The Young Mother: Management of Children in Regard to Health

CHAPTER XII.
CRYING

Its importance. Danger of repressing a tendency to cry. Anecdote from Dr. Rush. Physiology of crying. Folly of attempting wholly to suppress it.

"Crying," says Dr. Dewees, "should be looked upon as an exercise of much importance;" and he is sustained in this view by many eminent medical writers.

But people generally think otherwise. Nothing is more common than the idea that to cry is unbecoming; and children are everywhere taught, when they suffer pain, to brave it out, and not cry. Such a direction—to say nothing of its tendency to encourage hypocrisy—is wholly unphilosophical. The following anecdote may serve in part to illustrate my meaning. It is said to have been related by Dr. Rush.

A gentleman in South Carolina was about to undergo a very painful surgical operation. He had imbibed the idea that it was beneath the dignity of a man ever to say or do anything expressive of pain. He therefore refused to submit to the usual precaution of securing the hands and feet by bandages, declaring to his surgeon that he had nothing to fear from his being untied, for he would not move a muscle of his body. He kept his word, it is true; but he died instantly after the operation, from apoplexy.

There is very little doubt, in the mind of any physiologist, in regard to the cause of apoplexy in this case; and that it might have been prevented by the relief which is always afforded by groans and tears.

It is, I believe, very generally known, that in the profoundest grief, people do not, and cannot shed tears; and that when the latter begin to flow, it affords immediate relief.

I do not undertake to argue from this, that crying is so important, either to the young or the old, that it is ever worth while to excite or continue it by artificial means; or that a habit of crying, so easily and readily acquired by the young, is not to be guarded against as a serious, evil. My object was first to show the folly of those who denounce all crying, and secondly, to point out some of its advantages—in the hope of preventing parents from going to that extreme which borders upon stoicism.

One of the most intelligent men I ever knew, frequently made it his boast that he neither laughed nor cried on any occasion; and on being told that both laughing and crying were physiologically useful, he only ridiculed the sentiment.

Crying is useful to very young infants, because it favors the passage of blood in their lungs, where it had not before been accustomed to travel, and where its motion is now indispensable. And it not only promotes the circulation of the blood, but expands the air-cells of the lungs, and thus helps forward that great change, by which the dark-colored impure blood of the veins is changed at once into pure blood, and thus rendered fit to nourish the system, and sustain life.

But this is not all. Crying strengthens the lungs themselves. It does this by expanding the little air-cells of which I have just spoken, and not only accustoms them to being stretched, at a period, of all others, the most favorable for this purpose, but frees them at the same time from mucus, and other injurious accumulations.

They, therefore, who oppose an infant's crying, know not what they do. So far is it from being hurtful to the child, that its occasional recurrence is, as we have already seen, positively useful. Some practitioners of medicine, in some of the more trying situations in which human nature can be placed, even encourage their patients to suffer tears to flow, as a means of relief.

Infants, it should also be recollected, have no other language by which to express their wants and feelings, than sighs and tears. Crying is not always an expression of positive pain; it sometimes indicates hunger and thirst, and sometimes the want of a change of posture. This last consideration deserves great attention, and all the inconveniences of crying ought to be borne cheerfully, for the sake of having the little sufferer remind us when nature demands a change of position. No child ought to be permitted to remain in one position longer than two hours, even while sleeping; nor half that time, while awake; and if nurses and mothers will overlook this matter, as they often do, it is a favorable circumstance that the child should remind them of it.

Crying has been called the "waste gate" of the human system; the door of escape to that excess of excitability which sometimes prevails, especially among children and nervous adults. To all such persons it is healthy—most undoubtedly so; nor do I know that its occasional recurrence is injurious to any adult—a fastidious public sentiment to the contrary notwithstanding.

Some have supposed, that what is here said will be construed by the young mother into a license to suffer her child to cry unnecessarily. Perhaps, say they, she is a laboring woman, and wishes to be at work. Well, she lays down her child in the cradle, or on the bed, and goes to her work. Presently the child, becoming wet perhaps, begins to cry, as well he might. But, instead of going to him and taking care of him, she continues at her employment; and when one remonstrates against her conduct as cruelty, she pleads the authority of the author of the "Young Mother."

All this may happen; but if it should, I am not answerable for it. I have insisted strongly on guarding the child against wet clothing, and on watching him with the utmost care to prevent all real suffering. Mothers, like the specimen here given, if they happen to have a little sensibility to suffering, and not much love of their offspring, generally know of a shorter way to quiet their infants and procure time to work, than that which is here mentioned. They have nothing to do but to give them some cordial or elixir, whose basis is opium. Startle not, reader, at the statement;—this abominable practice is followed by many a female who claims the sacred name of mother. And many a wretch has thus, in her ignorance, indolence or avarice, slowly destroyed her children!

