DIET AND CARE OF 
CHILDREN DIET AND CARE OF 
CHILDREN 
Questions Mothers Ask the Doctor 
HARRY S. REYNOLDS, M. D. 
Visiting Physician to '\lanchester Memorial Hospital 
BY 
FORMERLY 
Clinical Instructor of Pediatrics, Yale Medical School; Assistant 
Attending in Pediatrics, New Haven Hospital; Associate 
Attending in Pediatrics, Grace Hospital; Attending, 
Babies’ Emergency Home, New Haven 
CHICAGO: 
LAIRD & LEE, INC. 
PUBLISHERS Copyright, 1924 
By LAIKD & BEE, Inc. 
Made in U. S. A. TO 
MY WIFE 
AND CHILDREN PREFACE 
THIS book represents an experience of many years 
in hospital, dispensary and infant welfare work, 
and in private practice with children. 
It is, therefore, a practical book with a practical 
origin. Its purpose is to aid and assure the conscien- 
tious mother and to provide for the comfort and well- 
being of both mother and child. 
South Manchester, Conn. 
January 8, 1924 CONTENTS 
Anatomy, Physiology and Development - - 11 
Hygiene and Environment ----- 25 
Diet and Feeding ------ 57 
Bad Habits - - - 103 
Common Ailments and Simple Treatments - 107 
Emergencies and Expedients - 133 
Alphabetical Index ------ 143 
[For complete alphabetical index see page 143.] Diet and Care of Children 
ANATOMY, PHYSIOLOGY AND 
DEVELOPMENT 
AS THE new-born infant enters the world he em- 
■ bodies in his minute organism the sum total of 
humanity, and in many ways and characteristics he has, 
during his brief prenatal life, harkened back to the very 
beginnings of biologic existence. 
In a remarkably short period of the average time al- 
lotted to the human drama he has enacted a synopsis 
of the plot which it is his destiny to continue. This 
role is henceforth translated into anatomical, physiologi- 
cal and developmental averages to which individuals 
conform more or less closely. Marked deviations from 
these averages are interpreted as abnormalities. 
1. What is the normal weight development during the 
first yearf 
Boys average to weigh a trifle more at birth than 
girls, but in general the average weight of a baby at 
birth is from 7% to 8 pounds. During the first few 
days there is an initial loss of weight (due chiefly to in- 
11 12 
DIET AND CARE OF CHILDREN 
sufficient nourishment and loss through urine and 
feces), usually amounting to several ounces, but at the 
end of a month the birth weight should be regained and 
increased to a total of about 8y2 pounds. The subse- 
quent gain up to 6 months should be at the rate of about 
iy2 pounds per month. This may be expressed as 
follows: 
Months.., 
.. 1 
2 
3 
4 
5 
6 
Pounds.., 
co 
10 
11% 
13 
14% 
16 
The average gain during the next 6 months is about 
1 pound per month, expressed as follows: 
Months.. 
.. 7 
8 
9 
10 
11 
12 
Pounds.. 
..17 
18 
19 
20 
21 
22 
Roughly speaking, the infant doubles his weight at 
6 months and triples it at 1 year. 
The above averages are a trifle arbitrary, but are 
approximately correct. 
2. What is the normal weight development during the 
second year? 
The average gain during the second year is y2 pound 
per month. This may be expressed as follows: 
Months.. 
..13-14 15-16 17-18 19-20 21-22 23-24 
Pounds.. 
..23 24 25 26 27 28 
3. What is the average weight development from two to 
ten years? 
At 10 years a child should weigh from 63 to 66 
pounds, or about 8 times that of a generous birth weight 
of 8 pounds, gaining an average of pounds per year. 
From 2 to 10 years boys average from 1 to V/z pounds 
heavier than girls. DIET AND CARE OF CHILDREN 
13 
4. What is the average weight development from ten to 
fifteen years? 
From 10 to 15 years a child should normally gain 
about 40 pounds, an average of 8 pounds per year. 
During this period girls average to slightly exceed boys 
in weight. 
5. What is the rate of gain in length during the first 
ten years? 
At birth the length averages inches. The gain 
is greatest during the first year, amounting to about 8 
inches. During the second year the gain is 3*4 inches 
and from then until 10 years the gain amounts to 20-22 
inches, making an average total length of about 4% 
feet. 
6. How does the pulse rate vary from birth to ten years? 
At birth the rate per minute averages about 130, at 
5 years 95-100, and at 10 years 80-90. 
7. How does the respiratory (breathing) rate vary from 
birth to ten years? 
At birth the rate per minute averages about 40, at 5 
years 20-25, and at 10 years 18. 
8. How many teeth are there in the first set? 
There are 20 teeth in the first set, 10 upper and 10 
lower ones. 
9. How many teeth are there in the second set? 
There are 32 teeth in the second set, 16 upper and 16 
lower ones. 
10. When do the teeth of the first set make their ap- 
pearance ? 
There are twenty teeth in the first or temporary set. 14 
DIET AND CARE OF CHILDREN 
The first teeth to appear, at about six months of age, are 
usually the two lower middle ones; these are followed 
by the two upper middle ones; and these are followed 
by the upper and lower ones immediately beside them, 
making eight middle or incisor teeth. Then come the 
first premolar teeth, one above and one below on each 
side, which will eventually (when all of the first teeth 
are erupted) be next to the extreme end or back teeth 
above and below; these are followed by the four canine 
or “eye” teeth, one above and one below on each side, 
which fill the spaces between the first premolars and the 
eight incisors; last of all come the extreme end or back 
teeth, which are also termed ‘ ‘ premolars. ’ ' Thus when 
all of the first teeth are erupted there are present: eight 
middle or incisor teeth, four canine or eye teeth and 
eight premolars. 
The above order of appearance may be represented 
by the following formula, the upper and lower rows of 
numbers corresponding to the arrangement in the 
mouth of the upper and lower rows of teeth, each num- 
ber representing the month of a child’s age when its 
corresponding tooth most commonly makes its appear- 
ance : 
Premolars 
Canines 
Incisors 
Canines 
Premolars 
28 
14 
18 
10 8 8 10 
18 
14 28 
30 
14 
20 
12 6 6 12 
20 
14 30 
There are many normal exceptions to the above exact 
order. 
11. When do the teeth of the second set make their 
appearance ? 
There are thirty-two teeth in the second or permanent 
set. DIET AND CARE OF CHILDREN 
15 
The twenty teeth nearest the mid-line of the mouth 
take that position by replacement of the first set, prac- 
tically forcing the latter out of their sockets, and are 
designated as indicated by the formula below. The 
additional twelve teeth occupy new spaces furnished by 
growth of the jaws and are termed molar teeth. 
The order of appearance of the second set may be 
represented by the following formula, the upper and 
lower rows of numbers corresponding to the arrange- 
ment in the mouth of the upper and lower rows of teeth, 
each number representing the year of an individual’s 
age when its corresponding tooth most commonly makes 
its appearance: 
Molars Bicuspids Canines Incisors Canines Bicuspids Molars 
18-25 12 6 10 9 
11 
8 7 7 8 
11 
9 10 6 12 18-25 
18-25 12 6 10 9 
11 
8 7 7 8 
11 
9 10 6 12 18-25 
The third, or last, molars, which are popularly called 
“wisdom teeth,” do not make their appearance until 
some time between the 18th and the 25th year. 
12. Does teething actually cause illness? 
There are great variations in the ease with which 
teeth perforate the gums in different individuals. In 
some babies they come through without any difficulty 
and in others the gums become red, swollen, hot, tense 
and sore. It is not remarkable that in such cases the 
vitality should be lowered, making the infant a more 
liable subject for an intestinal upset, with fretfulness, 
lack of appetite, fever and diarrhea, than he would 
ordinarily be. ' 
Of course teething is far too often blamed for symp- 
toms which are really not due to it, and it seems per- 16 
DIET AND CARE OF CHILDREN 
fectly safe to say that a vast majority of cases show- 
ing symptoms which are attributed to teething are so 
diagnosed from lack of careful examination or a true 
interpretation of the actual condition. Teething too 
often serves as an alibi for a proper diagnosis. 
13. What may cause delay in the appearance of the 
teeth? 
The condition known as rickets, a disease affecting 
bone nutrition and growth; cretinism, a condition due 
io defective development of the thyroid gland; and pro- 
longed illness. 
14. What is the soft spot? 
At birth the cranium (dome of the skull) is made up 
of a number of bony and cartilaginous (gristly) plates, 
the edges of which are united by strong fibers. These 
plates are in more or less close contact with each other 
and there is a limited amount of independent motion 
permitted at their edges, their junctions being termed 
sutures. In some places at the junction of several of 
the bony plates we find a considerable amount of sep- 
aration, causing the soft spots or fontanels. 
The motion permitted by the sutures allows the 
cranium to mold itself to the shape of the birth canal, 
and the heads of most normal babies at birth are con- 
siderably elongated or drawn out, which condition grad- 
ually disappears within a few hours or days. This 
structure of the cranium permits of the tremendous 
growth of 4Y2 to 5 inches in circumference which occurs 
during the first year as contrasted with the subsequent 
growth of only 3 inches during the next 12 years. DIET AND CARE OF CHILDREN 
17 
15. When does the soft spot close? 
The large lozenge-shaped soft spot in the mid-line, 
just above the forehead, technically known as the an- 
terior fontanel, averages to close at 18 to 20 months of 
age. 
16. Is the soft spot liable to be injured? 
Very few accidents occur to the soft spot or anterior 
fontanel, but it is well not to forget its presence in 
handling the baby and thus avoid possible injury. 
17. What may cause delay in closure of the soft spotf 
Rickets is the most common cause, the condition be- 
ing one of the manifestations of the perverted bone 
growth. Delayed closure occurs in cretinism, a condi- 
tion in which there is a deficient secretion of the thyroid 
gland; hydrocephalus, or water on the brain; and in 
Mongolian idiocy, a form of defective mentality accom- 
panied by Mongolian features. 
18. What causes flat chest I 
Flat chest is caused by obstruction to the upper air- 
passages and is a symptom of general weakness. 
19. What is pigeon chest and what causes it? 
In this condition the breast-bone projects promi- 
nently, the adjacent front portion of the chest being 
unduly narrowed. It is seen where the upper air-pas- 
sages are obstructed, as in adenoids, and in congenital 
heart disease, and is commonly a result of rickets. 
20. What is funnel chest and what causes it? 
In this condition the breast-bone is depressed, causing 18 
DIET AND CARE OF CHILDREN 
a hollow in the front of the chest wall. It sometimes 
exists at birth and is commonly caused by rickets. 
21. What is a “blue baby”? 
When there is a malformation of the heart existing 
at birth the blood may not be forced through the lungs 
in a proper manner to obtain a sufficient amount of 
oxygen and therefore remains blue (exposure to oxygen 
making it red). Depending largely upon the degree 
and kind of malformation, the baby may present a con- 
stant or only an occasional blue appearance. Some of 
these cases live to become adults, but the greater num- 
ber die before reaching maturity. 
22. When should a baby begin to hold his head up? 
At 3 to 4 months. 
23. When should a baby begin to take notice? 
Objects are followed by the eyes at about 3 or 4 
months. 
24. When should a baby begin to sit up? 
He should begin to sit up, unsupported, at about 
6 or 7 months. 
25. When should a baby begin to stand? 
He should begin to stand, with support, at about 9 
or 10 months. 
26. When should a baby begin to walk? 
He should begin to walk at about 12 to 14 months; 
however, it is not very unusual for unsupported walking 
to be delayed to 18 or even 20 months. DIET AND CARE OF CHILDREN 
19 
27. When should a haby begin to talk? 
Most babies begin to say words at 10 to 12 months, 
but do not begin to put them together into sentences 
until 20 to 24 months. 
28. How long is an infant especially liable to have colic? 
The first three months constitutes the colicky period. 
It takes about this length of time for the digestive ma- 
chinery to get to running smoothly. 
29. What is the normal appearance of the baby’s first 
stools? 
For nearly a week after birth the stools are dark, al- 
most black, having a slightly greenish tinge, and are 
called meconium. They consist for the most part of 
material thrown off from the walls of the intestines. 
Gradually, toward the end of the first week, they begin 
to assume the yellowish appearance of the later normal 
stools. 
30. How long does it take for food to pass through a 
baby’s intestines? 
It has been found by adding a colored (carmine) 
preparation to the food that it normally takes 18 to 22 
hours. 
31. How many times should a baby’s bowels move in 
twenty-four hours? 
Two or three times. If they move more often than 
four times conditions are decidedly abnormal and should 
be corrected. Oftentimes overfeeding will cause numer- 
ous stools. 20 
DIET AND CARE OF CHILDREN 
32. How often should a baby urinate? 
Babies vary in regard to frequency of urination, pass- 
ing water from once every hour to once every three 
hours. As a rule, the more the fluid intake the more 
frequent the urination. Also, urination is usually more 
frequent during the active waking hours. 
33. Should an infant’s urine be acid or alkaline? 
At birth the urine is in most cases of a distinctly acid 
reaction. Later on it is ordinarily faintly acid or of 
neutral reaction. 
34. What is physiological jaundice or icterus? 
In many (not all) babies within the first few days 
after birth the skin, mucous membranes and the whites 
of the eyes assume a greenish or yellowish hue of vary- 
ing intensity, being very pronounced in some cases. 
The discoloration lasts for a week or ten days—very 
rarely two weeks. There are various theories advanced 
in explanation of this condition, the cause of which is 
not definitely proven. The probability is that there is 
a degree of bile production in early infancy to which 
the minute tubes and ducts do not at once adjust them- 
selves in some cases, causing a damming back of bile 
into the blood. The condition is absolutely harmless 
and should cause no concern unless prolonged beyond 
two weeks, in which ease it may be due to some more 
serious cause. 
35. What changes may occur in a baby’s breasts soon 
after birth? 
They sometimes become temporarily swollen and 
somewhat dusky in appearance, due to an accumula- 21 
DIET AND CARE OF CHILDREN 
tion of fluid resembling colostrum (see colostrum, ques- 
tion 173). This fluid was formerly termed “witch’s 
milk.” The proper treatment of this condition is to 
leave the breasts absolutely alone. Otherwise infection 
is very liable to occur. The swelling will spontaneously 
subside in a short time if this benign treatment is ob- 
served. Considerable damage is liable to follow more 
strenuous methods. 
36. What is the digestive action of saliva ? 
Diastase is present in the saliva at birth, and later 
on maltase and potassium sulfocyanid appear. The 
diastase acts somewhat feebly upon starches, this ac- 
tion being continued for some time in the stomach. The 
mixture of the saliva with gastric juice enhances the ac- 
tion of the hydrochloric acid upon casein curds of milk. 
37. How early is saliva secreted? 
At birth. 
38. What is the function of the stomach? 
The first function is that of a reservoir. Preliminary 
digestion takes place there. Protein is coagulated by 
the rennet ferment in the presence of the hydrochloric 
acid secreted by the stomach. The pepsin in the gas- 
tric juice converts to some degree the coagulated pro- 
tein into peptone in the presence of the stomach acids. 
Some digestion of fats and starches probably also takes 
place in the stomach. 
39. Where does digestion chiefly take place? 
Most of the digestive process takes place in the small 
intestine. 22 
DIET AND CARE OF CHILDREN 
40. What are the principal digestive fluids of the 
stomach? 
Hydrochloric acid, lactic acid, rennin, pepsin, lipase. 
The hydrochloric acid and lactic acid permit the 
digestive fluid rennin to coagulate the casein in milk, 
causing curds. Pepsin partially converts these pro- 
tein curds into peptones to facilitate assimilation into 
the body. Lipase is present to some extent in the stom- 
ach and acts upon fats. 
41. What are the principal digestive fluids acting in the 
intestine ? 
Diastase, maltase, invertase and lactase, acting upon 
carbohydrates; tripsin, acting upon proteins; and 
lipase, acting upon fats. It is regarded that, in order 
to be effective, the latter two fluids require the presence 
of other chemical bodies with which they come in con- 
tact in the small intestine. 
42. What is the relative length of an infant’s and an 
adult’s intestines? 
The intestines of an infant are much longer in pro- 
portion to the body length than are those of an adult, af- 
fording more loops and turns than are present in the 
adult intestines. 
43. Why are young infants especially Halle to he con- 
stipated? 
The intestines, especially at the lower portion or sig- 
moid flexure, are not only relatively longer in a young 
infant, but are more tortuous, and the muscles which 
act in forcing the contents along are weaker and in some 
cases very weak, causing delay in the propulsion of the 
contents. DIET AND CARE OF CHILDREN 
23 
44. What is the pylorus? 
A muscular ring at the junction of the stomach and 
small intestine. After food has entered the stomach 
the pylorus relaxes at intervals, allowing small por- 
tions of the partially digested food to enter the small 
intestine, where digestion is completed. 
45. What is pyloric stenosis? 
A condition in which the contractions of the pylorus 
or muscular ring are so excessive as to prevent food 
from properly passing from the stomach into the small 
intestine. This causes retention and vomiting. The 
condition is dangerous, and in some cases, unless 
promptly treated, may rapidly lead to death by starva- 
tion, inasmuch as food is not fully digested and prop- 
erly assimilated until it reaches the intestine. The ex- 
cessive contractions are due to muscle spasm, and to 
this is often (some say always) added an overgrowth 
of the muscle itself. 
46. When do tears first appear? 
It is from two to four months before the tear-glands 
become fully developed and the secretion becomes com- 
pletely established. HYGIENE AND ENVIRONMENT 
CAREFUL attention to details of bathing, clothing, 
ventilation, sleep, exercise and all environ- 
mental factors is bound to reap its ultimate reward in 
aiding to put the recipient in the most favorable rela- 
tionship to the surroundings with which he will have 
to contend. 
Undue coddling, however, is liable to stand in the 
way of normal development of his natural faculties of 
adaptation, and should be avoided. 
47. Should a mother take the neighbors’ advice about 
bringing up her child? 
The mother who hazards the wellbeing and upbring- 
ing of her offspring upon neighborhood advice (par- 
ticularly the unsolicited brand) is gambling with val- 
uable stakes. 
Almost any physician of a few years’ experience 
could write voluminously in enumerating the sheer non- 
sense which he has heard recited to him as having been 
perpetrated in the guise of friendly advice. About the 
mildest thing that can be said about the unsolicited 
brand is that it is inconsistent and conflicting. 
There are many sensible, experienced mothers who 
are perfectly capable of giving most valuable advice if 
the young mother is fortunate enough to know where to 
request it, but seldom is this kind of advice peddled 
about promiscuously and unrequested. 26 
DIET AND CARE OF CHILDREN 
48. IIow should a baby be lifted and carried? 
It is essential that the back and neck should be sup- 
ported. The lower limbs should be raised with one hand 
and the upper back, neck and head should be supported 
on the spread palm of the other hand. 
A young infant may be satisfactorily carried about 
on a small pillow. 
When the baby is able to hold up his head unsup- 
ported he may be raised by placing the hands under the 
armpits and grasping the sides of the chest, taking care 
not to bring too much strain upon the shoulders alone. 
Great care must be taken at all times to avoid undue 
bending of the neck or spine. 
49. What items should be considered in furnishing a 
nursery? 
Low table for eating and play. 
Low table for bathtub (above can be used if nec- 
essary). 
Folding canvas-topped table for dressing, changing, 
etc. 
Table for toilet equipment. 
Table for scales, basket, etc. 
Chairs. 
Chamber chair. 
Clothes bureau. 
Receptacle for soiled diapers. 
Crib. 
Baby pen. 
Bathtub. 
Scales, DIET AND CARE OF CHILDREN 
27 
Thermometer for ascertaining room temperature. 
Heating facilities. 
Ventilating facilities. 
Lighting facilities. 
Screens for protection from light and draughts. 
Electric fan. 
Shades. 
Awnings. 
Simple hangings. 
Simple floor coverings. 
Decorations. 
50. What is a proper equipment for a nursery toilet 
tablef 
Alcohol. 
Olive oil or sweet oil. 
Albolene. 
Vaseline (in tube). 
Zinc oxide ointment. 
Boric acid crystals. 
Talcum powder. 
Zinc oxide powder. 
Zinc stearate powder. 
Starch. 
Castile soap. 
Sterile cotton. 
Salicylated cotton. 
Sterile gauze. 
Soft washcloths. 
Soft towels. 
Soft hairbrush. 
Fine comb. 
Safety pins, large and small (plenty of them). 28 
DIET AND CARE OF CHILDREN 
Needle. 
Thread. 
Blunt-tipped scissors. 
Rectal thermometer. 
Bath thermometer. 
Medicine-dropper. 
A glass. 
51. What makes a satisfactory waste receptacle for the 
toilet table? 
An ordinary paper bag attached to one of the top 
edges of the table by means of strips of adhesive plaster. 
The bag can simply be burned with its contents and 
replaced by a fresh one. 
52. What is a suitable type of crib for a young infant? 
An ordinary clothes-basket or a wooden box, enameled 
white, makes a very satisfactory and economical crib. 
If a basket is used, a woolen blanket can be placed in 
the bottom and draped up over the sides for the sake 
of additional warmth. A small mattress of bed ticking 
or unbleached muslin stuffed with hair, excelsior, cot- 
ton, felt or sphagnum moss should be placed upon the 
bottom of the crib. This should be covered with some 
waterproof material such as rubber sheeting, oilcloth, 
oiled silk or oiled paper (rubber sheeting is best). Over 
this should be placed a soft quilted pad. Later on an 
enameled metal crib with springs will be more ap- 
propriate. The latter should have high sides which can 
be raised or lowered. 
53. Should a young infant use a pillow? 
A pillow should not be used. Without it he will not DIET AND CARE OF CHILDREN 
29 
only sleep better, but the spine will have a more favor- 
able opportunity to develop normally. 
54. When does the cord-stump separate from the body? 
From five to ten days after birth. The cord becomes 
dried up and mummified, a constriction forms close to 
the body, and the cord finally separates spontaneously, 
leaving a raw surface which quickly heals over. 
55. What is a proper method of dressing the cord- 
stump ? 
Everything that comes in contact with the stump 
should be sterile. It may be gently washed off with 
alcohol and the end lightly painted over with a solution 
of alcohol and tincture of iodine, equal parts. Boric- 
acid powder is then dusted over it and it is bound up 
with salicylated cotton, and the latter wound about with 
thread or held in place by means of an ordinary rubber 
band. A pad of sterile gauze should be folded over this 
dressing, and the abdominal binder is then bound 
snugly on outside. Great care should be taken at bath- 
time not to wet this dressing. 
56. What danger may occur from careless and uncleanly 
treatment of the cord-stump? 
Fatal infection may readily occur. It should not only 
be treated as an open wound, but its intimate connection 
with the interior of the abdomen makes it imperative 
that the most sedulous care be observed in this con- 
nection. Cord infection is usually fatal. Tetanus 
(lockjaw) may result from careless handling. 
57. What routine care should an infant’s eyes receive? 
Immediately after birth a few drops of 2% silver 30 
DIET AND CARE OF CHILDREN 
nitrate solution should be instilled between the lids of 
each eye by means of a medicine-dropper. This may 
save the baby from blindness and should be insisted 
upon. At bath-time daily a few drops of warm boric- 
acid solution (one teaspoonful of boric-acid crystals 
to a cupful of warm boiled water) should be instilled 
between the lids. The eyes should of course always be 
protected from strong light and from dust. The baby 
should be kept away from anyone who has sore eyes or, 
in fact, any pus discharge. 
58. What is a proper bath-room temperature for infants 
and young children? 
At least 85 degrees F. at first. It is permissible to 
lower the temperature one degree every two months, 
reaching a minimum of 79 degrees at one year. 
59. How should the shin be cleansed immediately after 
birth? 
The skin at first has a cheesy or creamy coating called 
vernix caseosa. This should at first be softened by 
anointing with vaseline or olive oil. If the vernix is 
very abundant it may take several hours to soften up 
sufficiently for complete removal, but ordinarily a few 
minutes suffice. After softening remove by gentle rub- 
bing. The baby may then have a sponge bath. 
