Our Baby - for mothers and nurses

1929 edition (first published 1891)

CHAPTER NINE.

BABY'S NURSE AND TRAINING

A Good Nurse - Qualities of a Good Nurse - Cleanliness - Tidiness - Method - Nursery Routine - Training of Baby - The Force of Habit - Automatic Obedience - Sleeping - Breathing - Regular Bowel and Bladder Action - Warmth - Evils of Baby Comforters - Contentment - Toys - Normal Development - Lessons - School - Child's Record - Moral Training - Automatic Obedience - Punishment - Truthfulness - Self-control - Loving-kindness - Nervous System - Usefulness - Tidiness - Nursing of Sick Children - The Sick Nurse.

THE NURSE.

Baby must have a nurse - that is certain, and a nurse, too, for quite a long time. He develops very slowly, and needs constant supervision, even in the most elementary matters, for the first three or four years of his life.

It has often been said that the best nurse a child can have is its mother, but this is not always the case. A good nurse must possess certain qualities, be she the mother of the child or not.

If a mother can afford it, and especially if she be young and inexperienced herself, it is better not to choose too young a nurse for her first child; and she should give the preference to one who has had the care of quite young infants previously, and has been trained in one of the excellent Schools for Nursery Nurses now so deservedly popular.

A really competent nurse is an unspeakable treasure to a young mother ; but if her views on ventilation, artificial feeding, etc., be erroneous, her ideas must not be blindly followed, and it would be wise if every mother and nurse took a 'First Aid ' course, to be prepared for emergencies. This may not be possible, but both mother and nurse should possess open minds for new methods of child care, based on scientific research, and should be willing to profit by suitable books and lectures.

In London there are often courses of lectures at very small cost, and in towns where an Infant Welfare Centre exists there is generally opportunity for acquiring useful knowledge, as voluntary helpers are usually welcomed, and while the help required may be simply making tea for the mothers, or taking names, etc., yet anyone keen to learn will soon find herself in the right atmosphere to do so.

A Good Nurse must have a genuine love for all children, and should be a living exponent of all that she wishes them to become. She must be clean in body and mind, with no septic foci of any kind (e.g., decayed teeth, enlarged tonsils, or chronic catarrhs), possess a healthy family history, and be absolutely truthful and conscientious, and also patient, methodical, and tidy.

On these points it is well to remember that bad breath in a mother or nurse may be the cause of puzzling illness in a baby, while first lessons in deceit may be learnt from a nurse who behaves differently in the mother's presence and behind her back. Method and tidiness are essential both for general nursery routine and the training of the children. Every drawer and shelf should have its particular use, and be kept strictly to it. Lack of method produces a 'muddler' who is always trying to make up time and is useless in a busy nursery.

A calm, sunny temperament is a very great asset: an over-anxious, worried nurse will have fretful and nervous charges, whereas in a nursery of healthy children, joie de vivre should reign supreme. She should be intelligent, able to tell stories and invent games, although only occasionally participate in them, except in a one-child nursery.

Nurses are often seen, ostensibly in charge of children, who are reading, chatting to acquaintances, looking into shop windows, or even doing a little shopping on their own account. Some even go so far as to take their charges on visits to their friends. Now a nurse who does any of these things, except by special permission, is quite unfit to be entrusted with children; she cares more for herself and her own pleasure than for the little ones under her care. Many a case of illness has arisen through carelessness in one of these respects, and it is wise for every mother to make strict rules on this subject, which, if wilfully broken, should lead to dismissal.

Young children should never be taken shopping, if it can possibly be avoided : shops are crowded with germs of all kinds, and young children, being extremely susceptible to germs, should not be unnecessarily exposed to them.

A good nurse should be a second mother to the children, so that, when away, their real mother may leave them in her care with perfect confidence that the welfare of the little ones is in safe keeping. Such a nurse should have her authority always upheld, and if perhaps she be wrong in some little question of nursery discipline, this should be pointed out to her afterwards, and not before the children. Mother and nurse should always act as one, nursery rules being framed together and being in force downstairs as well as upstairs. Nurse's off-duty times should be carefully and generously planned, and not be curtailed except for illness.

NURSERY ROUTINE

There should be a time-table in every nursery. Nothing does more harm to the nervous system of a little child than constant change in its routine, especially if the element of choice is introduced.