I repeat, therefore, that I do not think my remarks on crying are necessarily liable to abuse; though I am not sure that there are not a few individuals to be found who may apply them in the manner above mentioned—an application, however, which is as far removed from the original intention of the author, as can possibly be conceived.

CHAPTER XIII.
LAUGHING

"Laugh and be fat." Laughing is healthy. A common error. Monastic notions yet too prevalent on this subject.

Laughing, like crying, has a good effect on the infantile lungs; nor is it less salutary in other respects. "Laugh and be fat," an old adage, has its meaning, and also its philosophy.

There is an excess, however, to which laughing, no less than crying, may be carried, and which we cannot too carefully avoid. But how little to be envied—how much to be pitied—are they who consider it a weakness and a sin to laugh, and in the plenitude of their wisdom, tell us that the Saviour of mankind never laughed. When I hear this last assertion, I am always ready to ask, whether the individual who makes it has read a new revelation or a new gospel; for certainly none of the sacred books which I have seen give us any such information.

But I will not dwell here. The common notion on this subject, if not ridiculous, is certainly strange. I will only add, that, come into vogue as it might have done, there is no opinion more unfounded than the very general one among adults, that children should be uniformly grave; and that just in proportion as they laugh and appear frolicsome, just in the same proportion are they out of the way, and deserving of reprehension.

It is strange that it should be so, but I have seen many parents who were miserable because their children were sportive and joyful. Oh, when will the days of monkish sadness and austerity be over; and the public sentiment in the christian world get right on this subject!

CHAPTER XIV.
SLEEP

General remarks. Hints to fathers.—SEC. 1. Proper hours for repose. Dark rooms. Noise.—SEC. 2. Place for sleeping. Sleeping alone—reasons.—SEC. 3. Purity of the air in sleeping rooms.—SEC. 4. The bed. Objections to feathers. Other materials.—SEC. 5. The covering of beds. Covering the head.—SEC. 6. Night Dresses. Robes.—SEC. 7. Posture of the body in sleep.—SEC. 8. State of the mind.—SEC. 9. Quality of sleep.—SEC. 10. Quantity of sleep.

Not a few persons consider all rules relative to sleep as utterly futile. They regard it as so much of a natural or animal process, that if we are let alone we shall seldom err, at any age, respecting it. Rules on the subject, above all, they regard as wholly misplaced.

Those who entertain such views, would do well, in order to be consistent, to go a little farther; and as breathing and eating and drinking—nay, even thinking—are natural processes, deny the utility of all rules respecting them also. Perhaps they would do well, moreover, to deny that rules of any sort are valuable. But would not this have the effect to bar the door perpetually against all human improvement? Would it not be equivalent to saying, to a half-civilized, because only half-christianized community—Go on with your barbarous customs, and your uncleanly and unthinking habits, forever?

But I have not so learned human nature. I regard man as susceptible of endless progression. And I know of no way in which more rapid progress can be made, than by enlightening young mothers on subjects which pertain to our physical nature, and the means of physical improvement. Not for the sake of that perishable part of man, the frame, but because it is nearly in vain to attempt to improve the mind and heart, without due attention to the frame-work, to which mind and heart, for the present, are appended, and most intimately related.

Let it be left to fathers to study the improvement of hounds and horses and cattle, and at the same time to think themselves above the concerns of the nursery. We may, indeed, read of a Cato once in three thousand years, who was in the habit of quitting all other business in order to be present when the nurse washed and rubbed his child. But our passion for gain, in the present age, is so much more absorbing and soul-destroying than the passion for military glory, that we cannot expect many Catos. Oh no. All, or nearly all, must devolve on the mother. The father has no time to attend to his children! What belongs to the mother, if she can be duly awakened, may be at least half done; what belongs to the father, must, I fear, be left undone.

I am accustomed to regard every day—even of the infant—as a miniature life. I am, moreover, accustomed to consider mental and bodily vigor, not only for each separate day, but for life's whole day, as greatly influenced by the circumstances of sleep; the HOUR, PLACE, PURITY OF THE AIR, THE BED, THE COVERING, DRESS, POSTURE, STATE OF THE MIND, QUALITY, QUANTITY, AND DURATION.

SEC. 1. Hour for Repose

Generally speaking, the night is the appropriate season for repose; but in early infancy, it is every hour. I have already spoken of the vast amount of sleep which the new-born infant requires, as well as of many other circumstances connected with it, requiring our attention. Suffer me, however, to enlarge, at the risk of a little repetition.

