The Maternal Management Of Children, In Health And Disease Part 15

BLEEDING FROM THE NAVEL-STRING.

Bleeding from the navel-string will sometime take place hours after it has been supposed to be carefully secured. This will arise, either from the cord being carelessly tied, or from its being unusually large at birth, and in a few hours shrinking so much that the ligature no longer sufficiently presses on the vessels. In either case, it is of importance that the attendants in the lying-in-room should understand how to manage this accident when it occurs, that it may not prove injurious or fatal to the child.

THE MODE OF ARRESTING THE BLEEDING.--The clothes of the child and the flannel roller must be taken off;--the whole cord without delay must be unwrapped, and then a second ligature be applied below the original one, (viz. nearer to the body of the infant,) taking great care that it shall not cut through the cord when drawn very tight, but at the same time drawing it sufficiently tight to compress the vessels.

The ligature should be composed of fine linen threads, three or four thicknesses, and not of tape or bobbin, or any substance of this nature, as it cannot be relied on for this purpose.

ULCERATION OR IMPERFECT HEALING OF THE NAVEL.

The cord separates from the navel generally some time between the fifth and fifteenth day from delivery, and the part usually heals without giving the slightest trouble.

This, however, is not always the case, for sometimes a thin discharge will take place, which, if the part be examined, will be found to proceed from a small growth about the size, perhaps, of a pea, or even less. This must be removed by applying a little powdered alum,--or, if this fail, it should be once or twice slightly touched with blue-stone, and afterwards dressed with calamine cerate.

At other times, though fortunately very rarely, excoriation of the navel and the parts around takes place, which quickly spreads, and a.s.sumes an angry and threatening character. If, however, the attention of the medical man is called to it early, it will always do well: until his directions are given, apply a nicely made bread and water poultice.

BLEEDING FROM THE NAVEL.

Sometimes, a day or two after the cord separates, or at the time of separation, bleeding takes place from the navel: fortunately, this very seldom occurs; indeed, it is very rarely met with; and I only mention it, to observe that, upon its occurrence, the point of the finger should be placed over the part, and pressure steadily applied until medical a.s.sistance is obtained.

Now and then, in these cases, a growth sprouts up and bleeds. Let this be touched with lunar caustic, or any other astringent application, or let pressure be employed, still it will bleed,--not freely or in a stream, but there will be a constant drain from the part, and the infant, as a consequence, will waste, and be brought to death's door.

Excise it, it will only make matters worse. The treatment in this case consists in simply winding a piece of very narrow tape round the growth, and then leaving it untouched. The bleeding will soon cease; the fungus will sprout over the upper margin of the tape; in a very short time it will, as it were, strangle the disease, which subsequently falling off, a complete cure is accomplished.

JAUNDICE.

It frequently happens, during the first or second week after birth, that the skin of the child becomes very yellow, and it has all the appearance of having the jaundice. This gives rise to great distress to the parent when she perceives it, and she becomes very anxious for the medical man's next visit.

Now, ordinarily, it is of no consequence; commonly disappearing spontaneously, and requiring no medical treatment. If, however, it does not go off in two or three days, a tea-spoonful of castor oil should be given once, or oftener, if necessary.

It is, of course, possible for an attack of real jaundice to occur at this early period, and a disease of a very serious nature will then have to be dealt with; but, except as a consequence of malformation (a very infrequent occurrence), it is not likely to arise; and therefore jaundice during the first and second week after delivery need not create alarm.

Tongue-tied.

FROM WHAT IT ARISES.--This arises from the bridle under the tongue being so short, or its attachment to the tongue extended so near the tip, as to interfere with the motions of the organ in sucking, and, in after years, in speaking. It is a rare occurrence, although nothing is more common than for medical men to have infants brought to them supposed to be labouring under the above defect.

HOW ITS EXISTENCE MAY BE DETERMINED.--The best guide for a parent to determine whether it exist or not, is for her to watch whether the infant can protrude the tip of the tongue beyond the lips: if so, it will be able to suck a good nipple readily, and nothing need or ought to be done. No mother will unnecessarily expose her infant to an operation, which, unless very carefully performed, is not altogether unattended with danger; and, if she suspects any defect of this kind to exist, she has only to observe the circ.u.mstance mentioned above, to satisfy her mind upon the subject.

MOLES AND MARKS ON THE SKIN, ETC.

The supposed influence of the imagination of the mother, in the production of the above appearances in the texture of the skin of her infant, has been fully discussed in the author's work "Hints to Mothers, etc." This part of the subject is, however, foreign to the present inquiry, which chiefly has reference to the probable effect of their presence upon the health of the child.

They may be divided into two cla.s.ses: the brownish mole, and claret- stain; and small but somewhat elevated tumours, either of a dark blue, livid colour, or of a bright vermilion hue.

MOLES AND STAINS.--They are of no importance, as far as the health of the infant is concerned. If situated in the face, however, they frequently cause great disfigurement, as the claret-stain, which may be seen sometimes to occupy nearly half the face. But they happily do not increase in size, remaining stationary through life; and as any operation that might be proposed for their removal, would only cause an equal, if not greater, deformity, they ought to be left alone.

COLOURED SPOTS OR TUMOURS.--These vary in their number, size, and situation. The same child is sometimes born with many of them. They may be as small as a pea, or as large as a crown piece. They are not only found on the skin, but on the lips, in the mouth, etc. etc.

These, also, sometimes remain stationary in their size, having no tendency to enlarge, unless, indeed, they are subjected to friction or pressure. But as they frequently require surgical aid, in which case, the earlier the application of remedial measures, the less severe in their kind, and the greater the probability of a speedy and successful result,--so is it always important for the mother early to obtain a medical opinion, that the measure of interference or non-interference may be decided.

Sect. II. DISORDERS OF THE STOMACH AND BOWELS OF THE INFANT.

INDIGESTION, FLATULENCE, VOMITING, GRIPING, AND LOOSENESS.

Disorder of the stomach and bowels is one of the most fruitful sources of the diseases of infancy. Only prevent their derangement, and, all things being equal, the infant will be healthy and flourish, and need not the aid of physic or physicians. Experience daily proves, that a large proportion of the children who die in infancy are lost from derangement of these organs, as the primary cause.

There are many causes which may give rise to these affections; many of them appertain to the mother's system, some to that of the infant. All are capable, to a great extent, of being prevented or remedied. It is, therefore, most important that a mother should not be ignorant or misinformed upon this subject. It is the prevention of these affections, however, that will be princ.i.p.ally dwelt upon in this chapter; for let the mother ever bear in mind, and act upon the principle, that the prevention of disease alone belongs to her; the cure to the physician.

For the sake of clearness and reference, these disorders will be spoken of as they occur:--

To the infant at the breast.

At the period of weaning.

And to the infant brought up by hand.

1. TO THE INFANT AT THE BREAST.