Kitabı oku: «The Young Mother: Management of Children in Regard to Health», sayfa 5

The Roman emperors—Dioclesian in particular—could make provision for bathing, to an extent which now astonishes us; but for whom? For whom, I repeat it, was incurred the enormous expense of fitting up and keeping in repair accommodations for bathing at once 18,000 people? For adults; and for adults alone. I do not say that children were not admitted, in any case; but I say they were not contemplated in these arrangements. Nothing was done—not a single thing—that would not have been done, had there been no child under ten years of age in the whole empire.

And what better than this do WE, now? We make provision for the happiness of the adult. The most indigent person will find time and money to spend for the gratification of his own senses, his pride, or his curiosity; but his children—they may be overlooked! Or, if he has an eye to the future happiness of his child, he conceives that he is promoting it in the best possible degree, by endeavoring to lay up a few dollars for his use, after his character is formed—at a period, as it too often happens, when money will do him little good, since it can neither purchase health, peace of mind, nor reputation.

Far be it from me to say, that the poor—ground into the dust as they are, by the force of circumstances operating with their own concurrence, to make them ignorant, vicious, or miserable—can do for their children all that is desirable. By no means. But they have it in their power to do much more than they are at present doing. They have it in their power, at least, to use the same good sense in the management of the human being that they do in that of a pig, a calf, or a colt, or even a young vegetable. No parent, let him be ever so poor, is found in the habit of neglecting either of these in proportion to its infancy, and of exerting himself only in proportion as it grows older. Common sense tells him that the contrary is the true course; that however poor he may be, he will be still poorer, if he do not take special pains with the young animal, to rear it and with the young vegetable, to give it the right direction, by keeping down the weeds, and pruning and watering it. And I say again, that however deserving of censure the wealthy of a Christian community may be in not directing the ignorant and vicious into the right path, and in not expending more of their wealth on those who are poor, in elevating their minds and their manners, and promoting their health, still the latter are inexcusable for their present neglect of their infant offspring, while they would not think of neglecting, on the same principle, the offspring of their domestic animals.

CHAPTER VII.
FOOD

SEC. 1. General principles.—SEC. 2. Conduct of the mother.—SEC. 3. Nursing—rules in regard to it.—SEC. 4. Quantity of food. Errors. Over-feeding. Gluttony.—SEC. 5. How long should milk be the child's only food?—SEC. 6 Feeding before teething. Cow's milk. Sucking bottles. Cleanliness. Nurses.—SEC. 7. Treatment from teething to weaning.—SEC. 8. Process of weaning-rules in regard to it.—SEC. 9. First food to be used after weaning. Importance of good bread. Other kinds of food.—SEC. 10. Remarks on fruit.—SEC. 11. Evils and dangers of confectionary.—SEC. 12. Mischiefs of pastry.—SEC. 13. Crude and raw substances.

SEC. 1. General Principles

The mother's milk, in suitable quantity, and under suitable regulations, is so obviously the appropriate food of an infant during the first months of its existence, that it seems almost unnecessary to repeat the fact. And yet the violations of this rule are so numerous and constant, as to require a few passing remarks.

There are some mothers who seem to have a perfect hatred of children; and if they can find any plausible apology for neglecting to nurse them, they will. Few, indeed, will publicly acknowledge a state of feeling so unnatural; but there are some even of such. On the latter, all argument would, I fear, be utterly lost. Of the former, there may, be hope.

They tell us—and they are often sustained by those around them—that it is very inconvenient to be so confined to a child that they cannot leave home for a little while. Can it be their duty—for in these days, when virtue and religion, and everything good, are so highly complimented, no people are more ready to talk of duty than they who have the least regard to it—can it be their duty, they ask, to exclude themselves from the pleasures and comforts of social life for half or two thirds of their most active and happy years? Ought they not to go abroad, at least occasionally? But if so, and their children have no other source of dependence, must they not suffer? Is it not better, therefore, that they should be early accustomed to other food, for a part of the time? Besides, they may be sick; and then the child must rely on others; and will it not be useful to accustom it early to do so?

