Advice to a Mother on the Management of Her Children Part 5

When a babe is born with teeth, they generally drop out. On the other hand, teething, in some children does not commence until they are a year and a half or two years old, and, in rare cases, not until they are three years old. There are cases recorded of adults who have never cut any teeth. An instance of the kind came under my own observation.

Dent.i.tion has been known to occur in old age. A case is recorded by M. Carre, in the _Gazette Medicale de Paris_ (Sept 15, 1860), of an old lady, aged eighty-five, who cut several teeth after attaining that age!

59. _What is the number of the FIRST set of teeth, and in what order do they generally appear_?

The first or temporary set consists of twenty. The first set of teeth are usually cut in pairs. "I may say that nearly invariably the order is--1st, the lower front incissors [cutting teeth], then the upper front, then the _upper_ two lateral incissors, and that not uncommonly a double tooth is cut before the two _lower_ laterals; but at all events the lower laterals come 7th and 8th, and, not 5th and 6th, as nearly all books on the subject testify." [Footnote: Sir Charles Loc.o.c.k in a _Letter_ to the Author.] Then the first grinders, in the lower jaw, afterwards the first upper grinders, then the lower corner-pointed or canine teeth, after which the upper corner or eye-teeth, then the second grinders in the lower jaw, and lastly, the second grinders of the upper jaw. They do not, of course, always appear in this rotation. Nothing is more uncertain than the order of teething. A child seldom cuts his second grinders until after he is two years old. _He is, usually, from the time they first appear, two years in cutting the first set of teeth_. As a rule, therefore, a child of two years old has sixteen, and one of two years and a half old, twenty teeth.

60. _If an infant be feverish or irritable, or otherwise poorly, and if the gums be hot, swollen, and tender, are you an advocate for their being lanced_?

Certainly; by doing so he will, in the generality of instances, be almost instantly relieved.

61. _But it has been stated that lancing the gums hardens them_?

This is a mistake--it has a contrary effect. It is a well-known fact, that a part which has been divided gives way much more readily than one which has not been cut. Again, the tooth is bound down by a tight membrane, which, if not released by lancing, frequently brings on convulsions. If the symptoms be urgent, it may be necessary from time to time to repeat the lancing. It would, of course, be the height of folly to lance the gums unless they be hot and swollen, and unless the tooth, or the teeth, be near at hand. It is not to be considered a panacea for every baby's ill, although, in those cases where the lancing of the gums is indicated, the beneficial effect is sometimes almost magical.

62. _How ought the lancing of a child's gums to be performed_?

The proper person, of course, to lance his gums is a medical man. But if, perchance, you should be miles away and be out of the reach of one, it would be well for you to know how the operation ought to be performed. Well, then, let him lie on the nurse's lap upon his back, and let the nurse take hold of his hands in order that he may not interfere with the operation.

Then, _if it be the upper gum_ that requires lancing, you ought to go to the head of the child, looking over, as it were, and into his mouth, and should steady the gum with the index finger of your left hand; then, you should take hold of the gum-lancet with your right hand--holding as if it were a table-knife at dinner--and cut firmly along the inflamed and swollen gum and down to the tooth, until the edge of the gum-lancet grates on the tooth. Each incision ought to extend along the ridge of the gum to about the extent of each expected tooth.

_If it be the lower gum_ that requires lancing, you must go to the side of the child, and should steady the outside of the jaw with the fingers of the left hand, and the gum with the left thumb, and then you should perform the operation as before directed.

Although the lancing of the gums, to make it intelligible to a non-professional person, requires a long description, it is, in point of fact, a simple affair, is soon performed, and gives but little pain.

63. _If teething cause convulsions, what ought to be done_?

