OUR BABIES

Dominion, Volume 9, Issue 2630, 27 November 1915, Page 10

OUR BABIES

! fßr HTarii.i

Published under the auspices of the Itoyal New Zealand Health Society for the Health of Women and Children. "It is wiser to imt up a fence at tlio top of & precipice than to maintain on ambulance at the. bottom." IS BABY REALLY ILL? ' From tLmo to time mothers in out-of-the-way parts of the .country askhow they are to form an idea as to what is wrong with baity, or whether, when an infant is "out of sorts," there is likely to he anything seriously wrong. It is easy to reply to all such questions that the safe rule is to call in a doctor without delay. Of course, this is' sound advice; hut thero are many little ups and downs ill which the country mother especially lias to judge for herself. Parents in the Back-Mocka, from 20 to 40 miles from a doctor, are faced with a very difficult problem when called on to form an opinion as to what is wrong with ail ailing child, and especially to decide whether the trouble is likely to be a mere passing sot-back or a serious illness calling for immediate medical attention.

* Asi a general reply to our correspondents on this point, I think I cannot do batter than quote the following from a "Book for Mothors," by Dr. Lerov Yale of New York. ' ' . THE EVIDENCES OF ILLNESS. _It is not necessary, even if ( it were desirable, that, the mother or nurse should be able to make a diagnosis of the iature of any disease that a child may have; but it is very desirable that she should be- ablo to recognise the symptoms of illness. These may be so direct and simple that they indicate the disease. At all events, they should convey to the mother the information that .the ohild is not well and in need of help, either hors or that of a physician. If she has familiarised herself with the signs of health, she will easily recognise departures from them. Below are some of the commoner ways in which a child manifests that it is not well, atv.l iuav possibly indicate its iralady. GENERAL' BEHAVIOUR. Deportment. The usual expression of discomfort is restlessness and fretfuluess. Sleep ia disturbed, the quiet baby is no longer so, but desires attention, wants to bo taken, up, or in other similar ways sliows that it is not «it oass. Less fro* quen.tly children in illness, especially if the temperature be raised, become unusually heavy and drowsy. ■Posture may vary somewhat in accordance with the just-mentioned nerv6u_s states —that is to say, the restless child constantly changes its position, while the heavy one may lie perfectly quiet in one position, without much apparent preference as to what that particular ono shall be. Special postures often are indications of particular conditions. Thus, the head, may be bent backward aud the neck stiffened, or there :may be a boring motion of the head, "with some inflammation-, of the brain envelopes (meningitis). If there is laboured breathing from any cause, the child may be unwilling to lie down, and may require to be helped or propped "P- - If there be pain in . the abdomen tllo' limbs are generally drawn.up. Many postures are assumed to avoid exciting local _ tenderness N -or pain. ■ ■ Pain is, expressed not only by ories, but sometimes by expressive gestures. Often the child's hand' is put "to the. seat of the pain. < " [Memo, by "Hygeia."—Tlio whole question of the expression of discomfort, pain, or illness'is very'fully dealt with in- the - sociot.v's book, "Feeding .and Care of Baby," under the heading of "Cries of the Baby"—see pages, 9C to 98.] ■-. • '

Of local symptoms a few may be mon. tioned:—

THE HEAD, FACTO, AND ; EYES.

The Head.—As evidence <xf acute illness, heat of the hoad, signs of headache, as shown by putting hands to the head; unwillingness to'move the head quickly, may be instanced. If the i child has the "soft snot" or fontanelle I still unclosed its throbbing may be used for oounting the pulse more easily than at the wrist. . It can be done by sight .. [Memo, by "Hygeia."—My 'impression is' that in practice very little value attaches to observations made by parents as to tho rate of the pulao or of the breathing in early. infancy. The normal rate of both:functions, is nearly double the average rate for adult life, and'; titers-, is a tendency .to wide variations from-, comparatively, slight causes. unaware of this fact aro liable to become alarmed when there is little or nothing wrong with the child, just as they may be driven, to panic by taking the temperature and finding that' it is 102 dog. or 103deg. Fahr. . In all such matters the response and variafion in early infancy are much moro extreme than in.the adult, and, takon by themselves, such variations are not fo be regarded with the same gravity as similar variations in adults. Writing on this matter, Dr. Leonard Guthrie saj-s wliat a world of groundless anxiety youn" doctors would bo saved if they clearly apprehended this point, and he remarks that we need not be alarmed, oven when the thermometer registers 104deg. Fahr., "if baby is placidly suckfiig its thumb; if lie can smile, his life cannot be in immediate danger." However, as people often wonder -what are to be regarded as the normal rates for the pulse and the breathing in babyhood, I may give the following"" as fair averages for the healthy child:— Pulse Breathbeats per ing per minute.- minute. First few weeks ... 120 to 140 30 to 50 Throughout rest of first year 110 to 120 25 to 40 Two to three years of age About 100 20 to 30 E'ivoto eight years .About 90 20 to 25 Adult 60 to 80 15 to 20. If the head be more full of blood than usual, as is sometimes the case 'in fever, the fontanelle may be prominent. ■Iu wasting diseases or with very poor nutrition, it may .be sunken. Tho expression of the countenance as a whole tells not a great deal, except, tho difference between comfort and discomfort; but the various parts of the face often are expressive. Thus:

Tho eyes are frequently suffused in illness, especially at the approach of cold, beginning as nasal catarrh ("cold, in the head"), or of measles. If the eye itself bo inflamed or sensitive, it may be red, or the child may avoid the light by closing the eyes or by turning the head. In disease the pupils may be enlarged or contracted, but rather, as evidence of existing mischief than' as a forerunfier of trouble. A foreign body in tho evo generally excites spasm of the eyelids and a flow of tears. Sleeping with half-closed eyes, if seen in illness, generally denotes depression. The sides of the nostrils are seen to move in respiration in conditions of laboured breathing, especially pneumonia.

[This article will be continued next week.]