Perhaps few mothers are conscious that this train of reasoning passes through their minds. But that something like it is often made the occasion of substituting food which is less proper, for that furnished by Divine Providence, there cannot be a doubt. And the mischief is, that she who has gone so far, will not scruple, ere long, to go farther. And, strange and unnatural as it may seem, that mothers should turn over their children to be nursed wholly by others, in order to get rid of the inconvenience of nursing them at their own bosoms, it is only carrying out to its fullest extent, and reducing to practice, the train of reasoning mentioned above.

Nor is it necessary that I should stop here to denounce a course of conduct so unchristian and savage. I know it is very common in some countries; and those American mothers who ape the other eastern fashions, or countenance their sons and daughters in doing it, will not be slow to imitate this also—especially as it is a very convenient fashion. And I question whether I shall succeed in reasoning them out of it. Habit, both of thought and action, is exceedingly powerful. I will, therefore, confine myself chiefly to those efforts at prevention, from which much more is to be hoped, in the present state of society, than from direct attempts at cure.

It will be soon enough to leave a child with another person, when the mother is actually sick, or unavoidably absent; or when some other adequate cause is known to exist. We are to be governed, in these and similar cases, by general rules, and not by exceptions. The general rule, in the present case, is, that mothers can nurse their own children; and, if they have the proper disposition, that they can do it uninterruptedly.

But those who are so ready to become counsellors on these occasions, will tell us, perhaps, that the child must be "fed to spare the mother." That is to say, nursing weakens the mother, and the child must be taken away, a part of the time, to save her strength.

Now it may safely be doubted whether the process of nursing, in itself considered, does weaken, at all. The Author of nature has made provision for the secretion (formation) of the milk, whether the child receives it or not. If it is not taken by the child, or drawn off in some other way, one of two things must follow;—either it must be taken up by what are called absorbent vessels, and carried into the circulation, and chiefly thrown out of the system as waste matter, or it will prove a source of irritation, if not of inflammation, to the organs themselves which secrete it. In both cases, the strength of the mother is quite as likely to be taxed, as if the child received the milk in the way that nature intended.

Besides, on this very principle, the plan of saving a mother's strength by requiring another to nurse for her, is but saying that we will weaken one person to save another. Or if we feed the child, to "spare its mother," what is this, in practice, but to say that the works of the Creator are very imperfect; and that he has thrown upon the mass of mankind a task to which they are not equal? For the mass of mankind are poor; and the poor, having neither the means nor the time to escape the duties in question, must submit to them, while their more wealthy neighbors escape.

But it is idle to defend customs so monstrous. They admit of no defence that has the slightest claim to solidity. The general rule then is, that mothers should nurse their own children.

SEC. 2. Conduct of the Mother

Originally it was not my intention to give directions, in this volume, in regard to the food, drink, &c., of the mother while nursing; but repeated solicitations on this point, have led me to the conclusion that a few general principles may be very properly introduced.

The future health, and even the moral well-being of the child, depend much more on the proper management of the mother herself than is usually supposed. How, indeed, can it be other wise? How can the mother's blood be constantly irritated with improper food and drink, without rendering the milk so? And how can a child draw, daily and hourly, from this feverish fountain, without being affected, not only in his physical frame, but in his very temper and feelings?

It is not enough that we adopt the principles already insisted on by some of our wisest medical men, and even by one or two medical societies,⁶ that children in this way often acquire a propensity for exciting drinks, that may end in their downright intemperance. What if it should not, in every case, proceed quite so far as to make the child a drunkard? If it but lays the foundation of a constitutional fondness for excitements, it tends to disease. Indeed that, in itself, is a disease; and one, too, which is destroying more persons every year than the cholera, or even the consumption. Consumption has at most only slain her tens of thousands⁷ a year; but a fondness for exciting food and drink—innocent and harmless as it is often supposed to be, and therefore only the more dangerous a foe—does not fail to slay every year, directly or indirectly, its hundreds of thousands. At least this is my own opinion.