60. When should tub bathing be started? 
After the cord has come off and the stump is well 
healed. For the first two weeks it is better to give 
sponge (so-called) baths, using a soft washcloth in- 
stead of a sponge. After two weeks tub bathing may 
be started. DIET AND CAPE OF CHILDREN 
31 
61. What is a good substitute for a tub bath? 
A shower bath, especially in children over one year 
of age. The shower may be started with the water at a 
temperature of 90 degrees F., gradually lowered to 80 
or even 75 degrees F. and followed by a good brisk rub- 
down. When the child has become accustomed to this 
method of bathing, and if he gets a good reaction after 
the cooling spray, he should be less liable to take ‘ ‘ cold ’ ’ 
when unavoidably exposed. 
62. How can the bath-water temperature be ascertained? 
By the use of an ordinary bath thermometer. The 
thermometer is encased in a wooden jacket and may be 
floated in the water. Procurable at any good drug- 
store, or hospital and nursery supply store. The tem- 
perature may be roughly judged by dipping the elbow 
into the water, but it is far better to use the ther- 
mometer. 
63. What is a proper water temperature for a cleansing 
bath for infants and young children? 
At first the temperature should be 95 to 100 degrees 
F. The temperature may be lowered one degree every 
month until at the end of five months it is 90 degrees, 
and may be continued indefinitely at this temperature 
for an ordinary cleansing bath. 
After one year of age the bath may be started at 90 
degrees F. and finished at 80 degrees F., followed by a 
brisk rubdown with a rough towel. This procedure will, 
in normal children, tend to increase the resistance to 
exposure to cold’ promoting a prompt and vigorous 
circulatory reaction. 32 
DIET AND CARE OF CHILDREN 
64. Is hard or soft water preferable for bathing? 
Soft water. If a good soap does not make an easy 
lather the water is too hard and can he softened by the 
addition of a little borax powder: one or two teaspoon- 
fuls to the gallon of water. The softer water will be 
less irritating to the skin. 
65. What hind of soap should be used for bathing? 
A pure Castile soap made from a good grade of olive 
oil. It is a good investment to get the best, purest and 
most reliable soap. 
66. How should washcloths be chosen and cared for? 
Good soft cloths can be made of wool, cotton or 
stockinet, and should be about 8 by 8 inches. There 
should be several of them and each one should be wrung 
and dried out after using. At least twice a week the 
cloths should be boiled. 
67. How should the shin of a young infant be dried 
after the bath? 
Ordinarily by patting with a towel of soft material 
rather than by rubbing, except when he has been sub- 
jected to chilling, when it is permissible to use the 
more violent rubbing. Patting is less liable to cause 
irritation of the skin. 
After thoroughly drying the skin with the towel dust 
on some talcum powder, zinc stearate or cornstarch, ex- 
cept on the genitals. 
Great care should be observed in drying the folds or 
creases of the skin and behind the ears, especially if 
soapy water is used; otherwise unpleasant skin erup- 
tions may occur, such as eczema or intertrigo. DIET AND CAEE OF CHILDREN 
33 
If there is a tendency to irritation, the skin can be 
wiped with a cloth saturated with zinc-oxide ointment 
or zinc-oxide powder in olive oil and then dusted lightly 
with stearate-of-zinc powder or cornstarch, except on 
the genitals. In such cases the particular parts involved 
should not be washed with soapy water. Water with- 
out soap, bran water or albolene can be substituted. 
68. What hind of powder should he used on the shin 
after drying? 
Ordinarily after drying the skin should be lightly 
dusted with talcum powder, zinc stearate, cornstarch or 
equal parts talcum and cornstarch. 
69. What care should the nose receive at bathing-time? 
Dried secretions may be softened with liquid albolene 
and gently removed by means of a wisp of sterile cot- 
ton twisted about the end of a toothpick or wooden ap- 
plicator. This must not be inserted far into the nostril, 
however. 
70. What care should the ears receive at bathing-time? 
The creases of the external ear and behind the ear 
should receive careful but gentle attention with soap, 
water and washrag. If there is much wax present in 
the external portion of the meatus or canal it may be 
removed by means of a wisp of sterile cotton twisted 
about the end of a toothpick or wooden applicator. This 
should only be used at the extreme outer portion of the 
canal, however, and should not be pushed inward to any 
extent for fear of injuring the delicate drum and ad- 
jacent parts. 34 
DIET AND CARE OF CHILDREN 
71. Should the mouth he washed out with horic acid? 
No. This is a very common and illogical procedure. 
The normal mouth secretions are alkaline and are most 
effective in combating infectious material when of this 
reaction. The continued use of boric acid is more liable 
to do harm than good to the delicate mucous membrane 
of the mouth. Although daily mouth-washing is un- 
necessary in young infants, if a mouth-wash is used 
it should be an alkaline preparation, such as sodium bi- 
carbonate one level teaspoonful to half a cupful of 
warm boiled water, applied gently by means of sterile 
cotton wrapped about the finger. 
t 
72. What attention should the foreskin receive? 
It should be fully retracted at bath-time about 3 
times weekly, the exposed glans quickly washed off, 
and a small amount of plain or borated vaseline gently 
applied. The whole operation should be quickly done; 
otherwise there is danger of not being able to properly 
pull it back to its normal position again, owing to 
swelling which is likely to occur. If the foreskin can- 
not be fully retracted a physician should be consulted 
with the view of removing adhesions, and in occasional 
cases performing circumcision. 
73. What precautions are to he taken in washing near 
the genital organs? 
Always wash away from these parts, especially in 
female infants, as there is danger of carrying serious 
infection from the intestinal discharges. 
74. What precautions are to he taken in using powder 
near the genital organs? 
Do not use dusting-powders on the genital organs of DIET AND CARE OF CHILDREN 
35 
female infants, as it is liable to cause irritation and con- 
sequent infection. 
75. What substitute may be used for water in bathing? 
Occasionally it is undesirable to use water upon the 
skin—e.g.y with certain rashes. Liquid albolene is 
sometimes used as a preferable substitute. 
76. What is a suitable time for a baby to exerciset 
Immediately after bathing he should be allowed to 
kick about without clothing and according to his own 
sweet will for 10 to 15 minutes. His muscles will have 
unhampered freedom of play, and great benefit will 
occur from his unrestricted movements. 
77. Should an infant be bathed when he has a “cold”? 
A very frequent question. 
Although bathing is always a necessary function, it 
seems to me that it is of greatest importance during 
illness, as it helps to free the body of impurities and 
promotes reflex stimulation, which is beneficial. When 
baby has a “cold” special pains are of course neces- 
sary to guard against undue exposure; therefore it is 
desirable to bathe him in a warm room, and, unless the 
latter is very warm, before a fire of some kind. Im- 
mediately after the bath the skin should be dried with 
sufficient vigor to produce a prompt reaction (redden- 
ing). 
78. Should a baby go beach-bathing f 
It is absolutely absurd to take a mere infant and 
subject him to the mental and physical shock attendant 
upon beach bathing in fresh or salt water. He is more 
likely to be frightened out of his senses than benefited 36 
DIET AND CARE OF CHILDREN 
thereby. If he shows an inclination at 18 months to 2 
years to paddle about in shallow water, all very well 
and good, but it is doubtful whether he will enjoy a 
dip much under 3 or 4 years of age, and even then it 
will not do him any good if he be unduly alarmed by it. 
Obviously, a child should get a good rubdown after- 
ward and should never be allowed to get chilled. 
It is almost unnecessary to emphasize that a child 
should be taught to swim as early as possible. 
79. Preparation of a bran bath? 
Take a piece of gauze or cheese-cloth 6 by 12 inches, 
fold into a square 6 by 6 inches and stitch up two sides, 
making a bag. Put in a handful of ordinary feed- 
store bran and stitch together the mouth of the bag. 
Shake and squeeze the bag in the bath-water until the 
latter becomes milky white. 
80. When are bran baths used? 
When soap-and-water baths are undesirable. Bran 
baths are used in eczema, prickly heat, chafing and 
other skin affections. 
81. Preparation of a soda bath? 
Two tablespoonfuls of baking soda to a gallon of 
warm water. Dissolve the soda in a pint of warm water 
and then add to the bath. 
82. When are soda baths used? 
Soda baths sometimes give relief in prickly heat and 
other skin irritations. The soda bath can be combined 
with starch water. DIET AND CARE OF CHILDREN 
37 
83. Preparation of a starch bath? 
One-half cupful of boiled laundry starch to a gallon 
of water. Mix it up in a pint of warm water before 
adding to the bath-water. Stir thoroughly. 
84. When are starch baths used? 
They are useful in hives and prickly heat. 
85. Preparation of a salt bath? 
One-lialf cupful of salt to each gallon of water. Dis- 
solve in a smaller portion of warm water before adding 
to the bath-water. The proportions are the same for 
table salt, rock salt or prepared sea salt. 
86. When are salt baths used? 
They are sometimes used (when there are no skin 
eruptions) as a tonic for malnourished children, as in 
rickets. The salt bath should follow the ordinary 
cleansing bath and be continued for three to five 
minutes, being accompanied by constant rubbing and 
followed by brisk friction with a rough towel. The 
water should be tepid or cool. If there are skin erup- 
tions of any considerable extent the salt will cause un- 
pleasant irritation. 
87. Preparation of a mustard bath? 
Four level tablespoonfuls of mustard to each gallon 
of water. 
88. When are mustard baths used? 
A mustard bath acts as a stimulant to the circulation 
and brings the blood to the body surface, tending to de- 38 
DIET AND CARE OF CHILDREN 
crease brain congestion. The baths are used in con- 
vulsions, to bring out the rash in eruptive fevers 
(measles, etc.) and to promote general stimulation 
through the circulation. The child should not remain 
in the bath for more than five minutes. 
89. When and how should a child be trained to move the 
bowels t 
Training may be started at two to three months of 
age. Each morning at the time when his bowels usually 
move he should be set upon a small warmed chamber 
which is held in the attendant’s lap, his back being to- 
ward the holder. Success may be promoted at first by 
the insertion of a soap or glycerine suppository or a 
lubricated small, smooth glass rod. Grunting on the 
part of the attendant will sometimes furnish inspira- 
tion. Failure should never be followed by punishment. 
90. What wardrobe should be prepared for a young 
baby? 
4 flannel binders—the binder to be sewed on each day 
after the bath. 
6 knitted 7-inch bands with shoulder-straps, avoiding 
rough inner seams as far as possible. 
4 long, high-necked and long-sleeved woolen, silk-and- 
wool or cotton-and-wool shirts. In very hot weather 
low-necked cotton shirts may be worn. 
3 dozen diapers, 20 by 24 inches or 20 by 40 inches. 
Cotton, stockinet or linen. 
6 petticoats of flannel, cotton or muslin (according 
to temperature). 
4 flannel slips. DIET AND CARE OF CHILDREN 
39 
6 plain muslin, nainsook or lawn slips, extending to 
the feet and fastening behind with buttons. 
2 knitted sacks. 
6 long nightgowns of flannel or canton flannel (mus- 
lin, thin outing flannel or cambric in warm weather) 
with drawstring at bottom. 
A warm cloak. 
Crocheted or knitted socks of silk thread or soft yarn. 
To be tied at ankles with ribbon or cord. 
2 pairs of mittens. 
2 gray or white veils. 
2 bonnets with interlining. 
Rubber, oilcloth, oiled-silk or oiled-paper crib sheeting. 
6 soft quilted pads for the crib. 
6 crib sheets. 
2 crib blankets. 
3 knitted blankets of various weights. 
4 blanket pins. 
1 or 2 hot-water bottles. 
91. What are some desirable factors to be considered in 
clothing a young child? 
The clothing should be light in weight and at the 
same time sufficiently warm. It should be soft in tex- 
ture; therefore no starch should be used in washing. 
Loose clothing is warmer than tight, all other things 
being equal, as the air contained between the clothing 
and the body is a poor heat conductor; moreover loose 
clothing permits greater freedom of muscle action. A 
certain degree of porosity allows of ventilation and 
evaporation from the body surface. Obviously cloth- 40 
DIET AND CARE OF CHILDREN 
ing should be dry and clean. Body contacts should be 
free from rough seams and irritating surfaces. 
92. What should govern the amount of a child’s cloth- 
ing? 
The temperature to which the child is subjected. Con- 
sult the thermometer rather than the calendar. 
93. What are some of the results of excessive clothing? 
There is a distinct tendency for mothers to over- 
clothe their children rather than err in the opposite 
way. Children who are habitually over-clothed are apt 
to be pale and languid and are liable to contract 
“colds” and be subject to intestinal disturbances. The 
result of too much clothing is to cause overheating and 
excessive sweating and even actual elevation of the body 
temperature (fever). Such babies are subject to prickly 
heat, sleep poorly and cry much as a rule. A super- 
abundance of clothing interferes with the bodily activi- 
ties, retards muscular development and oftentimes in- 
terferes with proper breathing. If the clothing is too 
tight there is liable to be vomiting. There may be fail- 
ure to gain or even actual loss of weight. 
94. How should the abdominal binder be made and 
worn? 
The abdominal binder serves a manifold purpose, act- 
ing primarily as a dressing to protect the cord-stump, 
and furnishing warmth to the delicate abdominal 
organs. The support furnished to the abdominal wall 
may perhaps be of some value at first, but would later 
on be a disadvantage owing to restriction of free muscu- 
lar action and development. The binder should be DIET AND CARE OF CHILDREN 
41 
made of all-wool flannel, an unhemmed strip, averaging 
7 inches in width and 18 inches in length. It should be 
fitted snugly hut not tightly over the abdominal wall in 
one layer, being fastened at the side with tapes or 
small safety pins. Do not allow it to come high enough 
to restrict chest movements, nor low enough to restrict 
leg movements. The binder can be replaced by a 
band after the cord stump has separated and the wound 
has completely healed. 
95. How should the abdominal band be made and worn? 
The circular band takes the place of the abdominal 
binder after the cord-stump has separated and the 
wound has healed. It is preferably knitted and made of 
wool, silk and wool or cotton and wool. It should aver- 
age 7 inches in width and the shoulder-straps should be 
knitted into the band without seams. It should extend 
from hips to ribs, but should not impede muscular ac- 
tion of chest or legs. The abdominal band is usually 
made with front and rear tabs for the purpose of pin- 
ning on the diapers. It is wo.rn until the runabout age 
and furnishes valuable warmth to the abdomen. 
96. How are shirts made and worn? 
The shirt is usually knitted of wool, cotton, silk, cot- 
ton and wool or silk and wool. Cotton or cotton and 
wool make very suitable materials. There should be 
various weights for varying temperatures, not very 
heavy at any time, and quite thin in warm weather. 
The neck should be high and the sleeves long enough to 
extend to the wrists. The shirt should open all the 
way down the front, and is usually fastened at the neck 
with a gathering-string and down the front by means 42 
DIET AND CARE OF CHILDREN 
of small flat buttons. There should be no rough seams, 
and the shirt should be loose enough not to compress or 
restrict the chest. 
97. How are 'petticoats made and worn? 
They should be made of all-wool flannel or of flannel 
and cotton, or the skirts can be made thus and fitted 
to a loose waist of cotton. The suspension should be 
from the shoulders by means of the waist without 
sleeves, which should open either in the back or on the 
shoulders. The skirt should not extend more than 8 to 
10 inches below the feet, as it is undesirable to impede 
leg motion. 
98. How are dressing-slips made and worn? 
They are worn over all indoor garments—i.e., band, 
shirt, diaper, petticoat. They should be made of some 
soft wash material, as cambric, nainsook, batiste or 
lawn, and should be laundered without starch. They 
should be loose, especially so in the armholes, should be 
preferably without a waist line, and should be buttoned 
at the back. The sleeves should extend to the wrists, 
where they can be fastened with small safety pins or 
turned up. The length should barely exceed that of the 
petticoat. There should be no hard or rough orna- 
mentation at the neck or wrists to cause irritation of the 
delicate skin. 
99. How are nightgowns made and worn? 
The night-slip should be longer than the dressing- 
slip and should be loose enough to allow free leg mo- 
tion. There should be various weights for varying tern- DIET AND CARE OF CHILDREN 
43 
peratures, and in cold weather the bottom seam should 
be furnished with a drawstring to permit the bottom to 
be closed up like a bag, protecting feet and legs. The 
material should be light, soft and washable. In cold 
weather it may be flannel, cotton and flannel or cotton 
stockinet; in summertime muslin, outing flannel or cam- 
bric. 
100. How are wrappers made and worn? 
A wrapper should open down the front and may be 
worn in place of a day or night slip. It may be made 
of flannel, cotton and flannel or cotton. It is designed 
for the sake of comfort and convenience rather than for 
appearance and is analogous to the dressing-gown of an 
older person. 
101. How are diapers made and worn? 
Diapers should be made of some soft, light, absorbent 
material which is not too heating, such as cotton, stocki- 
net or linen. The absorbent function is provided by 
material of loose texture. Diapers are usually applied 
so that the discharges are taken up on an inside ab- 
sorbent pad, the diaper proper serving chiefly to hold 
the pad in place. The diaper also performs a function 
in furnishing warmth and protection to hips, genitalia 
and thighs. 
The inner pad may simply consist of a small loose- 
textured diaper folded twice into a small square. It 
may be a special quilted pad or it may consist of gauze 
or cheese-cloth, or the latter wrapped about a mass of 
cleaned and dried sphagnum (florist’s) moss or some 
absorbent paper. 44 
DIET AND CARE OF CHILDREN 
If no pad is used a diaper 20 by 40 inches should be 
folded into a square, then diagonally into a triangle, 
forming four layers. The long side or hypothenuse of 
the triangle is wrapped about the waist and the two 
corners are pinned together and to the band in front. 
The apex is brought up between the thighs and pinned 
in front to the band; the open space on each thigh is 
closed by means of a safety pin, and the diaper at the 
same time pinned to the stocking. The back is also 
pinned to the band. 
If an inner pad is used an approximately square 
diaper (about 20 by 24 inches) will be more appropriate, 
furnishing only two thicknesses when folded diagonally 
into a triangle. It is applied in the same manner as the 
foregoing. 
The oblong diaper is sometimes applied by folding 
one end over sufficiently to cover the seat. The folded 
edge is wrapped about the waist, the middle is pinned 
to the band behind, and the two corners are pinned 
together and to the band in front. The lower portion is 
brought up between the thighs and pinned in four 
places in front. 
A waterproof cover should not be used, except on 
very special occasions, as it will promote sweating and 
skin irritation and will not permit of sufficient ventila- 
tion and evaporation. 
Stockings may be attached to the diaper by means of 
safety pins or by special garters which pin to the diaper. 
102. How should diapers he cared for? 
They should be removed as soon as soiled or wet, ex- 
cept at night, when they may be changed at feeding- DIET AND CARE OF CHILDREN 
45 
time. After removal place them in a closed receptacle 
until ready for washing, when they should be washed 
thoroughly with a good soap, not too alkaline, avoiding 
soda. After washing they should be boiled and then 
rinsed several times and aired for about 24 hours be- 
fore use. 
103. How should soiled diapers he kept until washed ? 
Preferably in a closed receptacle in a room or closet 
adjoining the nursery. If a physician is in attendance a 
specimen of stool should be preserved undisturbed on a 
recent diaper for his inspection. 
A galvanized or enameled pail with a cover makes a 
satisfactory receptacle. 
104. When should a baby first wear short clothes? 
At about six months of age. 
105. What should a baby wear indoors when first put 
into short clothes? 
Band. 
Shirt. 
Diaper. 
Stockings of light wool or cotton and wool. 
Soft, light moccasins of kid, felt or chamois leather. 
Soft flannel petticoat. 
Short white dress. 
Knitted sack (at times for warmth). 
106. Should a young infant wear stockings? 
Except in the warm summertime they should be worn 
as a protection. The,/ should be of light wool or cotton 46 
DIET AND CARE OF CHILDREN 
and wool. If made of the latter mixture they will 
be less liable to cause trouble by shrinking. If there is 
an annoying tendency to shrink they can be put on a spe- 
cial stocking-stretcher after washing. They must be 
large enough, and should not be allowed to cause any 
constriction of the feet or legs. The stockings may at 
first be pinned to the diaper, and later attached to the 
waist by means of garters. 
107. When should a baby begin to wear shoes, and what 
kind shoidd he wear? 
Until the baby begins to creep about he does not need 
real shoes. When he is put into short dresses, at about 
6 months, he may wear soft, light moccasins of kid, felt 
or chamois leather. When more active, at about 8 or 
9 months, he may begin to wear high shoes of soft kid 
with rough soles of thin leather or kid. There should 
be no heels, and the soles should be neither stiff nor slip- 
pery. The shoes should be somewhat longer than the 
foot, with toes rather wide and loose, and heels and 
instep fitting snugly to prevent rubbing or turning of 
the foot. Laces (not tight) will make the fit more per- 
fect. If the shoes are rather high they will be less likely 
to come off and will afford more warmth. 
Ankle-braces are undesirable, except when there is 
marked weakness and bending, as muscular development 
should be stimulated by the baby’s normal efforts to 
stand and walk. 
In the summertime, if the baby does not actually go 
barefooted, an excellent substitute is afforded by broad- 
toed sandals. DIET AND CARE OF CHILDREN 
47 
Shoes are to be worn when needed, and the baby 
should sleep with his shoes off, like other human beings. 
108. What should a baby wear at the creeping age f 
"When creeping, rompers may be substituted for the 
dress. At this period he may begin to wear high shoes 
of soft kid with rough soles of thin leather or kid. 
109. When should a baby first begin to wear drawers? 
As soon as he has been trained to get along without 
diapers in the daytime. He will need diapers at night 
for some time afterward. 
110. What shoidd a child wear indoors at the beginning 
of the runabout age? 
Band. 
Shirt. 
Diaper (if not trained). 
Waist. 
Garters. 
Drawers or bloomers. 
Dress or rompers. 
Knitted sack (at times for warmth). 
Stockings. 
Shoes. 
111. When should the clothing be suspended from the 
shoulders? 
As soon as the child is old enough to run about, the 
fundamental support for the clothing should be the 
shoulders, and it should not be supported by squeezing 
about the waist. 48 
DIET AND CARE OF CHILDREN 
112. What 'precautions should he taken in suspending 
clothing from the shouldersf 
Shoulder-straps should be wide enough to evenly dis- 
tribute the strain along the shoulder and not so narrow 
as to concentrate it in one place. Narrow straps are 
liable to slip to the point of the shoulder, causing it to 
sag downward and forward. 
113. What is suitable night clothing for older children? 
An inner shirt of knitted wool or cotton and wool. 
Outside of this, nightdrawers with feet (Dr. Denton 
type), made of flannel, cotton and flannel, stockinet, 
muslin or outing flannel, depending upon the weather. 
114. Why is sleep necessary? 
During the expenditure of nervous energy there is an 
actual using up or exhaustion of nerve tissues. This 
waste has to be replenished during sleep. 
115. How much time should a child spend sleeping? 
The average time spent sleeping during the 24 hours 
should be as follows: From birth to 6 months, 20 hours; 
from 6 months to 1 year, 18 hours; from 1 to 2 years, 16 
hours; from 2 to 6 years, 10 to 14 hours. 
There are likely to be, however, some normal and 
many abnormal exceptions to the above rule. 
116. How long should daytime sleeping be enforced? 
Midday naps should be continued up to 5 years at 
least, and in nervous, high-strung, active children even 
longer. Even though a child does not sleep at midday, 
a rest of an hour or so in bed will have great value in 
maintaining nervous equilibrium. DIET AND CARE OF CHILDREN 
49 
117. What is the proper position during sleep ? 
An infant should sleep without a pillow, but with the 
mattress placed upon such a plane that the head is 
elevated slightly above the level of the feet. In this 
position there will be less likelihood of vomiting after 
nursing. Immediately after nursing the best reclining 
position is on the right side, as during the passage of 
food from the stomach into the intestine the course 
taken is toward the right. However, a baby should not 
remain in any one position for any great length of time, 
and the position of the body should be shifted occa- 
sionally. 
118. Should a baby be coddled, rocked or walked with 
at bedtime? 
Only in case of illness or emergencies are such at- 
tentions excusable. Not only the baby, but also the 
parents and the whole household soon become absolute 
slaves to such indulgences. The best way to control 
such a habit is to never allow it to start in the first 
place. If it has already started it should be resolutely 
curbed. It usually takes about three nights of persist- 
ent refusal to accomplish the desired result. 
119. To what extent should a sleeping baby be guarded 
from noise? 