Life should move on in an ordered manner as to the main events of eating, sleeping, bathing, etc., as this produces the least possible expenditure of nervous force : so many new things are continually stimulating the nerves that they must be guarded from unnecessary excitement.

Indecision is fatal in a nursery, and many a child's nervous system is ruined by the continual calls upon it to decide this or that.

Between the routine events of life there must be scope for individual liberty of action for all toddlers, and this must be encouraged, not repressed, and all should be trained to play alone for short periods and to be responsible for small and coveted duties

The time-table should be pinned on the wall, and, after the general events applicable to all, the special little duties or 'turns' of each child be written out, e.g., which days a child goes down to Daddy's dressing-room or Mother's store cupboard, or helps to lay the table or water the flowers.

Children have a very strong sense of justice and very good memories, and any suspicion of favouritism is dispelled by an appeal to the time-table, long before they can read it, although they soon distinguish their own name.

There must be a wise recognition that there is such a thing as occasional oblivion to daring efforts to break rules or devise mischief. They are often only designed to bring the small doer into the limelight and attract attention. If ignored they are considered to be not worth repeating, though persistent disobedience must be dealt with seriously, in private, not before admiring followers.

In a one-child nursery, after two years, playmates and companions must be obtained at all costs. In the country it is sometimes possible to find a well-brought-up village child who could come regularly for some hours. No distinctions should be made, but in any disputes strict justice be shown, although it is best to leave the children to settle their own differences when at all possible, and, in fact, to maintain the least possible supervision over them, leaving them alone for short periods, etc.

A Day-nursery or Nursery School is of great assistance, as the discipline taught by contemporaries in age is of great value.

Baby Training. A nurse who undertakes the care of a young baby has a very responsible position. She must remember that on her devolves in a great measure the physical, mental, and moral health of a future man or woman.

One of the main points of early training is to produce strongly rooted good habits of action. At first these are on the side of purely physical needs, causing a harmonious working of a child's own internal arrangements and producing, consequently, a contented disposition, living in harmony with his surroundings.

Automatic Obedience. - Nature is on the side of obedience.

"The capacity for voluntary obedience, on which depends a man's capacity for rule"
is preceded by the capacity for automatic obedience with which a child is endowed at birth.

It is proved that a definite stimulus produces a definite response , i.e., automatic obedience. Apply the same stimulus for a certain time, and the response will be ingrained into a habit - good or bad according to the means used, but, whichever it is, exceedingly hard to break. To the mother and nurse belong the honour of initiating many of these automatic good habits, which have the most far-reaching effects on the health of the individual through life.

Some of the most important of these good habits will now be taken up.

SLEEPING

Good habits of sleeping and feeding can be developed together, as described in Chapter 2, as to a new-born infant.

Later on, the child should be laid in its cot for at least an hour after each meal ; the stimulus of the cool pillow to the head helping to produce the ' sleep after food' habit which is so valuable in babyhood, generally resulting in a short nap till seven or eight months old. Later the habit can be utilized for the mid-day sleep of the active child, which is such a recuperative agent to the nervous system that it should be encouraged as long as possible. A child made to lie in its cradle or perambulator, except when being fed, or occasionally nursed, will very rarely give any trouble when bed-time comes. When sleepy, it will go to sleep, and when wakeful, it will lie and kick about and coo to its heart's content, taking far more exercise than if being nursed, and being just as happy. The child will thus form a habit of loving its cradle, instead of hating it as so many do. Never accustom a child to being rocked to sleep, and never wait by its bedside while it is settling off.

Sometimes, of course, a baby is chilly, either from careless bathing or exposure, and then it would be cruel to put it down in a cold cradle - wrap it up in a blanket, and thoroughly warm it by the fire, and then it will go off happily enough. (See also pages 75 and 76).

BREATHING

Mothers and nurses often appear to be ignorant of the extreme importance of initiating in early days the habit of breathing only through the nose - not through the mouth.

Mouth breathing is a 'vicious habit' bringing a host of both immediate and future evils in its train.

Nature intends fresh air to pass into the system through the nostrils, and has provided that by so travelling it is wonderfully prepared for the lungs to deal with. It is moistened, warmed up to body temperature (no matter how cold it is when it starts its journey), and filtered of all dust, dirt, and bacteria. It requires deeper breathing than by the shorter route of the mouth; hence the chest muscles are developed, the lungs expand and receive a full allowance of oxygen, and the whole body is invigorated.