Why, where can you find the individual who is not a slave to this perpetual rage within—this perpetual cry, "Who will show us any" physical "good"? Who, in this land of abundance, will eat or drink plain things? Who will eat simple bread, meat, potatoes, rice, pudding, apples, &c. or drink simple water? A few instances may be found, of late, in which people confine themselves to simple water for drink; but they are rather rare. And no wonder. They must be rare so long as an unnatural thirst is kept up everywhere by the most exciting and most strange mixtures of food. Where, I again ask, is the person who will eat and relish plain bread, plain meat, plain puddings, &c.? Certainly not in the nursery. No young mother—scarcely one I mean—will, for a single meal, confine herself to a piece of bread, the sweetest and best food in the whole world, unless it is hot, or toasted, or soaked, or buttered. A natural, healthy appetite, is as rare a thing on our planet, almost, as an inhabitant of the sun or moon.

I have seen more than one mother made sick by using, while nursing, improper food and drink. I have known milk punch, taken by stealth—(because how could the mother, it was said, ever have a supply of food for her poor child without it!)—to kindle a fever that came very near burning up the mother and child both. And yet, if I have once or twice succeeded in convincing the mother that she was only suffering the natural punishment of her own transgressions, I have never, so far as I now recollect, succeeded in making her believe that her iniquities were visited upon her unoffending infant.

There is everywhere the most painful apathy on this most painful subject. We see little children of all ages, everywhere, the victims of debility, and pain, and suffering, and disease and death, and yet we very seldom seem to search for one moment for the causes of this premature destruction. In fact most parents—even many intelligent mothers—at once stare, if you attempt to inquire into the causes of their child's death, as if it was either a kind of sacrilege, or an impeachment of their own parental affection. Diseases, even at this day, with the sun of science blazing in meridian splendor, they seem to regard as the judgments of heaven; and to think of tracing out the causes of the early death of half our race, is, in their estimation, not only idle, but wicked.

Yet this is obviously one of the first steps, every, where, which philanthropy demands; to say nothing of the demands of christianity. It is the first step for the physician, the first step for the educator, the first step for the parent, and above all, the mother. Nay; more—we must not suppress so great and important a truth—it is the first step for the legislator and the minister. What sense is there in continuing, century after century, and age after age, to expend all our efforts in merely mending the diseased half of mankind, when those same efforts are amply sufficient, if early and properly applied, not only to continue the lives of the whole, but to make them whole beings, instead of passing through life mere fragments of humanity?

But I must not forget that this is merely a small manual, not intended for those who make it their profession to teach the laws of God and man, but simply for young mothers. For the sake of erring humanity, would that I could, but for one moment, divest myself of the idea, that in writing for the young mother I am not writing for legislators and ministers! Would that I could banish from my mind the deep conviction that the mother is everywhere far more the law-giver to her infant—far more the arbiter of the present and eternal destiny of her child—than he who is more commonly regarded as such.

Every mother owes it, not only to herself—for on this part she is not wholly forgetful—but to her offspring, to abstain, during the period of nursing at least, from all causes which tend to produce a feverish state of her fluids. Among these are every form of premature exertion, whether in sitting up, laboring, conversing, or even thinking. It is of very great importance that both the body and the mind should be kept quiet; and the more so, the better.

Among the particular causes of fever to the young mother, Dr. Dewees enumerates spirits, wine, and other fermented liquors, a room too much heated, closed curtains, confined air, too much exposure, and too much company; and during the early period of confinement, broths and animal food.

