quieted by it, or try to sing to themselves. Later they attempt to move their arms or bodies in time to the rhythm. This is a pleasure that nearly every home can give its baby. An infant likes to play peekaboo too, although at first he may look puzzled and worry about his mother’s disappearance. She is very important, indeed, to the baby. She does almost everything for him and he could not live without her or someone in her place. So when his mother’s face disappears over the side of the chair or behind a handkerchief and then comes back again, the *baby is de- lighted and shrieks and laughs happily. This age-old little game helps the baby to learn that his mother may be expected to come back to him even if she has been away for a while. By the middle of his first year, your baby will recognize members of his family. He may look toward the door when 69 New York City’s Baby Book he is told it is time for his father to come home. When he hears him, the child will greet him with a crow of pleasure and outstretched arms. He will be very fond of his big brother or sister if he has one. He enjoys seeing people so much that he may cry when they leave him. He will be aware of strangers and may be timid or a bit frightened by them. It is a good idea to encourage visitors to keep a little distance from the baby until he has had a chance to look them over and get used to them. Then he will be ready to play with them. Your baby, moreover, will know the difference between a frown and a smile. If you speak crossly to him, he may whimper and fret, or he may yell back at you. Through play with his family and friends a baby learns his first lessons in give and take. Playing with a ball, throwing it down and picking it up, saying “hello” and “goodbye,” are all part of his learning about people and how they get along together. At each stage in your baby’s growth you will find him more amusing and more interesting. If you enjoy watching and studying the many changes in your child, the work and responsibility of caring for him will seem less tiring and more fun. Protect Your Baby from Disease If anyone in the household has a cold or sore throat, he or she should stay out of the baby’s room, especially in the first days, when the infection is most contagious. No one, whether sick or well, should kiss a baby on the mouth. Be firm and refuse to allow visitors with colds to hold the baby or even come into the same room with him. When the mother hap- pens to be sick, it is wise to have someone else take care of the baby if possible. If the mother or whoever else takes care of the baby has a cold, that person’s hands should be washed thoroughly each time before the baby is handled. Babies should be protected against several contagious diseases that are sometimes fatal. Years ago many babies died of those diseases, but nowadays such deaths are infrequent. Some forms of health protection are now so well established that a parent is actually neglecting his child if he does not give him such protection. Many parents do not object to such protection or immunization, but never get around to it. Do not fail to have 70 The Big Baby: From Three to Nine Months your baby immunized. If you have no doctor for your baby, take him to the nearest Child Health Station to get the neces- sary treatments. Most doctors advise that babies be immunized against at least three serious diseases: smallpox, diphtheria and whooping cough. This is done by giving something that builds up the baby’s resistance to the disease. The treatments or “shots” should be completed by the time the child is a year old. Parents in New York City now realize how important vaccina- tion is. This is a result of the recent appearance of several cases of. smallpox in the city for the first time in many years. Smallpox 71 New York City’s Baby Book is a serious disease and is common in communities where vacci- nation is not compulsory. In the States where vaccination is compulsory, there are almost no cases of smallpox. The smallpox vaccination is made by pricking the skin and applying a drop of vaccine. After three days, if the vaccination takes, a small red pimple appears which changes into a blister. After eight or nine days a tough brown scab develops. Until this scab falls off of its own accord, the spot should not be washed but should be kept dry. Some babies may feel a little upset and run a fever, but most of them suffer no ill effects from the vaccination. Babies under a year are less likely to get sick from it than older children. Besides, it is easier to keep a young baby’s vaccination clean, since he is not so active. For protection against diphtheria, two or three injections are given a month or so apart before the baby is a year old. These injections provide safe and simple protection against a disease that used to kill thousands of children every year. The injection may sting for a few minutes after it is given, but it causes no serious discomfort or illness. The doctor may test the baby some months later to see whether immunity has been established. It will also be necessary to give a “booster dose” before the child goes to school. Whooping cough is a dangerous disease, especially for chil- dren under two. Not only is it dangerous, but it is such a long- drawn-out illness that the mother will certainly wish to prevent her children from getting it. Occasionally a baby will get whooping cough even though he has had the injections, but he gets a much milder form of the disease than he would if he had had no protection at all. Keep your baby away from anyone who has this disease. He may- be a little feverish and restless after the injection but is usually over it within 24 hours. Another type of protection that is very useful is given when a young or weak child has been exposed to measles. This in- jection protects him for about three weeks, but is of great value because measles in a child under three years of age or in a sick child may be extremely dangerous. If your baby has been near anyone with a contagious disease, ask your doctor’s advice. Do everything you can to keep your baby away from anyone who is sick. 72 Chapter IV THE BABY BEGINS TO GET AROUND: FROM NINE TO FIFTEEN MONTHS HOW OLD IS YOUR YEAR-OLD BABY? A baby’s first birthday is an important occasion to his family and is often celebrated with presents and a cake with a single candle. Somehow we feel that the baby has now passed a mile- stone and we expect him to be more grown up, but this is really a sort of in-between age. Several big events take place between the ninth and the fif- teenth month. Perhaps the most noticeable change is that the baby of a year really begins to get around. He crawls all over, climbs, pulls himself up by the furniture and toddles around hanging on to things. He may take a step or two alone, and some children may be walking by fifteen months. Your baby at this age is more active and curious. He wants everything and gets into everything. All these changes, as he grows, require many adjustments in his daily life. He still needs almost con- stant care. By a year, most babies have about tripled their birth weight and have grown eight or ten inches taller. But they no longer gain weight as rapidly as they did in the first six months. This is normal for healthy babies. It is part of nature’s plan of growth, and as they become more active and begin to lengthen out they lose some of their baby chubbiness. Think what giants babies would be if they doubled their weight every few months as they did in their first year! This is the time, too, when the baby is getting more teeth. He may have a poorer appetite, may be fussy during the day, and wake up frequently at night. Many babies have half a dozen teeth by the time they are a year old, and the others come in fairly rapidly. If your baby has not cut any teeth during the first nine months, he is likely to get several all at once. Along with teething and other developments of growth, sometime during this six-month period your baby will begin to wean himself, to go on three meals a day and to eat coarser 73 New York City’s Baby Book foods. By a year he may be ready to start learning to control his bowels. All these are tremendous changes for a baby to make. Thoughtful care will enable him to go from babyhood to childhood happily and confidently. The baby’s hands grow more skillful all the time. Now he can feed himself nicely with his fingers, dip his spoon in the dish and lick it off even though he may not get much into his mouth. He can also hold his cup and take a few swallows of milk before he spills the rest. He likes to carry something in each hand as he crawls or walks. He loves an audience and reneats his tricks when he gets a laugh. The child’s eating equip- ment should be unbreakable and easy to handle. To encour- age his feeling of independ- ence in taking care of himself, the spoon should be easy to grasp and hold and the dish from which he eats should have a rim to prevent the food from spilling over every time he pushes it to the edge. A chair with a tray, which should also have a rimmed edge, and a foot-rest will help him to sit comfortably. His cup, too, should have a good handle and a smooth edge. It should weigh enough not to tip over easily, and yet should not be so heavy as to be unwieldy. At this age a large oilcloth bib in some gay color protects the baby and makes it unnecessary for his mother to watch every mouth- ful he takes for fear lest it should be spilled. A certain amount of spilling, of course, will take place, until he has learned the right technique. Now the baby chatters a lot and may have learned to say a few words. In any case he sounds as if he were making con- versation, for he is very expressive. He exclaims, questions, pleads, demands. He may have a special grunt or sound that he makes over and over when he wants something, until his mother feels worn out by his continual demands and heartily 74 The Baby: From Nine to Fifteen Months wishes he would learn to talk. He understands a great deal of what is said to him, and his parents are often surprised to find how much he knows. He can follow simple instructions and, as he gains skill with his hands and can move them around, he can go after his ball, look for a toy, pull off his cap and maybe his shoes, hand his mother a spoon or shut a door. He listens and recognizes the sound of approaching footsteps, the telephone ringing, dog barking, the motors of cars and air- planes. He has a passion for climbing steps, pulling himself up by the furniture, exploring, and handling things. He can’t stay very long in any one place and needs a frequent change of toys. He knows what he wants and is very demanding, but he is easily distracted by something new. As the baby begins to feel less helpless and enjoys doing things himself, he naturally becomes more independent. He screams and fights for what he wants and resents being re- stricted in any way. At the same time he seems to be more dependent on his mother in some ways, may want to be near her while he is playing, and often cries when she leaves him. With all these changes in the baby’s abilities and activities, puzzling traits may appear—signs of fear, tantrums, naughti- ness or peculiar habits. Now that he has begun to get around, he finds himself in trouble because he insists on touching and handling things. His parents begin to wonder how they can make their baby mind and how they can teach and discipline him. At this stage patience is of the utmost importance. This is the time to put away the costly vase and floor lamp. The baby can hardly be expected to distinguish between a delicate work of art and an easily replaceable, inexpensive object. Anything within reach arouses his curiosity and he proceeds to investi- gate, For his own sake, as well as the protection of your most valued possessions and your peace of mind, fragile objects should be put away for a time. During this period, lanes of traffic through the rooms should be arranged so that there are no hazardous sharp corners, no floor plugs that can be chewed, no pot handles within reach on the stove, no buckets of water, no ink, or ammonia, or any medical or cleaning equipment left where the baby can get at it. He has not yet learned that these things can get him into very serious trouble. 75 New York City’s Baby Book IMPORTANT NEW LESSONS IN YOUR BABY’S EVERYDAY LIFE A. Eating in a More Grown-up Way Three Meals a Day .—Your baby’s own changing appetite was the best guide as to when he was ready to skip the night feed- ings and eat solid foods. So, too, he will let you know when he is ready to change to three meals a day. This time may come when he is between ten and fifteen months old. If he seems hungry and cries for food at the end of four hours, he still needs more frequent feedings. When he begins to have less appetite for some of his meals, or when he stays awake all morning and wants only one nap a day, he probably needs only three meals. The mother’s convenience plays a part, too, in this change, and if it makes things easier for her to feed him only three times a day, let her try this plan and see how her baby reacts to it. If your infant seems ready to change early, you might try giving him milk when he wakes up, which will probably be around 6 a.m. If he is about a year old, a drink of orange juice may satisfy him. Then he can have the rest of his break- fast—his cereal and fruit—around 8 or 9 o’clock. A little fruit juice and some toast or crackers in mid-morning and mid- afternoon will help him to get used to the long time between meals. It is better not to give him milk between meals as it may decrease his appetite. He should have his lunch around noon. Some babies get hungry by 11:30; others, especially if they take a morning nap, may not be hungry until 1 p.m. Supper may come between 5 and 6, and your baby will prob- ably want his bottle for a nightcap before he goes to sleep. Between nine months and a year, or earlier when he is able to chew, it is a good idea to get your baby used to eating chopped foods instead of strained ones. Even if he has no teeth, he can manage well-cooked bits of vegetables. If you wait till he is more than a year old, it will be harder to get him to change. An excellent way to begin is to put a few whole well-cooked peas or pieces of carrot on his tray. He will enjoy picking them up with his fingers and popping them into his mouth. Mash some of his food fine with a fork instead of straining it, and give him just a little at a time. Gradually mash the food into coarser bits until he is getting small pieces. He 76 The Baby: From Nine to Fifteen Months may eat finely chopped or scraped meat, too, even if he has to use his fingers. As soon as his hands are able to manage a spoon well, he will change to this neater way of feeding him- self. Meanwhile, put a spoon on his tray and let him practice with it at mealtimes. A messy face and floor are indications that he is on his way to growing up. It will take him a while, however, to learn new ways of eating, so give him plenty of time. What to Cook for the Baby's Meals— Plan your family meals so that it is easy to give the baby the food he needs. A GOOD MENU FOR THE WHOLE FAMILY The Family Meal Child from 1 to 2 Years Old Morning Orange Oatmeal with “approved” or evaporated milk Whole wheat or enriched toast Butter or margarine Milk or coffee Vitamin D—1,000 units Orange juice Oatmeal with “approved” or evaporated milk Whole wheat or enriched toast Butter or margarine Milk Noontime Vegetable soup Egg sandwich on whole wheat bread Raw carrot strip Apple Milk to drink Vegetable soup Hard-cooked egg Raw carrot Bread and butter sandwich Baked apple Milk Evening Beef balls with tomato sauce Baked potato String beans Coleslaw Bread and butter or margarine Vanilla pudding with choco- late sauce Small meat ball (no sauce) Baked potato String beans Vanilla pudding Milk 77 New York City’s Baby Book Offer small first servings of food to the young child. Gen- erally a child of this age will eat servings less than half as large as those eaten by adults. If the child wants more, give it to him. The baby may have a mid-morning and mid-afternoon lunch of milk or fruit unless it takes away his appetite for the next meal. When the baby goes on a schedule, a potato may be added if it has not already been given. Some babies gag on potatoes. You might try baking the potato or boiling it with the jacket on; mash fine, add a few grains of salt, fortified margarine or butter, and a little milk. Offer just a taste at a time for several days. If your baby does not like potato at first, you can try it again in a few weeks. The baby may like sweet potato or you may sometimes give him rice, macaroni, spaghetti or noodles, or else more bread. When he gets tired of his cereal, try a different variety or give him toast instead. Nearly all babies like bacon. It has a good flavor but is not a substitute for other meat. Fry the bacon in a pan over a slow fire. Turn it often until it is crisp and a light golden color, then drain on a piece of paper. At first you can crumble it in pieces for the child, but he will soon want to hold half a slice in his hand and feed himself. A good diet for children includes three or four eggs a week, and it is all right to give as many as one or two a day. If your baby doesn’t like eggs, try to include most of one in simple custard puddings, or beat one and add it to the milk. To prepare fish for the baby, bake or boil the fish until it is tender, then mash, making sure that all the bones have been removed. Add a little salt and butter. When your doctor advises you to add meat to the baby’s diet, start with a small amount, say a teaspoonful, of scraped or ground meat, well cooked, and increase it gradually. The meat may be given separately or mixed with mashed potato or vege- table. Liver, lamb and beef are usually the first meats that children get. Chicken may also be given to them, but veal, pork and ham require long cooking and are less digestible. It is there- fore better not to give them to babies. To prepare liver, use a thin slice of fresh beef, lamb, pork or calf’s liver. Heat a small pan, turn the gas low, then put the liver in the pan and sear, turning it constantly. Cook only long enough to change the color. Pork liver should be cooked longer. 