All these good points are reversed in mouth breathing, with the result that the nasal passages are neither developed nor swept clean by the air, germ infections attack the tonsils, adenoids form, ear disease or glandular swellings in the neck may follow, bronchial colds are frequent, and both physical and mental development are retarded.

Therefore, teach a child from its first day of life that mouths are to be kept shut except when needed for eating, talking, or crying. Mothers and nurses should therefore :-

    1. Keep baby's mouth under regular observation, especially when asleep, and always close it gently but firmly, if the lower jaw has dropped even slightly.

    2. See that baby's face droops slightly downwards, the chin not in the least elevated, the head, but not the neck, resting on the pillow.

    3. See that plenty of air can get to the face, or baby will have to open his mouth to get enough.

    4. At bath times press the nostrils gently downwards, and then cleanse the lower parts with a swab of wool dipped in saline solution, until he can be taught to blow his nose, and then see that he does so before washing operations night and morning.

    5. See that a baby, as well as a toddler, always has his own pocket handkerchief in his own pocket. If a child cannot breathe through the nose, take him to have his nose thoroughly examined, but this is very rarely the case if proper care has been taken from birth.

REGULAR BOWEL AND BLADDER ACTION

The first of these good habits should be initiated soon after birth. Twice daily after the morning and evening bath the stimulus of the cold rim of a soap dish or other little vessel should be applied to the buttocks, the abdomen should be gently rubbed at the same time, and the sphincter may be touched for the first few days, but not afterwards. If it is noticed at any time that an action is about to take place, try to get the vessel in place quickly so that the connection between the two will be accentuated. This stimulus must be absolutely regular and will soon provoke the required response, and will then be a good habit which has far-reaching effects. It will last through childhood (although fixed times for the child to 'sit down' must be strictly adhered to), and into adult life, and is one of the best preventives of constipation known.

For the second of these good habits the child should also be held over a utensil and the napkin be changed at first before each feed, but after six weeks or so, when the habit of going into the cot awake will be firmly established, it should take place immediately after the feed.

Most children can be taught to dislike a wet napkin, and by seven or eight months old can often discard it in the house, only wearing knitted drawers.

WARMTH

The preceding chapters have intimated the importance of gradual education in the good habit of keeping warm. It must not be carried on by fits and starts, but be systematically applied as to the temperature the child breathes, the water it is bathed in, and the amount of external heat required, each decrease being so slight that it is unnoticed by the child.

This education should not begin for the first week, as it takes as long as that to learn to accommodate itself even to our summer heat after having been accustomed to 100. A child of a year whose hands and feet do not keep warm in a temperature of 55 to 60 has not yet acquired this good habit, and efforts should at once be made to get its heat-regulating machinery into better working order. On inquiry it will often be found that such children always have their baths at 'elbow heat', which is too high after two or three months. The skin is probably too much protected by clothing, so that no air can reach it, to strengthen it, and exercise is probably not sufficiently encouraged (see sections on 'Clothing', 'Exercise', 'Bathing', etc.).

The graduated water bath should at once be started, together with air and sun baths (p. 80). The breathing of cool moving air by day and night also induces a quickening up of all vital processes, and increased heat production follows.

CONTINUAL SUCKING

A child is born with the instinct of sucking to maintain life, but it should be strictly limited to meal times. Sucking, as induced by the comforter, is an exceedingly bad habit, and one that will entail much crying to cure if not prevented from the beginning of life. A mother should prohibit the use of such a thing by her nurse, and it must be remembered that, never known, it is never wanted by a child. So many children are now brought up without these 'pacifiers' that their presence in a baby's mouth is looked upon as a sign of bad mothercraft.

The usual history is as follows : A child is uncomfortable and cries. It is not the hour for his feed, and instead of trying some of the many devices mentioned on page 27, one of these misnamed articles is placed in his mouth to save trouble. Anything between the lips of a young baby is a stimulus which evokes instant response by sucking, and this is of course associated in the infant mind with warm, comforting fluid. Some sensible children find out the deception quite quickly, and drop it in a rage; others, more patient and less sharp, suck on and on in hope of comfort. A few repetitions of this response to crying set up in these latter children a definite habit, and knowing what they want, they will continue crying till they get it.