Inasmuch as during the first six months a baby 
should average to sleep about 20 hours out of 24, it is 
a mistake to enforce excessive quiet during sleeping- 
hours. Usual household noises should be permitted and 
only loud, unusual noises guarded against. 50 
DIET AND CARE OF CHILDREN 
120. Should a young child sleep with an adult? 
He should by all means sleep alone if possible, and 
should preferably occupy his sleeping-room alone, but 
in living conditions as they commonly exist this is not 
always possible. However, it can usually be arranged 
to have him occupy his bed alone. 
121. What is overlying? 
A fatal accident that is very liable to occur if the 
baby is allowed to sleep in bed with its mother. The 
mother rolls over during sleep and smothers the baby. 
This accident has occurred many times, and when the 
nursing mother is in bed the nursing should be very 
carefully supervised, and the baby separated from the 
mother immediately after nursing. 
122. How should the nursery walls he constructed and 
covered? 
They should be preferably of plaster and simply 
painted of some light, pleasant shade—e.g., cream or 
colonial yellow. Such walls can and should be often 
washed. If wallpaper is used it should be of a type 
that can be washed. Avoid arsenical coloring in wall- 
paper or any nursery furnishings. 
The walls can be pleasingly decorated by pinning or 
pasting up appropriate colored pictures cut from maga- 
zines and other sources (children, animals, birds, etc.). 
123. What precautions should he taken in regard to the 
nursery hangings? 
They should be few, easily removable and often 
washed. DIET AND CARE OF CHILDREN 
51 
124. What precautions should he taken in regard to the 
nursery floor? 
It should not be a dust- and dirt-catcher and should be 
easily cleaned. It should be preferably of hard wood, 
with the boards closely matched, and varnished. It 
should not be slippery. Linoleum makes a satisfactory 
surface. While it is desirable to have some coverings, 
they should be capable of being readily taken up and 
often washed. 
125. How should the nursery he lighted? 
There should preferably be windows on at least two 
sides of the room, in which case easterly and southerly 
exposures are desirable as furnishing a maximum of 
light during the earlier and greater part of the day. 
If there are windows on only one side of the room they 
should be southerly. The windows should be furnished 
with dark shades, awnings for summer use, and, if pos- 
sible, old-fashioned blinds which will furnish darkness 
when required as well as ventilation. 
Electricity is the artificial light of choice, as it ex- 
hausts no air from the room. Gas and oil lighting 
should be carefully supervised to avoid possible dan- 
gers. Avoid dazzling lights. 
A candle protected by a chimney affords a satisfac- 
tory night light. 
126. How should the nursery he heated? 
The most hygienic heating system is afforded by the 
hot-air furnace with outside airbox. This permits of a 
constant ingress of fresh air from the outside. Such a 
furnace should be equipped with a water-pot, which 52 
DIET AND CARE OF CHILDREN 
should be carefully kept filled to prevent excessive dry- 
ing of the air. 
Hot water and steam furnish efficient heating, but 
afford no outside ventilation. When they are used 
radiator pans should be furnished to allow sufficient 
humidity of the air in the room. 
Coal, gas and kerosene stoves exhaust so much of the 
air as to render them less desirable. 
An open fireplace is a valuable accessory in a nursery, 
not only furnishing means of quick heating, but also 
providing valuable ventilation. 
127. What degree of humidity should he maintained in 
the nursery? 
From 50 to 60 per cent. If the air is too dry there is 
great danger of catarrhal and other affections of the 
respiratory tract. 
128. What is the most favorable average temperature 
for the nursery when the cnild is not bundled up 
for sleeping? 
Sixty-eight to 70 degrees F. It is easier to main- 
tain this temperature in wintertime by artificial means 
than oftentimes in summer. The temperature can 
be lowered if necessary by the judicious use of elec- 
tric fans, but out of doors during the daytime should 
usually be the chosen place for the child. 
129. What should be the minimum temperature when 
airing and sleeping? 
For normal vigorous infants: For the first month, DIET AND CARE OF CHILDREN 
53 
60 degrees F.; from 1 to 5 months, 40 to 50 degrees F.; 
after 5 months, 25 to 30 degrees F. 
In the case of very delicate infants the temperature 
should not be under 60 to 70 degrees F. 
Extremes above 70 degrees F. and below 25 degrees 
F. are to be combated, in the summertime, by keeping 
indoors during the hot sunny midday, and outdoors, 
on proper days, in the shade in the morning and late 
afternoon; and in the winter by sunny exposures when 
possible and by the use of special heavy clothing, hot- 
water bags, hot-water bottles, hot bricks or electric pads 
if necessary. 
130. When should a baby be first allowed out of doors? 
During the first month of life a winter baby is better 
off indoors. After the first month the baby may be al- 
lowed outside during the middle of the day on good 
days if the temperature is not below 50 degrees F., the 
minimum temperature being lowered as the baby be- 
comes older. All unfavorable exposures should be care- 
fully avoided. 
131. What unfavorable outdoor exposures should be 
avoided? 
Wind, dust, rain, snow, fog, extreme cold, hot sun 
and insects are the common exposures to be avoided. 
With the exception of fog, the other factors can often- 
times be successfully combated in outdoor airing by 
proper placing and seclusion. 
132. How can a porch, room or baby-carriage be effec- 
tually screened from dust and soot? 
Screen with ordinary cheese-cloth. This will not only 54 
DIET AND CARE OF CHILDREN 
act as a satisfactory strainer for most of the dust 
particles, but will at the same time protect to a certain 
extent from draughts and afford ample ventilation. It 
will also serve as a protection from insects. 
133. What special means can he used for airing a hahy 
out of doors? 
A screened porch on the shady side of the house in 
summer or a porch on the sunny side in winter. A spe- 
cial screened bed which can be extended out of a win- 
dow can be purchased, or a special roofed and 
screened-in platform can be constructed in the yard. 
134. How should the nursery he ventilated? 
There are various means of attaining this object, the 
simplest being to open the windows several times daily 
while the baby is out of the room, if the temperature is 
too cold or there is too strong a draught to have him 
remain in the room. However, it is desirable to have 
some steady means of ventilation such as may be ob- 
tained by the use of window-boards, muslin screens in 
the windows, ventilators or the presence of a fireplace 
in the room. A hot-air heating-plant with outside air- 
box affords a supply of fresh air which in wintertime 
can be properly warmed. The ventilating system 
should be so arranged as to provide immunity from 
draughts. 
135. What is a window-hoard? 
A board 6 to 8 inches in width and of a length corre- 
sponding to the width of the window, fitting into the 
casing under the lower sash of the window, which is DIET AND CARE OF CHILDREN 
55 
raised sufficiently to accommodate it. This permits a 
free supply of air to enter between the raised lower 
window and the upper one without causing an undue 
amount of draught. 
136. Is cold air necessarily fresht 
Many people imagine that if air is cold it is neces- 
sarily fresh, but this is of course a very dangerous as- 
sumption. Air may be very warm and, if well venti- 
lated, perfectly fresh. An undue exposure to cold, foul, 
close air is a doubly unsafe one. 
137. How early and how much should a baby be taken 
auto-riding ? 
In automobiling, the same temperature precautions 
should be observed as for ordinary airing with young 
babies, but these precautions are much harder to en- 
force, especially on long rides in an open machine. 
Crowding, confusion and undue exposure must be 
sedulously guarded against. Long “hikes” with 
young babies are impractical. Under proper con- 
ditions, a nursing baby should benefit by short automo- 
bile rides, not only as a result of good airing, but in- 
directly through benefit to the mother, whether she goes 
along and enjoys the ride or whether she remains at 
home and enjoys the rest and temporary freedom f~om 
responsibility. 
Under one year the baby will doubtless enjoy the 
scenery about as much in the seclusion of his veranda 
or under a good shady tree. 
138. Should a baby use a walking-machine? 
Development ought to be encouraged but not forced. 56 
DIET AND CARE OF CHILDREN 
The baby should be allowed every reasonable oppor- 
tunity to exercise his own inclinations as to sitting up, 
creeping, standing and walking, and thus receive a 
proper stimulus to normal development. When forced, 
as by a walking-machine, injury is liable to occur to the 
delicate body structures. 
139. Should a baby use a pacifier? 
No. Its use dodges the issue and allows a bad crying- 
habit, which may have originated from some such 
basis as underfeeding or overfeeding, to degenerate 
from bad to worse. Using a pacifier not only allows the 
baby to suck in an inordinate amount of air, but in 
time deforms the mouth, causes irritation and infection 
of the mouth, leads to adenoids, and affords an excellent 
means of introducing dangerous infections into the 
body. DIET AND FEEDING 
ANY intelligent farmer is cognizant of the tremen- 
- dous influence that proper feeding exerts upon 
the development of young stock, whether they be chicks 
or calves. The same fact applies to young human be- 
ings. If the proper feeding of young pigs is deserving 
of great expenditure of thought, time and money, is it 
logical that the feeding of young humans should be 
allowed to be of the hit-and-miss type that it so often is, 
especially after the runabout age has been reached? 
Maternal nursing is a normal physiological process 
which should furnish, if possible, the primary feed- 
ing-scheme of first choice during the first year. Ar- 
tificial feeding, on the other hand, is abnormal and 
should be of second choice. Its application is often a 
very complicated matter, and if any difficulty is ex- 
perienced with it, expert advice should be sought. In 
view of these facts the attempt has been made in these 
pages to offer a more intimate treatment of the normal 
feeding of choice than of the abnormal feeding of ne- 
cessity. 
An important criterion of success or failure in feed- 
ing is furnished by the progressive weight development, 
which should be recorded at least once a w^eek. 
140. What is the natural food for a human being during 
the first year? 
Human breast milk is the natural and ideal food. 58 
DIET AND CARE OF CHILDREN 
When properly furnished and administered, babies 
average to thrive better and show a greater immunity 
to disease and a smaller mortality percentage than do 
babies fed upon any other kind of food. 
141. Principal ingredients in milk? 
Butter fat (cream) ; protein (casein, paracasein, lac- 
talbumin, lactoglobulin) ; sugar (lactose) ; mineral 
salts; water. 
142. Approximate percentage of ingredients in breast 
milk ? 
Per cent. 
Fat 4. 
Protein 1.50 
Sugar 7. 
Salts 0.20 
Water 87.30 
Total 100. 
143. Approximate percentage of ingredients in cow’s 
milk ? 
Per cent. 
Fat 4. 
Protein 3.50 
Sugar 4.50 
Salta 0.75 
Water 87.25 
Total 100. 
144. What are the principal mineral salts present in 
human milk? 
Sodium, potassium, calcium, magnesium, chlorin, 
phosphorus and iron. DIET AND CARE OF CHILDREN 
59 
145. What are the principal mineral salts present in 
cow’s milk? 
Sodium, potassium, calcium, magnesium, chlorin, 
phosphorus, iron and sulphur. 
The amount of mineral matter in cow’s milk is about 
four times the amount present in human milk, but iron 
is present in smaller proportion than in human milk. 
146. What is cream? 
Cream represents the butter fats present in milk 
which, because of their relatively low specific gravity, 
have risen to the top after standing. The very top of 
the cream is nearly pure butter fat. These fats are 
chiefly olein, palmitin, stearin and volatile fatty acids. 
The volatile fatty acids are much more abundant in 
cow’s milk and are far less easily tolerated by the in- 
fant than are the oleates which predominate in human 
milk. 
The fat in human milk is more finely divided or emul- 
sified than is the fat of cow’s milk. 
147. What is protein? 
An essential food containing carbon, hydrogen, 
oxygen and nitrogen and other elements. It is well 
exemplified in egg albumin, lean meat and the cheesy 
curds of milk. 
148. How do hreast-milk curds compare with those of 
cow’s milk? 
The breast-milk curds are finer and more flocculent in 60 
DIET AND CARE OF CHILDREN 
structure, while those of cow’s milk are relatively 
coarse and tough. 
149. What is a carbohydrate? 
A combination of carbon, hydrogen and oxygen in 
certain proportions. Starches and sugars are carbo- 
hydrates differing somewhat in their combination of the 
above-named elements. 
150. What milk ingredients most often cause indiges- 
tion? 
Formerly protein was regarded as the disturbing in- 
gredient, and “percentage feeding” came strongly into 
vogue, partly as a result of this belief. Nowadays, how- 
ever, we have come to realize that true protein indi- 
gestion, manifested by so-called bean curds (hard, 
brittle curds, bean-shaped and bean-sized), is extremely 
rare. Fat is the usual offender. Natural sugar seldom 
causes trouble, but added carbohydrates often do. Min- 
eral salts are probably a negligible factor. 
151. Should a young child drink unboiled water? 
As a general rule, during the milk-feeding period up 
to one year of age, the water should be boiled, although 
in most large communities, where the water supply is 
carefully supervised, the tap water is practically free 
from disease-producing germs and should be safe for 
older children. It is always a safe precaution to boil 
water of uncertain origin. 
152. What quantities of feeding should a baby receive 
during the first year? 
The amounts of food given should approximately cor- DIET AND CARE OF CHILDREN 
61 
respond to the stomach capacity at any given age, and 
the following amounts will usually be satisfactory in 
normal cases: 
1 week iy2 oz. 4 months 5 oz. 
2 weeks 2 ‘ * 5 “ 6 “ 
3 “ 2% “ 6 “ “ 
4 << 3 f < 7 “ 7 “ 
2 months 4 “ 8 “ 7% “ 
3 “ 4% “ 9 ‘£ 8 “ 
From 9 to 12 months 8-ounce bottle feedings are 
sufficient. 
153. What length of time should elapse between an in- 
fant’s feedings? 
The normal digestion time in an infant’s stomach is 
nearly three hours, and as it is illogical to put food into 
a stomach in which digestion is uncompleted, shorter 
intervals than three hours are unsuitable for normal 
infants. There are normal variations in digestion-time, 
and some babies require longer intervals—practically 
never shorter ones. If the baby seems hungry before 
three hours have elapsed, it is better to increase the 
strength or amount of feeding rather than shorten the 
intervals. 
154. Why are short feeding-intervals undesirable? 
When too short feeding-intervals are used, food is put 
into a stomach which already contains food which has 
not passed out into the intestine. If this process is con- 
tinued there eventuates an over-accumulation of un- 
digested food, with consequent fermentation, mani- 
fested by indigestion, vomiting, colic, green stools and 
allied unfavorable symptoms. 62 
DIET AND CARE OF CHILDREN 
155. How does the digestion-time of breast milk com- 
pare with that of cow’s milk? 
It is shorter with breast milk than with cow’s milk. 
156. When should a child begin to take solid food? 
It is permissible to start a baby on semisolids at 7 
months—strained cereals and vegetable purees; zwie- 
back, dried bread and milk crackers may be given 
if he has teeth; or zwieback soaked in milk or water 
if the teeth have not erupted. At 8 months, broths 
with barley or rice. At 9 months, coddled egg mixed 
with bread, toast or cracker crumbs two or three times 
weekly. These additions to the diet may be given at 
regular feeding-times, taking the place of a portion of 
the breast or artificial feeding, or, if the baby’s appe- 
tite demands, as an addition. 
Milk feeding as a primary diet should not be abol- 
ished until 12 months of age, when normal babies should 
be put upon a regular runabout diet, irrespective of the 
season of the year. 
157. What is the appearance of the normal stool of the 
breast-fed? 
After the cessation of the passage of meconium: A 
light yellowish mass, having much the appearance of 
scrambled egg. It should not soak into the diaper to 
any extent. 
158. What is the appearance of the normal stool of the 
bottle-fed? 
After the cessation of the passage of meconium: 
Usually light yellow, but sometimes dark yellow when DIET AND CARE OF CHILDREN 
63 
certain carbohydrates are included in the formula. 
Usually more formed and of firmer consistency (often 
pasty) than in the breast-fed. 
159. What foods may cause variation in the color of the 
stools of the bottle-fed? 
Dextrimaltose, malt soup extract and barley flour 
darken the stools. 
160. Normal stool reactions in breast and bottle babies? 
In breast babies acid, in bottle babies alkaline. 
161. What is the significance of curdy stools? 
These are present in overfeeding—i.e., when the baby 
is getting too much food or is being fed too often. 
Curds are common in fat indigestion. These curds are 
yellowish or grayish, hard and brittle, and have a ran- 
cid odor when broken up. In fat indigestion we also 
at times get small whitish curds mixed with green. Fat 
curds dissolve for the most part in ether. Very rarely 
we get hard bean-shaped and bean-sized curds, made up 
chiefly of casein, occurring in protein indigestion. 
Usually if the milk is boiled, or a cereal or an alkali 
(such as sodium citrate) is added to the formula, these 
bean curds will disappear. 
162. What is the significance of frothy, irritating stools? 
These are a common symptom in carbohydrate indi- 
gestion, occurring especially when there is an excess of 
sugar. These stools are liable to be acid, causing irrita- 
tion and excoriation of the skin of the buttocks. The 
frothy appearance is due to the presence of gas. 64 
DIET AND CARE OF CHILDREN 
163. What is the significance of bean curds? 
See question (161) of curdy stools. 
164. What is the significance of green stools? 
Briefly, they are associated with the presence of an 
excess of some element in the food. Oxidation of one of 
the bile constituents is regarded as a factor in some 
green stools. 
After a stool has oxidized in the air for some time it 
tends to assume a greenish hue. 
165. What is the significance of mucous stools? 
Mucus is regarded as an invariable symptom of di- 
gestive disturbance, usually an indigestion associated 
with the presence of bacterial infection of the intestinal 
tract. Mucus is a usual accompaniment of the serious 
diarrheas of infancy. 
A physician should always be consulted when mucus 
occurs in the stools. 
166. What is the significance of bloody stools? 
These occur in the serious infectious diarrheas. In 
early infancy blood may occur in considerable quanti- 
ties in the stools in association with bleeding from other 
parts of the body in a serious condition known as hemor- 
rhagic disease of the new-born. Bloody stools some- 
times occur in scurvy. Hemorrhages may occur during 
the course of typhoid. Occasionally we find bright red 
blood in the stools in case of local bleeding low down, as 
in fissures of the anus. 
A physician should always be consulted when there 
is blood found in the stools. DIET AND CARE OF CHILDREN 
65 
167. What is the significance of tarry stools? 
These are significant of the presence of old blood, 
usually from high up in the digestive tract. They 
should not be confounded with the dark stools resulting 
from the administration of bismuth and iron. 
168. What drugs make the stools dark? 
The commoner drugs are bismuth and iron. 
169. Can immunity he transmitted through mother’s 
milk? 
A breast baby enjoys some immunity to the diseases 
to which the mother is immune. Breast babies show, 
on the whole, greater average immunity than bottle- 
fed babies. The immunity, however, is not lasting. 
170. Can disease he transmitted through mother’s milk? 
Pus bacteria, organisms causing some of the acute in- 
fectious diseases, and tuberculosis have been found in 
human milk. 
171. Is menstruation a contraindication to nursing? 
Practically never. For a few days during the 
mother’s menstruation the baby may be somewhat cross, 
irritable and out of sorts, and may even have a slight 
digestive disturbance, but if he shows signs of serious 
illness at menstruation time it is in all probability due 
to some other cause. 
172. Is pregnancy a contraindication to nursing? 
Women very frequently nurse babies through nearly 
the whole course of pregnancy. The best gauge of a 66 
DIET AND CARE OF CHILDREN 
mother’s ability to nurse during this condition is her 
own and the baby’s weight curves. If she is not of a 
highly nervous type and has no complications she will 
probably succeed in nursing during the early months, 
when it is of greatest importance. In the majority of 
cases it is better to discontinue nursing during the lat- 
ter half of pregnancy. 
173. Do the mother’s breasts secrete milk immediately 
after the baby is born? 
No. For the first 48 hours there is secreted a clear 
yellowish fluid called colostrum. This fluid is laxative 
and contains more protein and mineral salts, and less 
fat and sugar, than real milk. The baby should be put 
to the breasts regularly during the colostrum period, as 
by so doing the breasts are properly stimulated to pro- 
duce real milk, and furthermore its laxative action helps 
to clear out the baby’s intestinal canal. 
174. When and how does the fat content of mother’s 
milk change? 
After the milk comes into the breasts and the flow is 
well established there is very little average change over 
the whole period of lactation, the fat average being about 
as high in the earlier months as in the later. The prin- 
cipal change occurs daily, the evening milk being higher 
in fat content that that of the morning, and the later 
milk of an individual nursing being richer than the 
earlier milk. 
175. Is the milk of equal composition from both breasts? 
Sometimes the milk of one breast differs from that DIET AND CARE OF CHILDREN 
67 
of the other, and if only one breast is used at a nursing 
this may account for greater hunger after nursing from 
one side than from the other; it may also sometimes 
account for one twin thriving better than the other, if 
each one always gets milk from one and the same breast. 
176. Should a baby be awakened for feeding? 
Babies should always be fed according to schedule, 
and usually, if accustomed to be awakened at definite 
intervals for that purpose, will soon learn to awaken 
themselves at feeding-time. Unless for some reason 
the baby is badly in need of rest, he should be awakened 
for feeding. 
177. How long should an infant remain at the breast 
during each nursing? 
The average time under normal conditions is 20 
minutes. If the baby vomits or the mother has an ex- 
cessive flow of milk it may be necessary to shorten the 
nursing-time to 15 or 10 minutes or less, or rest at in- 
tervals during the 20-minute period. The baby should 
be able to secure enough milk in 20 minutes, and longer 
periods are undesirable. 
178. Should a baby drink water between nursings? 
The routine administration of water between nurs- 
ings is apt to result in loss of appetite and is not neces- 
sary. 
179. What care should be taken of the nursing mother’s 
bowels? 
They should be made to move at least once daily, al- 68 
DIET AND CARE OP CHILDREN 
though great care must be exercised in the matter of 
using cathartics, as some of them are excreted in the 
milk and may make trouble. When medication is nec- 
essary, I have found that mineral oil is most satisfactory 
in the majority of cases, as it is not absorbed. Cascara 
is often used successfully, although one should not lose 
sight of the fact that it is excreted to some extent in 
mother’s milk. The usual expedients of laxative foods 
—coarse breads, cereals and fruits such as prunes and 
dates—should first be tried. 
180. What should he done for a constipated nursing 
baby? 
The mother’s bowels should be made to move daily, 
using mineral oil if necessary. If over 3 months of age 
give orange juice l1 hours after one of the morning 
nursings. Begin with a teaspoonful and increase a tea- 
spoonful every 2 days until good results are obtained, 
up to 8 teaspoonfuls daily under 5 months of age. When 
over 5 months the baby may receive the juice of half 
an orange daily. Sometimes a like amount of prune 
juice (made from stewed prunes) is more effective. 
Oatmeal water (a heaping tablespoonful of oatmeal 
to a pint of water—boil for one hour, occasionally re- 
plenishing the evaporating water, and strain), 2 tea- 
spoonfuls before each feeding, may be given. 
Milk of magnesia for short periods of time may some- 
times have to be resorted to. Give 10 drops, more or 
less, according to results obtained, before each nursing. 
Some obstinate cases have responded to mineral oil, a 
teaspoonful more or less according to results obtained, 
three times daily. DIET AND CARE OF CHILDREN 
69 
Sometimes nursing babies are constipated because 
they do not obtain enough food. 
Avoid the suppository and enema habit if possible. 
181. Signs of successful nursing? 
The baby sleeps well, does not cry excessively before 
or after nursing, does not vomit much if any, has from 
one to three stools daily, passes little gas per mouth or 
rectum, and gains steadily and at a rate suitable to its 
age. 
182. Signs of unsuccessful nursing? 
The baby sleeps poorly, cries soon after nursing or be- 
fore it is time for nursing, or may cry almost con- 
tinually. He may vomit immediately or soon after 
nursing and may be constipated, sometimes not having 
even one stool daily; or the bowels may move more than 
three times daily, the stools often being greenish. There 
may be quantities of gas passed by mouth or rectum, 
with attendant colicky symptoms. The baby may fail to 
gain steadily at a rate suitable to its age, or may even 
lose weight. When a baby has colic the knees are usually 
drawn up close to the abdomen and the cry is vigorous 
and indicative of pain. 
183. How can a mother's milk secretion he increased? 
Most successfully by completely emptying the breasts 
at regular intervals—i.e., by the stimulation of sucking 
or pumping. If the mother’s own infant is unequal 
to the task of completely emptying the breasts another 
baby can sometimes be employed (especially if the 
mother is in a hospital) to complete the nursing, or the 
use of the breast-pump can be enlisted. 70 
DIET AND CARE OF CHILDREN 
Many so-called galactagogues (medicines) have been 
advocated to increase the milk supply, but their very 
multitude is a gauge of their inefficacy. 
