DRINKING WATER.

The baby needs plenty of cool, unsweetened water to drink. It is safe to boil all the drinking water for a baby, which should be given to a young baby lukewarm, never ice cold. Never put sugar or anything else in it. Offer it to the baby between feedings; in summer especially he needs to drink frequently. A "runabout" baby is constantly exercising while awake and requires a great deal of water. Fretful babies, especially those who are cutting teeth, are often quieted by a cool drink.

THE FEEDING OF OLDER INFANTS.

The following rules are quoted from the report of the committee of the American Medical Association before referred to:

Unless a child has loose bowels he should be given from 1 to 3 tablespoonfuls of strained fruit juice once a day after he is 7 or 8 months old.

After he is 9 months old he may be given squeezed beef juice, beef tea, or plain mutton or chicken broth once a day.

When he is 10 months old he may have part of a soft egg, a small piece of crisp toast or zwieback, or a crust of bread to chew immediately after his feeding.

Other solid foods should not be given during the first year.

At 12 months he may take his milk undiluted and strained cereal may be given twice a day.

During the second year the child should have four meals a day. Hours: 6 a. m., 10 a. m., 2 p. m., 6 p. m. Nothing but water should be allowed between his meals. At 12 months the baby should be weaned from the bottle and taught to drink milk from a cup. He may then have cereals twice a day, which should be thoroughly cooked, and for the first two or three months they should be strained. He should have 4 cups of milk daily.

When 15 months old he may have at first a teaspoonful, later 1 tablespoonful of rare scraped beef, mutton, or chicken.

When 18 months old he may have one-half of a mealy baked potato daily.

When 2 years old he may have most of the fresh green vegetables when thoroughly cooked and finely mashed.

The juice of fresh fruits may be given after 12 months.

Cooked fruit, such as baked apple or apple sauce, should be given once a day after a child is 18 months old; it should at first be strained.

Stale raw fruits are especially dangerous in the city and in the summer.

Begin with a very small quantity of each new food, noting carefully the effect on the baby, and strengthening it slowly as required For instance, begin by giving 1 teaspoonful of fruit juice, diluted with an equal quantity of water, and increase gradually until the proper amount for the given age is reached.

Beef juice is chiefly valuable as a stimulant. It has but little food value and is not to be given in the place of nourishing foods but as an addition to it. Two teaspoonfuls diluted with an equal quantity of water may be given fifteen minutes before the midday

52449°-144

feeding, beginning about the ninth month. If the baby is delicate, it may be begun as early as the fifth month in half the above quantity. Only one new article should be added to the baby's diet at a time and the effect on the baby should be carefully noted. (See p. 80 for preparation of vegetables.) Meat should be boiled, roasted, or broiled for the baby and must be cut in fine pieces, as the baby will not chew it sufficiently at this age.

Never give the baby cakes, candy, doughnuts, pastry, fresh breads, griddlecakes, sirups or molasses, pork or tough meat of any kind, bananas or any overripe fruit, pickles, tea, coffee, soda water, wine, cider, beer, nor tastes of the family meals. If this is begun he will soon demand a taste of everything he sees, and his appetite for the simple diet which is essential at this age will be quickly destroyed.

INFANT FEEDING IN THE TROPICS.

Because of the scarcity of cows' milk it has heretofore been customary to depend largely upon the use of condensed milk, both sweetened and unsweetened, for infant feeding in tropical climates.

Dr. Victor G. Heiser, Director of Health for the Philippines, is authority for the statement that experience in the Philippines has demonstrated the value of natural sterilized milk. This natural milk is now very extensively prepared in Switzerland, Italy, and Denmark, and is exported in cans of various sizes adapted to special uses. This canned milk keeps perfectly sweet for months and has proven a very satisfactory substitute for the ordinary milk supply. It is used in the same way as natural cows' milk would be used in the Temperate Zone.

A series of experiments in infant feeding which have been carried on at the Ancon Hospital in the Canal Zone since 1906 have resulted in the evolution of a method of infant feeding involving the use of both sweetened and unsweetened condensed milks. A set of formulas is published and distributed by the Department of Sanitation of the Zone.

INFANT STOOLS.

The first passages from a newborn baby's bowels are known as meconium. The excretion is black or nearly so, and is thick, of a tarlike consistency, with little or no odor. This soon changes to the normal yellow stool of the healthy infant as the baby begins to feed at his mother's breast. The stools are then of a dull yellow or orange color without disagreeable odor and soft and mushy in appearance. They are passed from one to three times a day, averaging twice a day in most breast-fed babies until 6 months of age, when one stool a day is usual. When there is a long interval between

feedings the number of stools is usually lessened, being only one a day, and sometimes only one in 36 hours. Artificially fed infants usually pass but one stool a day, and the color and odor vary with the character of the food. With breast-fed babies the stool is a mass, while with those fed on the bottle there is more tendency to a "formed" stool.