78 The Baby: From Nine to Fifteen Months Take it out and grind or cut it up very fine, or scrape with a spoon and mash. Remove the stringy fiber. Feed alone or with mashed potato or vegetable. To prepare scraped beef, buy beef chuck or round or any other cut. Scrape the meat off with a spoon and shape it into a small flat cake. Turn it in a hot pan until seared, or sear the meat first and scrape off into a ball afterwards. Ground beef may also be used. Ask the butcher to grind a piece of chuck or round, or a piece of any lean beef. Shape the meat into patties and cook in a hot pan 2 or 3 minutes, turning the meat often. Use no fat. To prepare lamb, cut a piece of the chop off the bone or cut a small piece from lean lamb. Broil or pan-broil it without using fat until it changes color, then chop or grind very fine. When you have chicken for the family, give the baby a piece of the meat or liver cut fine. He will enjoy chewing on one of the large bones. Make sure it has no splinters or sinews that might hurt him. You can safely keep raw meat 3 or 4 days in the icebox if you freeze it, but never re-freeze it after it has been thawed out. Cooked meat should also be kept cold. Meat broth or soup cooked with vegetables may be given to the baby if the fat is skimmed off, but broth does not take the place of meat. If your baby is satisfied with meat and vegetables for lunch, there is no need to give him dessert. If you do give him dessert, some kind that contains milk, eggs or fruit is best for him. Make desserts for the family that are suitable for the baby, such as custards, plain cornstarch pudding (vanilla, lemon, etc.), bread pudding and rennet. Plain ice cream may occasionally be given to a year-old baby. Raw fruits are good, too. Banana and apple may be given to the baby raw, mashed, scraped or cut into pieces for finger feeding, as may ripe peaches, pears and apricots. Stewed fruits are all right, too, but the syrup from canned fruits is too sweet for babies. If your baby likes fruit, you may give it to him twice a day; let him have orange or other fruit juice between meals and fresh or stewed fruit or more juice for dessert. Your baby may drink between 2 and 3 measuring cups of milk a day, but he can get along perfectly well on less. Milk may be added to his diet by cooking the cereal with milk instead 79 New York City’s Baby Book of water, or serving milk puddings or cheese. Remember that milk is a food and that if a child gets a lot of it with his meals, he will have less room for other foods. Trust Your Baby’s Changing Appetite.—Many kinds of food are good for a baby when he is eating solid foods. So long as he does not eat rich, sweet foods like fancy cookies and cakes or puddings to the exclusion of fruits and vegetables, you can pretty much trust your baby’s appetite in judging how much food he needs. If your baby should take a sudden dislike to spinach, do not mind; he will get just as much nourishment from other vegetables. Perhaps he will eat only peas and carrots for weeks or even months. Or a baby may refuse all vegetables for a while. Then give him lots of fruit to supply him with vitamins and minerals. The most important thing about eating is for your baby to like to eat. If he is one of those rare children who like anything and eat a lot of everything, you need not worry. You need not worry either if your baby has a very par- ticular appetite. It may mean a little more effort on your part to think up new varieties or you may get tired of preparing the same few things every day, but your baby will be just as healthy. If he does not like potato or some other vegetable, do not serve it for a while. Your best mealtime service to your baby is to trust his appe- tite and never force, urge, plead, show your annoyance or try to trick him into eating. Even a young baby soon catches on if his mother seems to be worrying about him. Babies love to get extra attention. If you are casual and cheerful at meals and do not get concerned when your baby isn’t very hungry, he will be free to follow the urges of his appetite. Nearly all food fads disappear in time if the appetite is respected. Your baby may even take a liking to things he refused for a time. When a baby is teething, he may have less appetite, and in hot weather he may eat considerably less than usual. Feeding problems, so called, often begin in this age period. You will save yourself much worry and real trouble later if you trust your baby’s appetite and do not urge him to take what he does not accept readily. If you think he is really eating too little, talk it over with your doctor. B. Now Your Baby Is Ready to Help to Wean Himself Weaning means changing from breast or bottle to cup, from sucking to drinking. Weaning is a very important experience in 80 The Baby: From Nine to Fifteen Months a baby’s life. You will remember that the baby loves to suck in his early months and that he outgrows this need gradually. It is a shock to anybody to have something that means a great deal to him taken away suddenly without any preparation. If your baby’s great satisfaction in his bottle or the breast is snatched away from him suddenly, it may bother him very much. He will let you know when he is ready to give up the breast or bottle. Breast-fed babies are usually ready for weaning when they are about eight or nine months old. Bottle-fed babies may not be quite ready until they are a year or fifteen months old. Some want their bottles till they are two years old. If the baby was born prematurely or has been sick, he usually needs a longer time before weaning. Therefore, watch when your baby is ready to change and help him to make the change gradually and pleasantly. It is better not to start weaning at a time when he is having other changes, such as starting on three meals a day, or moving to a different apartment, or having relatives visit. Give him extra mothering and attention, and see that he has an interesting time the rest of the day. This is the age when your baby is in- creasingly active and wants freedom. Let him crawl about, ex- plore things, have fun with toys, ride in his carriage and play nursery games. If he is having a good time, he will have less occasion to feel unhappy about weaning. If he feels miserable and is left alone to cry, especially at bedtime, he will find it that much harder to give up his beloved bottle. The evening bottle is usually the last one the baby wants to give up, and there is no reason to take it away from him until he is good and ready. Sometimes a little extra cuddling at bedtime will con- sole the baby and help him to feel that his mother still loves him. If your baby has been breast-fed, some time during the last months of his first year you will notice that he becomes less interested in nursing. He does not stay at it long but soon turns his head away, and begins to play or tries to sit up. If he has been getting a sip of milk from a cup since he was five or six months old, he will be used to drinking milk in this way. Now you may offer him milk at all his meals and give him as much as he wants this way. At first you might offer him the breast after the cup. Then begin to omit this offer at the meal in which he is least interested in the breast. In a few days leave 81 New York City’s Baby Book out a second breast feeding each day, and later a third one. The baby may still want the breast when he wakes up in the morn- ing, and take a long time to give up the bedtime nursing. It is best not to rush him but to take it away gradually. Remember that he may want to nurse again, especially if he has had some upset. Your breasts will gradually adjust themselves and secrete less milk. Ordinarily, if the weaning process is slow, the nurs- ing mother does not have to do anything special, such as omit- ting fluids or binding her breasts. If your baby has been bottle-fed, the same directions may be followed whenever he is ready for weaning. This is usually be- tween twelve and eighteen months. Sometimes a baby gets through with his bottle all of a sudden and one day just flings it away and will have nothing more to do with it. In most cases the process is a more gradual one. The baby begins to get bored with his bottle, and may prefer the cup at one or two meals while he still wants the bottle at bedtime. So try to follow his lead. Forcing your baby to hurry and give up the bottle before he is ready will only result in an unnecessary struggle.. It may even start a serious feeding problem and make him unhappy and difficult in other ways. If the baby at first refuses to drink from the cup, it is a good idea to wait a few days and try again. You might put a cup on his tray at each meal and let him take as much as he wants without urging him. If just a small quantity of milk is poured into the cup at one time, he will have the satisfaction of finish- ing it. Then, if he accepts this good-naturedly, the bottle he is least interested in may be omitted, and a few days later a second bottle may be omitted. The weaning may take several weeks. Some time after two years, if not before, the baby usually gives up his last bottle of his own accord. C. Now Your Baby Is Ready to Control His Bowels Just as a baby’s body is ready, when he is about a year old, to learn more grown-up ways of eating, he is getting ready for a more grown-up way of eliminating waste materials. He can really be taught how to control his bowels only when his nerv- ous and muscular systems are mature enough. Urging and hur- rying him will only result in a struggle in which he can beat you. Just as you can lead a horse to water but can’t make him drink, you can lead your baby to the bathroom but can’t make him go unless he is ready to. 82 The Baby: From Nine to Fifteen Months It may seem strange to you, but this important business of learning to control his bowels can be left almost entirely to the baby himself. Like so many other things that parents used to consider it their duty to force on children, grown-up toilet habits are things that children learn when they are old enough. All you can do is to help your child when he is ready. Some- times, if a mother pays no attention to toilet training, the baby between eighteen months and two years old will give her some sign or go to the bathroom himself. A mother may help her baby to learn this a little earlier if she watches for signs of his being ready to go, gives him a little assistance, and does not urge him or get into a fuss about it. If a baby regularly has a bowel movement after a meal, when he is nine or ten months old the mother may try putting him on the toilet and he will probably go. Even if he seems to be pretty well trained for several months, he may change after he is a year old. He may refuse to go, and start soiling his panties again. If he is not regular or does not give his mother any signs by grunting, looking at her or clutching his panties, it is better to wait. Real training in any habit comes when the baby himself takes over the control of the time and place he does a thing. When he is between a year and a year and a half old, a baby becomes more aware of his. bowel movements. He is able to hold back when he has to go or to try hard and push. This is a good time to begin putting him on a toilet. Babies seem to feel most comfortable on a little toilet chair of their own. Success is more likely to result if the baby is put on the toilet for a few minutes after his meal or at any other time that he regularly has a movement. The mother might grunt the way he does, or might make any other sound that he makes, to give him the idea, and at the same time use a regular word or expression to suggest what he should do. The little child may be confused if a word or phrase used for going to the toilet is also used for something else; for instance. 83 New York City’s Baby Book “number 1” and “number 2,” or “duty,” or “try hard.” Find a word that stands only for the toilet and will be suitable when the child begins to talk himself. For example, you might use the regular terms “make a bowel movement” and “urinate,” or “void,” or “go to the toilet,” or “go to the bathroom.” If the baby is ready for a movement, he will have one in about five minutes. It is better to take him off if he begins to fuss earlier than this. Sitting longer is not likely to bring results and may make him dislike the seat. If he has a movement, a little casual praise will show him that his mother is pleased with his new accomplishment. If he sits down but cannot go, he may do it on the floor or in his pants later, when he can relax better. This is the way he has been used to doing it ever since he was born, so he should not be scolded or blamed for it. Sometimes a baby will cry and fight against being put on the seat, and even if his mother succeeds in making him sit down against his will, he will not be able to relax but will simply become more stub- born. It is better to let him do it his own way and wait a few more weeks. Stewed prunes or prune juice given regularly may help if movements are painful. If the child has persistent con- stipation, the doctor should be consulted. It is dangerous to give a baby any patent medicines. Suppositories and enemas should not be used in order to establish regular toilet habits without a doctor’s advice. They do not teach the infant self- control but, on the contrary, may frighten him badly. It is natural for the baby, as he becomes aware of his bowel movements, to become interested in his stools. He wants to look at what he has done, is proud of it, and may try to touch them. This may seem odd and disgusting to you, but it is not to the baby, and you can use this normal interest in helping to train him. One advantage of a small toilet chair is that the baby can look at his stool and empty it into the big toilet himself. If he is given a few moments to look, this may satisfy his curi- osity, and in time, of course, he will outgrow this interest. If he should start to play in the stool, just suggest that he empty it out, and help him to do so. Then clean him up. If he regularly soils himself in bed, his diapers and pants should be pinned securely. Try not to show any disgust, and don’t scold him or make him feel ashamed on any of these occasions. He will out- grow this tendency if you don’t pay too much attention to it, but if he is blamed or punished he will be confused. Unpleas- 84 The Baby: From Nine to Fifteen Months antness between a mother and her child over toilet habits can have a very bad effect on their relationship. It is much wiser to be easygoing and friendly and not to show alarm or displeasure. Children love excitement and attention and soon learn how to get it, whether it be by not eating or by not performing on the toilet. If there is a great deal of scolding and insisting, a baby may get to feel like fighting and saying no to everything. If he gets the idea that his mother is very much displeased with him, he will feel guilty and anxious, for he needs her love. He should not be made to feel ashamed of his natural impulses. It takes time for a baby to learn and he should not be blamed for being unable,to grow up all at once. It may comfort you, when train- ing takes a long time, to remember that children will learn some time after two years of age, if not before. If you have made some mistakes, as all mothers do now and then, you can correct them by patience and understanding. D. Now Your Baby Learns to Stand Up For months you have noticed that your baby’s legs have been getting stronger, that he likes to push against the side of his crib or carriage with his feet, and that he tries to bounce up and down when he sits on your lap. After he sits up steadily alone, he learns to pull himself up to his feet, hanging on to the slate of his play-pen or a piece of furniture or his mother’s skirts. Usually this happens in the last months of the first year. A few wiry babies are ready to stand earlier, and some, especially the heavy ones, make no effort until they are more than a year old. After the baby has learned how to get up, he may not know how to sit down. He may get very tired and cry and need to be helped until he gets the courage to let go and bump down. Next he may try to make stepping movements when you hold him. He will not try to stand or walk until his muscles and bones are ready, so it is no use trying to teach him these tricks. Furthermore, you need not fear that he will get bowlegged. If anything is wrong with his feet, your doctor will tell you what to do. Shoes are not necessary for the baby in the house unless it is very cold or the floors are rough. Sometimes, after the child has learned to pull himself up- right, he will use both hands and stand alone for a few seconds. Most babies pull themselves around by holding on to the furni- ture, and it takes them several weeks or months to learn to walk alone. The baby’s size, rate of growth, heredity, general 85 New York City’s Baby Book liveliness and self-confidence may make a difference in the age at which he will begin to walk. By the time he is about a year old, he will probably enjoy walking around if someone holds one or both of his hands. This is fun for the baby but back- breaking for the mother, and it is not necessary in learning to walk. The average age at which babies take their first steps alone is about fifteen months. A few learn to walk earlier, and it may take a healthy, heavy baby or one who has been sick considerably longer. Around this time, too, babies love to climb steps and will quickly learn, after they have been shown how, to get up and down safely. If you have no stairs in your home, you can make a couple of steps out of boards, or put on overalls or a snow suit and let your baby climb steps outdoors in good weather. This is really exercise; it keeps him busy for a long time and strengthens his leg muscles. E. Playing Is Learning Your busy, active baby learns in two ways: through the steady, oft-repeated experiences of his daily routines, and through his play. From his earliest days he works hard and en- thusiastically at learning about his world. “The greatest edu- cator of all time,” it has been truly said, “will be the person who shows us the way to conduct children through the pre- school years so that this baby eagerness to learn is maintained.” The baby’s eager eyes and fingers explore the shape, size, texture and possibilities of everything he can reach. He finds out many things about the household—how doors and cup- boards close, where things go, that chairs are to sit on and stairs to climb, how covers fit on pans and tops screw on jars, how round things roll or bounce, what practically everything tastes and smells like. At the same time he learns much about what he himself can do and exercises all his muscles. Shoes fascinate him. He likes to pull and tug at his own and some day soon he will learn to take them off himself. One of his father’s or mother’s old shoes, scrubbed up for him, will interest him for weeks as he tries to pull the laces out and put them in. He learns first how to take things out and only later how to put them back. A desk or dresser drawer or low cupboard shelf of his own filled with old magazines, empty boxes and small objects varied from time to time will give him many happy hours. 