Our Babies

Mount Ida Chronicle, Volume XLV, Issue XLV, 13 July 1917, Page 4

Our Babies

(By- Hygeia). Published under tbe auipices of t&e Society for the Health of Women and Children. "It it wiser to put up a fence at tbe top of a precipice than to maintain •n ambulance at the bottom."

Constipation in Breast-Fed Babies. So many letters regarding Constipation in breaat-ftfd babies have reached us lately,- and the trouble is of such frequent occurrence, that I feel bound to deal with it again.

As an example of the inquiries which are made I shall quote from three letters. Mothers' Letters. From Queensland comes the following:—

My small boy is very well, except in one respect. He is a constipated baby. It is rather curious, as my husband and myself are particularly healthy in this respect, and I am able to feed baby myself. He has put on over half a pound a week since be was bom, and developed the complaint only a fortnight ago. He is fed regularly, sleeps well at night, gets heaps of fresh air, and plenty of exercise. He is bathed twice a day, is held out regularly every morning, is given a teaspoonful 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. Ti-e latter disagreed with baby, so- I •discontinued it. I give saline injection (as your book urges), and soap-and-water alternately. I have let a day pasa in between this week, as I'm afraid he will get lazy, and depend upon these artificial measures. Will you tell me if you think I am right in continuing to nurse my baby without the aid of bottles? I do so want to bring up a healthy, sane, normal boy. South Canterbury says:

I feel very troubled about my five and a-half months' old baby. She looks well, seems well, sounds well, bat slie has since birth been troubled with obstinate constipation. I have to inject from ioz 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 *1 have a baby girl four months old, breast-fed only, exceptionally good and healthy, being 15lb weight. She seldom cries, and sleeps most of her time; but she never has a motion of her own accord. I give her a glycerine injection once every 24 hours, and always about the same time. I have never let her go over the 24 hours to Bee if she would go herself, as I am afraid to do so. She is not at all costive, always having a nice soft motion after the injection. I have given her three or four doses of castor oil in all; but the last twice I had to use the uj jection to start her. off. I may state lam very regular myself. Her teeth are now starting to trouble her. etc. Comments. We can quite understand how anxious the3B mothers are to overcome the constipation in their babies. If the weste products—which ought to be got rid of regularly and in due time—were allowed to accumulate in the intestines, they would give off 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 use of one or two ounces of saline (see page 112 "Feeding and Care of Baby") as an injection, there ia no need to worry about the idea of forming a habit that would have to ha got rid of because the quantity injected is so small and the fluid is quite bland and unirritating. Indeed, what is called normal saline is almost identical with the fluid of blood, and can be used for injecting into 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 this 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 up some time ago'. The child was very frail and delicate from birtb, 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 these very small injections, the movement of the bowels is m&inly breugbt about by the stimulation of the nerve-endings in the lower bowel, and the amount of stimulation dependa on such factors as difference" of temperature of the fluid ' injected from the temperature of the bowel itself, heat or cold being both stimuli. Thus there is a decided stimulation if the fluid injected has a temperature about lOOdeg F., or below" 80deg P. Cool injections are probably the best for the mother- to use, the temperature beißg reduced day bsday dewn to, say, 65deg F. Glycerine and Castor Oil.

The Oiago mother speaks of using 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 due to the fact that glycerine acts as a decided irritant in the bowel, and that its repeated use tends to bring about a certain amount ''of damage. Like any 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 the bowel-contents where there is acute diarrhoea or some other bowel trouble.

Massage of the Abdomeu. ~- Abdomiaal Massage affords a very important means of toning arid bracing up not only the muscles of the abdominal walls, but also the muscles of the bowel itself, and the glands which pour their digestive juices into the . whole alimentary canal. It is wonderful what can be achieved in counteracting constipation in babies by skilful massage following on the use of an enema of loz to 2oz; tut this massage is rarely done efficiently. The great point in to manipulate tbe abdomen gently and yet firmly and deeply, following round the horseahoQ of the large intestine. A sausage-like tube starts just above the outer part of the right groin and runs upwards to the margin of the rib, then curves round across the abdomen above tne navel, until it reaches the rib in the left flank, wheie it round sharply,- and.j descends to reach tbe left groin. It then passe* downwards and backwards v to join the rectum, from which the motions a- e expelled. This course of tbe large bowel is shown in the diagram on page 4, Fig. A, "Feeding and Care of Baby." The first essential in treatment of, this kind is to understand just what you want to arrive at. The abdomen must be manipulated not merely on the surface, but also by deep and firm, yet gentle, pressure in the right direction. If this pressure were exercised without allowing for the breath- j ing, the child would struggle aad re- ! eiat at once, and the walls of the .ab- j domen would become "as stiff as a ! board"; but if the pressure is gently j and, tactfully applied mainly with each ' intake of the breath (when the abdo- • men naturally slackens), it is quite i easy to use continuous pressure in sue- ' cessive waves, as it were, gradually ! getting deeper and deeper, without j arousing the opposition of the muscles, j A really competent abdominal nurse j could teach this manipulative dexterity in a few lessons. | This article will bo concluded next j week, when we shall give an illustra- j tive case, in which the use of the j enema and massage of the abdomen ! were combined, with excellent results. |