This continual sucking induces an increased flow of saliva, which is swallowed together with a quantity of air, and causes flatulence and colic, besides interfering with the rest which the digestive organs need between meals; it also alters the shape of the soft palate, and predisposes to adenoid growths and irregular and outstanding teeth ; and the ' comforter ' itself is a frequent cause of septic intestinal derangements, owing to the numerous micro-organisms it gathers when dropped on the floor, or when keeping company with soiled handkerchiefs in nurse's pocket. It also drops from the mouth when asleep, and thus favours mouth breathing.

Some children will suck their fingers or a corner of the blanket, but all such things should be prevented before they become a habit. These children evince a lack of self-control later on, and often become inveterate sweet suckers and cigarette smokers.

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A baby, if healthy and brought up to good habits, is a very contented little creature. Until five months old, the pleasure of kicking and playing with its hands and feet is all-sufficient. After this age, an indiarubber or rag doll will amuse for hours, but the child should not be allowed to sit up to play until nine months old, and then only occasionally. If tired of lying flat, the child must be well bolstered up with pillows, for a few minutes at a time, and by seven or eight months should often be placed on his stomach on a rug in garden or nursery, to strengthen the back and neck muscles, and when tired will roll over on his back.

TOYS

Contentment is a great virtue to be cultivated in the nursery, and no mother should tolerate continual crying and whining; indeed, as a rule, a change of nurse is indicated. A child will often amuse itself for a long time by running round the table, singing as it goes, and when tired of that will be ready for some toys. A nurse should husband her resources, and should never allow all the toys to be in use at once.

If there is no outdoor shelter, it is a good plan to keep certain toys in reserve for wet days, e.g., a doll's cradle with its bed-clothes and doll inside, or a horse and cart which can carry loads of bricks, etc., and the landing and one or two bedrooms with plenty of moving air about should be given up to them. Most children, as soon as they can run, enjoy toys which they can push or pull about after them; strong unpainted playthings, which will bear rough treatment and regular washing, are the best. Celluloid toys should be avoided, as they are highly inflammable. Children like to imitate their elders, and a needle and cotton with a small piece of flannel will amuse for a long time, if only allowed occasionally. A pencil and paper, blunt scissors and paper, or large glass beads to thread, are always a source of delight, and from a farmyard or Noah's ark a child will soon be able to pick out the animals correctly.

At about two years old pictures begin to delight, but, until a child can be taught to turn the leaves carefully, they should be shown only, lest he become destructive. A large linen scrap-book which he can help to make should be begun - full of colour and familiar objects. All pictures should be of a pleasing character and true to nature, for a child should not have to unlearn what it has once learnt. A sand heap and clay- modelling will help to foster the constructive spirit, so lamentably deficient in many children when first sent to school. Toddlers of 4 or 5 should have access to wood and nails, and screws, etc., and after one or two trials will learn the use of small tools. Delightful caves can be put together with a few planks, and all sorts of things devised a little later.

A child should always be taught to put away one set of toys before bringing out another, and little dots of eighteen months will soon learn what tidiness means. The nursery should be a happy place ; of course, every child likes to come downstairs to its parents, but, if the nurse has a true mother-nature, it will be just as ready to go back again.

A doctor, much versed in child psychology, lately stated that naughtiness was a disease of civilized life, and that during fifty years in the South Sea Islands an observer had said that he had never heard any quarrelling among the native children. He then said that the three main principles in the training of a child were:

    (1) Make children do what you want;

    (2) Let them do what they like;

    (3) Make them like what they do.

These are not contradictory statements: let mothers and nurses consider them well.

NORMAL DEVELOPMENT

Roughly speaking, a normal child at-

2 Months - Should take some notice of coloured balls, and follow them with its eyes; smile when pleased, and coo to itself; lift its head an inch or so, and make vigorous movements with legs and arms.

4 Months - Should be able to hold the head erect, know its mother - especially by her voice; show active signs of pleasure at toys or outdoor clothing ; use the hands with more precision to grasp things within reach. When held under the arms, try to jump up and down on the knee.