86 The Baby: From Nine to Fifteen Months Small blocks that he can grasp easily will interest him. When he is a year old or a little older, he may be able to put one on top of another, and he loves to have someone build a tower for him to knock over. He is learning how to let go of things as well as how to hold them, and enjoys a game of throwing things down. He can now roll and even throw a ball. He likes to play with several small objects at the same time and put them in a container. When he crawls or cruises about the house, he gets some idea of distance and direction. He comes to understand the meaning of “under,” “on top of,” “in back of,” “in front of,” “in” and “out,” “here” and “there,” “wall” and “corners,” “in- doors” and “outdoors.” In steadying himself as he learns to walk he likes to push and pull things. A small toy on a string or a box, or a push toy of some kind, is useful at this age. A few extra minutes in the tub to splash or play with little cups will help to train the tiny hands to hold and dip and pour. Although babies at this age do not actually play with other children, they notice them and should have a chance to be with them now and then. They often pat one another’s faces, pinch, pull hair and jabber together as they find out what the other youngster is like. Getting together on the floor, they will grab one another’s toys. Thus they begin to learn how to live with their equals. They are not yet ready to share or to take turns, and one should be careful not to expect too much of them. Outdoors the baby eagerly watches people and cars going by and older children playing, and soon learns to recognize ani- mals, airplanes and other objects. When the baby is able to pull himself up and stand alone, he will enjoy being on his feet near a bench or fence, or climbing steps. In warm weather a trip to the park and a chance to sit on the grass will be fun. WHEN PUZZLING TRAITS DEVELOP A. When the Baby Gets Into Everything When a baby begins to get around, many new problems arise. As long as he “stays put” in his chair or carriage or play-pen, it is easy to select for-him the things he may play1 with and to keep him from getting hurt, or from damaging household ob- jects. But as soon as he can move around by his own efforts, he 87 New York City’s Baby Book is bound to get many falls and bumps, to reach for lamps, vases and books, to pull off the tablecloth, open drawers and try to turn on the stove or water faucets. It is normal for him to be curious and to want to learn about everything, but he needs to be protected from danger and must learn not to touch certain things. It is very puzzling for his parents to know how best to teach him, and it is puzzling for the baby too. Before this his mother gave him only pleasure and satisfaction. Now she be- gins to take away'some of the things he wants, and she may scold him. His mother begins to wonder how to make him mind, whether spanking will help, and how she is to» keep her house halfway tidy without losing her temper. If you say “no-no” to your big baby, he may think it is just a game and smile or laugh at you, and go right on with what he is doing. Naturally he cannot understand why he may not touch some things, though he may sense your disapproval. Will it help to slap his little hands? Well, fear and pain may check him, but they are poor teachers for anyone, baby or grownup. Slapping may give the baby the idea that it is bad to use his hands when he needs to use them to learn how to do things. A better way is to take the forbidden article away from the in- fant or remove him to another spot. Then give him something else to play with. A baby is easily distracted and it is a great help to give him a substitute that you approve of, or to say “do this” instead of “don’t do that.” In other words, redirect the baby’s interest; do not just try to restrain him. Show him what he may do and put the emphasis on that rather than on what he may not do. If he tries to get into a drawer or to climb up on a shelf, provide him with a low drawer or shelf. Then you can say, “This is mother’s drawer, but this is John’s drawer; see, you can open it and play with all these things.” It will take many lessons like this, repeated week after week, and a lot of patience to teach your baby this way. However, it is a much sounder way for him to learn and in the long run is usually more effective than scoldings or spankings. Your baby will be good-natured and rely on your love this way instead of getting confused, resentful and discontented. Besides, many prohibi- tions are unnecessary if we consider the baby’s needs. Even a very young child understands your tone of voice, and if you treat your baby like a reasonable person, you will be delighted to find how reasonable he can be. 88 The Baby: From Nine to Fifteen Months The fewer things you say “no-no” to your baby about, the quicker he will learn the rules. Put your valuable, breakable things out of his reach. Make a tour of your rooms to find the things he should not get hold of. Dresser drawers can be locked or a folded piece of paper or cardboard put in the drawer when it is closed to wedge it shut tight. A gate at the top of the stairs will protect the baby until he has learned to get up and down safely and can be trusted alone. A housewife is bound to find an untidy house a great trial, but it is inevitable with a young baby playing on the floor. Freedom for the child to learn and an easygoing attitude on the mother’s part, so that she can en- joy watching her youngster’s growth, are more important than a spick-and-span appearance. Learning a lesson in his own easy way will be much more effective with a baby than “no-no.” For example, to teach him to stay away from a hot stove or radiator, you might let him touch something that is not hot enough tc burn him but warm enough to be uncom- fortable. Say “hot’: when he touches it, and he will soon associate the word with the pain and will back away cau tiously whenever you say “hot.” The best preparatior for life that you can give your child is tc help him to be inde pendent, to control hh own behavior and gradually to develop a sense of judgment This training starts in infancy, when the baby’s own way of do- ing things, his own inborn wisdom, is respected. Now that he is a year old, he is beginning to be more independent. He wants to do things himself, such as feeding himself and trying 89 New York City’s Baby Book to pull off shoes. He has his own ideas of what he likes to eat, what he wants to play with and where he wants to go. He is likely to make a big fuss and clamor to assert himself, and to get angry if you do not give him what he wants. These are not bad traits in your baby; they are healthy, normal, useful parts of his growing up. He will learn best, when you avail yourself of his cooperation and his eagerness to do things. Wise parents seldom resort to sharp methods of discipline. They understand that the growing child needs different kinds of help at different ages. They neither expect more of him than he can do nor hold him back when he is ready to try something new for him- self. B. If Your Baby Shows Temper It must be very annoying to a baby when he cannot reach something attractive that he sees, or when a book or pretty dish that he has found is taken away from him. Often a little child gets angry when he does not know how to do something; maybe he can’t get his foot out when it is caught in a chair, or can’t get his toy out of a corner, or get the cover off a box. Then he naturally feels frustrated and may cry and kick. If he is in no danger, let him try to figure it out himself, and just ignore his temper for a little while. If he wants your help, he will yell for it or turn to you, and then you can show him how to do it. If a baby is restrained, he is going to feel angry too. Being taken out of his bath when he is having fun splash- ing may get him into a real temper so that he will fight and scream and throw himself around. Try giving him a word of warning a few minutes in advance. Then, if you calmly ignore the first signs of temper, he is more likely to get over it by himself. Sometimes you may take things away too quickly or may not have allowed him enough time to know what you want. You can avoid getting his temper up by giving in a little to his wishes; for example, by letting him have a few minutes longer to play in the tub or by suggesting something different to play with. If the mother speaks crossly to him and yells and slaps him, he will feel cross too and may soon imitate her and yell angrily. If the baby gets help when he needs it and is not given too many “noes,” his rage will last only a minute and in general he will be a good-natured, sunny child. 90 The Baby: From Nine to Fifteen Months C. If Your Baby Has Trouble Sleeping Most babies between nine and eighteen months begin at some time during this period to have difficulty in getting to sleep or else begin to wake up during the night. It is as if they had to learn a new way of settling down to sleep. Some- times it seems as if they dreamt at night, for they suddenly wake up crying, perhaps a number of times a night. Many babies who happily went to sleep by themselves before, now cry for their mothers at bedtime. Our long-range job is to help our children to learn to go to sleep quietly by themselves soon after they are put to bed. Babies have many ups and downs as they grow. We must expect changes from time to time and deal with them as wisely as possible. See that your child does not get too excited playing before he goes to bed. It may help to check over his clothing and covers to be sure he is comfortable. If he does not settle down after fifteen or twenty minutes and cries hard, it is best to go to him and comfort him. Sometimes just seeing the mother or hearing her voice will reassure the baby; or leaving the door open or a light on will help. If this doesn’t satisfy him, the mother may need to sit quietly beside him until he falls asleep. She need not be afraid she is spoiling her baby by this attention. When he feels lonely, restless or frightened, he should be comforted. If your baby is teething, he may wake up. This, too, is a time when he needs to be soothed. Sometimes a few minutes of mothering will quiet him. Often only a drink of water or milk will induce sleep. This is not likely to start a habit, for when the discomfort is gone, the baby will sleep through the night again. Frequently, when babies are old enough to walk, they learn to climb out of their cribs. They may wake up dur- ing the night, climb out and try to find their parents. A child should never be tied in his bed nor locked in the bedroom in an effort to solve the problem. Instead, his parents should be patient and try to find out why he keeps on getting up. Sometimes he just wants to practice his new accomplishment and will be better satisfied if he is allowed to climb in and out as often as he likes during the day or before it is time for him to go to sleep. Perhaps, since the child needs less sleep as he grows older, he will fall asleep more easily if he is per- mitted to stay up half an hour later. Or a child may be rest- less at night after the family has moved to a new house or the 91 New York City’s Baby Book bed or room has been changed. In such cases it is best for the mother to go in to the child and give him extra comfort- ing and reassurance until he gets used to the new place. D. If Your Baby Is Afraid You will remember that your little baby Avas easily fright- ened by unfamiliar loud noises and sudden movements. Your big baby may be scared by the same sort of thing. Maybe the strange noise of the vacuum cleaner terrifies him, or the sound of running water in the bathtub or of the toilet flushing, or he may seem afraid of his bath because he has been loAvered into it so quickly that he fears he is being dropped. It will help your baby to overcome his fears if you comfort and re- assure him as soon as you notice any fear reactions. If you can find out the cause, it is wise to help him to become familiar with the thing that frightened him and let him see for him- self how harmless it is. If a child’s cry of terror is ignored and he is left alone, he may feel frightened and may become anxious and timid about many things. When they are about a year old, many little children be- come shy and fearful of strangers. First visits to the barber or to a doctor he has not seen before can be terrifying to a young- ster. It is important to tell the baby about the visit beforehand and to talk to him about what is happening. The mother’s presence and voice will reassure him. If a child wakes up frightened by a whistle or fire engine, the mother might imi- tate it humorously, talk to him about it and comfort him until he falls asleep again. While some fears are natural for little children, wise handling of the first expressions of timidity and fright will help the child to feel more secure in time. Remember, too, that babies learn some of their fears from those around them. Too often, when a child falls, his mother screams before she knows whether he is hurt. Sometimes the sudden excitement of adults over the fall is more frightening to the baby than the fall itself. At other times babies seem to sense the fact that adults are afraid and to “catch” the same fear themselves. E. If Your Baby Plays with His Genitals Some day in his bath or on the toilet, or while you are dressing him, you may notice your baby fingering his sex or- 92 The Baby: From Nine to Fifteen Months gans just as he explores his toes and his tummy. It is natural for a baby to want to touch things and he may seem to enjoy touching himself. If the mother will just pay no attention and go on with the bath or whatever else she is doing, the child will soon get interested in something else. If he is scolded, slapped or punished, he will be confused and may get an un- healthy idea that his natural impulses are bad. Children learn privacy, decency and modesty best from their parents’ example as they grow. They slowly lose their original baby interest in the different parts of the body. Little babies often play with their genitals, sometimes about the period of weaning, and so do older children. If the baby is cared for intelligently, this habit will soon be forgotten and disappear of itself. F. If Your Baby Continues to Suck His Thumb Some mothers become worried when their babies keep on sucking their thumbs. Remember that in the little baby (see page 66) this is quite common. If he has had plenty of chance to suck at his mother’s breast or at the bottle, he often stops most of his thumb-sucking when he is about a year old. If he continues after that age, it is probably because he is trying to comfort himself. This is usually the case when he is tired or trying to get to sleep. He may not be feeling just right or perhaps hasn’t enough else to interest him. Babies, like grown- ups, have bad days when things go wrong. If your baby pops his thumb into his mouth once in a while for a few minutes, it is nothing to be concerned about. If he does it often, you might try to think over his day and ask yourself what you can do to make him feel more satisfied. Has he interesting toys? Is he outdoors enough? Does he get a chance to play with other children his own age? Is he being told “no” too much? Is he getting a fair amount of mothering? If there is a new baby in the family, the older one needs more loving instead of less. Maybe your baby will be happier if you make a few changes in his life and comfort him more. Trying to restrain his arm, or punishing him for sucking his thumb, will not help the year-old baby any more than it did the little one. With sym- pathetic understanding and a happy life, he will probably give up the habit in time. 93 Chapter V THE TODDLER: FROM FIFTEEN MONTHS TO TWO YEARS 1. THE BABY’S GROWTH IN INDEPENDENCE A. Walking, Climbing, Running Now your baby is at the toddling age. Week by week he is learning to walk more steadily. His most absorbing occupation is running about. Indoors and out he is almost constantly on the go. His energy is amazing and the grownups may feel tired just watching him. He is likely to move furniture and may pull a chair down on himself or tip over a table in his effort to get hold of something he wants. He climbs like a little monkey and needs to be watched if the window sills are low or if there are breakable or dangerous things on the table. He likes to push and pull and empty everything, even waste baskets and garbage cans. He delights in carrying things from place to place and holding something in each hand. So strong is his urge to stand and move about that at mealtimes