What time the infant is awake, should be during the day. It is of very great importance, in the formation of good habits, that he should be undressed and put to bed, at evening, with as much regularity as if be had not slept during the day for a single moment. It is also important that he be permitted to sleep during the whole night, as uninterruptedly as possible; and that when he is aroused, to have his position or diapers changed, or to receive food, it should be done with little parade and noise, and with as little light as possible. All persons, old as well as young, sleep more quietly in a dark room, than in one where a light is burning.

I am well aware that the course here recommended, may be carried to an excess which will utterly defeat the object intended, since there are children to be found, who are so trained in this respect, that the lightest tread upon the floor will awake, and perhaps frighten them. But this is an excess which is not required. All that is necessary during the night, is a reasonable degree of silence, in order to induce the habit of continued rest, if possible. In the day time, on the contrary, fatigue will impel a child to sleep occasionally, even in the midst of noise. I am not sure that the habit of sleeping in the midst of noise is not worth a little pains on the part of the mother. Nor is it improbable that a habit of this kind, once acquired by the infant, might ultimately be extended to the night, so that over-caution, even in regard to that season, might gradually be laid aside.

Dr. North, a distinguished medical practitioner in Hartford, Conn., confirms the foregoing sentiments; and adds, that he deems it an imperious duty of those parents who wish well to their infants, to form in them the habit of sleeping when fatigued, whether the room be quiet or noisy. With his children, no cradles or opiates are needed or used.

SEC. 2. Place

For some time after its birth, the infant should sleep near its mother, though not in the same bed. The bedstead should be of the usual height of bedsteads, and should be enclosed with a railing sufficient to secure the infant from falling out, but not of such a structure as to hinder, in any degree, a free circulation of the air.

The reasons why a child ought to sleep alone, and not with the mother or nurse, are numerous; but the following are the principal;

1. The heat accumulated by the bodies of the mother and child both, is often too great for health.

2. The air is too impure. I have already spoken of the change in the purity of the air which is produced by breathing in it. It is bad enough for two adults to sleep in the same bed, breathing over and over again the impure air, as they must do more or less, even if the bed is very large;—but it is still worse for infants. Their lungs demand atmospheric air in its utmost purity; and if denied it, they must eventually suffer.

3. But besides the change of the air by breathing, the surface of the body is perpetually changing it in the same manner, as was stated in the chapter on Ventilation. Now a child will almost inevitably breathe a stream of this bad air, as it issues from the bed; and what is still worse, it is very apt, in spite of every precaution, to get its head covered up with the clothes, where it can hardly breathe anything else. This, if frequently repeated, is slow but certain death;—as much so as if the child were to drink poison in moderate quantities.

Let me not be told that this is an exaggeration; that thousands of mothers make it a point to cover up the beads of their infants; and that notwithstanding this, they are as healthy as the infants of their neighbors. I have not said that they would droop and die while infants. The fumes of lead, which is a certain poison, may be inhaled, and yet the child or adult who inhales them may live on, in tolerable health, for many years. But suffer he must, in the end, in spite of every effort and every hope. So must the child, whose head is covered habitually with the bed clothing, where it is compelled to breathe not only the air spoiled by its own skin, but also that which is spoiled by the much larger surface of body of the mother or nurse.

But I have proof on this subject. Friedlander, in his "Physical Education," says expressly, that in Great Britain alone, between the years 1686 and 1800, no less than 40,000 children died in consequence of this practice of allowing them to sleep near their nurses. I was at first disposed to doubt the accuracy of this most remarkable statement. But when I consider the respectability of the authority from which it emanated, and that it is only about 350 a year for that great empire, I cannot doubt that the estimate is substantially correct. What a sacrifice at the shrine of ignorance and folly!

It should be added, in this place, both to confirm the foregoing sentiment, and to show that British mothers and nurses are not alone, that Dr. Dewees has witnessed, in the circle of his practice, four deaths from the same cause. If every physician in the United States has met with as many cases of the kind, in proportion to his practice, as Dr. D., the evil is about as great in this country as Dr. F. says it is in Great Britain.

If a child sleeps alone, it cannot of course be liable to as much suffering of this kind as if it slept with another person; though much precaution will still be necessary to keep its head uncovered, and prevent its inhaling air spoiled by its own lungs and skin.

