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few weeks, even if there is but little at first; the act of suckling causes the milk to come into the breasts and increases the supply. It is very important that the baby nurse regularly.
4. If the baby is too weak to nurse, a healthy infant can be used to excite the flow of milk until the baby has grown strong enough to nurse. This should not be done without a physician's advice.
5. The only way to tell how much food the baby is getting is to weigh it before and after each nursing; for at least 24 hours. The clothes need not be removed, but the baby should be dressed in exactly the same way when weighed after nursing as before. (If the baby should soil its diaper after the first weighing do not change it until after the second weighing.) In case the baby is not getting enough breast milk, the quantity lacking should be made up by properly prepared cow's milk. Let a physician decide this. This may be only a temporary shortage on the mother's part, and with suitable care the milk will probably increase so that the baby wili eventually be satisfied with the breast only.
6. The following things influence the milk supply: Peace of mind is necessary for the mother; she must not worry; she should not get overtired. She should eat freely of her customary diet. The total quantity of fluids taken by her in 24 hours should not be less than two quarts; in hot weather more. Stuffing, however, is unnecessary and undesirable.
7. Consumption in the mother is practically the only disease that always forbids nursing. Paleness, nervousness, fatigue, pains in the back and chest or the return of the monthly sickness are not sufficient reasons for weaning, but when these symptoms are present or pregnancy ensues a physician should be consulted at once.
8. Shortly after birth boiled water, without sugar, may be given to the baby at regular intervals until the mother's milk supply is established. The baby, however, should be put to the breast at stated times, as often as the mother's condition permits.
Iinportant Points to Be Remembered in Nursing the Baby.
It is always wise to make nursing as easy as possible for the mother and to give her opportunities for rest. Therefore, the sooner the bahy is satisfied and gaining on three-hour or even four-hour intervals the better.
Convenient hours for nursing the baby are as follows:
(1) Seven nursings in 24 hours: 6 a. m., 9 a. m., 12 noon, 3 p. m., 6 p. m., 9 or 10 p. ni., and once during the night.
(2) Six nursing's in 24 hours: 6 a. m., 9 a. m., 12 noon, 3 p. m., 6 p. m., and at the mother's bedtime; or at 6 a. m., 10 a. m., 2 p. m., 6 p. i., 10 p. m., and once during the night.
(3) Five nursings in 24 hours: 6 a. m., 10 a. m., 2 p. m., 6 p. m., 10 p. m., or later.
The baby should be offered cooled boiled water between feeding's, especialiy during hot weather.
The length of time for a nursing varies with the individual and the breast. The average infant rarely nurses longer than 15 minutes. The important point is to satisfy the baby. If there is any doubt, let it nurse longer, but not more than 20 minutes. If it is not satisfied after 20 minutes, consult a physician.
It is customary to nurse only one breast at each feeding, and to use them alternately. If, however, the baby does not get enough from one breast, give it both.
It is important to keep the nipples clean; they should be washed before each nursing. Caked breasts or cracked nipples are the usual causes of breast abscesses, and although they may be harmful to the mother, they do not make the milk poisonous for the baby. In both instances consult a physician.
The baby should be completely weaned at the end of the first year. Up to this time breast milk should be given to the baby as long as it thrives. It is better, when possible, to continue nursing through the summer and to wean in the fall. It is better to wean in the summer than in the spring, if by doing so the baby can have breast milk longer.
Do not wean the baby suddenly; it should be done gradually by replacing one breast feeding at a time with a bottle feeding. Several weeks are required for weaning.
It is dangerous to wean a young baby. It should not be done for the convenience of the mother and should never be done without the advice of a physician.
Contagious disease in the mother does not mean that it is necessary to wean the baby. In case of severe illness, contagious or otherwise, a temporary weaning may be necessary for the mother's sake. A physician should decide this. As soon as the mother's condition permits the baby should be put back on the breast. The supply of breast milk can sometimes be brought back by putting the baby regularly to the breast for several days, even when nursing has been stopped for several weeks.
When the mother's milk is diminishing it is advisable to make up the lack with properly prepared cow's milk. This may be done either by following one or more breast feedings with enough modified milk to satisfy the baby or by giving one or more full bottle feedings in place of a like nuniber of breast feedings.
The flow of breast milk tends to diminish when the baby nurses less than five times in 24 hours. When the baby is being nursed once every four hours and is not satisfied, it is better to give him after nursing enough modified milk to satisfy him, rather than to replace a nursing with the bottle. If, on the other hand, shorter intervals and more feedings are being used, a bottle feeding may take the place of a nursing without so much danger of decreasing the milk supply. Most babies need additional food after the seventh month.