he may prefer to eat standing rather than sitting and may want to run around between courses. Outdoors, when he is just learning to walk, he may cling to his mother’s hand even though he refuses it while indoors. But soon he will want to be off on his own. He explores all the bypaths, runs into doorways, climbs steps, darts into the street. He loves a game of being chased or running after some- one. He practices all kinds of movements—stopping, starting, squatting, leaning down to look between his legs, walking back- wards and sidewards, turning around, running. He would rather push his carriage than ride in it, although he may enjoy a ride when he is told where he is going. If his mother has errands to do and her time is limited, she should put him in his carriage rather than try to hurry him or urge him to walk in a straight line. He finds so much to investigate that it may take him an hour to walk a block or two. It is only too easy for a mother to start a never-ending “hurry up, hurry up” that doesn’t really help. The child may come more willingly if 94 The Toddler: From Fifteen Months to Two Years some goal is suggested—to call on a playmate, to get supper or to fetch a toy., A small harness with reins will help to keep the toddler in tow in the stores or on busy streets. He is hap- piest when he can keep moving, and is not likely to let his mother sit undisturbed for long. B. New Skills with His Hands Although the baby’s chief development is in the larger muscles for walking, pulling and pushing, his fingers also get more skillful all the time. He can hand his mother a dish at the end of his meal, mop up a puddle, shut a drawer and per- haps turn a doorknob. He learns to take off his clothes, be- ginning with cap, mittens and shoes. By the time he is two years old, he may be able to open cabinet doors, turn on the radio, take things out of drawers, build a tower of three or four blocks or line them up in a row, string large beads and blow soap bubbles from a pipe. A sandbox or small pan of water will keep him busy for long periods as he empties and fills dishes and boxes. C. Expressing Himself and Talking A year-old baby may have learned to say a few simple words. By the time he is two years old, he may have learned anywhere from a dozen to several hundred words and may be able to speak short sentences. But many perfectly normal children of that age cannot say any words clearly. Slowness in learning to talk, however, does not mean that a baby is backward. Whether he uses words or not, your child will express himself more and more clearly as he grows. He may grunt or make a clucking sound to ask for particular things, and may point and gesture to make his meaning plain. He will give many greetings and will wave bye-bye many times a day. He will talk a lot of jargon that will often sound as if he were carrying on a conversation. He will play with sounds and may hum or singsong to himself while learning words. Just as talking sensibly to a baby from the very start helps him to understand language, so conversation, simple explana- tions and many repetitions will help a toddler to learn words. Long before he can say them, a baby knows the names of toys, articles of clothing, the parts of his body, household objects and things he sees outdoors. He will go after or point to things 95 New York City’s Baby Book when asked. Often he will make a questioning sound as he points and will be satisfied only when the name is repeated to him over and over again. The frequent repetition of sounds enables him to tell them apart. Sometimes he asks in order, to make sure that the word he is thinking'of is the right one, or he may ask just to make conversation. By saying “You tell me’’ you may satisfy him occasionally. Simple picture books containing pictures of real things that are seen every day play a valuable part in teaching him to recognize and name objects. He learns by doing things over and over. It will be a help to your baby, in learning to speak cor- rectly and in preventing conditions like lisping, if he does not hear any baby talk from you. Speak to him as you do to adults. He will learn to say words correctly by his own efforts as his ears and tongue become more skillful. Consequently, it is not necessary to correct his pronunciation all the time. If you call attention to a lisp or make fun of his mistakes, you will only confuse him and make him self-conscious. 2. MORE GROWN-UP ROUTINES FOR THE DAY A. Meals Now your baby can walk to his meals and climb into a chair himself. He may try to drape his bib around his neck, and pulling it off at the end of the meal is often a sign that he is through. He can handle his cup and spoon pretty well and should be allowed and encouraged to feed himself most of the time, although he may need a little help in finishing a meal. He will eat better if his mother does not pay much attention to him after she has served him, and he may even tell her to go away. He should get only one dish at a time until he has finished. During this age period the baby gains weight less rapidly and eats less than formerly. His appetite often varies from one meal to the next. Many a mother worries because her baby seems to eat too little. Regular examinations by a doctor will decide whether there is any physical cause for what you think is a small appetite. If your child is generally in good condi- tion, you can trust his appetite as to how much food he needs. Do not urge him to eat the last spoonful in the dish when he is already satisfied. Serve a little less next time and give him 96 The Toddler: From Fifteen Months to Two Years a second helping when he is hungry. A mother can help to improve her child’s appetite by making mealtimes pleasant, by not scolding, urging or nagging when the baby is not so hungry as she would like him to be. Most grownups expect children to eat a great deal more than they are able to. Be- cause the adult standards are wrong, parents begin to worry and concentrate on how much the child eats rather than how much he enjoys his food. As long as children are offered a wholesome variety of vegetables, fruits, eggs, meat and milk, they can usually be trusted to take what they need. A healthy child will not starve himself. Nearly all youngsters get sudden likes and dislikes for cer- tain foods. Vegetables may be skipped occasionally without any harm if other food is taken. If the dessert is wholesome and the child insists on eating it first some days, there is no reason why he should not be allowed to have an ordinary portion and eat the other foods later. If the baby goes on a jag and wants only certain things, such as eggs, cheese or some par- ticular fruit, it will not hurt to give him as much as he wants, except that sweets should never be given. Many children de- velop very peculiar ideas about eating. Some refuse all cooked foods, mushy foods or foods of a certain color. If the child is let alone, most of these fancies pass away. If he has not learned to eat coarsely divided foods by the time he is a year old, it may take him many months to learn, and the change will need to be made gradually. In case your baby gets some odd food fancies or refuses to eat well, some of the following suggestions may help. First, a few don’ts: Don’t fuss, don’t force or scold or nag the child for not eating well. Try to make mealtimes more fun for him. Serve his favorite foods often. Give him small portions so that he will be likely to ask for more rather than to refuse part of the dish. If he refuses the first dish on the menu, take it away after a few minutes and offer him the rest of the meal. Try new ways of fixing foods, and serve them attractively. A different cup, a colored dish, a pretty oilcloth place mat for his table, may please your child. When he is about two, or as soon as he is able to do so, let him set his own table. Invite him to get his food out of the icebox. He will have fun scrub- bing his potato and putting it in the oven. Ask someone else to give him a meal once in a while, and arrange for him to 97 New York City’s Baby Book eat with other children occasionally. If your child drinks too much milk at meals, try giving him less and he may have more room for the rest of his meal. Let him have a reasonable time to finish his meal. After about twenty minutes of not eating but only playing with his food, quietly take it away with some friendly remark like “All finished?” or “I guess you’re not very hungry today.” Then try giving him nothing to eat between meals, but if he should get very hungry, you might give him his next regular meal a little early. Sometimes a child with a small appetite eats better with four small meals a day than with three large ones. If your child eats fairly well and wants something between meals, fruit juice, a piece of apple or raw carrot, a small cracker or piece of toast will satisfy him and not be so like- ly to affect his appetite for the next meal as candy or other sweets. Many dentists are of the opinion that candy should not be given to children, espe- cially little ones who cannot brush their teeth. Mothers of- ten find that once their chil- dren have started eating candy, they like it so much that they cry and tease for it much of the time. Wise mothers have decided that it is better not to give candy to their babies except on special occasions. A good diet for the child fifteen months of age to two years and more includes some of each of the following groups of foods: (1) milk, oranges, grapefruit, tomatoes; (2) leafy green or yellow vegetables; (3) potatoes and other vegetables and fruits; (4) meat, fish, poultry and eggs; (5) bread and cereals; (6) margarine or butter. The amount of each that your baby will eat is going to depend on his tastes and appetite, but the list may be of some use to you in checking on the kinds you are offering your baby and may suggest some new things. These are the same foods that are needed by the other members of the family. Plan your family meals so that it is easy to give your baby the right food. 98 The Toddler: From Fifteen Months to Two Years For the Family A GOOD MENU FOR ALL THE FAMILY For the Child Morning Grapefruit Juice Wholewheat cereal with Milk or Evaporated Milk Wholewheat or enriched toast Margarine or Butter Milk Coffee Grapefruit Juice Wholewheat cereal with Milk Wholewheat or enriched toast Margarine or Butter Milk Noon Scrambled Eggs Raw Vegetable Salad Bread and Margarine or Butter Fruit Cup Milk Scrambled Eggs Leaves of lettuce, spinach or escarole Bread and Margarine or Butter Fruit Cup Milk Meat Loaf with Gravy Boiled Potato Carrots Bread and Margarine or Butter Apple Pie Beverage Evening Meat Loaf Boiled Potato Carrots Bread and Margarine or Butter Apple Sauce Milk B. Baths and Clothes The runabout baby needs a bath at the end of the day. The tub bath may be given either before or after supper. Some babies are more wide-awake after a bath, while others are relaxed and go to sleep more quickly if the bath comes at bed- time. Try both ways to find out which suits your baby and your convenience better. Your baby will play with the washcloth and soap and may try to suck or eat them. Soon he will try to wash himself and help to clean out the tub. A small cup and spoon, clothespins or toys that float will be fun and he will enjoy playing in the water ten or fifteen minutes after being washed. Sometimes a child will take a sudden dislike to the bath or be afraid of it. Iq such cases it is better not to use force but to give the baby a sponge bath for a few days. Try to figure out what made him 99 New York City’s Baby Book afraid. Then try the tub bath again and offer the child a new cup or toy or soap bubble pipe to get him interested in play- ing in the water. Ordinarily a healthy baby’s teeth need no special care before he is two years old, when semiannual visits to the dentist should begin, not for special care, but to get the baby used to the dentist. A diet that gives him an opportunity to chew on hard foods like toast, raw vegetables such as carrots and celery, and coarsely divided foods, is good for the baby’s teeth. Should a greenish film or black spots develop, wash the teeth with a clean cloth and a little baking soda. When the child is about two years old and begins to imitate everything the grownups do, he will want to brush his own teeth and may then be given a little brush of his own. Children at this age begin to take part in dressing themselves, but your toddler may be so active that you have a hard time holding him still long enough to dress him. A small toy may keep him quiet while you put on his socks and shoes. Overalls, both indoors and out, will help to protect little legs from scratches and bruises. In hot weather, cotton suits or dresses and sun suits will keep the toddler comfortable. When the baby begins to walk, he needs shoes with firm soles. The sole of the shoe should be shaped like the baby’s foot, with a straight line on the inside, and without heels. The shoe should fit snugly at the heel but have roomy toes that are long enough, wide enough and high enough so that they will not rub or crowd the toes. Check the fit of your baby’s shoes often and carefully. New shoes should be about half an inch longer than his feet and at least a quarter of an inch wider at the sides. When you take the shoes off at night, examine the child’s feet to see whether there are any red or rough spots where the shoe has rubbed. Most youngsters outgrow their shoes in about three months, before the shoes are worn out. Buying a pair of shoes every two or three months is expensive, but is necessary to keep the baby’s grow- ing feet in good condition. Only your doctor can advise you whether the baby needs corrective shoes. Many healthy chil- dren look a little bowlegged or pigeon- toed. If these conditions are within nor- mal limits, they will disappear as the child gets older. 100 The Toddler: From Fifteen Months to Two Years C. Naps and Bedtime A midday nap is still needed and is usually welcomed by the toddler, for he works so hard running and playing. A long afternoon nap may cut down the amount of sleep at night; a short one will mean an earlier bedtime. Fussy children are often tired without knowing it themselves. They will be rested by looking at pictures or playing with something while they are stretched out on a rug or are sitting down. If your baby cannot get to sleep at nap time, a quiet rest alone in his crib playing with toys will refresh him. A daytime nap or rest time is a good routine to continue until your child is ready for school. Sleep disturbances frequently develop in the second year. Even a baby who has been accustomed to go to sleep by him- self in a darkened room with the door closed may now demand attention at night. This period can be very trying for the parents, and it may be a comfort to know that many children go through this stage and eventually learn to go to sleep by themselves. The baby must talk to himself or play in his crib for about an hour before he falls asleep, or he may call his mother and want her to sit beside him or sing to him. If the child is talking, he may ask for a drink or a handkerchief or want to go to the toilet. After you have tried leaving him alone for fifteen minutes or so to give him a chance to settle down by himself, do not hesitate to go to your baby and give him a little extra mothering if he cries hard. Sometimes delaying his bedtime half an hour, reading or singing to him before he goes to bed, or giving him a favorite toy to take to bed with him, will help. In other cases the baby will get to sleep more quickly if his father or some other member of the family puts him to bed. If your baby still wants a bottle at bedtime, it is wise to give it to him willingly. It is no disgrace for a two- year-old to want his bottle. , 3. NOW YOUR BABY BEGINS TO LEARN TO CONTROL HIS BLADDER When your baby is about fifteen months of age, he will begin to control his bowels and make his bowel movements when he is seated on the toilet. After that he is ready to control his urine. A baby does this naturally when his bladder develops 101 New York City’s Baby Book enough to hold the urine for a considerable length of time and when he is able to take responsibility for controlling him- self. He usually begins to keep dry during the day. This change occurs in the latter part of his second year, so his mother does not have to do much “training” until he is ready for this step. Some time after your baby is able to walk steadily, around fifteen or eighteen months, you will find him dry at the end of an hour and a half or two hours, whether he has been play- ing outdoors or having a nap. This is a sign that his bladder is now large enough to cooperate. If you put him on the toilet, he will naturally want to go, and if you praise him a little when he succeeds, he may soon get the idea. If he fusses or refuses to go after a day or two, he may not be quite ready to control himself. In such cases it is a good idea to wait a while longer. In any event you will find the baby dry only occasion- ally in the beginning. It will take him-some time to learn. If he cries and you insist, he may get stubborn about the whole idea, and the training may take that much longer. At first the child does not know when he has to go and therefore cannot tell his mother in advance. Later he may pull at his pants or use some gesture or expression after he has wet his pants or made a puddle. The mother should not feel that he is naughty or uncooperative when this happens. When a baby is aware that he is wet, he has made real progress. Mean- while, he will enjoy mopping up the puddle and may learn to bring a cloth and put it away afterwards. If he is scolded or a fuss is made about a puddle, he will quickly learn to get unnecessary attention this way. It is better to help him to clean it up, to praise him when he succeeds on the toilet, and to ignore accidents; or the mother might tell her baby calmly that soon he will be big enough to wait until he gets to the bathroom. By the time he is two years old, the child will