4. There is one more evil which will be avoided by having a child sleep alone. Many a mother has seriously injured her child by pressure. I do not here allude to those monsters in human nature, whose besotted habits have been the frequent cause of the suffocation and death of their offspring, but to the more careful and tender mother, who would sooner injure herself than her own child. Such mothers, even, have been known to dislocate or fracture a limb!²⁰

To cap the climax of error in this matter, some mothers allow their infants to lie on their arm, as a pillow. This practice not only exposes them to all or nearly all the evils which have been mentioned, but to one more; viz. the danger of being thrown from the bed.

A young mother, with whom I was well acquainted, was sleeping one night with her infant on her arm, when she made a sudden and rather violent effort to turn in the bed, in doing which she threw the child upon the floor with such violence as to fracture its little skull, and cause its death.

Enough, I trust, has now been said to convince every reasonable young mother, where absolute poverty does not preclude comfort and health, that her child ought never to be permitted to sleep in the same bed with her; but that it should be placed on a bedstead by itself at a short distance from her, and properly guarded from accidents—and above all, from inhaling impure air.

At a suitable age, a child may be removed from the nursery to a separate chamber. Here, if the circumstances permit, it should still sleep by itself; and if the bedstead be somewhat lower than ordinary, and the room be not too small, it will need no watching.

Perhaps this may be the proper place to say that there are more reasons than one—and some of them are of a moral nature, too—why a child should continue to sleep alone, after it leaves the nursery. Nor is it sufficient to prohibit its sleeping with younger persons, and yet crowd it into the bed with an aged grandfather or grandmother, or with both. There is no excuse for a course like this, except the iron hand of necessity. And even then, I should prefer to have a child of mine sleep on the hard floor, at least during the summer season, rather than with an aged person.

Let it not be supposed I have imbibed the fashionable idea that it is peculiarly unhealthy for the young to sleep with the old. I know this doctrine has many learned advocates. And yet I doubt its correctness. I believe that the manners and habits of the old may injure the young who sleep with them, and I know that they render the air impure, like other people. But I cannot see why the mere circumstance of their being old should be a source of unhealthiness to their younger bed-fellows. Still I say, that there are reasons enough against the practice I am opposing, without this.

Some parents allow dogs and cats to sleep with children. Others have a prejudice against cats, but not against dogs. The truth is, that they both contaminate the air by respiration and perspiration, in the same manner that adults do. And aside from the fact that they are often infested by lice and other insects, and addicted to uncleanly habits, they ought always to be excluded, and with iron bars and bolts, if necessary, from the beds of children. But of this, too, I have treated elsewhere.

SEC. 3. Purity of the Air

The general importance of pure air has been mentioned. I have spoken of the elements of the atmosphere in which we live, of the manner in which it may be vitiated, and the consequences to health. I have shown—perhaps at sufficient length—the impropriety of washing, drying, and ironing clothes in the room where a child is kept; of cooking in the room, especially on a stove; of suffering the floor or clothes, particularly those of the child, to remain long wet, in the room; of smoking tobacco, using spirits, burning oil with too long a wick, &c.

All which has thus been said of the purity of the air of the nursery generally, is applicable to that of all sleeping rooms. It is an important point gained, when we can secure a nursery with folding doors in the centre, so as, when we please, to make two rooms of it. In that case, the division in which the bed is, can be completely ventilated a little before night, and thus be comparatively pure for the reception of both the mother and the child.

Shall the windows and doors where a child sleeps, be kept closed; or shall they be suffered to remain open a part or the whole of the night? This must be determined by circumstances. If there are no doors but such as communicate with apartments whose air is equally impure with that in which the child is, it is preferable to keep them closed. If the windows cannot be opened without exposing the child to a current of air, it is perhaps the less of two evils, not to open them.

But we are not usually driven to such extremities. In some instances, windows are constructed—and all of them ought to be—so that they can be lowered from the top. When this is not the case, something can be placed before the window to break the current, so that it need not fall directly upon the child. Closing the blinds will partially effect this, where blinds exist.

I have known many an individual who was in the habit of sleeping with his windows open during the whole year, and without any obvious evil consequences. Dr. Gregory was of this habit. But if adults—not trained to it—can acquire such a habit with impunity, with how much more safety could children be trained to it from the very first year. Macnish says, "there can be no doubt that a gentle current pervading our sleeping apartments, is in the highest degree ESSENTIAL TO HEALTH."

This consideration—I mean the impurity of sleeping rooms, even after every precaution has been used to keep them ventilated—affords one of the strongest inducements to going abroad early in the morning (especially when there is no other room which either adults or children can occupy) while the nursery or chamber is aired and ventilated. The utility of rising early, I hope no one can doubt; but some have doubts of the propriety of going abroad, till the dew has "passed away." Such should be reminded, by the foregoing train of remarks, that early walking may be a choice of evils; and that if it is on the whole advantageous to adults, it cannot be less so to children. And as soon as the sun has chased away the vapors of the night, if the weather is tolerable, most children should be carried abroad.