When there is a greatly marked difference in the character of the stools, especially when the number increases, the mother should have a doctor see the baby, meanwhile decreasing the food or, better, withdrawing it altogether for some hours, giving water instead.

In order to do away with the need for diapers as early in life as possible, the baby should be taught to use the chamber. This training may be begun by the third month, or even earlier in some cases. It should be carried out with the utmost gentleness, since scolding and punishment will serve only to frighten the child and to destroy the natural impulses, while laughter will tend to relax the muscles and to promote an easy movement. In order to be effective, the chamber must be presented to the baby at the same hour every day, usually just before the morning bath, and it must be presented persistently each day until the habit is formed. Much time and patience will be required on the part of the mother, but in the end the habit thus formed will be a great saving of trouble to her and of untold value to the child, not only in babyhood, but throughout the whole of life.

Experience has shown that an ordinary porcelain cuspidor is an excellent vessel to use for a young baby. It should be kept scrupulously clean and in cold weather must be warmed before being used. The mother takes the vessel in her lap, seating the baby upon it with his back toward her breast, so that she may support him in a comfortable position. If the movement does not come within a few minutes the better course is to wait until the next day. A little observation on the mother's part will lead her to know at what hour the baby's bowels are ready to move, and she should choose that moment for the trial. If the baby has a tendency to be constipated, it may be well to introduce a well-oiled soap stick for a moment before beginning, in order to start the movement and to indicate to the baby what is wanted.

THE NORMAL BABY.

DEVELOPMENT.

An inexperienced mother is often greatly at a loss to know whether a baby is properly thriving or not, and may be unduly alarmed at small matters, or may not understand the serious nature of certain conditions. It may be helpful to mention the leading characteristics

of a normal, healthy baby, and the mother may assume the lack of these conditions to show that temporarily or otherwise the baby is not in perfect health:

A steady gain in weight.

Bowel movements of the normal number, color, and consistency. Absence of vomiting or regurgitation of the food.

A good appetite.

A clear skin.

Bright, wide-open eyes.

Alert, springy muscles, which respond readily to any stimulus. A contented expression.

Very little crying.

Quiet, unbroken sleep, with eyes and mouth tightly closed.
No evidence of pain or discomfort.

A constant growth in stature and intelligence.

Other points in a normal development are:

The soft spot in the top of the head begins to close at 14 months and should be entirely closed at 2 years.

The baby learns to hold up his head, unsupported, during the fourth month.

He laughs aloud from the third to the fifth month.

He reaches for toys and holds them from the fifth to the seventh month.

At 7 or 8 months he is usually able to sit erect and hold the spine upright.

During the ninth and tenth months he makes the first attempts to bear the weight on the feet, and can usually stand with assistance at 11 or 12 months.

He begins to walk alone in the twelfth and thirteenth months and walks alone at the fifteenth or sixteenth month.

At 1 year usually a few words can be spoken, and at the end of the second year the baby makes short sentences.

Children differ in the rapidity of their development, some being slower and some faster; therefore the mother should not be unduly alarmed at variations from this statement, although marked differences should put her on guard.

TEETH.

The embryonic teeth begin to develop at least six months before birth. It is probable that a nutritious diet for the prospective mother lays the foundation for healthy teeth in the baby and that lack of proper food for the mother may deprive both her own and the baby's teeth of some part of their normal vigor. Every child has two sets of teeth. The first set, known as the deciduous or "milk" teeth, are replaced, beginning at about the sixth year, with the permanent or "second" teeth. Nearly all so-called "teething" troubles belong

1 See Prenatal Care, pp. 8, 9, "Diet in pregnancy."

to the first period, as a disturbance is rarely connected with the coming of the permanent set.

At birth each tiny tooth of both sets lies partly embedded in a cavity of the jawbone, surrounded with and covered by the softer tissues of the gum. As the baby grows, the teeth grow also, and if the baby is healthy they are ready to cut through the gums, beginning at about the seventh month of life. There are 20 of the milk teeth, 5 in each half jaw. The teeth appear in groups. There are five of these groups, with intervals between their appearance. After the first group there is a pause of five to eight weeks; after the second a pause of one to three months; after the third, one of from two to three months; after the fourth, one of from two to four

months. Thus, by the time a baby is 1 year old it may have 6 teeth; at 12 years there should be 12; at 2 years, 16 teeth; and at 2 years the entire set should be cut. There is considerable variation, both as to the order in which they appear and in the time, so that the mother need not be alarmed if her baby does not follow the average as above stated, but if the baby has no teeth at the end of the first year it can hardly be said to be developing properly. Probably the diet is at fault, or some disease is retarding the growth of the baby in general. In such a case the doctor should be consulted.

Deciduous or "milk" teeth. The above illustrations, with the appended notes, show the position of the teeth in the mouth, their names, and the approximate times of their appearances.

This set of teeth is replaced by the permanent set, beginning about the sixth year. A child should be taken to the dentist at this time, if, as sometimes happens, the milk teeth are so firm that they do not

1 Courtesy of Dr. Kent Beattie.