probably be able to hold his urine until he gets on the toilet, to tell his mother that he has to go, or to walk to the bathroom himself. Not infrequently he may seem to learn this lesson for a while and then forget it. Accidents will happen long after the child has learned how to keep dry, especially when he is busy playing or gets excited. A little child cannot be expected to remember and tell his mother every time. Until he is at least three or four years old, the mother should do his remembering for him, 102 The Toddler: From Fifteen Months to Two Years and should either ask him whether he has to go or just lead him to the bathroom at fairly regular intervals. In time the child will be quite accurate in answering whether he needs to go, but often the mother’s question will suggest it and a few minutes later he will feel the impulse. Sometimes little children get so used to one toilet that they find it impossible to use a strange one. For this reason it is a good idea occasionally to help the child to use the big toilet instead of putting him on his small seat. Learning to control himself at night is something new and different from training during the day. This usually occurs only after daytime accidents no longer happen. Occasionally a baby will stay dry all night at an early age, but night wetting generally continues until the second year or later. The mother may be able to help the baby to learn control by removing his diapers and putting on training pants at nap-time, and by tell- ing him that he is now big enough to keep his bed dry. She should give him a gentle word of praise when he succeeds. If your child is not ready for this step yet, merely assure him that he will soon be old enough and put it off a few more weeks. After he learns to keep his bed dry during his nap, the same method may be tried at night. It may help to pick the baby up sometime during the evening and take him to the bath- room. As he grows, he will be able to control himself for longer periods at night. Some children may be upset by being wakened to urinate and may have difficulty in getting back to sleep. In such cases it is better not to disturb them. Some children will awaken by themselves and say they want to uri- nate, Study your own particular child and see what method helps him best to learn self-control. Scoldings and punishment are of no value in teaching babies to control their bladder or bowels. They merely confuse and upset the child and make it harder for him to grow up. A struggle over the toilet is likely to make him fight against the idea and become stubborn and cross. We do not expect babies to be able to dress themselves before they are two years old because their tiny fingers! have not yet developed the necessary skill. We cannot expect them to learn toilet habits completely much before the age of two either, because they just aren’t old enough. Some children are ready to be taught these habits sooner than others. If the neighbor’s baby is dry months before 103 New York City’s Baby Book yours, remember no two children are exactly alike, and it does not mean that her child is more intelligent than yours. Whenever the toddler is sick or upset by some new experi- ence, such as moving to a different apartment, going on a trip or getting a new baby brother or sister, he may show that he is disturbed by suddenly losing all the toilet control he has learned. Then the mother will find it best to be understanding and to wait a few weeks before expecting him to be able to restrain himself. 4. NEW LESSONS IN BEHAVING The two-year-old toddler is no longer a baby, but he is still a very young child, immature in many ways. At times he ap- pears to be quite grown-up because he understands so much and has learned to do so many new things. However, he still has a great deal to learn and we should not expect too much of him at first. A healthy, active, curious, tireless, into-every- thing youngster can wear his mother out before the day is over, and she may find it very hard to keep calm and patient. Taking care of the toddler is more difficult and puzzling in some ways than taking care of the little baby, but also more interesting. We must try to understand our children if we wish to guide them wisely and enjoy their liveliness, their eagerness to learn and their wonderful enthusiasm. A. Fitting into Family Life As the toddler runs about, explores things and watches other people, he learns a lot about his family and the way the house- hold runs. The busy mother may often wish she could shut him in a playroom or in a fenced-in yard until she gets her work done. Some children, to be sure, are willing to play in a room by themselves for a while, but most of them want to be with the rest of the family and to take part in what is going on. They long to do things and to be a part of the activities around them. This is their way of practicing for grown-up life. It is more important at this stage for children to be happy, lively, eager to learn and self-reliant than it is for their mothers to have time to keep the house spotless or to enjoy activities outside the home. With patience and imagination in thinking up ways for her baby to join the family in doing things, a 104 The Toddler: From Fifteen Months to Two Years mother can provide many happy hours for her little child and at the same time help him to learn many useful things. The household jobs that grownups find tiresome seem won- derful to a little child. He likes to help with the dusting and sweeping, to carry clothes to the washtub, to get his father’s slippers or pipe for him, to put the mail on the table. He notices where things are kept, will put the groceries in the right place, get his oranges or bottle of fish liver oil out of the icebox, help to clear or set the table, and pass ash trays. At first he is better at pulling things down, such as the towels in the bathroom, or at emptying things out, than he is at put- ting them back. He needs a great deal of practice before he can hang up his coat and cap, but if his mother sees to it that there are low hooks, or that there is a low drawer he can easily open, and goes with him regularly to get or to put away his things, he will begin to be neat and orderly. The little child’s eagerness to help will take much more of his mother’s time than if she worked alone, but allowing him to help for a few minutes will often satisfy him and will make him a willing partner later, when he has regular chores to do. The baby at this age is so active and curious that his mother has to be constantly on guard to protect him from danger. She must keep out of his reach anything made of glass that he might break, as well as knives, scissors, needles and war trophies. Medicines, poisons, cleaning materials and sharp tools should be kept in locked cupboards or on high shelves that he cannot reach. If he is left alone to play in his room, the electric outlets within his reach should be covered with adhes- ive tape in order that there may be no danger of his inserting some metal object and getting a shock. Windows should have bars, and screens should be securely fastened, so that if he should climb on the window sill, he cannot fall out. A young child can climb from toilet to washbowl and get into the medicine cabinet, or pull open drawers to stand on and wreck his mother’s powders and creams. Little by little the baby can be taught to be careful and not to touch things that belong to other members of the family, but until he is considerably older, it is his mother’s duty to think for him and prevent accidents. When he is about a year and a half old, a baby begins to imitate other children and also his elders. He wants to do 105 New York City’s Baby Book things the way grownups do. This desire to imitate others spurs him on to learn to go to the bathroom, brush his teeth, wash his hands, hang up his clothes, put his toys away and dress and undress himself. The child can learn good manners in the same way, through watching and imitating. If he hears adults say “please” and “thank you” to one another and to him, he will learn these words along with others he picks up. Similarly, he will try to imitate his parents’ table manners as soon as he is old enough. In the same natural, easy way a child learns from his family habits of cheerfulness, willingness, helpfulness, satisfaction in performing tasks well, courtesy and kindness. Of course, a child of two has not lived long enough to learn all these grown-up habits, but he starts to learn them bit by bit and his family is often surprised to see how much he has noticed and imitated of his own accord. During this period a baby is likely to become especially fond of his father, to want him to play with him when he comes home, to follow him around the house and to hang on his arm. A walk with Daddy is a special treat. If he is handy at fixing things, the youngster will enjoy watching him, handing him tools and being allowed to do what he does. Children of any age need a father (or someone to act like a father) to love and to love them. The little boy begins to imitate and pattern himself after his father and may copy his gestures. In a wordless way he learns from his father how a man behaves. A little girl wants a father to love, and it is from him that she gets her first impressions of how strong men are and how they take care of their families. A child learns to love both his father and his mother without preferring one parent to the other. If the father is away from home, the wise mother will seek every opportunity for her child to enjoy the companionship of men. A grandfather, uncle or family friends may be invited to visit or asked to take the child for walks. An older boy may be found to take care of the child at times. The mother’s deal- ings with the grocer, mailman and delivery boy and her chats with the neighbors will give the child friendly acquaintance- ship with men. While the father is away, the mother can help to keep the baby from forgetting him by talking about him, saying good night to his picture, showing the child the father’s clothes, keeping some of his things around, reading messages 106 The Toddler: From Fifteen Months to Two Years in his letters aloud, allowing the child to open packages from Daddy, and talking about the things they will do together when he comes back. Even an absent father should be an im- portant part of family life for the baby. Everything the mother does is important and interesting to her baby. He wants to be near her most of the time and to take part in what she is doing. While he grows more indepen- dent about doing things himself and may try to run away out- doors, he needs to know that his mother is near; him and that he can always count on her to give him a great deal of her attention. If the mother has a relative, friend or housekeeper with whom she sometimes leaves her child, or if she decides to take him to a nursery or has to leave him for a few days or a longer period, she should make every effort to get the child used to her absence gradually. He will be more willing to stay with others if he has had a chance to get acquainted with them while his mother was present. If she begins by staying away only a short time at first, say half an hour, the child is less likely to be frightened and unhappy without her. In this, as in other situations, it is wise to tell little children what to expect and not to slip away when they are not looking. Telling the youngster where his mother is going, that she will be back soon, or in time for dinner, or after his nap, will often recon- cile him to her departure. If the child during his babyhood has felt secure and loved, has learned to trust adults, has been held and played with and occasionally bathed and fed by other people, he is not likely to be bothered by his mother’s absence. It is good for him to learn to be separated from his mother at times. But a sudden separation that takes him by surprise may be a great shock to a little child and should be avoided whenever possible. If someone else takes care of your child for you, it is impor- tant to get a person who has in general the same ideas you have about handling children, or who is willing to learn your ways. It is very important that the person you engage be a healthy, happy person. If she is not willing to submit to a medical examination, including a chest X-ray, do not hire her. It is your responsibility to safeguard your child’s health. When a baby brother or sister arrives in the family, it is normal for the older child to feel jealous. Up to that time he 107 New York City’s Baby Book has been the center of the home. He has received all the love and attention of his parents and visitors. Suddenly he has to take second place, or at least to share other people’s attention with the new baby. He will need to become accustomed to this state of affairs and not feel hurt or resentful. When par- ents understand this, they can do much to help an older child to feel that he is loved as much as ever and to teach him to accept his little brother or sister. All children feel some jealousy of the new baby but some show it more than others. If the older child tries to hurt the 108 The Toddler: From Fifteen Months to Two Years infant, everyone realizes he is jealous. But children at times show their jealousy in less direct ways. One child may politely suggest that his mother “take the baby back to the hospital now.” Or he may want to be treated the same way the baby is, to be fed from a bottle, held and carried' like the baby. He may start soiling and wetting himself again even though he was well trained before. Sometimes a child who is suffering from jealousy loses his appetite, cries a great deal, hangs on to his mother all the time or loses interest in playing as he did before. His anxiety, in some cases, may show itself in fits of temper. The trouble with the jealous child is that he feels he isn’t loved. The best way his parents can help him to overcome this feeling is to give him more love, to show him that he is as important to them as the new baby. When the mother comes home from the hospital, the family should arrange to let the older child first have the fun of having his mother back and having her all to himself for a little while before he sees the new baby. When the father comes home from work, let him spend some time playing with his big baby before he rushes in to see the new one. If visitors bring presents to the new- comer, it is a good idea for the mother to have some ten-cent store presents on hand to give the older child so he won’t feel neglected. The father and mother should try not to talk to or about the new baby all the time. It is a very good idea to tell the older child in advance about the new baby who is coming, even if he is under two years of age. A few weeks ahead of time, try to explain things in a way that he can understand. If changes are to be made in the child’s routine, make them beforehand too. If he is to sleep in a different bed or in a different room, is to be taken care of by some strange person while his mother is in the hospital, or is to go to a nursery school, try to get him thoroughly used to the new situation before his baby brother or sister arrives. Show your older child you love him in ways he will under- stand. Set aside some time during the day when you pay at- tention to him only; read or play with him. If he wants to be treated like a baby, treat him that way for a while; tell him he is your baby too, and he will get over this phase more quickly. At the same time help him to take pride in being different from the baby; admire him for all the things he can 109 New York City’s Baby Book do that the baby can not. Above all, do not try to shame him, to scold, threaten or punish him for being jealous. Be patient and affectionate with him. Eventually your love will help him to conquer his jealousy. Later the two children will learn to play together, to share things and have fun with each other. Learning to get along with his brothers and sisters is an aid in helping the child to get along with other people and is one of the invaluable lessons of family life. B. Learning from Playmates and Playthings Sometimes at the age of two, but oftener when they are nearly three, little children begin to enjoy playing with others of their own age. They learn from one another even when they do not actually play together very much and even though they sometimes hit and scratch, pinch, and pull one another’s hair. Laughing together, chasing and pushing one another, snatching toys are all ways of getting acquainted. Such young children are naturally very possessive about their toys. They cling tena- ciously to their belongings, and having a thing in your own hands means that it belongs to you. “It’s mine” is one of their favorite utterances, and “my” and “mine” are perhaps the most important words in their vocabularies. Mothers can help by having duplicate toys available when several children play together, by letting children settle their own difficulties as much as possible, by keeping a watch- ful but apparently casual eye on them to prevent any real hurts. Little tussles, bumps and scratches are a necessary part of group living at first. Children are not born pre- pared to share, take turns, be unselfish or give up cherished belongings. They need to have their strong possessive feelings respected by the adults in charge of them before their gener- osity can become real. Children need careful supervision with a minimum amount of interference so that they may feel safe, contented and yet in charge of their own affairs. Under such conditions they play most happily and learn most from one 110 The Toddler: From Fifteen Months to Two Years another. Constant nagging and interference, telling children to do this or that, will make them restless, fretful and unhappy. Play is a necessity for the healthy growth of every child. It is his way of life and through it his learning goes on without his being aware of it. By using his hands and feet to try out his own ideas, by putting things together and