Our Babies

Mount Ida Chronicle, Volume XLV, Issue XLV, 20 July 1917, Page 4

Our Babies

(By Hygeia). Published under the auspices of tue Society for the Health of Women and Children. "It is wiser to put up a fence at the top of a precipice than to maintain ■a ambulance at.the bottom."

Constipation in Breast-fed Babies. (Continued). Last week we gave some extracts from three letters from mothers, each of whom was experiencing difficulty is overcoming constipation in her breast-fad infant. We dealt with the use of the enema, and then described the method of performing abdominal massage for ths treatment of constipation, emphasising the fact that the massage must be dons efficiently if it is to be really effective. The following is the case we promised to dsseribe illustrating the combination of massage and the enema:— Case Illustrating the Combined Use of Massage and the Enema.

Some years agu a breast-fed baby ws« brought to us suffering from the most obstinate constipation. A tiained General Hospital nurse was in attendance, but she bad had little experience With babies. The nurse was asked to massage the abdomen before resorting to an enema. We were surprised to find thst the nurse began to manipulate the abdomen without any rational system, exercising pressure in a direction the reverse of the course in which the bowel-contents have to move, and not using pressure deep enough to be at all effective in Bny case. A skilled expert then did tbe massnge for a minute or two, and as no movement took place an ounce of normal saline (see page 112 under Enema, "Feeding and Care of Baby") was injected This produced no reB"H, An injection cf about 2cz was then given, and after it massage proved perfectly effective. The whole time occupied from beginning to end was, perhaps, quarter of an hour, and the baby suffered no discomfort, and did

not cry. In this case perfect regularity was trroced within the week by the simple av ans we bare described, though every O'tif-r measure had failed. Ht-w to do Abdominal Massage. it is so important that mothers should have a clear picture of how abdominal masiage *houid be gone about that we feel impelled to summarise trie method of manipulation again, first asking our readers to turn up s»r-d to look cart-fully at diagram A , while reading the lolbwing description:—

A saasage-like r.iijo-,ttrts just above the uuter cart of tee right groin and runs UDwards to tdr margin uf the rib, curves away across the abdomen "Vf the navel until it reaches the 'b in th« left flank, where it curves >• inn sharply, and descends to reach i *• l<*ft gruin; it then passes down•a «-rda and backwards to join the rectum, from which tbe motions are expelled. The main point is to manipulate the abdomsn (following round tbe horse-shoe of the large intestine as described above), pressing gently and yet firmly and deeply, the fingers eventually almost touching tbe back wall uf the abdomen on the right side. If this praaaure were exercised without allowing for the breathing, the child would struggle and resist at once, and tbe wall of the abdomen would become quite stiff; bat if the pressure is gently and tactfully applied mainly with •ech intake of the breath (when the abdomen naturally slackens), it ia quite easy to nae continuous pressure in suceaaaive waves, as it were gradually getting deeper and deeper, without arousing the opposition of the muscles. Of course, the hand doing the massage must be warmed, and it ia well to dip the fingers in warmed Olive Oil, though opinions vary with regard to this. Whai we waDt to impress on our readers is that, to be effective for the relief of constipation, massage should be definitely and skilfully carried out. The technique, however, is quite simple, and it can be easily learned from a competent masseuse. At the

name time it is a mistake to suppose that simpls surface rubbing of the ab- >!< men with the fingers, carried out in tie light direction even $y some unSkilJed parga-n, ie uaelei*, Any such

rubbing and kneading of tbe abdomen tends to increase the activity of the movements of the bowel. Indeed, to a lesser extent, massage of the limbs tends in tbe same direction, because constipation is generally associated more or less with insufficient tone and activity of the whole system, and robbing of any kind acts hb a general ■timulus. Olive Oil.

In addition to careful attention to all the hygienic essentials, which my correspondents seem to have carried out well, there is not much to bs said, except that, besides giving fruit juice, half a teaspoonful of the best Olive Oil might be tried, and this might be gradnaily increased until a moderatesized teaspoonfal was taken. This should be given before the last feeding in the evening. Olive Oil is generally extremely well borne by babies, and it agrees wtth them where there may be difficulty with Cream. In sny case, the giving of Cream for constipation, though sometimes recommended, is not desirable indeed the presence of too much butter-fat is liable to aggravate matters, giving rise to what is known as "fat constipation." Rational Methods.

I am sure that the readers of this column will realise that the rational way to deal with a tendency to constipation, whether in the case of a baby or an aault, is to get the individual into the best possible all-round health and vigour, neglectiDg none of the" essentials mentioned on pages 1 and 2 of the Society's Book. The commonest mistake is trying merely one thing at a tim* where you want the cumulative effect of a number of factors used in moderation, such as massage, fruit juice, olive oil, etc., none of which might bring about the desired result if used by itself. Continue Nursing BBby.

Our Queensland correspondent askß if we think she is right in continuing to nurse her baby without the aid of bottles. We have not the slightest doubt on this point. A mother should never resort to bottle-feeding, unless for some absolute and unquestionable reason, such, for instance, as tuber» culosis, or because tbe supply of breast milk cannot be brought up to the required quantity. But even then the baby should be suckled regularly every feeding-time, the deficiency made up by bottle. (See pages 6, 10, and 57 to 59, "Feeding and Care of Baby.") We sympathise and concur with our correspondent's view that a mother ought to dp anything in her power to ensure a good start in Ufa for her children and nothing ein compare with the advantages of breait-feeding.