The most important period of any human being's life is the first twelve months. One child out of every ten dies before the end of the first year, and if mothers and nurses knew more about the management of children in health, and the care of infants in sickness, half, at least, of these lives would be saved.
The management of the healthy infant has been fully considered under the articles on " Baby's First Year." Infants may be perfectly' well one day and seriously ill before twenty-four hours have passed. The amateur nurse, therefore, must be able quickly to recognise signs of illness, and be observant of every detail in an infant's appearance.
When an infant is ill, it will be irritable and restless. It will sleep badly and have no appetite. Probably the child will turn from food, and refuse to suck his bottle. If this condition of affairs is allowed to go on the bowels become affected, and the infant loses weight. Even whilst ignorant of what is actually wrong with baby, the amateur nurse can take certain precautions.
First, she should keep baby in an even temperature, in a well-ventilated, well-aired room in order to guard against chill. The ailing infant is very liable to chill, which may have serious consequences.
Secondly, she will immediately investigate the diet question, and find out if a dirty jug or an unhygienic bottle will account for any digestive disturbance or diarrhoea.
She will examine the child to see if there are any signs of rash.
She will take the temperature, and if it is elevated she must send for the doctor. Any cough or signs of catarrh should make her pay special attention to the child's breathing, and if this seems difficult, and symptoms of bronchitis are present, she may put the bronchitis kettle full of water on the fire to keep the air moist and warm until the doctor comes.
Even when an infant is suffering from an ordinary cold it requires very careful nursing. An infant's breathing and sucking power are very much enfeebled by any catarrh of the nose and throat. Such inflammation also readily extends to the bronchi and lungs, and a baby's resisting power towards such a serious disease as pneumonia is not very great.
In nursing respiratory affections in infancy poultices will be found very useful. The nurse must be ready to make a hot linseed poultice at a moment's notice, and she should have everything at hand on a side table for this purpose - bowls, spoon, knife, meal, muslin, flannel - even if she does not think there is any immediate need of using them.
The ailing infant is more likely to contract a fit or a convulsion than one that is in good health. Any irritation about the body so affects an infant's delicate nervous system that convulsions may be said to act "reflexly."
Sometimes the irritation of teething associated with some error of diet will bring on an attack.
Convulsions, also, are sometimes the first sign of such an acute fever as scarlatina or measles, whilst an attack may occur as the result of the strain of coughing in whooping cough. Before the convulsions actually appear the observant nurse will notice that the child is restless, subject to startings and twitchings. The eyes show a tendency to roll upwards. Then the hands are clenched, the body stiffens, and the head is drawn back.
Suitable feeding, cleanliness, and quiet will do much to prevent a fit coming on. In convulsions the nurse must make the child sit in a bath of about 1oo degrees, and apply cold cloths to the head and neck. If there has been any dietetic disturbance a dose of castor oil should be given.
Other infantile disorders are associated with various intestinal conditions. The commonest of these are sickness and diarrhoea, and the safest plan when this condition is marked is to stop the milk and give white of egg and water strained through muslin. This is made by mixing the whites of two eggs in a breakfast-cupful of water, stirring in two lumps of sugar, and straining.
Young infants are sometimes liable to intestinal obstruction. The chief symptoms of this condition are the occurrence of blood in the motions, and sudden attacks of acute pain. No time should be lost in summoning a doctor, as an operation will probably be necessary. Meantime, mustard poultices or hot fomentations may be applied to the abdomen, and no food should be given until the doctor arrives. A very important point in these cases is to refrain from giving castor oil.
A nurse or mother will sometimes, in ignorance, dose a child with purgatives, with serious results, when there is some intestinal obstruction. A purgative should never be given when there is apparent obstruction to the bowels, or when the temperature is high, without consulting a doctor. In ordinary sickness and diarrhoea, however, where some error of diet is the cause, a dose of castor oil will clear away the undigested foodstuffs better than anything else. In all acute attacks the infant must be kept warm without ever being over-clothed, and •should be as little handled as possible. Sponging of the hands, face, and body with tepid water will allay restlessness, and often induce sleep.
During illness an infant should be taken from the baby cot or cradle and placed in a child's crib where the ends can slide down, or be removed, so that the nurse can get from one side to another and handle the child easily. A mackintosh should be placed between the mattress and the under blanket. Two should be kept in use, one for day and one for night, and each should be hung up or rolled up when not in use. An ailing infant should lie between blankets cut to the size of the cot, as these are not so heavy as large blankets folded once or twice.