6 Months - Should begin independent investigations by sight, touch, and taste; sit up; like to be sung to. Often begins to be shy of strangers. Likes to make noises by hitting on a table. Laughs and crows with pleasure, and screams if displeased. Plays with fingers and toes. The legs should be almost straight.

8 or 9 Months - Should now begin to imitate; use syllables, such as ma, pa, na, ta, without any distinct meaning, but begin to associate words with things ; jump up and down vigorously on the knee. Begins to crawl.

10 Months - Should try to stand alone, and by crawling or shuffling will get to a toy in the pen.

12 Months Should indicate by signs many objects correctly; say a few words, and understand many more ; should be able to pull itself up and stand alone, and walk a few steps. The fontanelje should be no larger than a shilling.

18 Months Should enjoy coloured pictures, begin to put blocks on each other, and use more words, coupling several together. Should walk well. The fontanelle should have closed; if not, a doctor should be consulted, as it may be a sign of disease. Should also be quite clean.

2 Years Should have a vocabulary of several hundred words, and use simple phrases correctly. Should be able to feed himself with a spoon, and obey simple commands.

3 Years - Has learnt to build with bricks and other materials, and knows the names of many objects, and a little later realizes sizes and weights, can take simple messages and do a good deal for himself.

LESSONS

A child for the first four or five years should learn simply by object lessons, and will thus lay the foundation for after-study.

The training of the special senses - sight, hearing, smell, taste, and feeling - however, should be begun early and on large lines, e.g., naming objects at a gradually increasing distance; listening to the different clocks and bells outside, and distinguishing between them; drawing familiar objects with chalk on a nursery black-board, standing up and using the whole arm; colouring large outline pictures with chalks, etc.; but allowing no details requiring small movements and concentration of sight. Recognizing different tastes, materials and objects, etc., with the eyes shut is a fascinating lesson.

At 4 years he should be introduced to a Montessori or Nursery School if there are not other children to stimulate his mental powers.

At 5 years he should begin to count and learn to read little words and write them out in large type on a blackboard, or the nursery painted dado, which incidentally teaches spelling, so that by-

6 years he can make out the posters and the names of streets. If he then goes to a Kindergarten, fine work must only be allowed for short periods.

The companionship and corporate life of the school arc most useful in counteracting the individualism of the home, especially in the case of only or eldest children.

If a child be sent to school, it is useless to be always coddling it up and keeping it away for the slightest thing; but for town children there should be a great effort made to send them to the country or seaside during the holidays. The air is purer, there is generally much more sunshine, as the town's smoke cloud is absent, and there should be a simpler life spent practically out of doors. Sharing in country life daily happenings, such as milking, hay-making, feeding animals, chickens, etc., finding wild flowers, etc., often does untold good ; though there should not be definite teaching or the charm is broken. A pony or donkey cart is a great asset. Motor cars are best reserved for later years.

CHILD'S RECORD

It is a good plan for mothers to keep a note-book for each child. It should contain:-

MORAL TRAINING

It is stated that "there are three golden rules which should be absorbed by all who are responsible for the environment of children." These are:

If these three rules are carried out by mother and nurse there will be happy and good children. Nursery rules must be very few, but what there are must be carried out.

If automatic obedience has already crystalized into good habits as described in Baby's Training, voluntary obedience will be of easier attainment. Voluntary obedience is a different thing from forced obedience, with which mothers are too often content, but which has only a bad moral effect. A child realizes its helplessness in the hands of an adult and gives in, but with no real submission of spirit, and will probably decide to do the same thing again when not likely to be found out. At about two years of age, quiet reasoning is often effective for all time, but before that age to tell a child not to do a thing is but to create the wish to do it, which is just human nature the wide world over.

It is best to make use of counter-suggestion and, if possible, divert his attention to something else, and he forgets all about the wrong action. A nurse will remember how she hated to be told brusquely " never to do such a thing again ", and should use the positive and not the negative method with little children, e.g., not " Do not touch those scissors ", but " Please bring me those scissors", and when brought she will explain their curious and painful habits if meddled with, illustrating it by letting the child really feel a prick. Curiosity is the means by which a child extends its knowledge, so that it must be guided - not always condemned.