A PETITION HUMANITY MUST HEED
V. BOTTLE FEEDING.
Cow's milk is the most satisfactory substitute for mother's milk. The best milk (this does not mean the richest milk) is none too good. Get "certified” milk if possible. If you cannot obtain certified milk, get the cleanest and purest bottled milk you can find. Milk sold in bulk, or bottled from the can in stores, or by milkmen in their wagons, is likely to be stale and contaminated and not a proper food for the baby, even though it looks and tastes good. “Baby foods” and condensed milks and the like are not satisfactory substitutes for good cow's milk and often harm the baby.
Raw milk may carry the germs of tuberculosis, scarlet fever, tonsilitis, diphtheria, typhoid and other communicable diseases. Unless the milk is above suspicion, danger should be prevented by proper pasteurization of the milk or by boiling or by sterilization.
Pasteurization.—Pasteurization means heating the milk to about 150° F. for 30 minutes and then rapidly cooling it. Milk for the baby should always be pasteurized in the feeding bottle. It may be done as follows: The milk should be mixed and poured into the clean feeding bottles, which should then be stopped with clean, nonabsorbent cotton. It is then ready for pasteurization. While a number of satisfactory pasteurizers may be bought in the shops, a home-made pasteurizer can be easily constructed.
Take a wire basket that will hold all the nursing bottles for 24 hours and place this basket containing the bottles in a vessel of cold water filled to a point a little above the level of the milk. Heat the water and allow it to boil for five minutes. Then run cold water into the vessel until the milk is cooled to the temperature of the running water. The milk is then put into the ice chest, which should be not warmer than 50° F.
Sterilization.-By sterilization of milk is meant the process rendering it germ free by boiling it on three successive days or by keeping it for 15 minutes under pressure at a temperature of 242° F.
Boiling.–Milk is boiled for one or two minutes in a large vessel and poured immediately into the sterilized bottles, stoppered with cotton, rapidly cooled in running water, and put on ice. This destroys all living bacteria but not spores or eggs, which will not do harm unless the milk is kept too long after boiling. It should be used within 24 hours.
If the baby's milk is to be mixed with other ingredients, such as oatmeal, barley water, rice water, sugar, etc., these should be added to the milk before pasteurization, boiling, or sterilization. When the milk is once prepared the bottle should not be opened until it is given to the baby.
Preservation of the baby's milk.—After the baby's milk has been prepared, it is very important that it should be kept cold until it is used.
A simple ice box can be made as follows: Procure a wooden box about 18 inches square and 12 inches deep. Get two tin boxes, one about 11 inches square and 9 inches deep, the other 10 inches square and 9 inches deep. Cracker boxes will do. Cut the bottom out of the larger box. Place three inches of sawdust in the wooden box. Put the larger bottomless box upon the layer of sawdust and fill the space between the wooden and the outer tin box with sawdust. Fasten the pieces forming the lid of the wooden box together with cleats nailed on the outer surface. Tack about 50 layers of newspapers cut to the size of the wooden box to the inner surface of the lid. Make hinges for the lid by tacking two strips of leather onto the outside of the box and then tack additional strips of leather to the front edge of the lid to catch on nails driven into that side of the box, in order to hold the lid down tightly. The ice box is now ready for use. Into the smaller tin box put your wire basket containing the filled and stoppered nursing bottles (or a quart and a pint bottle of milk) and surround them with cracked ice. Place the smaller tin box inside the larger and close the lid. Each morning remove the inner box, pour out the water, clean and repack with ice. Keep the ice box in a cool, shady place.
This ice box, if properly cared for and kept full of ice, will keep a day's supply of milk cool and sweet.
Precautions to Be Observed in Preparing the Baby's Food.
Everything that comes in contact with the baby's food must be clean. The hands should be washed with hot water, soap, nailbrush, and dried with a clean towel before touching anything that goes into the baby's mouth. The dishes used in preparing the food should be boiled and allowed to dry from their own heat. Do not use a dish towel.
Bottles.-As soon as the baby has finished his feeding throw out any remaining milk, rinse the nursing bottle and fill it with cold water. When ready to prepare the milk for the next 24 hours, empty the bottles, wash them thoroughly with hot soapsuds and a bottle brush, and then rinse and boil them for 15 minutes. The bottles are then ready for filling.
Nipples.—Only nipples that can be kept clean easily should be used. They should be turned inside out, scrubbed, cleansed and boiled. After boiling they should be kept covered in a clean, dry glass. Dirty nipples should not be kept with clean ones. Never use nipples connected with long glass or rubber tubes.
Directions for the Bottle Feeding of Babies. Complete instructions for bottle feeding cannot be given in : booklet like this. Babies that are artificially fed should be under the supervision of a physician, who should see them at regular intervals. Very young babies, or those that are not thriving, shoulů always be seen once a week, while older healthy babies should be seen at least once a month, whether they are sick or well. The following rules and suggestions apply to all bottle-fed babies :
Before feeding warm the food to blood heat by putting the bottle in a vessel of warm water. Do not test the temperature of the milk by putting the nipple in your own mouth, but sprinkle a few