OUR BABIES.

Stratford Evening Post, Volume XXXV, Issue 77, 8 April 1913, Page 7

OUR BABIES.

(By Hygeia.) Published under tli© auspices of the 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 an ambulance at the bottom.” HIGH! AND WRONG USE OF CASTOR OIL. Last week I dealt with a letter in which,t|ie writer assumed, from what had been said in this column, that the Plunket nurse had done wrong in ordering her baby a dose of Castor Oil for diarrhoea. The mother’s anxiety on the subject would have been allayed had she consulted the Society’s books, “Feeding and Care of Baby,” or “What Baby Needs,” where the following passages occur: —

If motions appear green when passed, or if they contain much undigested food, this indicates as a rule that less Humanised Milk and more boiled water should be given. Indeed, it is safer to give boiled water alone for one or more feedings. If the green motions are accompanied by obvious indigestion and diarrhoea, a teaspoonful of Castor Oil may be given and an instant change should invariably be made to pure boiled water for several meals, no food whatever of any kind being allowed. A motion looking like chopped spinach usually calls for an immediate dose of Castor Oil; but repeated doses of oil should on'no account be given. The extracts show the society's teaching with z’egard to the use of Castor Oil, and there was nothing in the article referred to by “Not Understood” which was not in accord with the above. However, Chavs no fault whatever to find with the writer’s misgivings, and I can feel indebted to her for drawing attention to them—only it seems to me that it would have been better to have written to myself asking for an explanation instead of assuming that the nurse had done wrong, and publicly expressing loss of_ faith in the Society, because of the mare’s nest she had found. From ‘/Not Understood’s” letter one gathers that her baby must have done well, and that she attributed the im-provement-jin part at least—to the dose of Castor Oil which she gave on the advice of the Plunket nurse when her baby was suffering from diarrhoea. Had this not been so she would not “have kept it in the house ever since in case of emergency”; noi;,\vpu]d she, have continued to “look upon Castor Oil as a friend.in timedf need,” as she says she did until she read my recent article. - . i ‘ ‘ , Evidently thh Plhnket pufse'impressed the moth hr with the fact that castor oil was only to he used in' ah emergency such as diarrhoea, and was not th be given’ 1 'habitually, f ih 'that instead ! of b&ngj 'blamed nurse ought rather to receive full credit and appreciation for the sound advice she gave. Castor oil properly and sensibly used—that is, a single dose given to clear out the fermenting and germladen contents’ df-'tlfe bowel when there is diarrhoea,'is 1 iWieed uWHfwsfilly recognised as a friend in® meed” where the baby is concerned. The fact that after the use of castor oil there is a tendency to constipation; ''-adds 1 do its value for diarrhoea. On the other hand, when chronic constipation is the trouble, this “binding?? property of castor oil makes it one of baby’s worst and commonest enemies. Then, if given habitually to induce movement of the bowels or simply because castor oil is supposed to be good for baby, extreme and intractable constipation and indigestion are liable to be the result. It was just such a case which led me to write about castor oil in the first instance. The following passage which J quoted from a mother’s letter tells the story:— J '"' There was a young mother .with her first hoy there (at the Maternity Home) at the same time as myself, and the nurse dosed them both every day with castor oil, and told the mother it was the right thing to do. I saw her a week or so ago. The baby .was always constipated, and so she always had to he giving him oil, or lie would not have a motion for three days, etc.

If those articles cause mothers to pause and think before administering any drugs to the babies, “Not tinderstood” will have done good by her letter; but it would have'been more friendly to write direct, and I trust she will do so next time if in any doubt.

With regard to the use of castor oil, it is well to keep three points clearly in view : 1. Never give castor oil for chronic constipation, or, indeed, for ordinary constipation at all. 2. At the onset of diarrhoea give one dose of castor oil, but never repeat it except under competent advice. 11. Never give castor oil, or, indeed, any aperient to a child seized with sudden, acute abdominal pain. FINAL WARNING. To make quite sure of driving home the last point, I quote the following from my original article—the article to which “Not Understood” took exception, and which she said caused her to hse faith in our advice. The re-

put trees should h'e to Sir Berkeley Morniham, as Dr. Moynjhan has since been knighted in appreciation of his distinguished services in the special held of intestinal trouble—indeed in recognition of ins being the leading pro > incial surgeon of the day in Eng-

“Tow let us turn to what Dr. Moyn- | iiiau (the leading English authority of I the day on the surgical aspect of in- ' terdnal disorders) is saying on this veiv subject. The British Medical

Journal for April, 1911, contains the following warning:— AVOID APERIENTS. By some means or other parents should be made to know that the dosing of children with aperients is an evil, and that they must put a check upon those “purgative-loving propensities” which seem inseparable from motherhood. I would like to have the power to write in every nursery in the Kingdom in large letters in the most prominent place the two words—AVOlD APERIENTS. To give aperients to children suddenly seized with acute abdominal pain is homicidal, yet it hardly occurs to any mother or nurse to do anything but this, the most disastrous thing of all. The onset of sudden intense pain in the belly is Nature’s special danger signal pointing to obstruction of the bowels by kinking or tucking-in, and is also her way of proclaiming the onset of appendicitis. Nurses ought to know that the pain may not he in the lower part of the belly, where the appendix -is situated, but at the top of the belly, in the region of the “pit of the stomach.” This fact is most misleading, both to parents and nurses, because they are apt to conclude that the child lias “swallowed something.” The first symptoms of an attack of acute appendicitis is pain. It is always pain, and never sickness or vomiting, nor mal-aise, nor any other symptom whatever. The pain is absolutely abrupt in onset. It may he rapidly followed by shivering, sharp rise of temperature, vomiting, diarrhoea, etc. What does the mother do in such a case? Having jumped to the conclusion that the child has been eating green fruit or other indigestible food, she flies to the castor oil bottle. The proper treatment is absolute starvation, even water being given sparingly, until the doctor arrives. The child should bo put to bed and hot fomentations .should be applied to the abdomen. Such measures can do no harm, always afford some relief,, and are equally applicable to sudden obstruction of the bovvel. In either case the use of purgatives and delay in calling in medical aid often puts the child beyond the hope of recovery before the doctor arrives on the scene. Castor oil does not cure constipation, but makes it worse.