taking them apart, by imitation, experimentation and repetition, he is con- stantly learning. He needs a variety of toys that are sturdy, scaled to his strength and size, movable and usable on his own terms. Such things as push and pull toys, steps and ramps, sand- boxes and wading pools, small ladders, boards, blocks, sawhorses, balls, low slides, swings and appropriate climb- ing apparatus should be provided. Special play areas exclusively for the use of these toddlers, such as are set up in some of our New York City public playgrounds, are of great value to these youngsters. A rocking horse, kiddie car, wagon or toy animal that he can sit on and push with his feet is fine for this age. Chairs, boxes and baskets can be pushed, dragged or pulled around in the house. A doll’s bed or a homemade cradle made out of a box with a rag doll or even a rolled-up towel encourages the child to play house. Playing with water is one of the joys of childhood. Small unbreakable cups, a pitcher and a pan, in the kitchen or bath- room, where the floor can easily be wiped up, will give the toddler happy practice in learning how to pour and dip. If he is allowed to dip the mop into the bucket of water or scrub the floor with a brush, he will almost tremble with excitement and pleasure. A footstool or step in front of the washbasin will encourage him to learn to wash his hands. A little girl will wash her dolls’ clothes and enjoy practicing this de- lightful job for many minutes at a time. The young child loves anything 111 New York City’s Baby Book that moves or turns and that he can take apart or put together, and will enjoy trying to turn the egg-beater, use a screwdriver or pliers, or screw caps on jars. A toy telephone, an iron, a small broom or a set of dishes gives him enjoyment. With a wagon or box he may haul things around like a delivery man. Both little boys and girls like to push a doll buggy. Any toy to lift or carry, to push or pull, will amuse them and give them prac- tice and exercise. At this age, however, a child does not play with any one toy long but changes from one to another every few minutes. Outdoors he will be interested in running, jump- ing and climbing and will be active most of the time. A walk to see buses, trolleys or a steam shovel at work will delight him, and he likes to watch workmen on the street. Nearly all chil- dren are fascinated by animals and usually are not afraid of them. Most children are very fond of soft cloth animals or teddy bears and will try to feed them, put them to bed, wash them and take them for rides. Large wooden beads to string on a heavy cord, balls, a bell or drum, a toy bank with pennies or buttons to rattle, simple picture puzzles consisting of two or three pieces, beanbags, a necklace of large buttons or painted spools, empty spice boxes, paper milk containers, spoons and other kitchen utensils can be had at little cost and will be used in many different ways by the child. A package of model- ing clay is fine for a little child to play with; he can taste it without danger, pound and rub it, break off pieces and have all the fun of playing with dirt safely. If his mother from time to time suggests a new game, such as playing with blocks or pushing his car around, she will keep the child interested and give him variety. It may be that the home has no special play space for the children. In that case, one should be provided for them by fencing off a corner somewhere with chairs or boxes. It will be easier to keep the rest of the house tidy and the child contented if he has some place of his own where he may do what he likes. Even in a small New York apartment, a special place can be set apart for a small child and is well worth the trouble. Babies differ in their interest in books, pictures and music but every child should have a chance to enjoy them. Old maga- zines with colored pictures are excellent, for it does not matter if they get torn and they often show objects the baby will 112 The Toddler: From Fifteen Months to Two Years recognize. Small cloth or heavy cardboard books, which can be made at home, with simple pictures one to a page, may interest him. He will enjoy rhymes and brief stories about little children and animals and things he knows. For short periods he may actually listen to music and may wave his arms and dance to the rhythm. C. How Parents Can Teach Their Children All of us want our children to be happy, agreeable to live with and willing to do what is asked of them. We also want them to develop self-control and good sense so that they can later take care of themselves and be good members of society. The parents are the first teachers, and some of the fundamental lessons of life are learned in the home before the child goes to school. How can we best help our little children to learn these lessons? One of the first and most important ways in which we can become wise parents is by learning to understand our children, by really watching them. Start by figuring out why your child does certain things. Children always have their reasons for what they do and the way they feel, although they themselves may not be able to tell what those reasons are. Try to put your- self in the child’s place. Sit back and think over what you have done and how he reacted to it. Then try out some different way of doing things. What worked with the neighbor’s child may not work with yours; what worked with your first baby may not work with the second one. Methods of dealing with children have to be tailored to fit the individual child and changed as he grows. Of course parents are human, just as children are, and we cannot always succeed in being as patient and wise as we should like to be. The best parents sometimes get cross with their children. Whenever your child gets on your nerves, stop a min- ute and see what he is trying to do. Maybe you can figure out a way to keep him happy. Success in bringing up children re- quires neither perfect children nor perfect parents, but a rela- tionship of mutual confidence and affection that enables the children to grow and learn happily. As a rule, children can be helped to learn and behave rea- sonably well without severe disciplinary measures. If your child trusts and loves you, he will have the best foundation for self- 113 New York City's Baby Book control and obedience. Fear and force may make your baby stop doing one particular thing but they will not teach him to do the things he should. Of course, a child must learn that he cannot have his own way all the time, but this lesson should be taught through kind firmness rather than through fear and punishment. He needs a guiding hand, not a spanking hand. Just as orderly, flexible routines were a good foundation for your baby’s health and contentment, so friendly teaching and a few simple, orderly rules will be a sound basis for good behavior now that he is older. Try to be consistent in what you require of him. It is well for the mother and father to talk over the child’s conduct and agree as far as possible in their ideas and methods. In this way the child will find the same thing expected of him whether he is with one parent or the other. Children are often confused when two persons try to tell them what to do at the same time. For this reason it is better for only one parent to be in charge of the child at any one time. The father can be a great help to the mother in teaching the child. Often his firmness will impress the child in a way that the mother’s requests do not. But it is hardly fair to the father to have to discipline the child when he comes home. After all, he wants the child’s love just as the mother does, and if any discipline is called for, action should be taken promptly by either parent so that the child will associate it in his own mind with his misbehavior. It is hard for grownups to remember how many things a child has to learn and how difficult things that are simple to us can be for little minds and muscles. A child needs time and repeated experiences to learn what is expected of him on differ- ent occasions. He will learn best if too much is not required of him at once. Small successes and quiet approval for even little things done well will encourage him to learn. Praise your child a bit when he tries hard and makes progress even though he may still be awkward. Most of the time children respond to a friendly invitation or suggestion, and the mother can figure out some pleasant way of interesting them in doing what she asks. A sense of humor, a light, friendly touch and an effort to do things together in a jolly way will make life much easier and more fun for both the mother and child. Fewer problems arise when the child has plenty to do to keep him busy. The baby 114 The Toddler: From Fifteen Months to Two Years whose mother likes to have him around, lets him take part in what is going on in the home, provides him with toys to suit his age and allows him to romp and explore, finds so many enjoyable things to do that he has little reason to be fretful or defiant. A young child does not realize that what he is doing is good or bad. What may seem like naughtiness is often only his nat- ural, healthy curiosity and liveliness. The vigorous activity of a child who gets into everything may be a trial to his mother but is a normal part of his growth. What he needs is not scold- ings and orders to stop but help in learning things he can do. Try to fix some place in the house where he can climb and jump from boxes, or a steady old chair, or a small ladder or steps. Let him run around the house hard sometime during the day, perhaps with a harness on like a horse; or play hide-and- seek with him for a few minutes; or dance with him to the radio or a song; or ask him to carry things to help you. This will work off some of his excess energy and make him more willing to settle down and play by himself from time to time. It is normal for little children, especially around the age of two, to be stubborn and “negative” at times. They are not able to do many things they want to do; they cannot express them- selves well; they do not know how to wait. Often they say “no” when they want to do things their own way, and a different ap- proach may start them doing what you want. Try to plan your home and your day so that there are as few chances as possible for a conflict of wills. Permit the child to do things his own way as long as it is not harmful even if it is less convenient for you part of the time. If he is to develop independence, he needs freedom and a chance to test his own will and to make his own judgments. As far as possible, let him make his own choice about things. If he rebels against going to the bathroom, ask him whether he wants to use the big toilet or the little one. Then he can assert himself without defying you. If he does not want to get dressed, ask him whether he wants to put on his red sweater or his blue one. Waiting a few minutes or laughing and talking about something interesting that you will do next will often put the child in an agreeable frame of mind. Nobody likes to be ordered around or nagged, and a child whose mother is always cross is bound to feel cross himself. Try to give as few stop signs as possible, and make your requests 115 New York City’s Baby Book “do this” instead of “don’t do that.” If your child does some- thing wrong, show him that you disapprove of the deed but never of him, and then show him the right way. If you see that he is about to do something actually harmful, you will need to stop him, but try to do it without being angry. When you ask him to do something or forbid him, first make sure that you have his attention and give him a simple, sensible reason if you can. If you tell him you will do such and such a thing if he does not do what you ask, carry out what you say you will do. Do not threaten to do anything unless you are prepared to fol- low it through, and do not make an issue of anything that is unimportant. A child will naturally be puzzled and confused if his parents laugh at his tricks one day but scold him the next day for the same things. If he finds he can get away with something once, he can hardly be blamed for trying it again and making a scene when it is forbidden. A child needs to know where he stands with his parents. He is better able to control himself if he knows how far he may go in being noisy, or taking other people’s things, or insisting on having his own way. A firm tone of voice, taking a forbidden object away from the child, making him sit quietly in one place for a few minutes, or removing him to another room, is often enough to let him know what the family rules are. Understanding, patience and tactful teaching make harsh methods of discipline as unnecessary as they are unwise. Some- times grownups imagine they have to frighten children to make them behave, or that the only way they will learn is by being whipped. But this is not true. Such treatment can seri- ously harm a child and may lead to more serious behavior problems. Young children are very sensitive. They feel lost and overwhelmed if their parents are angry or harsh with them. It is cruel and false to say to a child, “Mother won’t love you any more,” or that she will “go away and leave you,” when he is misbehaving. Scolding and punishments may make a child timid and fearful, or resentful and cruel. Threats may give him many mixed-up ideas. It is unwise to tell a child that his mother will call the policeman or take him to the doctor if he does not behave. He should trust police officers and turn to one if he is lost; and when he is sick, his parents will want him not to be afraid of the doctor. If he is told the bogeyman will get him, he may have nightmares. Harsh measures result in fears, 116 The Toddler: From Fifteen Months to Two Years restlessness and upsets of various kinds. The child may no longer feel that his home is safe. Remember, parents should keep on learning just as children do. D. When Problems Arise Many, parents are puzzled and troubled about certain habits that their children develop—fears, tantrums, eating dirt, biting, scratching and thumb-sucking. Many of these so-called bad hab- its are entirely normal and are outgrown in time if handled with patient understanding. It is often hard to find the parti- cular cause, but they do not indicate that the child is “bad.” Punishment is not a cure. Indeed, harsh methods will often fix the habit more firmly in the child’s mind, or if one practice is forbidden, the child may turn to another less desirable one. The following general suggestions may help your child to overcome some of these habits: Think over the child’s daily life to see whether he is getting1 enough rest, outdoor exercise, and play with children of his own age. Has he enough toys and interests to keep him busy? Does he get enough mothering and approval to make him feel good, or is he told “no-no” too much? Is he scolded and punished and expected to keep too quiet? Try to be honest with yourself about the way you deal with him. Sometimes a busy mother does not realize that she has been expecting too much of her baby. If she is worried and nervous, the child may reflect her mood and be restless and fussy and pick up some annoying habit to soothe himself. Take no direct notice of the habit itself. Do not try to stop it forcibly or scold the child or even call his attention to what he is doing. Try to keep him interested in healthy activities suitable to his age—games, toys, visiting other children. Try to spend some time every day reading to him, singing him songs, playing with him, so that he will feel his parents are interested in him and love him. If these attempts do not help and the habit continues, and seems to hold up his other interests and normal development, consult your doctor. Make sure there is no physical reason for his behavior. A general check-up by the doctor will determine whether the child is healthy and is get- ting a balanced diet, or whether he may have some illness that is not apparent. One should not hesitate to seek expert help if there is a behavior problem. The main thing is not to worry yourself or your child. Calmness, cheerfulness and affection, 117 New York City’s Baby Book more than anything else, will help a child, whether he is sick or merely upset. Fears — In the earlier chapters we discussed some of the fears babies may have and how to handle them. At about the age of two, a child begins to show his fears. Some children are timid and easily frightened, and cry whenever they are left alone. In such cases the mother should not hesitate to do whatever she can to reassure the child. A dim light in his room or a partly open door may comfort him and enable him to go to sleep. Such a solution is far better than letting him cry. He will even- tually outgrow many of his fears. If he wants to play near his mother and is unhappy alone, there is little danger of spoiling him by letting him enjoy her company. When he feels surer of himself, he will be ready to go off and play by himself. Whenever a child develops a sudden particular fear, try to think what new experience has made him feel unsafe. Children pick up many fears from grownups. Has the child heard or seen some adult frightened by a storm or worrying about burglars or an accident? Has he heard some unexplained noise in the house or over the radio? Try to get him to talk about his fear, and explain to him that there is no danger. Gradually and gently get him used to the frightening object. Laughing at a child, scolding or punishing him will not make him less fearful but will increase his timidity and may spread his fear to many other things. If he is treated wisely and sympathetically, he is almost sure to outgrow his fears. Tantrums—A baby cannot look ahead or remember as adults do; he does not yet know how to wait. When he wants some- thing, he wants it very much and right away. For these reasons we must expect crying, screaming, fussiness, “no” and “I won’t” from our little ones. The best way for the mother to deal with such behavior is by smiling and keeping calm and good-natured. Often, if she seems to pay no attention to the child but quietly goes on to the next thing on the program, he will forget and soon be laughing and busy. If your child becomes very cross and irritable, it may be because he is overtired, needs to go to the bathroom, is being nagged too much, or has not enough freedom to run and shout. Try putting him to bed earlier or getting him started on some game, or holding him on your lap while he looks at books or strings beads. Sometimes, however, irritability and restlessness 118 The Toddler: From Fifteen Months to Two Years mean that he is coming down with an illness (see page 122). Now and then, a real tantrum develops where the child screams, kicks, throws himself on the floor, tries to hit or stiffens his body so that you cannot hold him. When this happens, do not try to argue or force him but go on quietly with your busi- ness. If he is bothering other people, pick him up and take him into another room. This is a much better way to teach him that he cannot get anywhere by a tantrum than to spank or scold him. Remember, the baby may be frightened himself by his temper and may need to feel that his mother loves him even though she is firm with him. Before you refuse him, try to think whether it is really important not to give in to him, and then stick to your decision. If you give in to him, he may soon learn to stage a tantrum whenever he wants anything that you have refused to let him have. Such a habit can be very un- pleasant for the parents and is not good for the child. Try to be reasonable and consistent in what you allow or refuse him, and then make an effort to ignore the tantrum. When he finds that such storming gets him nowhere, he will usually learn to give up this kind of behavior; but if he is scolded, spanked, argued with or begged to stop, it may get worse. The mother may tell him she is sorry he is so angry, that she loves him but cannot let him have the things he wants. Her own calmness will help to quiet the child, and after he has stopped crying, she may suggest something else they can do. Once the tantrum is over, it is best not to refer to it again but to let bygones be bygones. Biting, Scratching and Hitting.