OUR BABIES

Dominion, Volume 10, Issue 3137, 16 July 1917, Page 3

OUR BABIES

FB? HTGEU.I Published under the auspices of tho Society for tlio Health of Women and Children. "It is wiser to put up a fence at tho top of a precipice than to maintain an ambulance at tlio bottom." CONSTIPATION IN BREAST-FED BABIES. So many letters regarding constipation in breast-fed babies have reached us lately, and the irouble ib of sucli frequent occurrence, that I feel bound to deal with it again. As an example of the inquiries which aru made 1 shall quote from three letters. MOTHEBS , LETTEBS. From Queensland comes the following:— My small boy is very well, except in one resuect. Ho is a constipated baby. It is rather curious, as my husband and myself are particularly healthy in this respect, and 1 am able to feed baby myself, lie has nut on over half a pound a week since he vas born, and developed the complaint only a fortnight ago. He is fed regularly, sleeps well at night, get , ) heaps of fresh air, and ylcnty of'exercise. He is bathed twice a day, is held out regularly every morning, is given a. teaspoontul of fruit juice every day and a dessertspoonful of water. Can I do any more? I was ordered to give a soap-and-water injection and doses of magnesia. The latter disagreed with baby, so I discontinued it. 1 give saline injectiou (as your book urges).' and soap-and-water alternately. I have let a day pass in between this week, as I'm afraid he will get lazy, and depend TOl° you eS tcli al me ICl if ymTthink I am right in continuing to nurse my baby without the aid of bottles? I do so want to briug up a. healthy, sane, normal boy. I South Canterbury says;— I feel very troubled about "my five and a-half mouths' old baby. She looks well, seems well, sounds well, but she has since birth been troubled with obstinate constipation. I have to Inject from Joz. to loz. of plain cooled boiled water to bring about a motion at all. I have spent hours upon her, doing everything common sense could suggest, etc. Anxious Mother, Otago, writes:— I have a baby girl four mouths old, breast-fed only, exceptionally good and healthy, being 151b. weight. She seldom cries, and sleeps most of her time; but she never ha 3 a motion of her own accord. I give her a glycerine injection once every twenty-four hours, and always about the same time. I have never let her go over the twentyfour hours to see if she would go herself, as I am afraid to do so. She is not at all costive. I have given her three or four doses of castor oil lu all; but tffe last twice i had to use the injection to start her. Her teeth are now starting to trouble her, etc. COMMENTS. We can quite understand how anxious these mothers are to overcome the constipation in their babies. If the waste products—which ought to be got rid ol regularly and in duo time—were allowed to accumulate in the intestines, they would gtve ofl poisons which would prove most injurious to the children. It is gratifying that all these mothers have been careful not to permit anything of the kind to "occur. THE ENEMA. Regarding the jise, of one or two ounces of saline (see page"ll2 "Feeding and Care of Baby") as an fujecilou, there is no need to worry about the idea of forming a habit that would !WTT! ~ be got rid of, because the quantity injected is so small and the flufS is (JI..M 'fane' and unirritating. Indeed, what |s callcu" normal ealine is almost identical with the fluid of blood and can be used for injecting iuto the blood vessels where people are collapsed through loss of blood; whereas the injection of pure water would be fatal. It is well to understand the bland nature of normal saline, because on this very account it is sometimes better to use plain water injections, as the Canterbury mother has done. This was so in the case of a baby who was brought us some thno ago. The child was very frail and delicate from birth, and bad to be gradually built up. Pure water injections succeeded where the injection of an ounce or two of saline failed. In the case of theso very small in-

icctions. tho movement of the bowels is mainly brought about by tho stimulation of the nerve-endinga in tho lower bowel, and the amonnt of stimulation depends on such factors as difference of temperature of the fluid injected from tho temperature of the bowel itself heat or told being both stimuli. Thus there is a '.'ecidjd stimulation if the fluid injected las a temperature about UOdcg. P or U-low eOdeg. F. Cool iujoctions are probably the best for the mother to use tho tcniporaturo being reduced day by dav down to. say, «deg. F. Glycerine and Castor Oil. Tho Otagq mother speaks of usin" a glycerine injection; but it should be borne in mind that the reason why glycerine acts more rapidly and surely than a plain water or normal saline- injection is tine to the fact that glycerine acts as a docidcd irritant iu the bowel. and that its repeated use tends to bring about a certain amount of damage. Like -uy other irritant, it may do more harm than good. Castor oil is still more- objectionable, except when a single dose is given to clear out tho bowel-conteuts whore there is acute diarrhoei or semo other bowel trouble. Massage of the Abdomen. Abdominal massage affords a very important means of toning and bracing up not only the muscles of the abdominal walls, bur- also the muscles of the bowel itself, cud the glnnds which pour their digestive juices into the whole alimentary It is wonderful what can be achieved in counteracting constipation in babies by skilful massage following on the use of an enema of loz. or 20z.; but this massage is rarely done efficient!". The great point is to manipulate the abdomen gentiy ar.c yet firmly and deeply, following round the horseshoe of the large intestine. A sausage-like tube starts just abovo the outer part of the right groin an J runs upwards to the margin <£ the rib, then curves round across the abdoraeii above the navel, until it reaches tho rib in the left flank, where it curves round sharply, and descends to reach the i FT' B theu passes downwards ana backwards to join the rectum. This courso of the large bowel is shown in the diagram on page 4, Pig. A, "Fcedin" and Care of Baby." The first essential in treatment of -his kind is to understand just what you want to arrive at. The abdomen must bo manipulated not merely on the surface but also deep and firm, yet gentle, pressure in the right direction. If this pressure were exercised without allowing for the breathing, the child would -tTufle and lcsist at onoe, and the walls cf the abdomen would, become "as still as a board ,, ; but if the pressure is gently and tactfully applied, mainly with each intake of tho breath (when the abdomen naturally slackens), it is quite easy to use continuous pressure in successive waves, as it were, gradually getting deeper and deeper, without arousing the opposition of the muscles. A really coinpek'nfc abdominal nurse could teach this n anipulative dexterity in a few lessons.

This article will bo concluded later, when we shall give on illustrative case, in which the use of the enema and massage of the abdomen were combined, \yith excellent, results.

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