A good wholesome diet embracing a generous amount 
of liquids is essential. 
A state of mental equilibrium and freedom from 
worry and anxiety are necessary. 
Healthful exercise (when she is able to indulge in it) 
and proper attention to sleep, bathing, fresh air and 
the condition of the bowels are essential requisites to 
good nursing. 
184. lias beer or any other alcoholic beverage any value 
in stimulating milk 'production? 
There is no convincing evidence that alcohol has any 
lasting value. Any possible gain in secretion would be 
more than offset by the loss to the infant by absorption 
of alcohol from the milk. 
185. IIow can breast nursing be materially assisted when 
the mother is unable to produce quite enough 
milk f 
By means of complementary feeding: Weigh the 
baby before and after several nursings and thus as- 
certain the average amount of milk obtained. Give a 
sufficient amount of bottle feeding after every nursing 
or every alternate nursing to make up for the deficiency, 
corresponding to the baby’s age and weight. By this 
means milk production continues to be stimulated by 
having the baby at the breast at the proper intervals, 
and the baby derives the advantage to be obtained from 
mother’s milk as long as it possesses beneficial qualities. DIET AND CARE OF CHILDREN 
71 
Another method is by means of supplementary feed- 
ing. One or more entire feedings are substituted for 
nursings. It is a good idea to give one supplementary 
feeding after three months in order to give the mother 
more freedom and to accustom the baby to cow’s milk. 
Later on this affords a suitable means for administering 
some form of cereal feeding with the milk. 
186. Some contraindications to nursing? 
Any serious acute illness of mother; constitutional or 
malignant diseases of mother—e.g., tumor, tuberculosis 
or syphilis; nephritis or inflammation of the kidneys; 
epilepsy; chorea; insanity; continued loss of weight and 
exhaustion of mother; social and economic obstacles, as 
when the mother has to work in a factory or away from 
home. 
Failure on the part of the baby to thrive after all 
fair means have been tried is an important contraindi- 
cation. In spite of the strong statements made by some 
enthusiasts, we not infrequently encounter mothers who 
simply cannot successfully functionate, and it is far 
better to meet the situation face to face, if we can get 
good reliable cow’s milk, than to dally along making 
the mother, the baby and everyone else miserable; for, 
all other things being equal: 
Good nursing is better than good feeding. 
Bad nursing is better than bad feeding. 
Good feeding is better than bad nursing. 
Oftentimes a breast baby who has lost, just held his 
own, or only barely gained for weeks, will begin to make 
good, substantial gains immediately when put upon a 
good formula. 72 
DIET AND CARE OF CHILDREN 
187. What drugs can a baby take in from a mother’s 
milk? 
Alkaloids (opium, strychnia, etc.), mercury, arsenic, 
iodides, bromides, antipyrin, quinine, salicylic acid, al- 
cohol, formaldehyde, turpentine, phenol, iodoform, cas- 
cara, rhubarb, purgative salts. 
The above are some of the commoner drugs. 
188. Why may a baby refuse to nurse? 
Aside from the loss of appetite that commonly goes 
with most acute febrile illnesses there may be other 
causes. The baby may have a sore mouth (stomatitis) 
with redness and inflammation or ulcerations of the 
mucous membrane, making it actually painful for him to 
nurse. Sometimes for a day or so during the eruption 
of teeth the baby may be reluctant to feed. Undevel- 
oped or inverted nipples may make nursing very diffi- 
cult or impossible, causing the baby to give up in 
despair. If the breasts are furnishing insufficient milk 
there is a very obvious cause which the baby readily 
learns to respond to. If a baby gets some milk or water 
from a bottle with an easy nipple, causing a very free 
flow, he will oftentimes rebel when put to a breast which 
does not secrete very freely. Nasal obstruction, as with 
a head “cold” or adenoids, may render it very difficult 
for the baby to breathe while nursing. Cleft palate 
and marked tongue-tie will interfere with proper nurs- 
ing. Overexcitement will sometimes be responsible for 
refusal to nurse. 
189. Row can caked breasts be avoided when the baby 
is weaned? 
Pump about 2 to 3 teaspoonfuls of milk from each DIET AND CARE OF CHILDREN 
73 
breast and bandage both breasts snugly. Take a heap- 
ing tablespoonful of Epsom salts in half a glassful of 
warm water and do not drink much liquid for 24 to 48 
hours. 
190. Suitable diet for nursing mothers? 
Pour to six glassfuls of water daily (two upon arising 
in the morning). 
One quart of milk daily. 
Meat. 
Poultry. 
Fish. 
Oysters. 
Scallops. 
Eggs. 
Cheese (not too much). 
Breadstuffs (not fresh). 
Vegetables. 
Cereals: Cornmeal, oatmeal, farina, cream of wheat, 
cream of rye, Pettijohn, groats, hominy, macaroni. 
Simple fruits, especially stewed prunes, dates. 
191. Unsuitable diet for nursing mothers? 
Heavy puddings. 
Underdone pastry. 
Fried foods soaked in fat. 
Doughnuts. 
Fritters. 
Croquettes. 
Pickles. 
Mincemeat. 
Baked beans. 74 
DIET AND CARE OF CHILDREN 
Pork (except bacon). 
Sausage. 
Cabbage. 
Cauliflower. 
Turnips. 
Highly seasoned foods. 
More than one cupful of tea or coffee daily. 
Alcohol in any form. 
Much candy. 
192. Care of the breasts at nursing-time? 
Before nursing the nipples should be gently washed 
with boiled water, and after nursing with boric-acid 
solution (a teaspoonful to half a glassful of warm 
water). If the breasts “leak” they should be kept dry 
by covering the nipples with pads of sterile gauze. If 
the milk is allowed to keep the nipples moist they are 
more likely to become cracked. 
193. Treatment of inverted nipples? 
The treatment should be commenced during the pre- 
natal period and should consist in massage with the 
object of drawing them out. After the babe has been 
put to the breast, if the nipples are too small it will be 
necessary to use a breast-pump, although massage 
should be continued as long as there is any hope to be 
derived from it. 
194. Treatment of cracked nipples? 
If the breasts tend to “leak” they should be padded 
with gauze to absorb the surplus milk, which will be 
likely to decompose and aggravate the condition. Wash DIET AND CARE OF CHILDREN 
75 
off, after nursing, with saturated boric-acid solution, or 
alcohol and water equal parts, dry and keep dry. Two 
or three times daily paint the nipples with silver nitrate 
solution 8% or bismuth powder and castor oil mixed 
into a paste. Applications of compound tincture of 
benzoin are of value. If necessary, use a nipple-shield 
for a few nursings or reduce the number of nursings 
from the fissured breast. Do not entirely cease nursing 
from the breast, however, if it is possible to continue. 
195. Treatment of sore nipples? 
After nursing wash gently with equal parts alcohol 
and water and apply white vaseline or lanolin and cover 
with pads of sterile gauze. 
196. Should a baby be nursed during the course of 
breast abscess? 
The baby should not be nursed at the abscessed breast, 
but should be nursed at the normal one. The diseased 
breast should be pumped at nursing-time, the milk be- 
ing discarded. After the abscess has healed, there will 
be present in most cases a considerable portion of nor- 
mal functionating gland from which the baby can de- 
rive nourishment. 
197. What precautions should be taken in choosing a 
wet nurse? 
The wet nurse should obviously have a good supply 
of milk, as best exemplified by the condition of her own 
child if she has one. She should be healthy, especial 
pains being taken to prove her free from syphilitic, 
tubercular or gonorrheal infection. Proper medical 76 
DIET AND CARE OF CHILDREN 
means should be taken to ascertain these points. She 
should have a Wassermann test made to disprove 
syphilis. Her habits should be temperate. She should 
be non-alcoholic and should be prepared to subsist upon 
a diet suitable to her function. For the protection of 
the nurse the child should be free from communicable 
disease. 
198. Should a mother give her baby formulas used by 
neighbors’ babies of the same agef 
Assuming that the neighbors’ formula is a proper one 
for a normal baby of its age: The mother might borrow 
it in case of emergency or as a temporary measure, pro- 
viding her own baby is normal. However, it must be 
understood that babies’ formula requirements are al- 
most as individual as human features and require 
proper adjustment of component elements to the needs 
of each particular baby. 
199. How do the ingredients of cow’s milk compare with 
those of human milk? 
The milk of Holstein and Ayrshire cows averages to 
contain about the same percentage of fat or cream as 
that of human milk. The milk of Jerseys and Guern- 
seys contains a higher percentage. As compared with 
human milk: Cow’s milk has a higher percentage of 
proteins or albuminous material (approximately twice 
as high), barely more than one-half as much sugar, and 
nearly four times as much mineral salts. 
Cow’s milk is acid in reaction, while human milk is 
alkaline. DIET AND CARE OF CHILDREN 
77 
200. What important requisites are called for in the 
production of suitable nursery milkf 
First of all the cows should be clean, healthy and 
tuberculin-tested. It is necessary to fulfill these re- 
quirements in order that accompanying and subsequent 
conditions may have their full value. Tuberculosis of 
bovine origin in children is of such great prevalence 
that it is to be hoped that in time the tuberculin test 
will be generally required. 
The stables should be well lighted and ventilated, and 
should be kept scrupulously clean. 
The milkers and milk-handlers should not only be 
clean, but it is important that their health as well as 
that of the cows should be under medical supervision. 
The udders of the cows and the hands of the milkers 
should be carefully cleansed before milking. Sterile 
rubber gloves for the milkers of course add to the as- 
surance of cleanliness. 
Every effort should be made to guard against con- 
tamination of the milk from dirt, flies and other ex- 
traneous hazards. All receptacles should be rigorously 
cleansed and sterilized. 
The milk should be quickly cooled—e.g., by placing 
the receptacles in running water—and kept cool (35 to 
45 degrees F.). 
The transportation should be reasonably quick, with 
a minimum of transfers. 
Fulfillment of these conditions tends to keep down 
the bacterial content of the milk. 
201. What diseases may be conveyed in milk? 
Among the most important diseases are the follow- 78 
DIET AND CARE OF CHILDREN 
ing: Diarrheal disease of infancy, dysentery, diph- 
theria, scarlet fever, typhoid, streptococcus infections, 
bovine tuberculosis, Malta fever, foot and mouth dis- 
ease. 
202. What cows should he chosen to furnish milk for 
infant feeding? 
Holstein and Ayrshire cows give milk of a more suit- 
able composition than do Jerseys and Guernseys, who 
give a milk somewhat too rich in cream for satisfactory 
ordinary feeding without skimming. 
It is better to use milk from a herd than to depend 
upon the milk from a single cow, who may at times 
give a wholly unsuitable milk. Obviously the herd 
should consist of healthy, tuberculin-tested cows. 
203. What is milk pasteurization? 
This consists in heating milk to a temperature of 144 
to 150 degrees F. for onc-balf hour and then rapidly 
cooling to 45 to 50 degrees F. in running water. This 
process kills the disease-producing bacteria (but not all 
of their spores) and most of the non-disease-producing 
ones. If pasteurized milk becomes contaminated the 
bacteria grow very rapidly, and for that reason com- 
mercial pasteurization gives a false sense of security if 
the milk is not carefully handled or if there is delay 
in delivery. 
204. Is pasteurized milk injurious? 
It is doubtful if pasteurized milk is injurious. While 
a good unpasteurized milk of absolutely reliable ante- 
cedents is preferable as a food, it is undoubtedly safer DIET AND CARE OF CHILDREN 
79 
to pasteurize milk in hot weather and when there is any 
doubt whatsoever about its preparation and marketing. 
205. What is milk sterilization f 
When milk is boiled from 5 to 20 minutes all bacteria 
and their spores are killed. In this process, however, 
marked chemical changes occur, and if such milk be- 
comes contaminated bacterial growth occurs very 
rapidly. Boiled-milk feeding is of value in some cases, 
but when continued for any considerable length of time 
should be accompanied by the administration of some 
such vitamin-containing substances as fruit or vege- 
table juices. 
206. Is boiled milk injurious? 
The continued use of boiled milk as the main staple 
of diet is liable to result in scurvy and should be avoided 
if possible. If its use is obligatory (it has considerable 
value in some eases), the tendency to scurvy may be 
met by the administration of orange juice and other 
fruit and vegetable juices. 
207. Is condensed milk injurious? 
While not actually injurious, it is inferior to raw 
milk as a food to be administered for any length of time. 
Occasionally a baby is encountered who thrives on con- 
densed milk better than on a raw-milk formula, but 
these exceptions doubtless prove the rule. There are 
certain valuable properties present in raw milk which 
are lost in the process of manufacture of condensed 
milk, although the latter is usually more easily digested. 80 
DIET AND CAKE OF CHILDREN 
208. Are patent foods injurioust 
Most of them are not injurious except in a negative 
way: in that they are often used to the exclusion of a 
sufficient amount of milk. When added to milk, the 
carbohydrate constitutents being invariable in the ma- 
jority of cases, it is impossible to alter the proportions 
to fit a particular case, and therefore they do not per- 
mit of sufficient individuality in any one formula. 
If one merely obeys the oft-given admonition to “read 
the directions on the box” the baby is not properly fed 
as an individual. 
209. Are patent foods desirable? 
Occasionally in certain cases patent foods have a dis- 
tinct value when added to a milk formula—i.e., the ar- 
bitrary combination of food elements may at some given 
time be indicated in a particular case. 
No physician is justified in ordering a patent food 
unless a knowledge of its exact composition is available. 
210. What common utensils are required in the prepara- 
tion of bottle feedingsf 
A large pitcher. 
An 8-ounce or 1-pint measuring graduate. 
A long-handled tablespoon. 
Bottles (at least 8 to begin with). 
Bottle-brush. 
Corks. 
Bottle-rack. 
Nipples. 
A large pan or kettle. 
Funnel. 
Double boiler. DIET AND CARE OF CHILDREN 
81 
211. What are desirable qualities for a nursing-bottle? 
The inside should be smooth, without seams or ridges, 
and it should have a fairly large mouth, thus rendering 
cleansing easy and effective. A scale for measuring 
the contents should be blown on the outside of the 
bottle, thus making it possible to ascertain the amount 
of contents at any given time. 
212. How should nursing-bottles be cared for? 
New bottles should be annealed to render them less 
liable to break when exposed to sudden temperature 
changes, as when cooled under running water or when 
the contents are boiled, etc. Put the bottles in cold 
water and bring the water up to the boiling-point, keep- 
ing them there for 15 to 20 minutes, then allow to 
gradually cool. 
When each bottle is emptied of milk it should be filled 
with cold borax water, being allowed to stand until 
all of the day’s bottles are emptied and thus collected. 
Then scrub thoroughly with soapsuds and water, using 
a bottle-brush. Boil for 15 to 20 minutes. The bottles 
are now ready for refilling with the next 24 hours ’ feed- 
ings. 
213. How should rubber nipples be kept during feeding 
intervals? 
The nipple should be thoroughly scrubbed with soap 
and water on both sides (turned inside out) and then 
placed in a sterile drinking-glass kept for the purpose, 
and the glass should then be covered with a saucer. 
Immediately before using, the nipple should be rinsed 
off with boiling water. When kept dry in this manner 82 
DIET AND CARE OF CHILDREN 
rubber nipples deteriorate less quickly than when they 
are kept in boric-acid or salt solution. The nipples 
should be boiled once daily. 
214. What is 'percentage feeding f 
A method of artificial feeding formerly in general 
use and based upon the not unnatural assumption that 
a milk formula should be made to imitate, in proportion 
of ingredients, as closely as possible, the composition of 
human milk. It has been found, however, that when 
some of the most satisfactory results are obtained in 
artificial feeding the formulas oftentimes do not very 
closely resemble human milk. Infants tolerate far 
greater proportions of protein to fat than was form- 
erly regarded possible, and greater latitude is now 
successfully allowed in the administration of carbo- 
hydrates, chiefly in the form of various sugars, malt 
preparations and flours. 
The fat of cow’s milk differs so greatly from that of 
human milk that so-called “humanized” cow’s milk is 
very far from being the near substitute that it was 
formerly supposed to be. 
215. What is caloric feeding? 
A method of artificial feeding based upon the fuel 
value of the ingredients used when introduced into the 
human body. This forms the basis of a method of in- 
fant-feeding which has been found satisfactory, and 
has to a large extent superseded percentage feeding. 
However, no one method should be used to the entire 
exclusion of all others. The physician should be well ac- 
quainted with all methods. DIET AND CARE OF CHILDREN 
83 
216. What is a calorie ? 
The quantity of heat required to raise the tempera- 
ture of one litre of water one degree Centigrade. 
217. What are the caloric values of some of the common 
infant foodsf 
Whole milk . 
ounce 
Calories 
21-23 
Skimmed milk 
(1% fat)... 
( l 
( ( 
13 
Skimmed milk 
(fat-free). . 
< < 
i ( 
11 
Cream 
i i 
C i 
54 
Whey 
6 ( 
l ( 
5-6 
Buttermilk . . . 
< f 
i ( 
10 
Casein milk . 
< C 
( < 
13 
Sugar 
( i 
i 6 
120 
Barley flour . 
i ( 
i ( 
120 
Bice flour .. . . 
i t 
( < 
102 
Wheat flour . . 
i i 
i ( 
120 
Oatmeal 
i ( 
i < 
120 
Soy-bean flour 
( < 
f ( 
120 
218. What are the bulk equivalents of the principal car- 
bohydrate fornada ingredients? 
Weight 
Measure 
Milk sugar 
1 
1% 
Cane sugar 
1 
1% 
Dextrimaltose . . . 
1 
1% 
Barley flour .... 
1 
214 
Rice flour 
1 
V/j 
Wheat flour . . . . 
1 
2% 
Oatmeal 
1 
3 
Soy-bean flour .. 
1 
2 
219. Mow many calories should an infant receive daily? 
During the first 3 months, 50 calories per pound of 
weight. 84 
DIET AND CARE OP CHILDREN 
During the second 3 months, 45 calories per pound of 
weight. 
During the third 3 months, 40 calories per pound of 
weight. 
During the fourth 3 months, 35 calories per pound of 
weight. 
Afterwards about 30 calories per pound of weight. 
Premature infants require a greater caloric intake: 
55 to 60 calories per pound of weight. 
220. What kinds of sugar are commonly used in infant- 
feeding ? 
Lactose, or milk sugar; saccharose, or cane sugar 
(ordinary table sugar) ; dextrimaltose, a combination of 
dextrin and maltose and usually some added mineral 
salts in different combinations. 
221. What rules should govern the choice of sugar in a 
formula? 
It seems permissible to make only a few observations 
upon this subject. 
Cane sugar is relatively inexpensive and is often 
used very successfully. 
If there is vomiting when cane sugar or dextrimaltose 
is used in the formula, it may be worth while to try 
sugar of milk. 
If the baby does not gain sufficiently when cane sugar 
or sugar of milk is used, if they do not digest well, or 
if he is constipated, dextrimaltose may be tried. The 
proprietary preparation of dextrimaltose combined with 
potassium carbonate is, in most cases, more laxative DIET AND CARE OF CHILDREN 
85 
than the preparation combined with sodium chloride, 
or than cane sugar or sugar of milk. 
222. What kinds of flour are commonly used in infant- 
feeding ? 
Barley, oatmeal, rice, wheat and soy-bean flours. The 
wheat flour is sometimes baked. The flours are prac- 
tically always boiled before being fed in a formula. 
They are fed not only for their nutritional value, but 
also, in some cases, to counteract or act as a substitute 
for the more laxative sugars or to replace sugar when 
it is undesirable to give it. 
Barley flour is somewhat constipating and is popular 
in diarrheal disturbances, being given as barley water 
or barley gruel, these terms merely signifying differ- 
ences in consistency. Oatmeal flour is laxative, and soy- 
bean flour has considerable nutritional value, being rich 
in protein. Kice flour is sometimes given in eczema 
cases. 
223. How is skimmed milk prepared? 
By allowing milk to stand in a bottle for 4 to 5 hours, 
or until the cream has arisen to the top. Then a cer- 
tain given amount is dipped off from the top or 
siphoned off from the bottom, the bottom milk being 
retained and the upper portion discarded. Upon the 
amount of top cream discarded will depend the per- 
centage of fat in the mixed bottom retained portion. 
The mixed lower 24 ounces from one quart of Holstein 
or Ayrshire milk yields about 1% fat, which is about 
as low a percentage as it is possible to obtain by ordi- 86 
DIET AND CARE OF CHILDREN 
nary methods of skimming or siphoning. By centri- 
fuging may be obtained a practically fat-free milk. 
224. When may skimmed milk be given advantageously? 
Oftentimes in vomiting, as vomiting cases do not, as 
a rule, tolerate fats well. It has a decided advantage 
in eczema, and serves, when given boiled, as an intro- 
duction to the resumption of normal milk feeding late 
in convalescence from diarrheal disease. 
225. How is peptonized milk prepared? 
Add 4 teaspoonfuls of pancreatic extract and 30 
grains (about teaspoonful) of sodium bicarbonate 
to 1 quart of milk which has been warmed to 105 de- 
grees F. Keep at this temperature for 6 to 20 minutes, 
according to the degree of peptonization desired. Bring 
up to the boiling-point to destroy the ferment (chiefly 
tripsin) and then cool. There is a convenient proprietary 
preparation known as Fairchild’s tubes. Use two tubes 
to one quart of milk. 
After 20 minutes of peptonization the milk assumes a 
bitter taste. For complete peptonization continue the 
process for two hours. 
Peptonized milk has some value in cases of weak pro- 
tein-digestion and acute indigestion. 
226. IIow is whey prepared? 
Add 1 teaspoonful of rennet, 1 tablespoonful of es- 
sence of pepsin, or 1 junket tablet to 1 quart of milk 
which has been heated to 100 degrees F. Keep at this 
temperature until the curd has settled out. Break up 
the curd and strain through gauze. DIET AND CARE OF CHILDREN 
87 
The casein and considerable of the fat, also in- 
soluble salts, remain in the curd, while a small portion 
of the fat, the sugar, the soluble salts and soluble pro- 
teins are contained in the whey. 
Whey is somewhat laxative. 
227. How is junket prepared? 
The same process is used as for making whey, except 
that to the one quart of milk are added sugar and 
vanilla to taste, and the whole preparation is allowed 
to stand and set without breaking up the curd. 
228. What is buttermilk? 
It is produced by souring whole or skimmed milk 
through the introduction of lactic-acid bacilli. These 
bacteria produce lactic acid through decomposition of 
the milk sugar, which gives to the buttermilk a sour 
taste and also causes the fat globules to separate out 
and coagulate. Lactic-acid bacilli multiply rapidly in 
milk under favorable conditions, and if a small quantity 
of buttermilk be added to sweet fresh milk, more but- 
termilk will be formed. Lactic-acid cultures may be 
obtained at almost any drug-store. After removal of 
the coagulated fat the resultant preparation is essen- 
tially a sour skimmed milk with less sugar than ordi- 
nary milk. 
229. What are some uses of buttermilk? 
It affords the use of a milk containing a minimum of 
fat and less sugar than in ordinary milk, and the 
presence of lactic-acid bacilli which are inimical to the 88 
DIET AND CARE OF CHILDREN 
growth and activities of some of the unfavorable in- 
testinal bacteria. 
It is sometimes given during convalescence from diar- 
rheal disease. 
It is an essential ingredient of casein milk. 
230. What is casein milk? 
A preparation made from whole milk, buttermilk and 
water. Essence of pepsin is added to whole milk, 
causing casein curds, a considerable part of the fat, 
and calcium and magnesium salts to coagulate out. 
These are strained out from the whey by passing the 
milk through gauze. A small amount of boiled water 
is added to wash this coagulated mass. The latter is 
then forced through a fine-meshed sieve, buttermilk be- 
ing added at the same time. The resultant mixture con- 
sists chiefly of water, casein, butter fat, calcium and 
magnesium salts and lactic-acid bacilli. There have 
been discarded in the whey: soluble proteins, some but- 
ter fat, sodium and potassium salts, milk sugar, water, 
some lactic-acid bacilli and lactic acid. The percentage 
composition is approximately as follows: 
Fat, 3 to 3.50%. 
Protein, 3.50 to 3.75%. 