There is nothing which he insists on more strongly, than the importance of fresh air. Indeed, the practice of confining a nursing woman in a space scarcely six feet square, and excluding the air surrounding her by curtains and closed windows, and subjecting her to the necessity of breathing twenty times the air that has already been as often discharged, filled with poison, from her lungs, is not too strongly reprobated by Dr. Dewees, or anybody else. But I have spoken of these things in the chapter which treats on "The Nursery." I would only observe, on this point, that if I were asked what one thing is most indispensable to the health of the nursing woman, I would reply, Fresh air; and if asked what were the second and third most important things, I would still repeat—in imitation of the orator of old, in regard to another subject—Fresh air, Fresh air.

This important ingredient in human happiness, and especially in the happiness of the young mother and her tender infant, can usually be had within doors, if pains enough be taken. But if the weather is fine and in every respect favorable, a woman who is in tolerable health may venture abroad a little in about three weeks after her confinement, and sometimes even in two. Whether her exercise be without or within doors, however, she should be effectually protected against chills, and against the influence of currents of cold air.

It has been incidentally stated, that Dr. Dewees objects to the mother's use, during her early period of nursing, of broths and animal food. This is about as much as we could reasonably expect from one who belongs to a profession whose members are, almost without exception, enslaved to the practice of flesh-eating. But even this advice of his, if duly followed, would be a great advance upon the practice which generally prevails. There is so universal a belief among females that they demand, at this period of their existence, not only a larger quantity of food than usual, but also that which is more stimulating in its quality, as almost to forbid the hopes of making much impression upon their minds. Many young mothers seem to consider themselves as licensed, during a part of their lives, not only to eat immoderately, and even to gluttony, but also to swallow almost every species of vile trash which a vile world affords.

How long will it be, ere the mother can be induced to take as much pains to select the most appropriate and most healthy aliment for herself and her child, as she now does that which is demanded by a capricious appetite, without the smallest reference to fitness or digestibility! How long will it be ere the mother can be brought to believe and feel that, in every step she takes, she is forming the habitation of an immortal spirit—a spirit, too, whose character and destiny, both present and eternal, must depend, in no small degree, upon the character of the dwelling it occupies while passing through this stage of earthly existence! How long will it be, before mothers can be made to believe even these two simple truths, that the nourishment, which the human being actually receives, is not always in exact proportion to the quantity of nutritious food which he throws into his stomach, and that the diet is always best for both mother and child, which is least exciting.

The Charleston Board of Health, during the existence of cholera in that city in 1836, publicly announced that the "best food is the least exciting," and this great truth is just as true in all other places and circumstances on the globe as it was then in South Carolina. And though I am far from believing that health depends more on food and drink than on all other things put together, as many seem to suppose, yet I am entirely of opinion that he who should devote himself successfully to the work of applying this truth, in all its bearings, to the dietetic practice of all mankind, would do more for their reformation—yes, and their salvation too—than has yet been done by any merely human being, since the first day of the creation.

SEC. 3. Nursing—how often

Many lay it down, as an invariable rule, that no system can be pursued with a child till it is six months old; and it must be admitted by all, that for several months after birth there are serious difficulties in the way of determining, with any degree of precision, how often a child should be nursed or fed. Still, there are a few rules of universal application; some of which are here presented.

1. A child should never be nursed, merely to quiet it; for if this be done, it will soon learn to cry, whenever it feels the slightest uneasiness, not only from hunger, but from other causes; merely to be gratified with nursing. Besides, if its cries should happen to be from illness, it is ten to one but the reception of anything into the stomach will do harm instead of good.

2. The stomach, like every other organ in the body which is muscular, must have time for rest; and this in the case of children as well as adults. But to nurse them too frequently is in opposition to this rule, and therefore of evil tendency.

3. For reasons which may be seen by the last rule, there should be regular seasons for nursing, and these should be adhered to, especially by night. When very young, once in three hours may not be too frequent; I believe that it is seldom proper to nurse a child more frequently than this. But whenever three hours becomes a suitable period by day, once in four hours will be often enough by night. I will not undertake to say at what precise age children should be nursed at intervals of three and four hours each; because some children are older, constitutionally, at three months, than others are at four.