Direct disobedience should not be overlooked ; but never as punishment deprive a child of its food, or shut it up in the dark. Taking away anything it is very fond of, e.g., a favourite doll or toy, for a short period, will be acutely felt. Being made to sit quietly on a stool for ten minutes is another good method, but as a rule the punishment should be a direct result of the disobedient act. It should also be short, or a young child will forget the cause and only feel aggrieved.

In very extreme cases, e.g., an act of direct spite or cruelty, a sound slap may be required, but should only be administered by the parent. It is better, however, if possible, to reproduce the act, e.g., if a child pinches the baby, to do the same to him to show him what it feels like. Never box a child's ears. Parents, when obliged to punish, should always make the child feel how grieved they are to be forced to do so, and that it is not inflicted in the spirit of revenge. Favouritism should be carefully guarded against, always remembering that children have a very keen sense of justice.

A child often passes through a phase in which there is an extreme dislike to obeying the slightest command, even in the ordinary events of life, but as a rule it is only temporary. It is now known as ' negativism ', and is often applied to refusal of food, or vomiting if made to take it, and refusals of all kinds. In a simple case, if a child should absolutely refuse to be dressed to go out, take no notice of the refusal, but while beginning to button his shoes talk of the little ducks he is going to feed in the park, or remind him of the game of hide-and-seek he loves, so that by a lively recollection of the past, or anticipation of the future, he will quite forget the objectionable present. Should these tactics, however, fail, it is of no use to lose one's temper. Give way pleasantly, saying, " Very well, if Baby will not be dressed, of course he cannot go out, but he will have to stay all alone in the nursery", and there he must be resolutely left to realize the necessary consequence of his wilful-ness. A good fit of crying will probably result, but the lesson will be thoroughly learnt.

Negativism is most highly developed in only or spoilt children, and is difficult to cure until the parents understand that it is the result of over-anxiety and over-attention. Such a child is often the pivot on which the whole household revolves, and the child knows it well. Removed to a different environment, with the influence of healthy, hungry, busy children living normal and natural lives all around him, lie will soon be cured, but may relapse on returning home unless the parents have learnt their lesson, and have provided for a change of nurse and of life altogether, with suitable companionship.

A child who has lost his self-control must not be reasoned with, but be ignored till he has regained it. Wholesome neglect is too little understood and practised in many nurseries.

Truthfulness - A child must at all times be encouraged to tell the truth; he must therefore find it in all his guardians. To let him hear the maid say "Not at home" when he knows his mother is at home is teaching him untruthfulness - as such a subterfuge could not possibly be explained away. Never mind what he has done wrong, let the little one always find in his parent or nurse a friend to whom he can confess and tell everything. To punish a child when he comes to confess a fault is but to set a premium on telling a lie. Let him clearly see your sorrow for the wrong deed, but do not punish. Many a child has been driven to tell a lie from fear of the consequences of telling the truth. A tiny child will say ' Yes' or ' No,' just as it feels inclined, not really knowing the difference : but of course this is an entirely different thing from telling a lie.

Self-control - This habit is one of the greatest assets of a child in afterlife. The mother and nurse must be living exponents of it, and train by example. A one-child nursery is not a good training school for character, and should be supplemented as early as may be by the company of other children, that the child may learn, unconsciously, to ' give and take' with cheerfulness. Selfishness, or lack of self-control, should result in instant removal from the scene of play unless his companions decide to leave him out of their game, which is a far better method of teaching the lesson. This treatment will not often require repetition.

Loving-kindness - This includes a great deal. It is necessary primarily in the parents and the nurse, and the example shown by them of uniform loving-kindness, under the most trying circumstances, goes a long way in teaching it to the little ones. The elder should always share with the younger, but the younger ones must not have the best of everything.

Never allow a child to snatch from any one ; teach it to ask for a thing nicely, and if baby has taken an elder child's toy, the latter should be taught to give baby something in exchange for its own property.

Never allow a child to cherish a spirit of revenge. How often, if he falls down, is he told to " Whip the naughty floor ", or chair, as the case may be, or even allowed to vent his wrath upon some naughty person who displeases him. Make as little of it as possible - but put the blame on himself, if on anyone, for stumbling, and suggest rubbing on some eau de Cologne, and praise him for not crying. He will then quite forgSt to be angry. Of slight falls and knocks it is best to take no notice ; too much sympathy engenders a fretful disposition, easily upset by trifles. Gentleness and loving-kindness to all living creatures should be insisted upon.