Sugar, 1.80 to 2%. 
Salts, .65%. 
Water, up to 100%. 
Casein milk is also termed “protein milk” and 
“eiweiss milk.” 
231. What are some uses of casein milk? 
It is sometimes used in malnutrition and marasmus, 
and has great value in certain diarrheal conditions. DIET AND CARE OF CHILDREN 
89 
232. How is barley water prepared? 
The following preparation will not require much (if 
any) enlargement of the nipple hole: Barley flour 1 
heaping tablespoonful, water 1 pint. Stir the flour up 
with a little warm water at first and then add to the 
remainder of the pint, which should be boiling. Con- 
tinue the boiling for 20 minutes, occasionally replenish- 
ing the evaporating water. Strain out any lumps that 
may be present. 
233. How is oatmeal water prepared? 
Add a heaping tablespoonful of oatmeal to a pint of 
water, boil for one hour, occasionally replenishing the 
evaporating water, and strain through gauze or a fine- 
meshed sieve. 
234. What steps are taken in making up an ordinary 
formula? 
All utensils and receptacles that come in contact with 
the formula preparation should be sterilized by boiling. 
If an ordinary whole-milk formula is prescribed, the 
milk delivery bottle should be gently agitated by in- 
verting several times before the cap is removed, to make 
the contents uniform throughout the bottle. After re- 
moval of the cap the rim over which the milk is to be 
poured should be wiped off with sterile cotton or gauze. 
The proper amount of milk should be poured out into 
the sterilized glass graduate and from thence into the 
mixing-pitcher. A small amount of the boiled water 
to be used should be warmed, and the sugar is added 
and dissolved in the graduate. The remainder of the 
boiled water is then added to the sugar solution, and 90 
DIET AND CARE OF CHILDREN 
this mixture is poured into the milk in the mixing- 
pitcher, and the whole formula gently stirred with a 
long-handled spoon. The requisite amount of the 
formula is then poured by means of a funnel into each 
individual bottle. Each bottle is stoppered with a 
boiled cork, cooled in running water and placed in the 
cold (an icebox or refrigerator in the summertime). 
235. How should feedings he kept after preparation? 
The proper amount of the formula mixture for each 
feeding should be put into an individual nursing-bottle, 
a sufficient number of bottles being provided for the 
number of feedings to be given in 24 hours. Each 
bottle should be stoppered with a cork which has been 
boiled, and the contents should be cooled by putting the 
bottle into running water—e.g., under a water faucet. 
•The bottles should then be kept cold (in an icebox or 
refrigerator in warm weather). 
236. At what temperature should the formula he fed to 
the hahy? 
It should be fed at blood temperature or a trifle above 
—e.g., 99 to 100 degrees F. The mother readily learns 
to judge of the proper temperature by dropping a 
small quantity of milk on the back of the hand, on the 
wrist or the forearm. If the bottle is placed in a small 
woolen bag the heat is retained sufficiently for the 
duration of the feeding. 
237. What rules should govern the writing of an ordi- 
nary average formula? 
In view of the general remarks concerning artificial DIET AND CARE OF CHILDREN 
91 
feeding made in the introduction to this section the fol- 
lowing outline is deliberately and necessarily brief and 
sketchy, and if its application to a particular individual 
is unsuccessful it should not be condemned, but expert 
medical advice should be solicited. 
We must consider the age of the baby, his approxi- 
mate stomach capacity and his weight. In determining 
the number of feedings, quantity of each feeding and 
total quantity in 24 hours I personally have, in the long 
run, found the following scheme very satisfactory: 
Age 
Number of 
Quantity of 
Total 
in 
feedings 
each feeding 
34 hours 
Weeks 
1 
8 times 
1% 
ounces 
12 ounces 
2 
8 “ 
2 
(( 
16 
£ £ 
3 
8 “ 
2% 
(( 
20 
£ £ 
4 
8 “ 
3 
(( 
24 
£ £ 
Months 
2 
7 “ 
4 
(( 
28 
£ £ 
3 
7 “ 
4y2 
t ( 
311/6 
£ £ 
4 
7 “ 
5 
l £ 
35 
£ £ 
5 
6 “ 
6 
C £ 
36 
£ £ 
6 
6 “ 
6i/2 
£ £ 
39 
£ £ 
7 
6 “ 
7 
£ £ 
42 
£ £ 
8 
6 “ 
71/2 
£ £ 
45 
£ £ 
9 
6 “ 
8 
£ £ 
48 
£ £ 
30 
6 “ 
8 
£ £ 
48 
£ £ 
11 
6 “ 
8 
£ £ 
48 
£ £ 
12 
6 “ 
8 
f £ 
48 
£ £ 
These feedings are given on a basis of 3-hour inter- 
vals. 
When 7 feedings are given in 24 hours the night in- 
tervals are lengthened, and when 6 feedings are given 
the night feedings are omitted. 92 
DIET AND CARE OF CHILDREN 
This alternative scheme may be used if desired: 
Age 
Number of 
Quantity of 
Total 
in 
feedings 
each feeding 
24 hours 
Weeks 
1 
8 times 
1 y% ounces 
12 ounces 
2 
8 “ 
2 “ 
16 
It 
3 
8 “ 
2y2 “ 
20 
( t 
4 
8 “ 
3 “ 
24 
( ( 
Months 
2 
7 “ 
4 “ 
28 
t < 
3 
7 “ 
4 “ 
28 
< t 
4 
6 “ 
5 “ 
30 
t < 
5 
5 “ 
6 “ 
30 
t ( 
6 
5 “ 
ey2 “ 
32 y2 
( < 
7 
5 “ 
7 “ 
35 
( < 
8 
5 “ 
7y2 “ 
37y2 
( i 
9 
5 “ 
8 “ 
40 
< « 
10 
5 “ 
8 “ 
40 
t ( 
11 
5 “ 
8 “ 
40 
i ( 
12 
5 “ 
8 “ 
40 
4 < 
When 5 feedings are given in 24 hours the interval is 
increased from 3 to 4 hours, and sufficient boiled water 
may be given during the day to keep the liquid intake 
equivalent to that for the same age in the first scheme 
given in this section (237). 
Both of these schemes allow of a gradual increase in 
the amount of individual and total 24-hour feedings. 
During the first 4 weeks, equal parts of milk and 
water should suffice for a normal baby of average 
weight. 
In general, after the first month, the amount of whole 
milk given corresponds in ounces to 1% times the num- 
ber of pounds of body weight. If the infant is not satis- 
fied it is permissible to gradually try to increase to 2 
times the number of pounds of body weight. Prac- DIET AND CARE OF CHILDREN 
93 
tically, ill-nourished infants with good digestion thrive 
better on the latter allowance. The balance of total 
quantity of fluid is made up with boiled water or cereal 
water (in the average formula). 
At the end of the first week one level teaspoonful of 
sugar should be enough; after that two to four level 
tablespoonfuls of sugar is a reasonable average allow- 
ance above which it is seldom necessary to go. 
The number of calories corresponding to the amount 
of milk introduced can be calculated, and the balance of 
calories corresponding to the weight and age of the 
child can be made up with sugar and other carbo- 
hydrates whose caloric values are known. 
The subject of infant-feeding cannot be condensed 
into a nutshell, and the above paragraphs merely de- 
scribe briefly one method. The expert should have all 
methods readily available for use. 
238. What is a suitable diet for a healthy child from 12 
to 15 months of age f 
Carbohydrates—Oatmeal jelly, barley jelly, wheat 
jelly, cream of wheat, farina, boiled rice, stale bread, 
bread crust, toast, zwieback, Italian bread sticks, milk 
crackers, soda crackers, graham crackers, bran biscuits, 
agar biscuits. 
Dry, ready prepared cereals are less desirable, as they 
are less digestible, but may occasionally be used for the 
sake of variety. 
Protein Foods—Milk, scraped rare beef, soft boiled 
egg, coddled egg, hard-boiled (grated) egg, beef juice, 
beef broth, lamb broth, chicken broth. 
Vegetables—Mashed stewed carrots, chopped spin- 
ach, asparagus tips, strained stewed tomatoes. 94 
DIET AND CARE OP CHILDREN 
Fruits—Orange juice, prune juice, grape juice, pine- 
apple juice, orange pulp, prune pulp, scraped raw apple, 
apple sauce, baked apple. 
Fats—Cream, butter, oleomargarine. 
Desserts—Bread pudding (without raisins), rice 
pudding (without raisins), junket, custard, cornstarch, 
tapioca, gelatine. 
SAMPLE DIET 
7 :00 a.m.—Oatmeal jelly, 2 tablespoonfuls in a cup- 
ful of milk. Cook the cereal for 3 hours and strain. 
Toast and butter. 
9 :00 a.m.—The juice of half an orange, prune juice, 
grape juice or pineapple juice. 
11:00 a.m.—Three teaspoonfuls of scraped rare beef 
mixed with bread crumbs and moistened with beef juice. 
(To obtain the scraped beef: broil a piece of round steak 
over a hot fire, split it, opening it up like a book, and 
scrape the inside with a spoon.) Crackers. A cupful of 
milk. 
3:00 p.m.—Beef broth containing rice. Mashed 
stewed carrots. Stale bread with butter, or Italian 
bread sticks. Plain rice pudding or apple sauce. 
6 :00 p.m.—Two tablespoonfuls of farina in a cupful 
of milk. Cook the cereal for 2 hours. Zwieback. 
10:00 p.m.—A cupful of milk if desired. 
239. What is a suitable diet for a healthy child from 15 
to 18 months of age? 
Carbohydrates—Oatmeal jelly, barley jelly, wheat 
jelly, cream of wheat, farina, boiled rice, hominy, corn- 
meal, cream of rye, macaroni, spaghetti, stale bread, DIET AND CARE OF CHILDREN 
95 
bread crust, toast, zwieback, Italian bread sticks, milk 
crackers, soda crackers, graham crackers, bran biscuits, 
agar biscuits. 
Dry, ready prepared cereals are less desirable, as they 
are less digestible, but may occasionally be used for the 
sake of variety. 
Protein Foods—Milk, scraped rare beef, soft boiled 
egg, coddled egg, hard-boiled (grated) egg, beef juice, 
beef broth, lamb broth, chicken broth, creamed fresh 
codfish, creamed haddock, creamed halibut, oysters (well 
cooked and chopped). 
Vegetables—Mashed stewed carrots, chopped spin- 
ach, chard, asparagus tips, strained stewed tomatoes, 
pea soup, bean soup, lentil soup, squash, oyster plant. 
Fruits—Orange juice, prune juice, grape juice, pine- 
apple juice, orange pulp, prune pulp, scraped raw 
apple, apple sauce, baked apple, baked banana, raw ripe 
banana. When the banana is fully ripe the skin should 
be nearly black, and the contents should be nearly as 
soft as custard. 
Fats—Cream, butter, oleomargarine, olive oil, cotton- 
seed oil. 
Desserts—Bread pudding (without raisins), rice 
pudding (without raisins), junket, custard, cornstarch, 
tapioca, gelatine, ice cream. 
SAMPLE DIET 
7:00 a.m.—Three tablespoonfuls of cornmeal served 
with milk and sugar. Stale bread and butter. A bran 
biscuit. A cupful of milk. 
9 :00 a.m.—Half a cupful of prune juice. 96 
DIET AND CARE OF CHILDREN 
11:00 a.m.—A poached egg on toast. Graham crack- 
ers. A cupful of milk. 
3:00 p.m.—Soup made from peas, beans and lentils 
mixed, with soup stock added. Creamed fresh codfish, 
cut fine. Chopped spinach, well cooked. Bread and 
butter. Well-baked banana. Gelatine. 
6:00 p.m.—Three tablespoonfuls of cream of rye, 
served with milk and sugar. Zwieback. A cupful of 
milk. 
10:00 p.m.—A cupful of milk if desired. 
240. What is a suitable diet for a healthy child from 18 
to 24 months of age f 
Carbohydrates—Oatmeal jelly, unstrained oatmeal, 
barley jelly, unstrained barley, wheat jelly, cream of 
wheat, farina, boiled rice, hominy, cornmeal, cream of 
rye, macaroni, spaghetti, stale bread, bread crust, 24- 
hour-old bread, toast, zwieback, Italian bread sticks, 
milk crackers, soda crackers, graham crackers, bran bis- 
cuits, agar biscuits, ginger snaps, molasses cookies. 
Dry, ready prepared cereals are less desirable, as they 
are less digestible, but may occasionally be used for the 
sake of variety. 
Protein Foods—Milk (not more than l1 pints 
daily), buttermilk, cream cheese, scraped rare beef, 
boiled, roasted or broiled beef, cut fine, roast lamb or 
lamb chop, cut fine, minced chicken, lean bacon, soft 
boiled egg, coddled egg, hard-boiled (grated) egg, beef 
juice, beef broth, lamb broth, chicken broth, fresh cod- 
fish, haddock, halibut, swordfish, flounder, oysters (well 
cooked and chopped fine). 
Vegetables—Mashed stewed carrots, chopped spin- DIET AND CARE OF CHILDREN 
97 
ach, chard, kale, beet greens, asparagus tips, strained 
stewed tomatoes, pea soup, bean soup, lentil soup, 
squash, oyster plant, beets, boiled onions, well baked 
potato, lima beans, string beans, peas, lentils, mashed 
cauliflower, stewed celery. 
Fruits—Orange juice, prune juice, grape juice, pine- 
apple juice, peach juice, orange pulp, prune pulp, 
scraped raw apple, apple sauce, baked apple, baked 
banana, raw ripe banana, stewed dried peaches, stewed 
dried apricots. When a banana is fully ripe the skin 
should be nearly black and the contents should be nearly 
as soft as custard. 
Fats—Cream, butter, oleomargarine, olive oil, cotton- 
seed oil. 
Desserts—Bread pudding (without raisins), rice 
pudding (without raisins), farina pudding, junket, cus- 
tard, cornstarch, tapioca, gelatine, ice cream. 
SAMPLE DIET 
7:00 a.m.—Four tablespoonfuls of hominy, served 
with butter and salt. A coddled egg mixed with cracker 
crumbs. Buttered toast. A cupful of milk. 
9:00 a.m.—Two tablespoonfuls of grape juice, diluted 
with water. 
12:00 m.—Chicken soup with macaroni. Chicken 
meat, cut fine. Well baked potato. Two boiled onions. 
Bread and butter. Apple sauce. 
3:00 p.m.—Italian bread sticks and a cupful of milk 
if desired. 
6:00 p.m.—Four tablespoonfuls of cream of wheat 
served with butter and sugar. Milk toast. Jelly sand- 
wich. 98 
DIET AND CARE OF CHILDREN 
241. What is a suitable diet for a healthy child from 2 
to 7 years of age ? 
Carbohydrates—Oatmeal jelly, unstrained oatmeal, 
barley jelly, unstrained barley, wheat jelly, cream of 
wheat, farina, hominy, cornmeal, cream of rye, whole 
wheat, broken rice, samp, malt breakfast food, Petti- 
john, cracked wheat, pearl barley, macaroni, spaghetti, 
stale bread, bread crust, 24-hour-old bread, graham 
bread, rye bread, corn bread, toast, zwieback, Italian 
bread sticks, milk crackers, soda crackers, Uneeda bis- 
cuit, French rolls, Huntley & Palmer biscuits, bran bis- 
cuits, agar biscuits, ginger snaps, molasses cookies. 
Protein Foods—Milk (not more than pints 
daily), buttermilk, cream cheese, peanut butter, scraped 
rare beef, boiled, roasted or broiled beef, roast lamb or 
lamb chop broiled, chicken and poultry (boiled or 
roasted), lean bacon, soft-boiled egg, coddled egg, hard- 
boiled (grated) egg, scrambled egg, omelet, beef juice, 
beef broth, lamb broth, chicken broth, fresh codfish, had- 
dock, swordfish, halibut, flounder, etc., oysters, well 
cooked and chopped fine. 
Vegetables—Stewed carrots, spinach, chard, kale, 
beet greens, asparagus tips, strained stewed tomatoes, 
pea soup, bean soup, lentil soup, peas, lentils, squash, 
oyster plant, beets, boiled onions, well baked potato, 
lima beans, string beans, mashed cauliflower, stewed 
celery. 
Fruits—Orange juice, prune juice, grape juice, pine- 
apple juice, peach juice, orange pulp, raw apple, apple 
sauce, baked apple, baked banana, ripe peaches, raw 
ripe banana, stewed dried peaches, stewed dried apri- 
cots, pears, rhubarb. When a banana is fully ripe the DIET AND CARE OF CHILDREN 
99 
skin should be nearly black, and the contents should be 
nearly as soft as custard. 
Fats—Cream, butter, oleomargarine, olive oil, cotton- 
seed oil. 
Desserts—Bread pudding (without raisins), rice 
pudding (without raisins), farina pudding, junket, 
custard, cornstarch, tapioca, gelatine, ice cream, plain 
cookies, molasses cookies, ginger snaps, sponge cake, 
lady finger^. 
SAMPLE DIET 
7 :00 a.m.—One saucerful of boiled rice, served with 
butter and sugar (1 teaspoonful). Scrambled egg (in 
milk). Corn muffins with butter. One fully ripe 
banana, one orange or one-half grapefruit. A cupful 
of cocoa made with milk. 
12 :00 m.—Meat stew with vegetables, or lamb chop 
cut fine, or broiled halibut. Potato, stewed carrots or 
macaroni with olive oil or butter. Spinach, chard, 
squash, string beans, boiled onions or boiled celery: 3 to 
4 tablespoonfuls. Bread and butter: 2 slices. Stewed 
dried apples, peaches, prunes, apricots: 3 to 4 table- 
spoonfuls. Ginger snaps or sponge cake. Water. 
6:00 p.m.—Cereal: 1 saucerful. Broth or 1 coddled 
egg on toast. Crackers and milk, or can have 2 slices 
of bread with butter or peanut butter and a cupful of 
milk or of cocoa made with milk. Plain pudding made 
with milk. 
242. How should meats, 'poultry and fish he cooked? 
Roasted, broiled or boiled, and not fried. 100 
DIET AND CARE OF CHILDREN 
243. What are some foods to be avoided by young 
children? 
Tea, coffee, alcoholics, sausage, pork (except bacon), 
ham, liver, smoked, salt or dried fish, nuts, pickles, 
fried foods, unripe bananas (except baked), pies, pas- 
tries, rich cakes, particularly those made with nuts and 
dried fruits, raw vegetables, raw fruits in excess. 
Very little cake, and then only as dessert. 
Very little candy or chocolate to be given. 
Not more than one teaspoonful of sugar to be given on 
a dish of cereal. 
Hot bread or rolls, griddle cakes and doughnuts are 
not to be given. 
244. What are some necessary eating 'precautions? 
Do not allow the child to eat too fast, nor to wash 
food down with water, nor to eat at irregular hours. 
245. When should water be given? 
Cool water may be given between meals in the case of 
older children. 
246. What are vitamins? 
Complex chemical bodies present notably in certain 
yeasts, animal fats, fruits and vegetables and having a 
very important influence upon nutrition and growth. 
The absence of vitamins in the food may cause very 
grave disorders of nutrition. Their chemical composi- 
tion has been shrouded in considerable mystery, but 
modern investigation is at last beginning to shed con- 
siderable light upon their more exact nature. 
Their potence is well illustrated by the remarkable DIET AND CARE OF CHILDREN 
101 
manner in which the nutritional disease known as 
scurvy begins almost immediately to clear up following 
the administration of orange juice or other fruit juices. 
247. When should a baby begin to take fruit juices? 
If not constipated, the baby should be started on fruit 
juices at 5 months of age. If constipated, or if getting 
sterilized food, it may be necessary to start earlier. 
248. Does orange juice make the urine acid? 
Orange juice makes the urine less acid. BAD HABITS 
BAD habits should be corrected at the time of their 
inception, because when once well established they 
are, as a rule, very tenacious. 
Oftentimes there is an obscure underlying basis, such 
as faulty feeding, bad hygiene, or some physical or 
nervous abnormality. 
249. How should masturbation be treated? 
A physician should be consulted regarding the neces- 
sity for circumcision, breaking down of adhesions of 
foreskin or clitoris, or as to the presence of an irri- 
tating condition of the urine. 
The child’s abnormal activities should be rigidly and 
forcibly restrained if necessary. In the case of thigh- 
rubbing a diaper or towel or a pad within the diaper 
should be used to keep the thighs apart. It may be nec- 
essary to resort to a special brace (which may be pur- 
chased) to keep the thighs apart. If the child indulges 
in hand manipulation it may be necessary to use alumi- 
num mits or a restraining tape extending from the 
neck to the wrists. 
He should be carefully watched at times when he 
would ordinarily be alone, especially morning and 
night, and should not be allowed to sleep alone. If it is 
necessary to leave him alone he should be supplied with 
sufficient toys and other amusements to take up his 
mind. 104 
DIET AND CARE OF CHILDREN 
Absolute cleanliness should be enforced. Cool baths 
may have some value. 
250. How should thumb-sucking be treated? 
In mild cases it may be sufficient to remove the offend- 
ing member from the mouth and distract the baby’s at- 
tention. If persisted in this may effect a cure. If in- 
effectual, bitter substances may be applied to the 
thumb—e.g., tincture or extract of aloes, bisulphate of 
quinine solution (7%). Although the child may not 
seem much disturbed by the bitter taste he will tire of 
it after awhile. It may be necessary in some cases to 
resort to restraint, such as pinning the sleeves to the 
dress, using cardboard cuffs to prevent bending of the 
elbows sufficiently, or by applying aluminum mitts. 
Thumb-sucking may lead in time to angular deform- 
ity of the upper jaw, with projection of the upper 
middle teeth; it may cause adenoids, restlessness at 
night, thick lips and mouth infections. 
251. How should finger-nail biting be treated f 
The treatment is about the same as that for thumb- 
sucking. Persistent finger-nail biting is liable to ruin 
the shape of the finger-tips. Any existent nervous con- 
dition should be treated. 
252. How should dirt-eating be treated? 
The eating of dirt and plaster should of course be 
prevented by surveillance and restraint. Indirect 
treatment consists in correcting the nervous or digestive 
derangement which is probably the underlying cause. DIET AND CARE OF CHILDREN 
105 
253. How should breath-holding be treated? 
This is really not a habit, but is due to spasm of the 
larynx: a nervous condition. 
The immediate treatment is to gently slap the child 
on the face with a wet towel, or to sprinkle cold water 
on the face. This will cause him to catch his breath. COMMON AILMENTS AND SIMPLE 
TREATMENTS 
ONE of the chief objections to medical books de- 
signed for home use is the fact that there is a 
liability of instilling just enough knowledge to be dan- 
gerous. 
When there is a margin of reasonable doubt send for 
the doctor. 
254. What is a proper equipment for a home emergency 
cabinet? 
Two-inch gauze bandages. 
Sterile gauze in 1-yard packages. 
Sterile cotton. 
A 2-inch roll of zinc oxide plaster. 
Alcohol. 
Tincture of iodine, 314%. 
Tincture of benzoin compound. 
Rhubarb and soda mixture. 
Castor oil. 
Sweet oil. 
Boric-acid ointment. 
Zinc-oxide ointment. 
Vaseline. 
Glycerine suppositories. 
Calomel, 1-10 grain tablets. 
107 108 
DIET AND CARE OF CHILDREN 
Bichloride of mercury tablets. 
Sodium bicarbonate. 
Boric-acid crystals. 
Epsom salts. 
Dry mustard. 
Medicine-droppers. 
Clinical thermometers (mouth and rectal). 
Hot-water bags. 
Enema bag. 
Large-sized soft rubber catheter (for rectal use). 
Bulb syringe. 
Croup kettle. 
255. What is the normal temperature of an infant? 
The usual rectal temperature varies from 98.6 to 99.2 
degrees. It is not uncommon to get a temperature of 
98 degrees or even lower in a normal infant, but a tem- 
perature above 99.2 is abnormal. It must be realized, 
however, that an infant’s temperature may become ele- 
vated as a result of very slightly abnormal causes. Ex- 
ternal heat (e.g., hot-water bags) may cause very high 
elevation of the temperature. 