There is one grand mistake, however, against which I must caution young mothers; which is, not to indulge the vain expectation that feeble infants will become robust, in proportion to their indulgence. On the contrary, it is the more necessary to be strict with feeble children, because they are feeble. To keep them hanging at the breast to invigorate them, is the very way to counteract our own intentions, and defeat our own purpose. Seasons of entire rest are even more important to their stomachs than to those of other persons.

4. But in order to secure intervals of rest, both to the strong and the feeble, we must avoid the pernicious habit of giving infants pap, and other delicacies, "between meals." Many a child's health is ruined by this practice. Nothing should be put into their stomachs for many months—if they are in health—but the mother's milk.

"This," says Dr. Dunglison, "is the sole food of the infant, and is consequently sufficiently nutrient to maintain life, and to minister to the growth, during the earliest periods of existence."⁸ In another place, he says, "Milk is an appropriate nourishment at all ages, and is more so the nearer to birth."

SEC. 4. Quantity of Food

"We all know," says Dr. Dewees, "how easily the stomach may be made to demand more food than is absolutely required; first, by the repetition of aliment, and secondly, by its variety;—therefore both of these causes must be avoided. The stomach, like every other part, can, and unfortunately does, acquire habits highly injurious to itself; and that of demanding an unnecessary quantity of aliment is not one of the least. It should, therefore, be constantly borne in mind, that it is not the quantity of food taken into the stomach, that is available to the proper purposes of the system; but the quantity which can be digested, and converted into nourishment fit to be applied to such purposes."

There is a great deal of truth in these remarks; and especially in the closing one, that not all which is taken into the stomach is digested. It is highly probable, that the least quantity which is usually given to an infant is more than sufficient for the purposes of digestion; and that nearly every child in the arms of its mother, is over-fed.

I know it has been said, by some physicians—and by those who are sensible men, in other respects, too—that the child's stomach is a pretty correct guide in regard to quantity. If we give it too much, say they, it will reject it;—as if that were an end of the matter.

But it is not so. It is by no means harmless to fill the child's stomach as full as is possible without overflowing. Such a process, though it should not create disease directly, would produce a gluttonous habit. The stomach, being muscular, may be increased in size by use, like all other muscular organs. The hands, the arms, the legs, the feet, the fleshy portions of the face, even, may be disproportionally enlarged by constant use. Thus a sailor, who uses his hands and arms much more than his legs and feet, has the former unusually large; one who is much accustomed to walking, has large feet; and in a tailor, who from childhood uses his lower limbs comparatively little, they are both small and slender. On the same principle, the stomach, by inordinate use, and by carrying unreasonable loads, may be made nearly twice as large as nature intended, and may demand twice as much food. And I have no doubt that the bulk of mankind, young and old, eat about twice as much as nature, unperverted, would require.

If the suggestions of our last section are duly attended to, one of the causes which lead the stomach to demand an unreasonable quantity of food will be avoided—I mean the too frequent "repetition of aliment." And if we never depart from the general rule, already laid down, not to give the infant anything but its mother's milk, we shall escape the evils incident to variety.

SEC. 5. How long should milk be the only food

On this point, there is a great diversity of opinion. Perhaps the most approved role, of universal application, is, that the first change should be made in the child's diet, when the teeth begin to appear.

This period, it is well known, cannot be fixed to any particular age, but varies from the fifth to the twelfth month.

Some mothers, who have borne with me patiently to this place, will probably here object. "What child," they will ask, "would ever have any strength, brought up so?" Not only a little pap and gruel is, in their estimation, necessary, long before this period, but even many choice bits of meat.

Now I am very sure, that these choice bits—whatever they may be—given to a child before it has teeth, not only do no good, but actually do mischief. Indeed, that which does no good in the stomach must do harm, of course; since it is not only in the way, but acts like a foreign body there, producing more or less of irritation.

