The Care and Feeding of Children | Page 8

energy and playfulness, but is either listless and indifferent or cross, fretful and irritable, and is apt to sleep poorly. It grows pale and an?mic and its tissues become soft and flabby. When the milk is scanty it will often nurse a long time at the breasts, sometimes three quarters of an hour, before stopping. At other times it may take the breast for a moment only, and then turn away in apparent disgust.
What should be done when such symptoms appear?
This depends upon the severity of the symptoms and how long they have lasted. If the child has made no gain for three or four weeks, or is losing weight, immediate weaning will probably be necessary; in any case, other food in addition to the breast milk should be given at once. One may begin by alternating the nursing and the bottle-feeding and increase the number of bottle-feedings as may be indicated by the results.
Is there any objection to a baby being partly nursed and partly fed?
None whatever; it is often better from the outset to feed the baby during the night, in order not to disturb the mother's rest.
_What symptoms indicate that the mother's milk disagrees with the child?_
The child suffers from almost constant discomfort sleeps; little and then restlessly, cries a great deal, belches gas from the stomach, and passes much by the bowels, or if not passed, the gas accumulates and causes abdominal distention and colicky pain. There may be vomiting, but more often the trouble is intestinal. Sometimes the bowels are constipated, but usually the movements are frequent, loose, green, contain mucus and are passed with much gas.
What should be done under these circumstances?
If the symptoms have persisted for two or three weeks and the child is not gaining in weight, there is little chance of improvement, and the child should be taken from the breast at once. If there is some gain in weight, one may try for a little longer, endeavouring to improve the mother's milk by rest, fresh air, careful diet, etc. However, one should always realize that the trouble is with the milk, not with the child.
What changes should be made if a nursing infant habitually vomits?
If this occurs soon after nursing, the infant has usually taken too much and the time of nursing should be shortened, or one breast may be given instead of two; the nursing should also be interrupted by occasional rests, so that the milk is not taken too fast.
If the vomiting occurs some time after nursing and is repeated, it is a sign of indigestion; often because the milk is too rich in fat. The intervals between nursings should then be lengthened; the breast milk may be diluted by giving one or two tablespoonfuls of plain boiled water, lime-water, or barley-water, five or ten minutes before nursing; the mother should eat less hearty food, especially less meat.
What should be done if the infant has frequent or habitual colic?
This is usually because the milk is too rich in proteids; the mother should take more out-of-door exercise, eat less meat, and seek to control her emotions; all causes of worry should be removed.
_Can constipation in a nursing infant be controlled through the mother's milk?_
Only to a limited extent. It is important that the mother's bowels be regular and her digestion good. An increase in the meat and milk of her diet is sometimes beneficial.
WEANING
At what age should the child be weaned from the breast?
Usually weaning should be begun at nine or ten months by substituting one feeding a day for one nursing, later two feedings, and thus gradually the child is to be taken from the breast altogether.
What is the principal reason for weaning earlier?
The most important one is that the child is not thriving--not gaining in weight and not progressing normally in its development. Serious illness of the mother, or pregnancy, may make weaning necessary.
At what age should the weaning be completed?
Generally at one year. In summer it may sometimes be advisable to nurse an infant a little longer rather than wean in warm weather; but even then the dangers of weaning are much less than those of continuing to nurse, as is so often done, after the milk has become very scanty and poor in quality.
_When should a child who is weaned from the breast be taught to drink from the cup, and when to take the bottle?_
If weaning is done as early as the eighth or ninth month it is better to give the bottle; if from the tenth to the twelfth month the infant should be taught to drink or be fed with a spoon.
How may some of the difficulties in weaning be overcome?
By feeding every nursing infant once a day or by giving it water regularly from a feeding-bottle. It then becomes accustomed to