256. How is an infant’s temperature best taken? 
In the rectum. The rectal thermometer has a mer- 
cury bulb somewhat larger in diameter than the ordi- 
nary mouth thermometer, although the latter type can 
be used without much difficulty. The baby should be 
placed face downward on the lap, and the thermometer, 
after lubricating the bulb with vaseline, sweet oil or 
soap, should be inserted into the rectum for about one 
inch. DIET AND CARE OF CHILDREN 
109 
257. How early in life is it practicable to take the tem- 
perature by mouth f 
It is not only impracticable but also unsafe to attempt 
to take mouth temperature in a child under 5 years 
of age, as he will not only fail to hold the ther- 
mometer properly in the mouth, but will be likely to 
bite off the end. 
258. What information should be available for a physi- 
cian when called to see a sick child f 
Any abnormal conduct, occurrence of fever, symp- 
toms of pain, vomiting, condition of bowels, character 
and amount of urination, character of diet, nervousness, 
restlessness, sleeplessness or drowsiness, cough, nasal 
discharge, discharge from ears, character of breathing. 
259. IIow can urine be collected from young infants? 
A simple method, if one has sufficient patience, is to 
wait for an interval after the baby has urinated, then 
hold him on a chamber or basin, at the same time apply- 
ing a warm cloth or a cold sponge over the lower ab- 
domen. In collecting from a male infant the penis can 
be placed within a test tube or a small bottle and the 
latter securely held in place by means of strips of ad- 
hesive plaster. In the case of female infants it is a 
somewhat more difficult matter, but can be accomplished 
successfully by cutting a finger out of a rubber glove, 
leaving some of the surrounding material. The extreme 
tip is cut off from the finger and the latter is stretched 
over the neck of a small bottle and the other end of the 
glove finger strapped to the vulva with adhesive plas- 
ter by means of the surrounding glove material. When 110 
DIET AND CARE OF CHILDREN 
urine is collected for examination the genitalia should 
be carefully cleansed to prevent possible external con- 
tamination. 
260. What are some causes of sleeplessness in infancy? 
Febrile illness (notably infections of the urinary tract 
and otitis or ear inflammation), bad training, over- 
feeding, underfeeding, excessive clothing, insufficient 
clothing, irritation from clothing (as pins or soiled nap- 
kins), adenoids and other nasal obstructions, rickets, 
malnutrition, constipation with fecal masses, eczema 
and skin eruptions and irritations. 
The above are some of the more common causes. 
261. What can be done for weakness of the ankles? 
The weakness is usually manifested by bending in one 
direction, either outward or inward. If the weakness is 
only moderate it may be met by thickening the portion 
of sole most worn, by splitting the sole and inserting 
a leather wedge, usually near the heel. If the child 
tends to walk on the outer edge of the foot the wedge is 
inserted in the outer edge of the sole, and vice versa. 
Extension outward of the heel at the point of greatest 
wear is an extremely valuable measure and insures a 
much more stable foundation. If the weakness is more 
marked it is possible to use in addition to the above an 
ankle corset, stiffened with strips of whalebone, which 
can be laced on inside the shoe. 
Be sure to avoid over-support, in which case the 
muscles will not receive proper stimulus to develop. 
Simply aim to give sufficient support to equalize the 
balance. In cases of marked weakness a physician of DIET AND CARE OF CHILDREN 
111 
course, preferably an orthopedic specialist, should be 
consulted. 
262. What should he done for scalding with urination? 
Often the urine is markedly acid and will turn litmus 
paper bright red. Such a condition can be met by the 
administration of sodium bicarbonate (baking soda) : 
Give i/4 level teaspoonful 4 times daily in the feedings 
or in water before feedings. If there is an ammonia 
odor to the urine be very careful to rinse the napkins 
thoroughly. In older children scalding and irritation 
may sometimes be relieved by reducing their intake of 
fruit, meat and salt. 
263. What causes an infant’s urine to have an ammonia 
odor? 
An ammonia odor from the diaper is liable to be 
caused by the release of free ammonia from certain 
chemical combinations in the urine by the action of an 
alkali in the diaper or by contact with alkaline stools. 
The alkali present in the diaper may be soap, lye or lime 
and is most likely to be present as a result of lack of 
careful rinsing or the use of a strongly alkaline water. 
It is probable that a neutral or nearly neutral rather 
than an acid urine is most often present. 
264. Wnat should he done when the hahy has a “cold in 
the head”? 
At the onset give a cathartic: calomel (10 doses of 
one-tenth grain each at intervals of 10 minutes), cas- 
tor oil or milk of magnesia. Give a hot bath, followed 
by a hot drink after 1 year (milk or lemonade), and put 112 
DIET AND CARE OF CHILDREN 
to bed, covering warmly with the object of promoting 
sweating. Vaseline or albolene (a few drops of the 
latter) may be put into the nostrils several times daily. 
The nose may be irrigated with a Seiler’s tablet solu- 
tion (one tablet to half a glassful warm water) morning 
and night, allowing repeated small quantities to run 
into each nostril, using a medicine-dropper and so tip- 
ping the head as to allow each instillation to run out 
before giving another. Keep the bowels open and keep 
the child at rest, preferably in fresh air, and avoid 
overfeeding. 
If he gets worse, having fever, or does not improve 
within a few days: Call a doctor. 
265. What should he done for diarrhea? 
A diarrheal attack should not continue to be treated 
by home measures if a prompt response is not obtained 
—otherwise the case should be turned over to a physi- 
cian. 
The first thing to do is to stop food, especially milk. 
It is permissible to give barley water (made in the pro- 
portion of 2 level tablespoonfuls of barley flour to 1 
pint of water: boil for 20 minutes) at the regular feed- 
ing intervals and in amount corresponding to the usual 
amount of milk given at each feeding. Boiled water 
should be freely administered between the feeding-inter- 
vals. This feeding should be maintained for at least 
24 hours and prolonged for another 24 hours if the 
condition has not abated (and if still not abated will 
probably be continued under the supervision of a physi- 
cian). A cathartic (calomel, 10 doses of one-tenth 
grain each at intervals of 10 minutes, castor oil or milk DIET AND CARE OF CHILDREN 
113 
of magnesia) should be administered to rid the intes- 
tines of offending materials as far as possible. The 
administration of a high enema of salt and water (2 
teaspoonfuls of salt to 1 quart of warm water) is a 
valuable measure. Sodium bicarbonate, 2 teaspoonfuls 
in 24 hours, dissolved in the boiled water and given in 
small frequent doses, is valuable in combating acid in- 
toxication. When milk feeding is finally returned to, 
the milk should at first be skimmed, boiled and much 
diluted and given without sugar. 
During recovery, children over one year of age may 
receive strained well-cooked cereals, toast water and 
crackers. Toast soaked in bouillon made from cubes 
makes a palatable food. 
Milk of bismuth in 1-teaspoonful doses every 3 hours 
has some value as a medicinal agent. 
If there is fever or if there is blood or much mucus in 
the stools: Call the doctor. 
The above is a necessarily brief outline of home treat- 
ment. 
266. How can a mother know whether her child has 
worms? 
Intestinal worms are not nearly as common as they 
are popularly supposed to be. If present they or their 
ova (eggs) should be present in the stools, although re- 
peated examination may be necessary to demonstrate 
them. If they are seriously suspected, the physician 
should be requested to make a microscopic examination 
of the stools for the ova. 
267. How do children acquire pin worms? 
Pin worms are undoubtedly first introduced into the 114 
DIET AND CARE OF CHILDREN 
body in the form of ova (eggs) by way of the mouth as 
a result of direct or indirect contamination from some 
other individual. It is quite possible for a child to 
repeatedly reinfect himself by carrying the ova into his 
mouth on his fingers. Doubtless the house fly includes 
among his many impolite activities that of conveying 
ova about and depositing them on food. It has been 
claimed that before the ova can hatch in the body they 
have first to enter the stomach from above, but it is 
much more likely that reproduction goes on more or 
less continually in the intestines and vermiform appen- 
dix regardless of this procedure. 
268. What treatment should he given for pin worms? 
Any treatment should be persistently followed up and 
repeated at intervals, as there is a probability that many 
of the worms develop in such inaccessible portions of the 
intestinal canal as the vermiform appendix. Persist- 
ence will, however, eventually be rewarded, and it is 
possible to eventually eradicate them. 
A very successful method of treatment is by the 
use of enemas of garlic infusion. One or two garlics are 
steeped in a pint of water for one hour, and then, after 
a preliminary clearing out of the lower bowel by means 
of an enema of soapsuds and water, the warm garlic 
infusion is slowly allowed to flow into the lower bowel, 
the hips being elevated—e.g., over the end of a sofa. 
The enema should be retained for 20 minutes, pressure 
being applied over the entrance to the bowel if neces- 
sary. This procedure should be followed two or three 
times every week until the worms are eradicated. 
The child should be prevented from reinfecting him- 
self through the mouth after scratching. DIET AND CARE OF CHILDREN 
115 
If the itching is intense, apply mentholated or carbo- 
lated vaseline. 
269. How do children acquire round worms? 
The mode of infection is not absolutely clear. The 
probability is that the ova (eggs) are taken in with raw 
food or with food which has not been thoroughly cooked 
—e.g., vegetables or salads. It is possible for the ova 
to hatch in garden earth under favorable conditions. 
The worms hatch and develop in the small intestine, 
but they later migrate to the large intestine, stomach 
and other contiguous body cavities, and I have seen 
specimens which have actually crawled into the throat 
and have been expelled by coughing. 
270. What treatment should he given for round worms? 
Give no supper except a little milk or broth. Ad- 
minister at bedtime calomel and santonin, each one 
grain, in one-tenth grain doses of each at intervals of 
15 minutes. In the morning give a soapsuds enema, or 
an enema of infusion of quassia chips. 
This treatment may have to be repeated occasionally. 
271. How do children acquire tape worms? 
The ova (eggs) are taken into the gastro-intestinal 
canal during the eating of meat which has been cooked 
insufficiently to kill them. 
The beef tape worm is much more common in this 
country than the one occurring in pork. 
Tape worms are far less common than pin worms or 
round worms. 116 
DIET AND CARE OF CHILDREN 
272. What are some causes of bed-wetting? 
The vast majority of cases are due primarily to in- 
stability of the nervous control mechanism. In treat- 
ment it is essential to arrive at a correct diagnosis, and 
before we can definitely attribute the condition (or dis- 
ease) entirely to nervous instability we must eliminate 
a certain small minority of prime or contributing fac- 
tors, chiefly organic, reflex, dietetic and hygienic. The 
principal of these are as follows: Small bladder, 
paralysis of or lack of tone in the nerve supply to the 
bladder neck, large urethra or water passage leading 
from the bladder, phimosis (or adherent foreskin), ad- 
herent clitoris, vaginitis, vulvovaginitis, inflammation 
of the urethra, inflammation of the bladder, bladder 
stone, pyelitis (or inflammation of the pelvis of the kid- 
ney), rectal polypi, anal fissures, strongly acid urine 
(due to excess of protein foods), strongly alkaline urine 
(due to excess of sugar and starches), thread worms 
(pin worms), constipation, excessive bed-clothing, sleep- 
ing on the back, adenoids, enlarged tonsils, hypothyroid- 
ism (or lack of proper thyroid secretion). 
The nervous control mechanism is governed by so- 
called conditional reflexes which are more recent in 
origin and far less stable than the unconditional re- 
flexes, which simply respond to the primitive stimulus 
to empty the bladder. The higher conditional nerve 
tracts, dependent largely upon psychic (mental) con- 
trol, are not easily built up, but are easily broken down 
or interrupted, especially in nervously unstable chil- 
dren. 
273. What can be done for bed-wetting? 
First of all endeavor to ascertain any existing con- DIET AND CARE OF CHILDREN 
117 
tributing factors with the object of eliminating them. 
Some of the most important general measures to be 
observed are as follows: 
Stop intake of liquids, with the exception of a wine- 
glassful of water or milk if desired, after 5 p.m. 
Give a light supper. 
Especially avoid overfatigue, physical or mental. A 
midday or afternoon rest and reasonable arising and re- 
tiring hours—e.g., 7:30 a.m. and 8 :30 p.m.—are neces- 
sary. 
The child, if old enough, should be trained as fol- 
lows : When urinating he should invariably start, stop, 
start, stop, start, stop, start—thereby developing nerv- 
ous control over the bladder. 
He should urinate immediately after supper, before 
retiring, and once or twice after retiring at a definite 
time. When gotten up at night he should be fully con- 
scious of what he is doing. 
He should not lie on his back. If necessary a spool 
strung on a cord, or a knotted towel, may be placed at 
the small of the back. 
The foot of the bed may be raised about 1 foot. 
Avoid too heavy bed-clothing. 
Avoid sweets and rich, highly seasoned foods. Ob- 
viously tea, coffee and alcohol should be avoided. 
Medical treatment such as the administration of alkalies 
and sedatives and glandular products should be under 
the control of a physician. 
Good results should be rewarded and bad ones not too 
strongly condemned. 
Surroundings should be quiet and restful, and some- 
times a change to country or seashore will be beneficial. 118 
DIET AND CARE OF CHILDREN 
274. What is meant by the term “incubation period”? 
It is used in connection with the acute contagious dis- 
eases and denotes the period of time elapsing between 
exposure to the disease and the first symptoms of ill- 
ness manifested by the exposed individual. Within cer- 
tain limits each contagious disease has a rather definite 
incubation period, after the expiration of which, if 
symptoms of illness have not developed, there is no 
likelihood for apprehension. 
275. What are the chief characteristic symptoms of 
measles? 
Incubation period 10 to 14 days. 
There are usually languor, drowsiness, nasal dis- 
charge, eye irritation and discharge, cough, headache, 
nausea and fever. The fever occurs on the 2nd day 
and averages 104 degrees F. There occur minute 
whitish spots surrounded by a reddened base on the 
mucous membrane inside of the cheek. 
The skin eruption occurs on the 3rd, 4th or 5th 
day and manifests itself on the forehead, face, neck, 
chest, arms, body and legs. It consists of elevated red- 
dish spots which are liable to group themselves in a cres- 
centic arrangement. 
276. What are the chief characteristic symptoms of 
German measles? 
Incubation period 1 to 3 weeks. 
There are usually drowsiness, slight fever and sore 
throat. There are occasionally chills or convulsions, 
vomiting and swelling of lymph nodes of the neck. The 
fever is very transitory. DIET AND CARE OF CHILDREN 
119 
The eruption occurs on the 1st or 2nd day and ex- 
tends over the face, neck, body and extremities. It 
may somewhat resemble the rash of measles or that of 
scarlet fever. 
277. What are the chief characteristic symptoms of 
scarlet fever? 
Incubation period 1 to 8 days. 
Onset occurs with vomiting and high fever (104 to 
105 degrees F.). The surface of the tongue somewhat 
resembles that of a strawberry; there are present 
marked sore throat, highly colored urine, restlessness, 
headache, and sometimes delirium. 
The skin eruption appears on the 1st or 2nd day 
on the neck and chest, and then occurs on the entire 
body. The rash may in some cases be extremely faint. 
It disappears on pressure and immediately returns when 
the pressure is released. There is a pale area around 
the mouth. It is liable to consist of minute reddish 
spots in the groins, under the arms and upon the roof 
of the mouth. There is desquamation (peeling) late in 
the disease. 
278. What are the chief characteristic symptoms of 
diphtheria? 
Incubation period 2 to 7 days. 
There are symptoms of a “cold,” oftentimes with an 
irritating nasal discharge and mild sore throat. The 
fever is usually moderate (100 to 102.5 degrees F.). 
There is enlargement of the lymph nodes at the angle 
of the jaw. There occurs a grayish white membrane in 
the region of or upon the tonsils; it is removed with 120 
DIET AND CARE OF CHILDREN 
difficulty and removal is accompanied by bleeding. 
There is a peculiar fetid odor to the breath. 
The onset may be more severe and accompanied by 
chill, vomiting, headache and high fever. There may 
be marked prostration. The membrane may spread 
rapidly and involve the larynx, causing membranous 
croup, or it may extend to the nose. 
279. What are the chief characteristic symptoms of 
chicken-pox ? 
Incubation period 14 to 16 days. 
There may be chilliness, slight fever, languor, nausea 
and vomiting. The fever is highest on the 2nd or 3rd 
day. 
The eruption occurs in crops and consists of elevated 
spots or papules surrounded by a reddened area. 
These papules soon become filled with fluid, giving some- 
what the appearance of drops of water on the skin. The 
spots dry up and sink in. They are liable to occur 
anywhere upon the body—e.g., upon the scalp and with- 
in the mouth. There is liable to be unpleasant itching. 
280. What are the chief characteristic symptoms of 
whooping-cough f 
Incubation period 7 to 14 days. 
During the 1st week of onset the symptoms are in- 
sufficiently definite to surely base a diagnosis upon them 
unaided. If there has been an exposure to whooping- 
cough within the past 7 to 14 days it affords strong 
evidence in favor of its presence. After the first week 
of cough the attacks become more characteristic, being 
more numerous at night and becoming more and more DIET AND CARE OF CHILDREN 
121 
explosive in nature. The intervals between coughing 
attacks or paroxysms are free from cough, but the at- 
tacks themselves become more severe, causing reddening 
of the face and later on gagging and finally vomiting. 
The typical cough consists of a series of explosions 
finally ended up by a violent intake of breath develop- 
ing into a definite whoop. 
The physician can obtain valuable corroborative evi- 
dence by means of a simple blood examination. 
281. What are the chief characteristic symptoms of 
mumps? 
Incubation period 2 to 25 days (usually 10 to 21 
days). 
There may be fever, chilliness, drowsiness, languor, 
vomiting, sweating, faintness, pain in the ear and diffi- 
culty in opening the mouth. There is pain at the angle 
of the jaw when saliva is secreted, especially in the 
presence of sour substances. There is progressive en- 
largement under the angle of the jaw (downward and 
forward of the ear) and in front of the ear on one or 
both sides. There may also be swelling under the side 
of the jaw. 
There may be swelling of the testes in boys and of 
the ovaries in girls. 
282. What are the chief symptoms of adenoids? 
When the symptoms are marked the child is pale, ill- 
nourished and listless. He breathes through the mouth, 
is subject to nasal catarrh, hears with difficulty, is in- 
attentive and is subject to cough and discharging ears. 
He is restless at night and thrashes about uneasily, 122 
DIET AND CARE OF CHILDREN 
especially when lying upon the back, snores and is sub- 
ject to bad dreams. A nasal twang to the voice is often 
noticed. There may be deformity of the chest, narrow- 
ing of the upper jaw and persistent bed-wetting. 
283. When is circumcision advisable? 
It is doubtful if the wholesale circumcision advised 
by some physicians is advisable. If the foreskin is un- 
duly long or if the opening is so small as to prevent full 
retraction of the foreskin over the glans or part be- 
neath, the operation is indicated. 
Often retraction is prevented because of the existence 
of adhesions, which merely need to be broken up by a 
physician. 
If the child is addicted to masturbation or bed-wet- 
ting, circumcision may solve the problem of cure. 
284. How should eczema be treated? 
This unpleasant skin affection has a constitutional 
basis (so-called exudative diathesis) and is most ob- 
stinate and discouraging from the standpoint of treat- 
ment. The treatment of a persistent case (and most 
of them are) is such a complicated affair as to tax the 
resources of the best medical talent available. 
In practically all cases it is found desirable to greatly 
reduce or eliminate as far as possible the intake of 
sugars, fats, eggs and oatmeal. Avoid skin irritation, 
using little or no soap (bran water or albolene can be 
substituted). 
As far as local applications are concerned, they do 
not effect much alone without constitutional treatment. DIET AND CARE OF CHILDREN 
123 
One of the best known of external applications is Las- 
sar’s paste. 
Scratching of the face and head can be prevented in 
the very young by using pasteboard cylinders or cuffs 
at the elbows, thus preventing sufficient bending of the 
arms to permit touching the face with the hands. 
Sometimes it is necessary to apply a special face mask 
to guard against rubbing the skin on pillows, bed- 
clothing, etc. 
Medical supervision is usually desirable. 
285. How should sunburn be treated? 
Best by avoiding. If exposed to the sun’s rays it is 
a mistake to soak the skin with water, especially salt 
water, as this only intensifies the action of the rays. 
After burning, some relief may be obtained by the 
application of zinc-oxide ointment, cold cream, plain 
vaseline, mentholated or carbolized vaseline, or a com- 
bination of lime water 1 part and olive oil 3 parts. 
286. How should prickly heat be treated? 
Avoid clothing too warmly, especially with wool. 
Avoid sweating if possible and heating drinks. Give a 
mild laxative, such as milk of magnesia. Administer a 
soda or starch bath, followed by a rinsing with a com- 
bination of alcohol 1 part and water 3 parts; then 
apply a dusting powder of talcum and starch equal 
parts. 
287. How should chilblains be treated? 
Woolen stockings should be worn, but should be 
rather loose, and the shoes should be ample in size, 124 
DIET AND CARE OF CHILDREN 
special pains being taken to avoid any impediment to 
the circulation. Avoid sudden warming of the af- 
fected members when chilled. Paint with tincture of 
iodine and follow with collodion. Painting with equal 
parts tincture of aconite and iodine liniment sometimes 
gives relief. 
288. How should ivy poisoning he treated? 
A saturated boric-acid solution constitutes a very 
satisfactory wash. Make it up in the proportion of 1 
tablespoonful of boric-acid crystals to a pint of warm 
water. The skin can be kept saturated with this solu- 
tion, or it can be used merely as a wash and followed by 
an application of zinc-oxide ointment or carbolized 
vaseline. The ointment application can be preceded 
by a wash of lime water or sodium bicarbonate solution 
(1 teaspoonful to a cup of water) instead of the sat- 
urated boric-acid solution. 
289. What is the cause of hives? 
Hives (or urticaria) is caused by external and inter- 
nal irritants, the latter comprising by far the greater 
proportion. 
External irritants include insect-bites, tight clothing 
and some plants. 
Internal irritation may be caused by certain drugs, 
sera and antitoxins, and foods such as strawberries, 
grapeskins, tomatoes, oatmeal, buckwheat, rice, potato, 
peas, nuts, fish, shellfish, pork, chicken, veal, egg, cheese, 
casein, beef juice. In some individuals one or more of 
these agents are always effective, and other individuals 
only occasionally respond to them. 
Proper bowel function is one safeguard against hives. DIET AND CARE OF CHILDREN 
125 
290. How should hives be treated? 
Eliminate the cause, give a cathartic and keep the 
bowels open, and feed upon carbohydrate food for sev- 
eral days. 
Itching may be relieved by the use of soda baths and 
the application of carbolated or mentholated vaseline. 
291. What should be done for cradle cap (milk crust) t 
The medical name for this. condition is seborrhea 
capitis—a form of eczema. 
The crusts should be softened by applying vaseline or 
olive oil for 1 to 3 days, depending upon the severity 
of the condition. When well softened, scrub vigorously 
with Castile soap and warm water (slight bleeding will 
do no harm) and at night apply 3% resorcin ointment, 
procurable at any drug-store. 
292. What should be done for chapped skin? 
This condition is really a mild form of eczema due 
to exposure to cold air, wind, cold water, harsh soaps 
and other irritants. 
Treat, after bathing, by the application of glycerine, 
or glycerine with zinc-oxide powder stirred into a thin 
cream, or by vaseline or olive oil. 
293. What are the causes and treatment of styes? 
A stye is an inflammation forming at the base or 
follicle of an eyelash. There is a small localized hard 
spot of tenderness near the edge of the lid. This spot 
is surrounded by a reddened area and is liable to 
eventuate in a small abscess with a discharge of pus. 
The condition is usually an accompaniment of a de- 126 
DIET AND CARE OF CHILDREN 
ranged or run-down condition of the system, or may 
accompany the presence of a refractive error. 
Occasionally pus formation may be aborted by the 
application of cold compresses to the eye, but if favor- 
able results are not soon apparent it is better to bring 
it to a “head” by the substitution of hot compresses. 
The withdrawal of the involved eyelash will often prove 
beneficial. 
If repeated styes occur general tonic treatment should 
be instituted—e.g., the administration of the syrup of 
the iodide of iron. Diet, rest and bathing should be 
carefully supervised. The bowels should be kept open. 
It is important that the presence of refractive errors 
should be sought for by an eye specialist. 
An ointment containing yellow oxide of mercury 1% 
may be applied to the lids in the morning and at night. 