I ought to state, in this place, that many people—mothers among the rest—have very inadequate ideas of digestion. They appear to have no farther notion of the digestive process than that it consists in reducing to a pulp the substances which are swallowed; and hence, whatever is reduced to a pulp, they regard as being digested. Whereas nothing is better known to the anatomist and physiologist, than that this—the formation of chyme in the stomach—constitutes only a very small part of the digestive process. The chyme must pass into the duodenum and other portions of intestine beyond the stomach, and be retained there for some time, before it will form perfect chyle.

This is a more important part of the work of digestion than even the former. For, suppose the chyme to be perfect, though even this may be mere pulp, rather than chyme, and suppose it pass quietly along into the duodenum and other small intestines. All this process, thus far, may go on naturally enough, and yet the chyle may not be well formed, and the chymous mass may find its way out of the system without answering any of the purposes of nutrition. For no matter how well the food is dissolved in the stomach, if it do not become good and proper chyle, the blood which is formed will not be good and perfect blood; or, lastly, if it seem to make good blood, it may still be faulty, so that the particles which should be applied to build up or repair the system, are either not used, or if used, answer the purpose but imperfectly.

We hence see how little prepared a large proportion of the community, are, to judge of the digestibility or fitness of a substance for infants, by their own observation and experience merely; and how much more wisely they act, in contenting themselves with giving them—at least until they have teeth—such food only as the Author of nature seems to have assigned them; especially when thus course, is precisely that which is recommended or sanctioned by nearly every judicious physician, as well as by almost all our writers on health.

SEC. 6. On Feeding before Teething

Having laid down the general rule, that until the appearance of teeth, the sole food of an infant should be the milk of its own mother, I proceed to speak of some of the more common exceptions to it.

EXCEPTION 1.—The first of these is when the supply furnished by the mother is scanty. There may be two causes of the scantiness of this supply; 1st, the want of suitable nourishment by the mother; and, 2dly, a feeble constitution, or bad health. In the former case, it should be her first object, as it undoubtedly will be that of her physician, to improve the quality of her diet; and in the latter, to restore her health, or at least invigorate her constitution.

In regard to the proper diet of a mother, as such, as well as the general management which her case requires, a volume might be written without exhausting the subject. But I have already said as much on this subject, in another place, as my limits will permit.

But we cannot wait for the mother's health to improve, and allow the infant to suffer, in the mean time, for a due supply of food. The appropriate question now is, How shall such a supply be furnished?

This should be done by means of an article resembling in its properties, as closely as possible, the mother's milk. For this purpose, we have only to mix with a suitable quantity of new cow's milk, one third of water, and sweeten it a little with loaf sugar. This is to be given to the child, at suitable intervals, and in proper quantities, by means of a common sucking bottle. It is, indeed, sometimes given with the spoon; but the bottle is better.

To the question, whether the child should be confined to this, till the period of weaning, Dr. Dewees answers, No. I am surprised at this; and my surprise is increased, when I find him, almost in the very next breath, urging with all his might, numerous reasons against the very common notion, that children in early life require a variety of food. He even insists on the importance of confining the child to a single article of food when it is practicable. Yet he has not given us so much as one reason why it is not practicable in the case before us; but has gone on to speak of barley water, gum arabic water, rice water, arrowroot, &c. I venture, therefore, to dissent from him, and to answer the foregoing question in the affirmative. When one good and substantial reason can be given for change, the decision will, however, be reconsidered.

I have already stated the general rule for preparing this substitute for the mother's milk. But there are several minor directions, which may be useful to those who are wholly without experience on the subject.

If possible, the milk used should not only be just taken from the cow, but should always be from the same cow; for it is well known, that the quality of milk often differs very materially, even among cows feeding in the same pasture, or from the same pile of hay; and the stomach becomes most easily reconciled to the mixture when it is uniform in its qualities. Great care should also be taken to see that the cow whose milk is used is young and healthy.