The first thing to be done (after sending for a medical man) is to freely dash water upon the face, and to sponge the head with cold water, and as soon as warm water can be procured, to put him into a warm bath [Footnote: For the precautions to be used in putting a child into a warm bath, see the answer to question on "Warm Baths."] of 98 degrees Fahrenheit. If a thermometer be not at hand, [Footnote: No family, where there are young children, should be without Fahrenheit's thermometer.] you must plunge your own elbow into the water: a comfortable heat for your elbow will be the proper heat for the infant. He must remain in the bath for a quarter of an hour, or until the fit be at an end. The body must, after coming out of the bath, be wiped with warm and dry and coa.r.s.e towels; he ought then to be placed in a warm blanket. The gums must be lanced, and cold water should be applied to the head. An enema, composed of table salt, of olive oil, and warm oatmeal gruel--in the proportion of one table-spoonful of salt, of one of oil, and a tea-cupful of gruel--ought then to be administered, and should, until the bowels have been well opened, be repeated every quarter of an hour; as soon as he comes to himself a dose of aperient medicine ought to be given.

It may be well, for the comfort of a mother, to state that a child in convulsions is perfectly insensible to all pain whatever; indeed, a return to consciousness speedily puts convulsions to the rout.

64. _A nurse is in the habit of giving a child, who is teething, either coral, or ivory, to bite: do you approve of the plan_?

I think it a bad practice to give him any hard, unyielding substance, as it tends to harden the gums, and, by so doing, causes the teeth to come through with greater difficulty. I have found softer substances, such as either a piece of wax taper, or an India-rubber ring, or a piece of the best bridle leather, or a crust of bread, of great service. If a piece of crust be given as a gum-stick, he must, while biting it, be well watched, or by accident he might loosen a large piece of it, which might choke him. The pressure of any of these excites a more rapid absorption of the gum, and thus causes the tooth to come through more easily and quickly.

65. _Have you any objection to my baby, when he is cutting his teeth, sucking his thumb_?

Certainly not: the thumb is the best gum-stick in the world:--it is convenient; it is handy (in every sense of the word): it is of the right size, and of the proper consistence, neither too hard nor too soft; there is no danger, as of some artificial gum-sticks, of its being swallowed, and thus of its choking the child. The sucking of the thumb causes the salivary glands to pour out their contents, and thus not only to moisten the dry mouth, but a.s.sist the digestion; the pressure of the thumb eases, while the teeth are "breeding," the pain and irritation of the gums, and helps, when the teeth are sufficiently advanced, to bring them through the gums. Sucking of the thumb will often make a cross infant contended and happy, and will frequently induce a restless babe to fall into a sweet refres.h.i.+ng sleep. Truly may the thumb be called a baby's comfort. By all means, then, let your child suck his thumb whenever he likes, and as long as he chooses to do so.

There is a charming, bewitching little picture of a babe sucking his thumb in Kingsley's _Water Babies_, which I heartily commend to your favourable notice and study.

66. _But if an infant be allowed to suck his thumb, will it not be likely to become a habit, and stick to him for years--until, indeed, he become a big boy_?

After he have cut the whole of his first set of teeth, that is to say, when he is about two years and a half old, he might, if it be likely to become a habit, be readily cured by the following method, namely, by making a paste of aloes and water, and smearing it upon his thumb. One or two dressings will suffice as after just tasting the bitter aloes he will take a disgust to his former enjoyment, and the habit will at once be broken.

Many persons I know have an objection to children sucking their thumbs, as for instance,--

"Perhaps it's as well to keep children from plums, And from pears in the season, and sucking their thumbs." [Footnote: _Ingoldsby Legends_.]

My reply is,--

P'rhaps 'tis as well to keep children from pears; The pain they might cause, is oft follow'd by tears; 'Tis certainly well to keep them from plums; But certainly not from sucking their thumbs!

If a babe suck his thumb 'Tis an ease to his gum; A comfort; a boon; a calmer of grief; A friend in his need--affording relief; A solace; a good; a soother of pain; A composer to sleep; a charm; and a gain.