294. What should he done for cross eyes? 
“Cross eye,” squint, or strabismus may occur in one 
or both eyes. There may be present a permanent squint 
or a temporary deviation (lieterophoria) which may be 
overcome by effort. There is often present a refractive 
error in one eye, and under all circumstances the child 
should be attended to by a competent eye specialist as 
soon as the condition is noticed. 
There is present a disturbance of coordination or 
equilibrium, or a paralysis of one or more of the eye 
muscles, which may result from disease or other inter- 
nal disturbances. If refractive error is present it 
should be corrected by the time the child is 5 years of 
age; otherwise “binocular fixation,” or the harmonious 
use of both eyes, will in all probability not be estab- 
lished. DIET AND CARE OF CHILDREN 
127 
It is emphatically urged that any deviation of one or 
both eyes should receive the prompt attention of a com- 
petent eye specialist. 
295. What are the causes and treatment of running 
ears? 
This condition commonly results from an inflamma- 
tion occurring within the middle ear (otitis media) 
which has caused a perforation of the drum membrane. 
It is frequently preceded by a “cold” and is especially 
liable to accompany adenoids and enlarged and inflamed 
tonsils, and some of the acute infectious diseases, 
notably scarlet fever and measles. 
The condition is usually accompanied or preceded by 
fever and earache and should be attended to by a physi- 
cian, who will be likely, among other things, to order 
ear irrigations with warm boric acid, the latter being 
instilled with slight force into the ear by means of a 
rubber bulb syringe. 
Usually cotton should not be placed within the ears, 
as it is liable to retard drainage. If it is used to catch 
discharges it should be changed frequently. 
296. How should protruding ears he treated? 
Protruding ears are liable to be bent over when the 
infant is lying down, the existing condition thereby be- 
coming aggravated. 
The judicious use of a bonnet, net or a little adhesive 
plaster will prevent this and may be of some value in 
improving the condition. 
297. What is tongue-tie? 
Tongue-tie is a condition often more apparent than 128 
DIET AND CARE OF CHILDREN 
real, although it occasionally exists. It consists of a 
shortening or an extension toward the tip of the tongue 
of the frenum or fold extending from the bottom of the 
tongue to the floor of the mouth. In some instances 
nursing may be interfered with, and later in life phona- 
tion or clear enunciation of words may be interfered 
with. 
It is a very simple matter for the physician to cut this 
fold or band and thereby cure the condition. 
298. What are the causes and treatment of night 
terrors? 
Night terrors (pavor nocturnus) occur in children 
from 2 to 8 years of age. The child awakens in a state 
of extreme fright, a condition analogous to nightmare 
in older individuals. He is usually much confused and 
is unable to express the cause of his terror. 
The children subject to this condition are likely to 
be of a sensitive nervous type, and there is often some 
accompanying digestive disturbance. The child may 
have enlarged tonsils, adenoids or worms. Over-study, 
excitement and extreme fatigue are often factors. 
Treat by careful regulation of the diet, giving a light 
meal at night. The bowels should be kept free and all 
possible exciting causes enumerated above (and includ- 
ing too much “movies”) should be eliminated. 
299. What can he done for stuttering? 
Stuttering is due to a nervous overaction of the 
muscles of breathing and phonation and may be ac- 
quired by inheritance, imitation or following sickness. 
There is an overproduction of sounds, as repetition of DIET AND CARE OF CHILDREN 
129 
certain consonants, while in stammering there is diffi- 
culty in producing distinct sounds. 
The child should be urged to use careful speech, being 
trained to an association of breathing and slow phona- 
tion. Whispering may be tried first, followed by louder 
speech. There should be careful repetition in case of 
failure. The child should not be allowed to associate 
with stutterers or stammerers, because of liability to 
imitation. He should be treated with patience and 
should not be scolded. 
300. IIow should constipation in children be treated? 
In the treatment of constipation of a chronic type it 
is essential to discover the causative factors. These 
may involve faulty diet or too low liquid intake, seden- 
tary habits, lack of regular bowel training; or there 
may be less obvious physiological and organic factors. 
There may be some abnormal condition of the lower 
bowel interfering with proper action because of attend- 
ant pain or spasm, as in anal fissures, inflammation or 
hemorrhoids. There may be mechanical obstruction 
or delay of various kinds, as in abnormal position or 
kinking of the intestines. The condition may be the 
result of the injudicious use of cathartics, as castor oil. 
Over-catharsis overstimulates and in time weakens or 
exhausts the natural muscular or peristaltic action of 
the bowel. Nervous excitability may thus or by gen- 
eral weakness be lessened. Some kinds of poisoning and 
debilitating conditions, as disease, may be factors. Con- 
finement indoors in winter is a common factor in con- 
stipation of children. 
As indicated above: seek the cause and endeavor to 130 
DIET AND CARE OF CHILDREN 
eliminate it. Medical advice will often be necessary. 
Encourage a regular bowel habit by having the child 
endeavor to move the bowels at a regular time daily, 
preferably after breakfast. In refractory cases it may 
be necessary to encourage this regularity by an oil in- 
jection on the preceding night, followed in the morning, 
after breakfast, by a soap or glycerine suppository. 
The meals should be regular, proper attention being 
paid to thorough mastication, suitable amount and kind 
of food. In some cases a laxative mineral water may be 
takenbefore breakfast. The following foods have a laxative 
tendency: Vegetables, fruits and fruit juices (as orange 
juice, stewed prunes and apple sauce), coarse or brown 
bread, bran muffins, cereals with cream and sugar or 
butter and sugar (1 tablespoonful of bran may be mixed 
with a saucerful of cereal), sweet butter, cream, beef 
juice, beef broth. 
Limit the amount of milk taken (1 to 1 y2 pints 
daily), also crackers, sweets, pastry and bananas. 
Plenty of water should be taken at other than meal 
times. Malt extract may also be taken. 
Massage may be practiced, the hand being lubricated 
with oil, vaseline or cocoa butter, or powdered. Begin 
at lower right abdomen, work upward, across to the left 
and then downward, thus following the course of the 
large intestine. This should be kept up for about 10 
minutes immediately preceding the time selected for the 
bowel movement. 
Oil enemas, given at night, may be administered by 
means of a rubber bulb syringe to which is attached a 
length of rubber catheter. This should be inserted into 
the lower bowel for a distance of 8 to 9 inches, from 1 DIET AND CARE OF CHILDREN 
131 
to 4 ounces of warm olive oil, or glycerine and water, 
equal parts, being used. 
Warming compresses may be applied to the abdomen. 
Daily cool baths indirectly stimulate bowel action. 
For a casual cathartic calomel may be used in total 
dosage of 1 grain, being divided into 1/4’s, adminis- 
tered at intervals of 15 minutes. Castor oil may be ad- 
ministered in 1 to 2 teaspoonful doses. 
301. What is rickets? 
Rickets (or rachitis) is a constitutional nutritional 
disease affecting especially certain children who are sub- 
jected to poor economic and hygienic surroundings. It 
occurs in temperate and cold climates, and is particu- 
larly noticeable among races who have migrated from 
warmer to colder climates. Proper food, cleanliness, 
ventilation, fresh dry air and proper exercise are fac- 
tors of importance in prevention. 
There is present a faulty assimilation of calcium 
taken in the food, which is manifested by a softness of 
the bones and an enlargement in the region of their 
growth centers. This is noticeable at the wrists and 
ankles, the ends of the ribs, the spine, and in certain 
cranial bones. 
Common symptoms are restlessness at night, head 
sweating, abdominal enlargement, constipation, delay 
in teething, in fontanel (soft spot) closure and in walk- 
ing, noticeable enlargement of the wrists, thinning of 
cranial bones, beading of ribs and spinal curvatures. 
Children with rickets have low resistance against 
disease. 
Cod liver oil has great value as a treatment and has 132 
DIET AND CARE OF CHILDREN 
been used with success as a preventive in susceptible 
cases. Good food and good hygiene are necessary fac- 
tors in treatment. 
302. What is scurvy? 
Scurvy (or scorbutus) is a constitutional nutritional 
disease affecting especially infants who have been fed 
to excess upon sterilized foods (often patent and boiled 
foods) and have had too little raw food. Vitamin de- 
ficiency is probably an important factor. 
The prominent symptoms are pain and tenderness of 
the limbs, simulating rheumatism, hemorrhagic swell- 
ing along the shaft of one or more of the long bones, 
irritability, restlessness, loss of appetite, anemia, spongi- 
ness and bleeding of the gums, bleeding beneath the skin 
and mucous membranes, and sometimes bloody urine. 
The infant is liable to hold his limbs as though par- 
alyzed. 
The specific treatment is orange juice and other fruit 
and vegetable juices. An infant 1 month old may re- 
ceive 1 teaspoonful daily. EMERGENCIES AND EXPEDIENTS 
PROMPT and intelligent resort to some simple ex- 
pedient will oftentimes relieve or prevent much 
discomfort. It may even serve as an effective preven- 
tive of some dire consequence. 
303. What should he done for nosebleed? 
The simpler methods of treatment consist of keeping 
the patient in an upright position, holding the arms 
above the head, applying cold water to the back of the 
neck and to the root of the nose, or applying pressure 
to the root or sides of the nose. Sometimes a piece of 
paper, rolled up into a cylinder slightly smaller in di- 
ameter than a lead pencil and about an inch in length, 
inserted up under the upper lip, will control bleeding. 
If these measures fail a physician should be called, 
who will probably pack the nostril or use some styptic or 
both. 
304. What should be done when a foreign body is 
swallowed? 
Usually nothing. Ordinary objects such as coins, 
marbles, whistles, buttons, etc., almost invariably pass 
through without causing any trouble. It is surprising 
to contemplate the impunity with which young children 
will swallow and pass off straight pins, clasp pins and 
even open safety pins. 
If a pin is swallowed do not give an active cathartic, 134 
DIET AND CARE OF CHILDREN 
as the resulting contractions of the muscular wall of the 
bowel might cause perforation. It would be better to 
give a saline purgative such as Epsom salts (a level 
tablespoonful in a half glassful of warm water) with 
the object of washing the foreign body through. It is 
often recommended to give potato or starchy food of 
some kind to form a protective coating over the foreign 
body, but as a matter of fact, the majority of children 
who swallow pins not having reached the potato-eating 
age, its administration would likely do more harm than 
the foreign body itself. Cereal can be given after 7 
months. 
Watch the stools carefully. 
If the foreign body is stuck in 'the throat the child 
should be turned upside down, or cautious attempts 
may be made to dislodge it with the finger. 
305. How should a cut he treated? 
It should first of all be thoroughly cleansed with hot 
or very cold water, either of which will tend to check 
bleeding. Severe bleeding can be controlled by direct 
pressure, if necessary, exerted by the finger or a small 
cloth pad (preferably sterile, of course). Paint it with 
tincture of iodine and apply a dry dressing of 
sterile gauze if the wound is clean; otherwise a dressing 
soaked in a solution made by dissolving a bichloride of 
mercury tablet in 2 quarts of water—and bandage. If 
the cut is more than % inch in length or is upon the 
face, the edges may require bringing together, and in 
case of doubt consult a physician. If the bleeding is 
intractable, or if the wound has more the character of a 
puncture than of a cut, a physician should be consulted. DIET AND CARE OF CHILDREN 
135 
306. How should simple burns be treated? 
If the clothing is afire the victim should be made to 
lie down, thus preventing the flames from rising up- 
ward to the face and head. Wrap him tightly in a coat, 
rug or blanket to exclude the air, or if water is handy 
douse him with it. After the flames are extinguished 
the clothing should be gently removed from the burned 
regions, being cut if necessary to avoid further injury 
to already damaged parts. If pain is severe apply 
several layers of linen or gauze soaked in a solution of 
sodium bicarbonate (baking soda), 1 teaspoonful added 
to warm water 1 cupful. Later on apply carron oil, 
vaseline, olive oil, sweet oil, zinc-oxide ointment, boric- 
acid ointment, cream or fresh lard, the object being 
to keep air away from the injured area. A satisfactory 
way to exclude air is to make a paste of water combined 
with baking soda or with starch or flour. A blister may 
be opened by means of a needle which has been sterilized 
in a flame and inserted under Ihe skin at the periphery. 
If the burns are not extensive or deep they may be 
kept cleansed with boric-acid solution, 2 teaspoonfuls to 
a pint of water, then covered with gauze which has been 
smeared with boric-acid ointment. This dressing should 
be lightly bandaged. 
In case of extensive or deep burns a physician should 
be immediately called. 
307. How should insect bites be treated? 
If the sting has remained in the wound it should be 
removed by means of tweezers. Immediate relief from 
discomfort may be sought by the application of am- 
monia water, spirits of camphor, wet salt, wet clay or 136 
DIET AND CARE OF CHILDREN 
dirt, or baking soda paste. Cold water to which has 
been added carbolic acid (5 drops to the teaspoonful) 
should be applied to prevent swelling. Mentholated 
or carbolized vaseline may be later applied to prevent 
discomfort. 
308. IIow should poisoning in general he treated? 
Cause vomiting to rid the stomach of the poison. Give 
Epsom salts, 1 tablespoonful in y2 glassful of warm 
water, to flush out the bowels. Combat shock by ex- 
ternal heat (blankets and hot-water bottles or hot-water 
bags) and by administration of stimulants: whiskey, 
strong coffee, aromatic spirits of ammonia, y2 tea- 
spoonful in water. 
If the antidote is known give it. 
Send for a doctor. 
309. What should he done for bichloride of mercury 
poisoning ? 
Cause vomiting by giving a teaspoonful of mustard 
or salt in water. Follow vomiting by giving milk or 
raw white of egg, or both. 
Combat shock by hot-water bags and blankets. 
Give stimulants. 
Later give Epsom salts, 1 tablespoonful in y2 glass- 
ful of warm water. 
Give plenty of water and milk to drink. 
310. What should he done for vomiting? 
Vomiting is such a common symptom that it may be 
a precursor of any one of a great many illnesses, some 
having very remote relationship to the stomach and DIET AND CARE OF CHILDREN 
137 
digestion. Therefore, any treatment that may be de- 
scribed here will apply only as an emergency and where 
there has been some known dietetic error. If vomiting 
continues it should receive expert medical attention. 
The first thing to do is to stop all food. If there is a 
gold clear history of dietetic cause give a cathartic: 
calomel, 10 doses of one-tenth grain each at intervals 
of 15 minutes, combining 1 to 2 grains of sodium bicar- 
bonate (baking soda) with each dose of calomel. Give 
no food for at least 12 hours. At the expiration of that 
time, if the child is over 1 year of age, give a cracker 
or a little toast, dry or soaked in hot water or bouillon- 
cube tea. Later he can receive a little boiled skimmed 
milk. This should suffice for another 12 hours. Then, 
if there is no more vomiting, cautiously give a little 
well-cooked cereal. Avoid fats. 
Dissolve a teaspoonful of sodium bicarbonate in half 
a glassful of warm water and give a teaspoonful of this 
solution every 15 minutes while vomiting continues. 
Later give rhubarb and soda mixture: a teaspoonful 3 
times daily after meals, and gradually return to normal 
diet. 
If the patient is a nursing baby increase each interval 
between nursings 30 minutes and decrease each nursing- 
time 5 minutes. 
311. How should colic l)c treated? 
Most babies are subjected to occasional attacks of colic 
during the first three months, but if they are of great 
frequency, persistence or severity there is usually some- 
thing radically wrong with the feeding, be it breast or 
bottle. Colic attacks are readily precipitated by ex- 138 
DIET AND CARE OP CHILDREN 
posure to cold, which condition should be prevented or 
corrected. Especially avoid chilling of the extremities, 
and during an attack heat should be applied to the feet 
and legs by means of woolen stockings and by the use 
of a hot-water bag or an electric pad. The application 
of heat to the abdomen will usually aid in giving relief. 
This may be accompanied by laying the baby face down- 
ward on a liot-water bag or an electric pad, or by the 
application of a mustard plaster (1 part mustard and 3 
parts flour) until the skin becomes rosy red (about 10 
minutes). Eub on a little sweet oil or vaseline after- 
ward. 
Colic attacks being usually accompanied by accumu- 
lation of gas, the expedient of holding the baby face 
downward over the shoulder and gently patting the 
back will materially assist in getting rid of gas. Like- 
wise an enema of soapsuds and warm water is a valuable 
procedure. Two or three teaspoonfuls of hot pepper- 
mint water and water, equal parts, should be admin- 
istered. 
Many cases of colic are the result of too frequent or 
too fast feeding, or both, and it will usually be found 
worth while to lengthen the feeding intervals and at 
the same time prolong the nursing period, resting the 
baby between mouthfuls. Sometimes diluting the nurs- 
ing by giving one or two tablespoonfuls of warm boiled 
water before nursing will lessen the tendency to colic. 
In some cases colic in a nursing baby is due to some 
intrinsic defect in the mother’s milk, especially if she 
be of a nervous temperament and has reacted unfavor- 
ably to the baby’s condition. If the colic is persistent 
a physician should be consulted. Likewise, if the baby DIET AND CARE OF CHILDREN 
139 
is bottle-fed, a physician should be consulted in view 
of changing the formula. 
312. What should he done for convulsions? 
The child should be put into a warm bath (100 to 105 
degrees F.), immersing all of the body as high as the 
neck. Dry mustard may be added to the bath (4 level 
tablespoonfuls to the gallon of water). He should re- 
main in the bath until the skin assumes a rosy hue 
(about 10 minutes), cold applications meanwhile being 
applied to the head. When removed he should be 
wrapped in a blanket, cold applications should be kept 
on the head and a hot-water bag should be applied at 
the feet. 
Vomiting should be induced, when the patient as- 
sumes consciousness, by means of syrup of ipecac, 1 tea- 
spoonful. A soapsuds enema should be administered. 
Send for a physician. 
313. Row should earache he treated? 
Relief may sometimes be attained by gently irrigating 
the ear with a solution of boric acid (1 teaspoonful to 
a cupful of water) as warm as can be borne, and ad- 
ministered by means of a medicine-dropper which has 
been sterilized by boiling. This can be followed by a 
few drops of 2% phenol in water solution, with 10% 
glycerine added. Warm glycerine alone may be tried. 
A hot-water bag applied to the external ear will give 
relief at times. 
If there is elevation of the temperature, or if the 
condition persists, a physician should be consulted, as 
it may be necessary to incise the drum to permit the 140 
DIET AND CARE OF CHILDREN 
escape of pus and prevent spontaneous perforation of 
the drum membrane or even more serious consequences. 
314. How should toothache he treated? 
As a means of temporary relief the cavity should be 
cleansed out by winding a pledget of cotton on the end 
of a toothpick and gently twisting it about in the 
cavity. The cavity should then be packed with cotton, 
or cotton soaked in oil of cloves, or oil of cloves and 
chloroform equal parts, or creosote. 
Usually a piece of cotton moistened with spirits of 
camphor and placed between the overlying gum and the 
cheek will give relief, although it will burn somewhat 
unpleasantly at first. A hot-water bag placed against 
the cheek should give some relief. 
Of course decayed teeth should receive the attention 
of a dentist, and one should never forget the old adage 
about the ounce of prevention. Start the toothbrush 
habit early in life. 
315. How should croup he treated? 
Spasmodic croup comes on suddenly without much 
warning, usually in the night, and tends to recur on 
one or two successive nights, the patient being free from 
symptoms during the daytime. The symptoms are 
alarming, especially to one who has never before wit- 
nessed them. There is a harsh cough, resembling some- 
what the bark of a dog; there is difficulty in breathing, 
especially with expiration or expulsion of air from the 
lungs; the face frequently becomes cyanotic (bluish) ; 
the child struggles for breath. 
Nausea or vomiting should be induced by means of DIET AND CARE OF CHILDREN 
141 
syrup of ipecac. If the attack is very severe it will be 
well to induce vomiting by giving from to 1 tea- 
spoonful. If the attack is not very severe give 10 drops 
every half hour to a child of 1 year, until relief is 
obtained. 
Inhalations of steam are valuable and may be admin- 
istered by means of an ordinary tea-kettle or a regular 
croup kettle. The addition of tincture of benzoin com- 
pound (1 teaspoonful to the pint of boiling water) will 
enhance the inhalation. 
Cold or hot compresses over the throat are valuable in 
venting or moderating an attack on the following night. 
To a child of 1 year may be given 5 drops every 2 hours. 
During the following day small doses of syrup of 
ipecac should be administered with the object of pre- 
relaxing the spasms. 
If the condition does not subside by morning or pro- 
gressively gets worse a physician should be consulted. 
316. What are the causes and treatment of hiccough? 
Hiccough is due to spasm of the diaphragm, the 
muscle lying between the chest and the abdomen. This 
muscle assists materially in drawing in and expelling the 
breath. Stomach disturbances—e.g., the sudden en- 
trance of hot or cold liquids or rapid feeding—start the 
spasms. 
A usually efficient means of stopping hiccough is to 
give a small amount of sugar on the tip of a spoon or 
with a little warm water. Tickling the nose and causing 
to sneeze is one method. Sometimes medical aid has to 
be enlisted. ALPHABETICAL INDEX 
A 
Abdominal: band, 95; binder, 
94. 
Abnormal conduct, 258. 
Abscess of breast, 196. 
Aconite and linimentum iodi, 
287. 
Adenoids, 250, 260, 272, 282, 
295, 298; and pigeon chest, 
19. 
Advice of neighbors, 47. 
Air, cold, 136. 
Air-passages, obstruction of, 
18. 
Airing out of doors, 130, 131, 
132, 133. 
Albolene, 67, 69, 75, 264, 284. 
Albuminous material, 199. 
Alcohol, 191; in breast milk, 
184, 187; and milk produc- 
tion, 184; and water, 194, 
195, 286. 
Alkaloids in breast milk, 187. 
Aloes, 250. 
Aluminum mitts, 250. 
Ammonia: aromatic spirits, 
308; odor of, in urine, 262, 
263; water, 307. 
Anal fissures, 272, 300. 
Ankle: braces, 107; weakness, 
261. 
[The figures indicate numbers of questions.] 
Antipyrin in breast milk, 187. 
Apple sauce, 300. 
Aromatic spirits of ammonia, 
308. 
Arsenic in breast milk, 187. 
Assimilation of food, 40. 
Automobile riding, 137. 
Ayrshires, milk of, 199, 202, 
223. 
B 
Baby-carriage screen, 132. 
Baked beans, 191. 
Baking soda, 225, 262, 2S8, 
306, 310; in mouth, 71; in 
vomiting, 310. 
Barley flour, 217, 218, 222, 
232. 
Barley water, preparation, 
232; indications, 222. 
Bath: room temperature, 58; 
thermometer, 62; water sub- 
stitution, 62; water tempera- 
ture, 61, 62, 63. 
Bathing: 60-75; bath tempera- 
ture, 61, 62, 63; beach bath- 
ing, 78; during illness, 77. 
Baths: bran, 67, 79, 80; cool, 
249; mustard, 87, 88; salt, 85, 
86; shower, 61; soda, 81, 82, 
290; sponge, 60; starch, 83, 144 
DIET AND CARE OF CHILDREN 
84, 286; stimulant, 86, 88; 
tonic, 86, 88; tub, 60. 
in brain congestion, 88; 
convulsions, 88; eczema, 80; 
eruptive fevers, 88; hives, 
84; malnutrition, 86 ; prickly 
heat, 80, 82, 84; rickets, 86; 
skin irritations, 80, 82; stim- 
ulant, 86, 88. 
Beach bathing, 78. 
Bean curds, 163. 
Beans, 191. 
Bed-wetting, 272, 273, 283. 
Beer and milk secretion, 184. 
Benzoin, 194, 315. 
Bicarbonate of soda, 71, 225, 
262, 288, 306. 
Bichloride of mercury, 305; 
poisoning, 309. 
Bicuspid teeth, 10, 11. 
Bile, 34. 
Bismuth, 265; and castor oil 
paste, 194; in stools, 168. 
Bites, 307. 
Biting nails, 251. 
Bladder: inflammation, 272; 
stone, 272. 
Bloody: stools, 166; urine, 
302. 
Blue babies, 21. 
Boiled milk, 206. 
Borax, 64. 
Boric acid, 288, 295; in 
mouth, 71; ointment, 306. 
Bottles for feeding, 211; care 
of, 212. 
Bowel: condition, 258; move- 
ments (see stools) ; training, 
89. 
Bowels of nursing mother, 179. 
Brain congestion, baths, 88. 
Bran baths, 79; preparation, 
79; when used, 80. 