—A young baby, especially when he is teething, will sometimes bite his mother on the breast, hand or face. He does not mean to hurt her but may want to express his love, or he may just be trying out his new teeth as he tries out a new toy. Naturally he should not be punished. The mother should tell him he is hurting her and give him something else to bite on. Little children around the age of two will often bite one another or a parent when they are angry, or they may scratch and hit. Of course, this must be stopped and, if necessary, the child must be removed to another place. It is cruel to bite the child in return, as is sometimes mistakenly done. The problem is not an easy one to solve but the period is usually of short duration. The parent should watch the child closely while he 119 New York City’s Baby Book is at this stage whenever he plays with other children, and calmly prevent him from biting his playmates. If possible, sug- gest something else to him that he can do. Biting is likely to occur when another child takes his toys. Try to have the same sort of toys for both children so that each plays with his own toys or so that they can exchange playthings. See to it that the stronger or bolder child does not take advantage of the other. Biting is not a sign of cruelty and, if correctly handled, will disappear. Little children almost always fight over their possessions. We cannot let them hurt one another seriously but we must decide whether we want the child to learn to settle his own affairs with other children or whether we want him to cry and run to his mother helplessly when he is in trouble. Often children of two are punished for hitting their playmates, yet a year or two later they are urged to fight back and are scolded and shamed for not defending themselves. This must be very puzzling to a young child. Dirt-Eating.—Sometimes children between one and two years of age eat dirt or chew paint off the furniture. Now and then this is done to get attention, and the parents may find that giving extra attention in other ways, such as playing and read- ing to the child, will cause this habit to disappear. Sometimes it is connected with teething. Giving the child more hard foods to chew on or toys he can bite on will help to satisfy this urge. A small amount of sand, chalk, dust, grass or modeling clay will not hurt him. Of course, all poisonous substances should be kept out of his reach. Furthermore, he should not be allowed to play with small objects like pins, nails, buttons and marbles, all of which should also be kept out of his reach. If the child should eat really large amounts of dirt repeatedly, or chew a lot of paint off the furniture, the doctor should be consulted. Sex Play.—In the chapter on the nine to fifteen months old baby, we talked about masturbating or playing with the geni- tals. This habit may develop in children of any age. It is a normal phase of growth, and if little attention is paid to it, the child will soon find other interests. He is not bad or im- moral if he tries to observe or touch his bowel movement or his organs. He is naturally interested in his own bodily func- tions and in the bowel movement he has produced. If we understand this, we shall see that scolding, shaming and pun- 120 The Toddler: From Fifteen Months to Two Years ishment are not necessary or wise. A child will not go on doing these things. It is therefore best to ignore them and after a time to see that his attention is diverted to something more interesting. When he is older, he will learn adult attitudes about sex from his parents, and will understand such things from a grown-up point of view. Meanwhile, let us remember that we want our children to be natural; we do not want them to feel confused, ashamed or mixed up about things they are too young to understand. A child should always feel free to ask his parents questions. The time to begin a healthy, sensible sex education is when the baby starts pointing to the various parts of his body and asking the names of them. It will satisfy his curiosity if we tell him the names in a matter-of-fact, un- embarrassed way, as we do for his fingers or toes. His attention will go on to other things if he is not made to feel guilty or ashamed, and if he has other interesting activities as well. When they are about two years of age, many little children begin to notice the difference between boys and girls, especially if they have been in the bathroom with a person of the opposite sex. If the child has not been scolded or has not felt that his mother was embarrassed when he asked her about different parts of his own body, he is more likely to ask questions freely about other children and also about grownups. Here, again, it is well for little children to learn the simple facts in an easy, casual way from their parents. If they are told to hush or if the answer they get is “Never mind,” they will feel that there must be something bad, secret or dirty about it; they will be- come more curious, and will no longer feel free to ask their parents. But if their curiosity is satisfied and they are allowed to look when a natural occasion arises, they will accept these differences in time and take no more than a normal interest in them. 121 Chapter VI WHAT TO DO WHEN YOUR BABY IS SICK 1. HOW TO TELL WHETHER YOUR BABY IS SICK It is often very hard to tell when a baby is sick or to know what is the matter with him. As you get to know your child, you will be better able to judge what he looks like, how he usually feels and when he shows some sudden change. The following information may help you to decide whether he is sick. If you are in any doubt, call in a doctor. The most com- mon signs of illness in a baby are: Fever.—His skin feels hot and dry. Vomiting.—If the baby vomits only once during the day, he may have some little upset, but if he vomits more than once a day, or has any other signs of upset, he is sick. Diarrhea.—If the baby has more bowel movements a day than usual; if the movements are loose and watery, or green, and contain an excessive amount of slimy mucus, consult your doc- tor. If there is blood in the stool, call the doctor at once. Running Nose, Cough or Hoarseness.—Even a slight cold may be serious in a young baby, and may be the first sign of some other illness. Eating.—A sudden change in appetite may be one of the first signs of sickness. Restlessness, Crankiness, Crying as if in Pain.—All babies have their off days when they may be fussy. Be on the lookout, however, for other signs of illness if your baby gets unusually restless and irritable, cries a great deal and is not comforted by the things you ordinarily do for him, or is unusually drowsy and wants to sleep when it is his regular time to be wide-awake and eager to play. If another member of-the family has been sick, watch your baby with special care. If the child shows any sign of illness, he needs a doctor. Prompt attention will insure earlier recovery and may even save his life. Home remedies or preparations recommended by a neighbor are not wise treatment for your baby. Neither your neighbor 122 What to Do When Your Baby Is Sick nor your corner druggist is a baby specialist. Never give your baby patent medicines. If a child has abdominal pain, it may be dangerous to give a laxative, as it may make the condition very serious. Never give your baby any medicine unless the doctor orders it. 2. HOW TO CHOOSE A DOCTOR FOR YOUR BABY In the old days in small towns most families had a physician who knew all about the family, all the diseases they had ever had, and how the family would be able to manage in case of sickness. Nowadays in the city few people have a family doctor, 123 New York City’s Baby Book and when a baby arrives the parents have to choose a doctor for him. A baby often needs a doctor who has had special training and experience in the care of infants and children. The doctors who specialize in baby care are called pediatricians. The boards of medical experts know who the best-trained of these specialists are, and these are certified. As certification is a relatively new thing there are also many qualified specialists who are not licensed by these boards. If you want to know about a particular doctor, ask your county medical society. Another good way to find a qualified baby doctor is to call up one of the large well-known hospitals in the city, ask for the pediatrics department, and then ask the head doctor to tell you the name of a child specialist. Most of the good baby doc- tors work part-time in the pediatric clinics of good hospitals. You can be sure of seeing a good pediatrician by taking your baby to one of these clinics if you do not have a private physi- cian, Do not hesitate to ask a doctor what his training has been; you have a right to know. If you take your baby to a general practitioner or family doctor and the child gets very sick, you should ask the doctor to call in a specialist for consultation. In an emergency, if you cannot reach your own doctor, call up a hospital and get the name of one of the staff members whom you may call, or rush your baby to the hospital. All the large hospitals have well-equipped, well-run emergency depart- ments where a sick or injured person can be taken any hour of the day or night. Wrap the baby warmly. If his condition is serious and you cannot carry him to the hospital or get a cab, you can get an ambulance by calling the Police Department. Many good doctors differ about the particulars of baby care. You may find that your doctor advises some methods different from those described in this book or from those some other doctor told someone else. Follow what your own doctor says. A visiting nurse will be glad to help you when your baby is sick. She can teach you a great deal about home nursing and can help you to carry out the doctor’s plan of treatment. The visiting nurses will answer any call during the day. They will make the necessary number of visits for whatever you are able to pay, or without charge if you cannot pay for the service. 3. WHAT TO DO BEFORE THE DOCTOR COMES Put the baby to bed in a warm, quiet room. See that he is 124 What to Do When Your Baby Is Sick comfortable but not too warmly covered. Keep other children and visitors out of the room. Give the baby a chance to quiet down and sleep. If the baby’s skin feels hot and dry, take his temperature rectally. If he vomits or has diarrhea, do not give him any food. If he does not vomit and is not suffering from diarrhea, give him his usual food at mealtime but do not urge him to take more than he wants. Do not give him any medicine until the doctor orders it. Write on a piece of paper what the baby’s temperature is, how often and how much he has vomited, how many bowel movements he has had today and how many he had yesterday, what they looked like (save one for the doctor to see), what he has eaten during the day, anything unusual that you have noticed about his appearance and behavior, and anything else that you think might help the doctor to under- stand his condition. Keep calm. Your baby needs to be soothed and comforted, not agitated. 4. HOW TO CARE FOR YOUR BABY WHEN HE IS SICK A. Follow the Doctor’s Orders Exactly Write down the directions he gives you. If there is anything you do not understand or if you have a question, telephone to him and ask him what to do. Give your baby only the medicine your doctor orders, only the exact amount he tells you to, and only as often as he orders. In recent years doctors have learned that the treatment of many diseases of infants and children can be carried out successfully without any special medicines. Many millions of dollars have been spent in advertising to convince the public that this or that medicine is important. Do not ex- pect your doctor to order medicine every time and do not feel cheated if he does not, because it is often safer not to give any. While medicines are very important in some sicknesses, there are many illnesses for which only the simplest medicines, or none at all, are necessary. B. Keep the Baby in a Warm, Quiet Room Do not allow other children or visitors to enter. Let the child sleep as much as he can. Give him only the food the doc- tor advises and do not urge him to eat. Try to make him as comfortable as possible. Give him a warm sponge bath once or 125 New York City's Baby Book twice a day, but no tub baths until he is over the sickness. If he has diarrhea, wash his buttocks every time he has a move- ment so that his skin will not get irritated. Change his sheets and his position in bed from time to time. Give him a drink of water whenever he wants one. Do not let him cry hard, but sing or talk to him gently, or hold him quietly on your lap if that soothes him. A sick baby needs to feel his mother’s love. C. How to Take a Baby’s Temperature Temperatures should be taken with a rectal thermometer that has a thick round or oval bulb at the end. Do not use a mouth thermometer, as it has a thin, pointed end that might break and injure the child. Wash the end of the thermometer with cold (not hot), soapy water; rinse, and wipe it off with alcohol. Shake down the mercury in the thermometer by taking hold of the upper part firmly and shaking it with a few sharp jerks, so that the mercury goes below 96 degrees. Then rub on a little white petroleum jelly, mineral oil, cold cream, or boric acid ointment. Put the baby in his crib or on a table or hold him on your lap. Put a pad or diaper under him. Turn him on his stomach or on his side. With one hand separate the buttocks and gently push the end of the thermometer into the rectum. Push it in about one- third of the length of the thermometer and hold it there for two minutes by the clock. Keep the baby quiet and hold his legs with one hand. Do not let go of the thermometer for a moment, as the child might move and break it. Then take out the thermometer, read the temperature and write it down. When you have finished, wash the thermometer with cold, soapy water, then wipe it off with alcohol. The temperature of a healthy baby is usually some- where between 98 and 99.8 degrees. If your child’s tem- perature is 101 degrees or higher, you should call a doctor even though the baby has no other signs of illness. Young babies often have a fever even with a small up- set, but as you cannot tell what the cause is and the 126 What to Do When Your Baby Is Sick temperature may quickly go much higher, it is wise to call a doctor and get his opinion. D. How to Give an Enema When the Doctor Orders It Elsewhere in this book you have been advised not to give your baby an enema or use a suppository unless your doctor orders it. An enema is not the best treatment for constipation. If the infant has a distended stomach, he may have a bowel ob- struction or some condition in which an enema would be in- jurious. The baby may be hurt and frightened by the enema. For these reasons an enema should not be given except on the doctor’s orders. Your doctor will tell you when an enema is necessary and if you ask him, he will tell you just what to use. Ordinarily a glassful of warm water is used in which half a teaspoonful of salt has been mixed. For a baby under six months of age, half a glassful is enough, and for an older baby, a whole glassful. Either an infant syringe or an enema bag with a small nozzle may be used. If the syringe is used, put the rubber tip in the glass of water and squeeze the bulb while the tip is under the 127 New York City's Baby Book water. Then let it go. If an enema bag is used, close the snap on the rubber hose and pour the water into the bag. Put a little petroleum, mineral oil or cold cream on the tip of the nozzle. The baby may lie on his back in his crib, on a table or on your lap, with a pad under him. Lift up his legs with one hand and insert about an inch of the nozzle into his rectum. Do it gently and slowly. Then slowly squeeze the bulb of the syringe or unfasten the snap on the rubber hose and let the water run in slowly. Take out the nozzle carefully and hold the buttocks together for a few minutes. Then put a diaper on the baby and let him lie quietly in his bed until he has a bowel movement. Sometimes the water from the enema does not come out. This will not harm the baby. If a bowel movement does not result, you should consult your physician about giving another. E. How to Give an Alcohol Sponge Bath If your baby has a fever, the doctor may advise you to give him an alcohol sponge bath two or three times a day to bring down his temperature. Give him the bath in a warm room pro- tected from all drafts. Use a mixture of half rubbing alcohol and half lukewarm water in a basin or small pan. Remove the baby’s clothes and cover him with a towel or blanket. It is not necessary to wash his face or head with the alcohol. Be careful that none gets in the eyes or on the genitals. Dip a washcloth in the alcohol, wring it out slightly, then wash a small part of his body with long, slow strokes, soaking the cloth often in the alcohol. Go over the part until he feels cooler. Pat the washed part dry gently with the towel, cover it and then wash another part of the body. When the whole body has been washed, put the baby’s clothes on and lay him in his bed. A sponge bath is refreshing and cooling and your baby will feel more comfor- table after he has had one. F. How to Keep the Air in the Baby’s Room Moist The air in most steam-heated apartments is too dry. When the baby has a cold or croup, your doctor may tell you to see to it that the air in the child’s room is kept moist. It is a good plan at all times to keep a pan of water on the radiator or from time to time to hang three or four hot, wet bath towels in a warm room, over the radiator if possible. 