There is a great difference between animal spirits and rowdiness. It shows a painful want of training for children always to rush into the sitting- room, slam the door, and stamp on one's toes in their wild spirits. A lack of reverence, is very noticeable in the youth of the present day, and respect for elders should be early enforced. At the same time, the personality of the child should be respected, and as kissing any but the nearest relatives is not only disliked, but is often a danger-carrying proceeding, he should be taught to hold out the right hand prettily to friends, and not expect to be kissed, and this should be explained to the visitor.

The Nervous System of a child should receive a great deal of attention from quite early days. It is exceedingly sensitive, i.e., it responds instantly and intensely to any outside influence, and, if stimulated unduly, many serious troubles may arise. For this reason a young child should not be constantly played with or talked to. When awake it should lie quietly in its cot or on a sofa, where it can watch people moving about, and outside impressions can be received slowly, as the nervous system can bear it.

A precocious child is one to be dreaded, and to be kept especially quiet, and never have its sayings or doings repeated in its presence, much less be encouraged to perform before admiring visitors.

A child should never be frightened, and stories of ghosts, bogies, fire, and robbers should be left untold. Small children reflect the fears of grown-ups - if they sec a nurse frightened of thunder they think they ought to be so too, and the opposite condition holds good. This was strikingly exemplified during the air raids. If no fear was shown and they were led to expect that some night they would have a treat and be brought down to a wonderful cave under a table where there would be treasures hidden in parcels, etc., etc., and bangs were just only fireworks, no evil results were seen ; but where panic prevailed much harm was done. Ugly sights and discordant noises, e.g., Guy Fawkes and Punch and Judy shows, strongly affect some children, and should then be avoided for a time, gradually training the child to calmness and self-control in the presence of strange sounds. In such children a sudden terror has produced fits, or St. Vitus's dance, or has caused a shock from which the child has never really recovered.

These children are often the victims of nervous tricks, e.g., twitching, making grimaces, nail-biting, etc., which require a doctor's attention, and also - which is really essential with these nervous children - a calm, quiet, open-air existence. There should be practically no occasion for choice of action, which generally is a great difficulty and leads to much expenditure of nervous energy before a decision is made ; so that a systematic rule of life, under healthy and pleasant conditions, rendering excitement and special treats unnecessary, is of the utmost importance.

Night terrors, when a child awakes crying with fright, have often their origin in days of excitement. Nervous children should be taught to be alone. A nurse can go in and out of the room on her own business till they gradually become accustomed to her absence. They should not be worried by petty restrictions or by grown-ups supervising their play, but permitted to trust to their own initiative. This applies particularly to an only child.

Bad moral habits are too prevalent. Quite small boys may handle their private organs, or baby girls rub their thighs together, and a little later use their hands to produce friction of the parts, thus laying the foundation for ill-health and moral degeneracy. Boys often require circumcision, and both boys and girls should be trained to go to sleep on their side, with hands folded on the pillow or outside the bedclothes. This should be done from a few months old, but if a little later there is any difficulty, or, on examination when asleep, the hands are found near the parts, the first blanket should be tightly tucked in under the armpits, so that the child cannot get its hands down. Pyjamas, made all in one, should be worn by both sexes for some years, and, as it often occurs before going to sleep, it is a good plan to allow a doll to sleep on the pillow, to provide an outside interest. By the time the child is three or four years old it can be taught that the habit will make it ill, though there must be no suggestion of naughtiness ; but till reasoning is possible, measures must be taken to make the act physically impossible.

Usefulness and Tidiness - These arc important items in a nursery education. All toys should be put away by the children themselves, and it is astonishing how tidy a child of two years old may become, even putting away things that its mother may have left about. A child delights to be made useful ; to fetch and carry little things from one room to another, such as its father's slippers, or mother's gloves ; to help to dust the furniture - all these things and many more go to make up a great deal of happiness for a child, and, at the same time, teach it many useful lessons. It will thus be seen that moral training requires much wisdom. A spoilt child is a nuisance to itself and everyone else, and a lasting monument of disgrace to its guardians.

There are now many useful books dealing more in detail with character training, and a list of some of the most useful will be found on page 177.