'Tis handy, at once, to his sweet mouth to glide; When done with, drops gently down by his side; 'Tis fix'd, like an anchor, while the babe sleeps.

And the mother, with joy, her still vigil keeps.

67. _A child who is teething dribbles, and thereby wets his chest, which frequently causes him to catch cold; what had better be done_?

Have in readiness to put on several _flannel_ dribbling bibs, so that they may be changed as often as they become wet; or, if he dribble _very much_, the oiled silk dribbling-bibs, instead of the flannel ones, may be used, and which may be procured at any baby-linen ware house.

68. _Do you approve of giving a child, during teething, much fruit_?

No; unless it be a few ripe strawberries or raspberries, or a roasted apple, or the juice of five or six grapes--taking care that he does not swallow either the seeds or the skin--or the insides of ripe gooseberries, or an orange. Such fruits, if the bowels be in a costive state, will be particularly useful.

All stone fruit, _raw_ apples or pears, ought to be carefully avoided, as they not only disorder the stomach and the bowels,--causing convulsions, gripings, &c.,--but they have the effect of weakening the bowels, and thus of engendering worms.

69. _Is a child, during teething, more subject to disease, and, if so, to what complaints, and in what manner may they be prevented_?

The teeth are a fruitful source of suffering and of disease; and are, with truth, styled "our first and our last plagues." Dent.i.tion is the most important period of a child's life, and is the exciting cause of many infantile diseases; during this period, therefore, he requires constant and careful watching. When we consider how the teeth elongate and enlarge in his gums, pressing on the nerves and on the surrounding parts, and thus how frequently they produce pain, irritation, and inflammation; when we further contemplate what sympathy there is in the nervous system, and how susceptible the young are to pain, no surprise can be felt, at the immense disturbance, and the consequent suffering and danger frequently experienced by children while cutting their _first_ set of teeth. The complaints or the diseases induced by dent.i.tion are numberless, affecting almost every organ of the body,--the _brain_, occasioning convulsions, water on the brain, &c.; the _lungs_, producing congestion, inflammation, cough, &c.; the _stomach_, exciting sickness, flatulence, acidity, &c,; the _bowels_, inducing griping, at one time costiveness, and at another time purging; the _skin_, causing "breakings-out."

To prevent these diseases, means ought to be used to invigorate a child's const.i.tution by plain, wholesome food, as recommended under the article of diet; by exercise and fresh air; [Footnote: The young of animals seldom suffer from cutting their teeth--and what is the reason? Because they live in the open air, and take plenty of exercise; while children are frequently cooped up in close rooms, and are not allowed the free use of their limbs. The value of fresh air is well exemplified in the Registrar-General's Report for 1843; he says that in 1,000,000 deaths, from all diseases, 616 occur in the town from teething while 120 only take place in the country from the same cause.] by allowing him, weather permitting, to be out of doors a great part of every day; by lancing the gums when they get red, hot, and swollen; by attention to the bowels, and if he suffer more than usual, by keeping them rather in a relaxed state by any simple aperient, such as either castor oil, or magnesia and rhubarb, &c.; and, let me add, by attention to his temper: many children are made feverish and ill by petting and spoiling them. On this subject I cannot do better than refer you to an excellent little work ent.i.tled Abbot's _Mother of Home_, wherein the author proves the great importance of _early_ training.

70. _Have the goodness to describe the symptoms and the treatment of Painful Dent.i.tion_?

Painful dent.i.tion may be divided into two forms--(1) the Mild; and (2) the Severe. In the _mild_ form the child is peevish and fretful, and puts his fingers, and everything within reach, to his mouth, he likes to have his gums rubbed, and takes the breast with avidity, indeed it seems a greater comfort to him than ever. There is generally a considerable flow of saliva, and he has frequently a more loose state of bowels than is his wont.