128 What to Do When Your Baby Is Sick If the baby has croup or a bad cold, take him into a closed warm room with the windows and door closed. Get steam into the room by letting the hot water run or keeping an uncovered kettle of water boiling on a stove or electric plate. If this treat- ment is to work at all, there must be plenty of steam in the room. You should be able to feel the moisture in the room and may even find it uncomfortably warm. When the room is quite warm, the baby may be clothed in only a diaper. Be sure the hot water is far enough away from the baby to prevent him from touching or spill- ing it, or getting his blan- kets near the fire. A vaporiz- er to make steam can be bought in a drugstore and is useful if the baby has croup or gets frequent colds. In severe cases of croup the doctor may tell you to put the baby in a steam tent. Menthol crystals may be added to the water for their pleasant odor. Be very careful that the steam does not go directly onto the baby, and that his clothing and bedding do not get anywhere near the heater. A very dangerous burn might result. When the treat- ment is finished, dry the baby, put dry clothes and covers on, and let him sleep. Be careful not to take him into a cold room too soon; if you do, he may get a chill. In severe cases your doctor may advise you to keep the steam kettle going and not to open the windows for several days. 5. IF YOUR BABY MUST GO TO THE HOSPITAL Your doctor will tell you whether it is advisable to send your baby to a hospital for special nursing care. If your child 129 New York City’s Baby Book has some condition that makes an operation necessary, your doctor will decide the best time for it in terms of its urgency and your baby’s general condition. If you decide to have your baby circumcised, it is usually advisable to have this done soon after birth, before you and the baby go home from the hospital. If your doctor does not think it wise to have it done then, he will advise you as to the best time. An operation is likely to be a painful and frightening ex- perience for anyone, especially a baby. Going to a hospital for the first time and being separated from his family may also be strange and frightening at first. This is one reason why it is never wise to threaten children with having to see the doctor or go to the hospital if they are not good. If it ever becomes necessary for them to be sent to the hospital, they may feel it is a punishment or that something dreadful will happen to them. Parents can do much both beforehand and afterwards to re- assure their baby about a hospital stay. Unless he is too sick to hear you, tell him where he is going and try to prepare him for it. Do not lie to him about it or he may not believe you when you promise to take him home again. If he is old enough, tell him what the hospital will be like, that the doctors and nurses will be his friends, that he will soon feel better and have fun with the other children, that you will come to see him while he is in the hospital, and that you will take him home as soon as he is better. Find out ahead of time when you may visit him, tell him when you will come again, and do not fail to keep your word. Remember, a little child lives in the present and unless he sees his parents from time to time, he may fear he will never see them again and that they do not love him. Talk it over with your doctor and see what he advises about the fre- quency of visits. Send the child a postcard every day, if you can- not visit him that often, and a little present at frequent intervals to let him know you remember him. You can buy little gifts in the ten-cent store, or paste bright-colored pictures on paper to make a little book, or cut out figures from magazines. Take him some of his favorite toys so that he will have something from home with him, but do not forget to bring them home again when he leaves. The baby who has always been treated gently, who has never been frightened by threats or punishments, and who feels that the doctor is his friend, is less likely to be upset by a separation 130 What to Do When Your Baby Is Sick from his family. When your child comes home again, give him extra attention for a while and do not leave him alone too long. If he is old enough to talk, let him talk about his experiences if he wishes. Try to answer any questions that may be puzzling him, and assure him that he is better now. In this way you will help him to get over any fears he may have. 6. WHEN YOUR BABY IS GETTING BETTER Your doctor will advise you when your baby has passed the danger point in his illness, when to begin giving him regular meals, when he may sit up or walk around again, when to stop giving him the medicine, if he has prescribed any, and when you may safely take him outdoors. It is usually best to keep the child at rest from 48 to 72 hours after his temperature has dropped to normal. The length of time will depend on what illness the child had, and the doctor will decide iri each individual case. Remember that as a result of his illness your baby may be weak and need a long rest and careful watching to prevent serious after-effects. During the time your doctor advises you to keep your baby at rest, keep him in bed if possible. If not, put on all his clothes except his shoes and let him lie or sit in his carriage or on the living room sofa. Give him toys he can play with while sitting down. Try to think up things he can do that will be fun in bed—looking at magazines, stringing large beads, playing with small toys. A box with large buttons to rattle, modeling clay, crayons and paper, clothespins with a box to put them in, old Christmas cards, a music box, a package of Christmas seals that he can stick in a notebook, musical blocks, a box of scraps of colored cloth, animal cookies, a tinker toy set, are all good. Any time your child gets tired of his toys, put some of them away for a while. Then they may be brought out on special occasions and will seem like an extra treat. Even though the doctor says you may begin to give him regular meals again, it will often take some time for the baby’s appetite to get back to normal. His own body knows best what its capacity is. Above all, do not try to coax him to eat when he has no taste for his food. After he has got back to normal, he will make up for the meals he has missed. If you force food on 131 New York City’s Baby Book him when he is not ready for it, you may upset him and have a real feeding problem on your hands. The convalescent period is often harder on the mother than the days when the baby was sick. Many children tire easily and become very cranky, fussy and demanding at this time because they are not able to entertain themselves. A mother can get very fed up with a child’s demands during illness. Try to be patient with your ba- by and de- vote as much of your time as you can to making him comfort- able. Provide him with things he can play with quietly while he is in bed, or on the sofa, or in his car- riage. You need not be afraid that doing these things will spoil him. K e e p h i m amused, but do not give in to him all the time; be firm about the things he needs to do. Spend as much time as possible doing little things that will interest but not excite him. As he gets stronger from day to day, you may let him play by himself a little longer. But do not expect him to be cheerful and lively or to feel all right as soon as the crisis has passed. Do not think he is naughty just because he still needs extra attention. 132 What to Do When Your Baby Is Sick 7. A FEW POINTS ON SOME COMMON DISEASES OF CHILDHOOD A. Colds What is only a slight cold in a grownup may be a bad cold in a little baby. Try to keep any member of the family who has a cold away from your child. If the mother herself has a, cold, she should be careful not to put her head near the baby or breathe on him, and should wash her hands thoroughly when- ever she is about to touch him or give him anything. If your baby begins to sneeze or cough or gets a running nose, keep him as quiet as you can, protect him from drafts and try to keep the temperature in the room as even as possible. It is better not to take him outdoors, even if he has no fever, unless the day is warm and sunny and there is no wind. If his nose is stuffed, it will make him breathe more easily if you put him in a room with some moisture in the air as often as your physician advises (see page 128). Do not put any medicine in the baby’s nose unless the doctor tells you to do so. Nose drops for adults or other children are usually too strong for the baby, and even medicine that the doctor gave the baby for an earlier illness may not be the right kind this time. If the baby’s nose is running, wipe a little cold cream or lanolin under it to keep the skin from getting sore. Most doctors agree that oily nose drops are dangerous and should never be used without careful supervision by a doctor. If your baby shows any other signs of illness, call the doctor. What is apparently a cold may be the first sign of a more serious illness. B. Croup Croup is accompanied by difficulty in breathing which often comes on suddenly at night. The baby breathes in a harsh, noisy way, wheezes and coughs. His voice sounds harsh. Some- times croup is dangerous, so call the doctor as soon as possible. Before he comes, put the baby in a room that has moisture in the air. Keep calm. The child may be frightened by his discom- fort and may need a calm, reassuring mother to soothe him. C. Convulsions Convulsions are very frightening to a mother, and she should know what to do before the doctor comes. There is a spasm or 133 New York City’s Baby Book twitching of the muscles of the face, legs, hands or other parts of the body. The baby’s lips may turn blue, he may have a fixed stare and his body may get stiff. Since convulsions often occur as the result of fever, you should give the child an alcohol sponge bath before calling the doctor. D. Chicken Pox Chicken pox is one of the most contagious diseases of child- hood, so keep children who have it away from your baby. It takes from 14 to 16 days for the disease to develop after one has been exposed to it. At first there may be a fever for a day or two. The first sign of a rash is usually small red spots. These spots spread over the back, chest and the rest of the body and then, become little watery blisters. There may be a lot of itch- ing. Whenever your baby develops a fever and a rash, call the doctor. He will determine what the disease is and advise you on the proper treatment. E. Measles Measles is another common catching disease and is frequently very serious in babies because pneumonia and other complica- tions may develop. If you know that your infant has been near someone who has the disease, ask your doctor whether he would advise a protective injection of gamma globulin. This can be obtained from the Department of Health. Try to keep your baby away from other children who may have measles. The first symptoms of measles are similar to those of a cold —running nose and eyes, a cough and fever. Later, small white spots appear on the inside of the mouth and a red rash on the face and body. If the doctor decides that your baby has measles, follow his advice carefully. F. Whooping Cough This is one of the most serious diseases a little baby can catch. You should help to protect your infant against this danger by having him inoculated when he is six months old (see page 70). Never allow other children who have coughs or colds to come near your baby, even if you have to offend your best friends. What they call “just a cold” may be the beginning of whooping cough. If your child should get this disease, the 134 What to Do When Your Baby Is Sick constant supervision of a physician is needed. No druggist’s “special cough mixture” can take the place of good medical care. 8. FIRST AID FOR ACCIDENTS A. Cuts and Scratches The ordinary cuts and scratches a baby gets should be washed with water and a mild soap, and covered with a piece of sterile gauze or by fastening on a piece of clean cloth pressed with a hot iron. There are many antiseptic preparations that may be put on small cuts. Tincture of iodine, especially if it has been standing for some time, must be used very carefully because it may cause burns. Some of the preparations you can buy do not sting so much as others and therefore are preferable for chil- dren. A severe or deep cut should be treated by a doctor. All babies are bound to get falls and bruises when they begin to walk, and may even get a big, dark lump like an egg on the forehead. It is usually not necessary to do anything for a minor bruise, but you should take your baby to the doctor if the child has hurt his head or has other severe injuries. B. Swallowing Objects Small buttons, coins and even pins that the baby swallows usually pass through the intestines without causing injury. If the child shows any kind of upset or pain, or has swallowed a sharp pointed object and chokes or coughs, showing that the object has gone into his windpipe instead of his stomach, hold him by the heels and shake him. If this does not dislodge the object, rush the child to a hospital or a doctor. Do not try to stick your finger down his throat to get the object out. C. Poisons or Pills Poisons and medicine should be kept in a locked cupboard or on a high shelf where the baby cannot possibly get at them. If you have boric acid in the house, be sure to keep it in the medicine closet, and do not let the baby drink the solution you fix for rinsing his diapers. Remember to keep all such dangerous things out of his way. Besides, they should be bought only in small amounts in order that they may not get stale. If you think your baby has eaten pills, roach poison or any cleaning things such as lye, washing soda or similar articles, rush him to the hospital or the doctor. Take along the material he was eating so that the doctor will know how to treat him. Be- 135 New York City’s Baby Book fore the doctor sees him, try to make the baby vomit by tickling the back of his throat with soft tissue paper or by giving him warm water with a teaspoonful of salt in it. D. Burns For a mild small burn that makes a small spot of skin red, cover with a paste of bicarbonate of soda mixed with water, and a clean dry bandage. Do not put oil or absorbent cotton on the burn. For severe burns that cause blistering or cover a large part of the skin, rush the baby to a hospital or the doctor’s office immediately. Do not put any ointment or absorbent cotton on the burns. Do not break the blisters. Do not try to remove the child’s clothing but wrap him in a warm blanket, and hurry. 9. BE CAREFUL BUT DO NOT WORRY After you have read this chapter, you may be afraid your baby will get sick. Of course he will not get all the diseases men- tioned in this book. If you give him good care every day, keep him away from people who have colds and other contagious diseases, and take him to a doctor or child health station regularly for examination, he will stand a good chance of es- caping serious illness. It is wise, however, to know the signs of illness and to see that the baby gets prompt medical attention when he first becomes ill. Money paid for a doctor’s visit at the beginning of a sickness is health saved in the long run. If the infant has no fever but shows other signs of sickness, you can take him to the doctor’s office or to a clinic. Remember to write down the name, address and telephone number of your doctor and also of the nearest hospital. Keep them in a handy place so that you will be able to get at them quickly in an emergency. You have now had two years of wonderful experiences with your baby. There have been many puzzling and discouraging moments, but there have also been many moments of, real joy and satisfaction. Your baby has only one set of parents, and on their wisdom, from the very start, depend his sturdiness, his happiness, his health. It is a real achievement for you to have reached this stage. May you continue to be successful in bringing up your child. 136 New York City’s BABY BOOK A Handbook for Parents Issued by the DEPARTMENT OF HEALTH, CITY OF NEW YORK Israel Weinstein, M.D. Commissioner of Health William O’Dwyer Mayor