SICK CHILDREN

A few words must be added on the subject of nursing sick children. All mothers are advised, when convenient, to pay a visit to a children's ward or children's hospital. The art of nursing sick children is to be seen there at its best, and mother will then understand that, in cases of real illness, knowledge as well as loving instinct is required, if a child is to have the best chance of recovery. If, unfortunately, her child is stricken with a serious illness, a mother must consider :-

    1. Shall I be able to nurse the child myself ?

    2. Will it be best to have a trained nurse ?

    3. Will it be best to send the child to a hospital or nursing home ?

Respecting the first point, she must remember that in order to nurse the child properly she must devote all her time to the patient. It is useless to think of carrying on her ordinary household duties while ^cting the part of nurse. Her own health and the well-being of her husband and other children must also be considered ; and last, but not least, she must decide whether she is competent to carry out all the doctor's orders and to stand the strain of responsibility.

If the answer to No. 1 be in the negative, those to No. 2 and No. 3 will be mainly questions of expense. If this need not be considered, it is in almost every case best for both mother and child to have a thoroughly trained nurse, accustomed to children, for at least the acute stage of the illness. The mother will, naturally, assist her, and take her place when ' off duty', and she will be able to learn the best way of performing many little nursing details, which she will be glad to turn to good account at another time, especially if she has several little ones.

It is in illness that a wise mother will reap the benefit of her careful training in good habits - sleeping, feeding, obedience, etc. A sick child requires a great deal of ' letting alone.' The quieter it is kept in its cot, not dandled in the arms, the better. The struggles of a spoilt child over taking its medicine or food have often gone a long way towards causing a fatal termination. In nursing sick children there must be infinite patience, but invincible firmness ; a vast amount of tact, but absolute truthfulness. If something nasty has to be swallowed, there should be no saying : " Now, darling, will you take something nice ? " Once deceive a child, and it will never trust you again. Truth is essential ; to say: " Now, darling, you must take this ; it is not very nice, but will make you better, and you shall have a piece of chocolate after it", is far better policy, and will nearly always succeed with a child who has been brought up to obey.

Should the child refuse, it is best not to worry and irritate it, but to lift it gently out of bed, wrap a sheet round it, with the hands by the sides, gently hold its nose, and, when the mouth opens, put the spoon containing the medicine as far back as possible, keeping it there until the fluid is swallowed. This may, in some cases, apply to feeding. There must be no sign of anger or impatience on the nurse's part, but the operation should be performed just as a necessary consequence of the refusal on the child's part to take food or medicine. It will not often require repetition.

The doctor should be asked to say exactly what food he wishes to be given. As a general rule all cases with high temperature are kept on diluted milk with citrate of soda added (2 grains to each ounce of milk - not milk and water) to help its digestion. Weak broth is sometimes given, and, unless there is diarrhoea, fruit-juice and water to drink as liked. Water should not be withheld, as with high temperature the tissues are needing fluid.

The strength of a child should be carefully husbanded. If ordered to bed, it should be kept lying down, and, if really ill, other children excluded. Reading or relating to it little histories of its every-day life are usually great charms to a child.

The nurse of a sick child cannot go on continually without being relieved, for one who is overwrought and tired out cannot be cheerful and patient. A competent person must take charge while the nurse has exercise and sleep. In cases of serious illness it is always well to keep a chart, and note down every time the patient takes food, sleeps, has the bowels open, etc.; for example : -

This acts as a guide to the doctor as well as to the nurse.

A sick child is soon up and down, and, when on the road to recovery, often traverses it with rapid steps. Convalescence is often a more trying time to the nurse than any. A new picture book, or some Kindergarten work to employ the hands, is now called for ; but, as a general rule, a child recovering from a severe illness will sleep a great deal more than when in health. This is one of nature's methods of renewing the waste to which the tissues have been subjected, and should be encouraged as much as possible.



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page 88:

Baby's Progress

... work through the following signs, writing down any divergence for consideration:

1) A steady weakly increase in weight, according to the weight curve  

2) A firm condition of the flesh, and uniform (not red) colour of the cheeks with warm hands and feet.  

3) A good appetite at meal times  

4) Long quiet sleeps  

5) General contentment, and vigorous voluntary exercise  

6) Teeth appearing at the right time  

7) Mental and muscular development, proceeding as at pages 99 and 100

8) Good 'habits', as in chapters two and nine, and on page 85, well established.