Bran water, 67, 79, 284. 
Breadstuffs, 190. 
Breast: abscess, 196; compara- 
tive secretion, 175; fissures, 
194; nursing assisted, 185; 
pump, 189, 193; secretion, 
beginning of, 173. 
Breast milk: disease transmis- 
sion, 170; drugs secreted, 
187; immunity, 169; ingre- 
dient percentages, 142. 
Breast-nursing assisted, 185. 
Breasts: baby’s, 35; caked, 
189; care of at nursing-time, 
192. 
Breath-holding, 253. 
Breathing, 7; character, 258. 
Bromides in breast milk, 187. 
Bulk equivalents of carbohy- 
drates, 218. 
Burns, 306. 
Buttermilk, 217, 228, 229. 
c 
Cabbage, 191. 
Caked breasts, 189. 
Calcium, 230; in rickets, 301. 
Calomel, 264, 265, 270, 300, 
310. 
Caloric feeding, 215; intake of 
infants, 219; values, 217. 
Calorie, definition, 216. 
Camphor, spirits, 307, 314. 
Candy, 191. ALPHABETICAL INDEX 
145 
Canine teeth, 10, 11. 
Carbohydrates, 149; in intes- 
tine, 41. 
Carbolated (carbolized) vase- 
line, 268, 285, 288, 290, 307. 
Carbolic acid, 307. 
Cardboard cuffs, 250, 284. 
Carron oil, 306. 
Carrying the baby, 48. 
Cascara in breast milk, 187. 
Casein, 226; curds, 230; milk, 
217, 229, 230, 231. 
Castile soap, 29. 
Castor oil, 264, 265, 300. 
Cathartics, 300. 
Cauliflower, 191. 
Cereals, 190. 
Chafing, 80. 
Chapped skin, 292. 
Cheese, 190. 
Chicken-pox, 279. 
Chilblains, 283. 
Chorea and nursing, 186. 
Circumcision, 72, 249, 283. 
Clay paste, 307. 
Cleansing of skin, 50. 
Cleft palate and nursing, 188. 
Clitoris, 249, 272. 
Clothing: amount, 92; baby’s 
wardrobe, 90; creeping age, 
108; excess of, 93; factors, 
91; indoors, 105; night cloth- 
ing, 113; runabout age, 110; 
short clothing, 104; sus- 
pended, 111, 112. 
Clove oil and chloroform, 314. 
Cod liver oil, 301. 
Coddling, 118. 
Coffee, 191, 308. 
Cold air, freshness, 136. 
Cold cream, 285. 
‘ ‘ Colds ’ ’: improper clothing, 
93; treatment, 264. 
Colic, 28, 154; treatment, 311. 
Collodion, 287. 
Colostrum, 35, 173. 
Communicable disease, 197. 
Comparison of cow’s milk and 
human milk, 199. 
Complementary feeding, 185. 
Compound tincture of benzoin, 
194, 315. 
Condensed milk, 207. 
Conduct, abnormal, 258. 
Constipation, 180, 272, 300; of 
infants, 43. 
Constitutional disease and 
nursing, 186. 
Contagious diseases, 274-281. 
Contraindications to nursing, 
186. 
Convulsions: baths, 88; treat- 
ment, 312. 
Cooking of meats, poultry and 
fish, 242. 
Cord: dressing the stump, 55; 
improper treatment, 56; in- 
fection, 56; separation, 54. 
Cornmeal, 199. 
Cornstarch, 67, 68. 
Cough, 258. 
Cows, 199, 200, 202, 223. 
Cow’s milk: compared with 
human milk, 199; ingredient 
percentages, 143. 
Cracked nipples, 192, 194. 
Cradle cap, 291. 
Cranium: circumference, 14; 146 
DIET AND CARE OF CHILDREN 
fontanels, 14; fontanel clos- 
ure, 15; growth, 14; sutures, 
14. 
Cream, 146, 217, 306. 
Cream of rye, 190; of wheat, 
190. 
Creosote, 314. 
Cretinism and fontanel closure, 
17; and teething, 13. 
Croquettes, 191. 
Cross eyes, 294. 
Croup, 315; kettle, 315. 
Cuffs, 250, 284. 
Curds, 226, 227; bean curds, 
163; in breast milk, 148; in 
cow’s milk, 148. 
Curdy stools, 161. 
Cuts, treatment, 305. 
D 
Dark stools, 29, 168. 
Dates, 199. 
Dentition, 8, 9, 10, 11, 12, 13. 
Development of faculties: head 
holding, 22; sitting up, 24; 
standing, 25; taking notice, 
23; talking, 27; walking, 26. 
Dextrimaltose, 36, 41. 
Diapers, 101; care of, 103. 
Diaphragm, 316. 
Diarrhea, 231; treatment, 265. 
Diarrheal diseases, 201, 222, 
224, 229. 
Diastase, 36, 41. 
Diet, character, 258. 
for nursing mother; suit- 
able, 190; unsuitable, 191. 
from 12 to 15 months, 238; 
from 15 to 18 months, 239; 
from 18 to 24 months, 240; 
from 2 to 7 years, 241. 
Digestion, 39. 
Digestion timo of breast milk 
and cow’s milk, 155. 
Digestive fluids: acting in in- 
testine, 41; of stomach, 40. 
Diphtheria, 201. 
Dirt-eating, 252; dirt paste, 
307. 
Discharge from the ears, 258, 
282; from the nose, 258. 
Disease transmission in breast 
milk, 170. 
Diseases conveyed in milk, 201. 
Doughnuts, 191. 
Drawers, 109. 
Dressing-slips, 98. 
Drowsiness, 258. 
Drugs secreted in breast milk, 
187. 
Drum puncture, 313. 
Dusting-powder, 286. 
Dysentery, 201. 
E 
Ear: care, 70; discharge, 258. 
Earache, 313. 
Ears, protruding, 296. 
Eating dirt and plaster, 252. 
Eating: precautions, 244. 
Economic obstacles to nursing, 
186. 
Eczema, 222, 224, 260, 284, 
291, 292; bathing, 80. 
Eggs, 190, 284. 
Eiweiss milk, 230. ALPHABETICAL INDEX 
147 
Enema, 268, 311, 312; high, 
265. 
Epilepsy and nursing, 186. 
Epsom salts, 304, 309. 
Eruptive fevers and baths, 88. 
Excessive clothing, 93. 
Exercise, 76; time of, 76. 
Exhaustion and nursing, 186. 
Exudative diathesis, 284. 
Eyes: crossed, 294; protection 
of, 57; routine treatment, 
57; styes, 293. 
Eye teeth, 10. 
P 
Faculties (see Development of 
faculties). 
Farina, 190. 
Fat, 199, 226, 228, 229, 230, 
284; in breast milk, 142, 
174; in cow’s milk, 143; di- 
gestion in stomach, 38. 
Fat indigestion, 161. 
Feeding: awakening for, 176; 
caloric, 215; complementary, 
185; duration of, 177; for- 
mulas, origin, 198; intervals, 
153, 154, 176, 237; keeping 
after preparation, 235; num- 
ber of, 237; percentage, 
214; quantity, 237; quanti- 
ties during 1st year, 152; 
supplementary, 185; temper- 
ature, 236; utensils, 210. See 
also Diet. 
Ferment, 225. 
Fever, 258. 
Fevers, eruptive, and baths, 
88. 
Finger nail biting, 251. 
Fish, 190. 
Fissures of anus, 167; of 
breast, 194. 
Flat chest, 18. 
Floor of nursery, 124. 
Flour, 222; barley, 217, 218, 
222, 232; oatmeal, 222; 
paste, 306; rice, 217, 222; 
soy-bean, 217, 222; wheat, 
217, 222. 
Follicle, 293. 
Fontanel closure, 15, 17; in- 
jury, 16. 
Fontanels, 14. 
Food: assimilation of, 40; dur- 
ing 1st year, 140; solid, 156. 
See also Diet. 
Foods: avoided by young chil- 
dren, 243; highly seasoned, 
191; patent, proprietary, 
208, 209; solid, 156. 
Foot and mouth disease, 201. 
Foreign body swallowed, 304. 
Foreskin, 249, 283; adhesions, 
72; care of, 72. 
Formaldehyde in breast milk, 
187. 
Formulas: origin of, 198; 
preparation of, 234; rules 
for writing, 237. 
Frenum, 297. 
Freshness of cold air, 136. 
Fried foods, 91. 
Fritters, 191. 
Fruit juices, 247. 
Funnel chest, 20. 148 
DIET AND CARE OF CHILDREN 
G 
Garlic enema, 268. 
General weakness, 18. 
Genitals: care of, 73, 74; pow- 
dering, 74; washing, 73. 
German measles, 276. 
Gians, 72. 
Glycerine, 292, 313; enema, 
300; suppository, 300. 
Gonorrhea, 197. 
Green stools, 29, 154, 164. 
Groats, 190. 
Guernseys, milk of, 199, 202. 
H 
Hangings of nursery, 123. 
Head-holding, 22. 
Heart disease and pigeon chest, 
19. 
Heart malformations, 21. 
Heating nursery, 126. 
Hemorrhagic disease, 166. 
Hemorrhoids, 300. 
Heterophoria, 294. 
Hiccough, 316. 
Hives, 289, 290; bathing, 84. 
Holsteins, milk of, 199, 202, 
223. 
Hominy, 190. 
Human milk compared with 
cow’s milk, 199. 
Hydrocephalus and fontanel 
closure, 17. 
Hydrochloric acid in stomach, 
38, 40. 
Hypothyroidism, 272. 
I 
Icterus, 34. 
Illness and teething, 13. 
Immunity in breast milk, 169. 
Incisor teeth, 10, 11. 
Incubation period, 274; chick- 
en-pox, 279; diphtheria, 278; 
German measles, 276; 
measles, 275; mumps, 281; 
scarlet fever, 277; whooping- 
cough, 280. 
Indigestion, 154, 225; milk in- 
gredients causing, 150. 
Infectious diarrheas, 165, 166. 
Infectious diseases, 274-281. 
Information for doctor, 258. 
Insanity and nursing, 186. 
Intestinal disturbances and 
clothing, 93. 
Intestines, 43, 44; kinking, 
300; length, 42. 
Invertase, 41. 
Inverted nipples, 188, 193. 
Iodide of iron, 293. 
Iodides in breast milk, 187. 
Iodoform in breast milk, 187. 
Ipecac, 312, 315. 
Ivy poisoning, 288. 
J 
Jaundice, 34. 
Jerseys, milk of, 199, 202. 
Junket, 226. 
Junket tablets, 226. ALPHABETICAL INDEX 
149 
K 
Kidney disease and nursing, 
186. 
Kinking of intestines, 300. 
L 
Lactase, 41. 
Lactic acid, 230; in stomach, 
40. 
Lactic acid bacilli, 228, 229, 
230. 
Lactose, 218. 
Lanolin, 195. 
Lard, 306. 
Lassar’s paste, 284. 
Length of body, 5; at birth, 5; 
gain, 5. 
Lifting the baby, 48. 
Lighting the nursery, 125. 
Lime water, 288; and olive oil, 
285. 
Lipase in the stomach, 40. 
Lockjaw from cord infection, 
56. 
M 
Macaroni, 199. 
Magnesium, 230. 
Malignant disease and nursing, 
186. 
Malnutrition, 231; baths, 86. 
Malta fever, 201. 
Maltase, 36, 41. 
Marasmus, 231. 
Masturbation, 249, 283. 
Measles, 275, 295. 
Meat, 190. 
Meconium, 29. 
Menstruation and nursing, 171. 
Mentholated vaseline, 2G8, 285, 
290, 307. 
Mercury in breast milk, 187. 
Mercury oxide, 293. 
Milk: boiling, 206; casein, 
230; comparison of cow’s 
and human, 199; condensa- 
tion, 207; conveyed diseases, 
201; ingredients, 141, 142, 
143, 144, 145, 146, 147, 148, 
149, 150, 199; pasteuriza- 
tion, 203, 204; peptonized, 
225; production requisites, 
200; skimmed, 217, 223; 
sterilization, 205. 
Milk crust, 291. 
Milk of bismuth, 265; of mag- 
nesia, 264, 286. 
Milk secretion: alcohol effect, 
184; of breasts, 173; in- 
crease of, 183. 
Milkers, 200. 
Mince meat, 191. 
Mineral salts in breast milk, 
142, 144; in cow’s milk, 143, 
145. 
Molar teeth, 11. 
Mongolian idiocy and fontanel 
closure, 17. 
Mouth: infections, 250; sore, 
188; washing, 71. 
Mucous stools, 165. 
Mumps, 281. 
Mustard baths, 87; indica- 
tions, 88; plaster, 311. 
Mustard in convulsions, 312. 150 
DIET AND CARE OF CHILDREN 
N 
Nail-biting, 251. 
Nasal discharge, 258. 
Natural food during first year, 
140. 
Nephritis and nursing, 186. 
Nervousness, 258. 
Night clothing, 113. 
Night terrors, 298. 
Nightgowns, 99. 
Nipple shield, 194. 
Nipples, 213; cracked, 192, 
194; inverted, 188; rubber, 
213; sore, 195; undeveloped, 
188. 
Normal temperature, 255. 
Nose care, 69; discharge, 258. 
Nosebleed, 303. 
Notice taking, 23. 
Nurse, wet, 197. 
Nursery: floor, 124; furnish- 
ings, 49; hangings, 123; 
heating, 126; humidity, 127; 
lighting, 125; temperature, 
128; toilet table equipment, 
50; ventilation, 134; walls, 
122; waste receptacle, 51. 
Nursery milk requisites, 200. 
Nursing: awakening for, 176; 
contraindications, 186; du- 
ration, 177; during men- 
struation, 171; during preg- 
nancy, 172; mother’s bowels, 
179; refusal, 188; social ob- 
stacles, 186; successful, 181; 
unsuccessful, 182. 
Nursing-bottles, 211; care of, 
212. 
0 
Oatmeal, 190, 217; water, 
preparation, 233. 
Oil of cloves and chloroform, 
314. 
Olive oil, 291, 292, 306; 
enemas, 300; and lime water, 
285. 
Opium in breast milk, 187. 
Orange juice, 248, 300, 302. 
Otitis media, 260, 295. 
Out of doors: allowed, 130; 
unfavorable exposures, 131. 
Ova, 266, 267, 269, 271. 
Overfeeding and stools, 31. 
Overlying, 121. 
Oxidation of bile, 164. 
Oysters, 190. 
P 
Pacifier, 139. 
Pain, 258. 
Pancreatic extract, 225. 
Pasteurization, 203. 
Pasteurized milk, 203, 204. 
Pastry, 191. 
Patent foods, 208, 209. 
Pavor nocturnus, 298. 
Peppermint water, 311. 
Pepsin, 226; in gastric juice, 
38, 40. 
Peptones, 40. 
Peptonized milk, 225. 
Percentage feeding, 214. 
Peristaltic action, 300. 
Petticoats, 97. 
Pettijohn, 190. ALPHABETICAL INDEX 
151 
Phenol, 313; in breast milk, 
187. 
Phimosis, 272. 
Pickles, 191. 
Pigeon chest, 19. 
Pillow, use of, 53. 
Pin worms, 267, 268, 272. 
Plaster-eating, 252. 
Poison ivy, 288. 
Poisoning, 308; bichloride of 
mercury, 309; ivy, 288. 
Porch screen, 132. 
Pork, 191. 
Position during sleep, 117. 
Potassium, 230; sulfocyanid, 
36. 
Poultry, 190. 
Powdering skin, 67, 68. 
Precautions in eating, 244. 
Pregnancy and nursing, 172. 
Premolar teeth, 10, 11. 
Prickly heat, 286; bathing, 80, 
82, 84; clothing, 93. 
Proprietary foods, 208, 209. 
Protein, 147, 199, 222; in 
breast milk, 142, 148; coagu- 
lation, 38; in cow’s milk, 143, 
148. 
Protein milk, 230. 
Protruding ears, 296. 
Prunes, 190, 300. 
Puddings, 191. 
Pulse, 6; at birth, 6; varia- 
tions, 6. 
Purgative salts in breast milk, 
187. 
Pyelitis, 272. 
Pyloric stenosis, 45. 
Pylorus, 44, 45. 
Q 
Quinine bisulphate solution, 
250. 
Quinine in breast milk, 187. 
R 
Rachitis, 301. 
Rectal: fissures, 272; polypi, 
272. 
Refractive error, 293, 294. 
Refusal to nurse, 188. 
Rennet, 226; in stomach, 40. 
Rennin in stomach, 40. 
Resistance to cold, 61, 63. 
Resorcin, 291. 
Respiration, 7. 
Respiratory rate, 7; at birth, 
7; variations, 7. 
Restlessness, 258. 
Rhubarb and soda, 310. 
in breast milk, 187. 
Rice flour, 217, 218. 
Rickets, 301; baths, 86; fun- 
nel chest, 20; pigeon chest, 
19; teething, 13. 
Rocking, 118. 
Room screen, 132. 
Round worms, 269, 270. 
Rubber nipples, 213. 
s 
Salicylic acid in breast milk, 
187. 
Saline purgative, 304. 
Saliva, 36; digestive action, 
36; secretion, 37. 
Salt baths, 85; indications, 86. 152 
DIET AND CARE OF CHILDREN 
Salt, wet, 307. 
Salts, 226; in breast milk, 142, 
144, 187; in cow’s milk, 143. 
Sandals, 107. 
Santonin, 270. 
Sausage, 191. 
Scalding with urination, 262. 
Scallops, 190. 
Scarlet fever, 201, 277, 295. 
Scorbutus, 302. 
Screening: baby carriage, 132; 
porch, 132; room, 132. 
Scurvy, 166, 206, 246, 302. 
Seasoned foods, 191. 
Seborrhea capitis, 291. 
Seiler’s tablet, 264. 
Shirts, 96. 
Shoes, 107. 
Short clothes, 104. 
Shoulder-straps, 111, 112. 
Sigmoid flexure, 43. 
Silver nitrate, 194; in eyes, 
57. 
Sitting up, 24. 
Skimmed milk, 217, 223, 224; 
uses, 224, 228. 
Skin: cleansing, 59; drying, 
67; powders, 67, 68. 
Skin irritations, bathing, 80, 
82. 
Sleep, 114; daytime, 116; dis- 
turbance, 119; position, 117; 
time spent, 115. 
Sleeping alone, 120. 
Sleeplessness, 258, 260. 
Soap, 65. 
Soapsuds enema, 311, 312. 
Social obstacles to nursing, 
186. 
Soda baths, 81; indications, 
82, 286, 290. 
Sodium, 230. 
Sodium bicarbonate, 225, 262, 
288, 306, 310; in mouth, 71; 
in vomiting, 310. 
Soft spot, 14; closure, 15, 17; 
injury, 16. 
Solid food, 156. 
Sore: mouth, 188; nipples, 
195. 
Soy-bean flour, 217, 218, 222. 
Spirits of camphor, 307, 314. 
Squint, 294. 
Stables, 200. 
Stammering, 299. 
Standing, 25. 
Starch: baths, 83; digestion in 
stomach, 38; digestion in in- 
testines, 41; paste, 306. 
Starvation in pyloric stenosis, 
45. 
Stearate of zinc, 67. 
Sterilization, 205. 
Stewed prunes, 190, 300. 
Stimulant baths, 86, 88. 
Stomach, 38; capacity, 152; 
function, 38. 
Stomatitis, 188. 
Stools, 29; abnormal number, 
31; bloody, 166; color varia- 
tions, 159; curdy, 161, 163; 
dark, 29, 168; green, 29, 154, 
164; meconium, 29; mucous, 
165; normal, 157, 158; nor- 
mal number, 31; reactions, 
160; tarry, 167; time of 
passage, 30; yellowish, 29. 
Strabismus, 294. ALPHABETICAL INDEX 
153 
Strawberry tongue, 277. 
Streptococcus infections, 201. 
Strychnia in breast milk, 187. 
Stuttering, 299. 
Styes, 293. 
Successful nursing, 181. 
Sugar, 216, 226, 227, 228, 229, 
230, 284; in breast milk, 
142; cane, 218, 220, 221; 
choice of, 221; in cow’s 
milk, 143; dextrimaltose, 
218, 220, 221; milk, 218, 
220, 221. 
Sunburn, 285. 
Supplementary feeding, 185. 
Suppositories, 89, 300. 
Sutures of cranium, 14. 
Swallowing foreign bodies, 
304. 
Sweet oil, 306, 311. 
Syphilis, 197; and nursing, 
186. 
Syrup of iodide of iron, 293. 
Syrup of ipecac, 312, 315. 
T 
Table, 50. 
Talcum powder, 67, 68, 286. 
Talking, 27. 
Tape worms, 271. 
Tarry stools, 167. 
Tea, 191. 
Tears, 46. 
Teeth, 8; appearance, 10, 11; 
first set, 8, 10; second set, 9, 
11. 
Teething, 12; illness in, 13; 
delayed, 13. See also Denti- 
tion. 
Temperature, 255; airing, 129; 
nursery, 128; sleeping, 129; 
taking, 256, 257. 
Tetanus from cord infection, 
56. 
Thermometer: bath, 62; rectal, 
256. 
Thigh rubbing, 249. 
Thread 'worms, 272. 
Thumb-sucking, 250. 
Tincture: iodine, 287, 305; 
benzoin comp., 194, 315. 
Toilet table, 50; waste recep- 
tacle, 51. 
Tongue, strawberry, 277. 
Tongue-tie, 297; and nursing, 
188. 
Tonic baths, 86, 88. 
Tonsils, enlarged, 272, 295, 
298. 
Toothache, 314. 
Tripsin, 225; in intestine, 41. 
Tuberculosis, 197; bovine, 200, 
201. 
Tuberculosis and nursing, 186. 
Tumor and nursing, 186. 
Turnips, 191. 
Turpentine in breast milk, 187. 
Typhoid, 166, 201. 
u 
Undeveloped nipples, 188. 
Unsuccessful nursing, 182. 
Urethra, inflammation, 272. 
Urination: amount, 258; char- 
acter, 258; frequency, 32; 
scalding with, 262. 154 
DIET AND CARE OF CHILDREN 
Urine: acid, 33; alkaline, 33; 
ammonia odor, 263; collec- 
tion, 259; reaction, 33; re- 
action after orange juice, 
248; scalding, 262. 
Urticaria, 289. 
Utensils for bottle-feeding, 
210. 
V 
Vaginitis, 272. 
Vanilla, 227. 
Vaseline, 72, 195, 264, 268, 
285, 291, 292, 306, 311; car- 
bolated (carbolized), 307; 
mentholated, 307. 
Vegetables, 190. 
Ventilation of nursery, 134. 
Vernix caseosa, 59. 
Vitamins, 205, 246, 302. 
Vomiting, 154, 221, 224, 258, 
310; in croup, 315. 
Vulvovaginitis, 272. 
w 
Walking, 26; with baby, 118; 
machine, 138. 
Walls of nursery, 122. 
Wardrobe for young baby, 90; 
baby in short clothes, 105; 
at runabout age, 110. 
Wash-clotlis, 66. 
Wassermann test, 197. 
Water, 141, 142, 143, 229; bar- 
ley, 232; in breast milk, 
142; in cow’s milk, 143; 
drinking, 151, 178; hard, 64; 
oatmeal, 233; soft, 64; sub- 
stitutes for bathing, 75; 
when given, 245. 
Waterproof diaper cover, 101. 
Weakness of ankles, 261. 
Weight: birth, 1; of boys, 1, 
3, 4; development, 1, 2, 3, 4; 
gain, 1, 2, 3; of girls, 1, 3, 
4; loss, 1. 
Weight loss and nursing, 186. 
Wet nurse, 197. 
Wheat flour, 217. 
Whey, 217, 226. 
Whiskey, 308. 
Whole milk, 217. 
Whooping-cough, 280. 
Window-board, 135. 
Wisdom teeth, 11. 
“Witch’s milk,’’ 35. 
Worms, 299; indications of, 
266; pin worms, 267, 268; 
round worms, 269, 270; tape 
worms, 271. 
Wrappers, 100. 
Y 
Yellow oxide of mercury, 293. 
Yellowish stools, 29. 
z 
Zinc oxide: and glycerine, 292; 
ointment, 67, 285, 288, 306; 
powder in olive oil, 67. 
Zinc stearate, 67, 68.