Now, with regard to the more _severe_ form of painful dent.i.tion--The gums are red, swollen, and hot, and he cannot without expressing pain bear to have them touched, hence, if he be at the breast, he is constantly loosing the nipple. There is dryness of the mouth, although before there had been a great flow of saliva. He is feverish, restless, and starts in his sleep. His face is flashed. His head is heavy and hot. He is sometimes convulsed. [Footnote: See answer to Question 63.] He is frequently violently griped and purged, and suffers severely from flatulence. He is predisposed to many and severe diseases.

The _treatment,_ of the _mild_ form, consists of friction, of the gum with the finger, with a little "soothing syrup," as recommended by Sir Charles Loc.o.c.k, [Footnote: Soothing syrup--Some of them probably contain opiates, but a perfectly safe and useful one is a little Nitrate of Pota.s.s in syrup of Roses--one scruple to half an ounce.--_Communicated by Sir Charles Loc.o.c.k to the Author._ This 'soothing syrup' is not intended to be given us a mixture but to be used as an application to rub the gums with. It may be well to state that it is a perfectly harmless remedy even if a little of it were swallowed by mistake.] a tepid bath of about 92 degrees Fahrenheit, every night at bed time, attention to diet and to bowels, fresh air and exercise. For the mild form, the above plan will usually be all that is required. If he dribble, and the bowels be relaxed, so much the better. The flow of saliva and the increased action of the bowels afford relief, and therefore must not be interfered with. In the _mild_ form, lancing of the gums is not desirable. The gums ought not to be lanced, unless the teeth be near at hand, and unless the gums be red, hot, and swollen.

In the _severe_ form a medical man should be consulted early, as more energetic remedies will be demanded; that is to say, the gums will require to be freely lanced, warm baths to be used, and medicines to be given, to ward off mischief from the head, from the chest, and from the stomach.

If you are living in the town, and your baby suffers much from teething, take him into the country. It is wonderful what change of air to the country will often do, in relieving a child who is painfully cutting his teeth. The number of deaths in London, from teething, is frightful; it is in the country comparatively trifling.

71. _Should an infant be purged during teething or indeed, during any other time, do you approve of either absorbent or astringent medicines to restrain it_?

Certainly not. I should look upon, the relaxation as an effort of nature to relieve itself. A child is never purged without a cause; that cause, in the generality of instances, is the presence of either some undigested food, or acidity, or depraved motions, that want a vent.

The better plan is, in such a case, to give a dose of aperient medicine, such as either castor oil, or magnesia and rhubarb; and thus work it off. IF WE LOCK UP THE BOWELS, WE CONFINE THE ENEMY, AND THUS PRODUCE MISCHIEF. [Footnote: I should put this in capitals, it is so important and is often mistaken.--C. Loc.o.c.k.] If he be purged more than usual, attention should be paid to the diet--if it be absolutely necessary to give him artificial food while suckling--and care must be taken not to overload the stomach.

72. _A child is subject to a slight cough during dent.i.tion--called by nurses "tooth-cough"--which a parent would not consider of sufficient importance to consult a doctor about: pray tell me, is there any objection to a mother giving her child a small quant.i.ty either of syrup of white poppies, or of paregoric, to ease it_?

A cough is an effort of nature to bring up any secretion from the lining membrane of the lungs, or from the bronchial tubes, hence it ought not to be interfered with. I have known the administration of syrup of white poppies, or of paregoric, to stop the cough, and thereby to prevent the expulsion of the phlegm, and thus to produce either inflammation of the lungs, or bronchitis. Moreover, both paregoric and syrup of white poppies are, for a young child, dangerous medicines (unless administered by a judicious medical man), and _ought never to be given by a mother_.

In the month of April 1844, I was sent for, in great haste, to an infant, aged seventeen months, who was labouring under convulsions and extreme drowsiness, from the injudicious administration of paregoric, which had been given to him to ease a cough. By the prompt administration of an emetic he was saved.

73. _A child, who is teething, is subject to a "breaking-out," more especially behind the ears--which is most disfiguring, and frequently very annoying what would you recommend_?