SEC. 4. The Bed

This should never be of feathers. There are many reasons for this prohibition, especially to the feeble.

1. They are too warm. Infants should by all means be kept warm enough, as I have all along insisted. But excess of heat excites or stimulates the skin, causing an unnatural degree of perspiration, and thus inducing weakness or debility.

2. When we first enter a room in which there is a feather bed which has been occupied during the night, we are struck with the offensive smell of the air. This is owing to a variety of causes; one of which probably is, that beds of this kind are better adapted to absorb and retain the effluvia of our bodies. But let the causes be what they may, the effects ought, if possible, to be avoided; for both experience and authority combine to pronounce them very injurious.

3. Feather beds—if used in the nursery—will inevitably discharge more or less of dust and down; both of which are injurious to the tender lungs of the infant.

Mattresses are better for persons of every age, than soft feather beds. They may be made of horse hair or moss; but hair is the best. If the mattress does not appear to be warm enough for the very young infant, a blanket may be spread over it. Dr. Dewees says that in case mattresses cannot be had, "the sacking bottom" may be substituted, or "even the floor;" at least in warm weather: "for almost anything," he adds, "is preferable to feathers."

Macnish, in his "Philosophy of Sleep," objects strongly to air beds, and says that he can assert "from experience," that they are the very worst that can possibly be employed. My theories—for I have had no experience on the subject—would lead me to a similar conclusion. A British writer of eminence assures us that the higher classes in Ireland, to a considerable extent, accustom themselves and their infants to sleep on bags of cut straw, overspread with blankets and a light coverlid; and that the custom is rapidly finding favor. I have slept on straw, both in winter and summer, for many years, yet I am always warm; and those who know my habits say I use less covering on my bed than almost any individual whom they have ever known.

I have no hostility to soft beds, especially for young children and feeble adults, could softness be secured without much heat and relaxation of the system. On the contrary, it is certainly desirable, in itself, to have the bed so soft that as large a proportion of the surface of the body may rest on it as possible. But I consider hardness as a much smaller evil than feathers.

It is worthy of remark how generally physicians, for the last hundred years, have recommended hard beds, especially straw beds or hair mattresses, to their more feeble and delicate patients. This fact might at least quiet our apprehensions in regard to their tendency on those who are accustomed to them in early infancy.

Some writers on these subjects appear to doubt whether, after all that they say, they shall have much influence on mothers in inducing them to give up feather beds for their infants. But they need not be so faithless. Multitudes have already been reformed by their writings; and multitudes larger still would be so, could they gain access to them. It is a most serious evil that they are often so written and published that comparatively few mothers will ever possess them.

The pillow, as well as the bed, should be rather hard; and its thickness should be much less than is usual, or we shall do mischief by bending the neck, and thus compressing the vessels, and obstructing the circulation of the blood. But on this subject I will say more, when I come to treat on "Posture."

The child's bed should not be placed near the wall, on account of dampness. There is also, during the summer, another reason. Should lightning strike the house, it will be much more apt to injure those who are near the wall than other persons; as it seldom leaves the wall to pass over the central part of the room.

Curtains are not only useless, but injurious. They prevent a free circulation of the air. Everything which has this tendency must be studiously guarded against, in the management of infants.

Nothing is more injurious to the old or the young than damp beds and damp covering. It behoves, especially, all those who have the care of infants, to see that everything about their beds is thoroughly dry. The walls and clothes should also be dry; and wet clothes should never be hung up in the room. By neglecting these precautions, colds, rheumatisms, inflammations, fevers, consumptions, and death, may ensue. Many a person loses his health, and not a few their lives, in this way. The author of this work was once thrown into a fever from such a cause.

Warming the bed is, in all cases, a bad practice. While in the nursery, if the air be kept at a proper temperature, there will be no need of it; after the child is assigned to a separate chamber, its enervating tendency would result in more evil than good. It is better to let the bed became gradually heated by the body, in a natural and healthy way.

No person, and above all, no infant, should be suffered to sleep in a bed that has been recently occupied by the sick. The bed and all the clothes should first be thoroughly aired. Could we see with our eyes at once, how rapidly these bodies of ours fill the air, and even the beds we sleep in, with carbonic acid and other hurtful gases and impurities, even while in health, but much more so in sickness, we should be cautious of exposing the lungs of the tender infant, in such an atmosphere, until everything had been properly cleansed, and the apartments properly ventilated.

SEC. 5. The Covering

The covering of the bed should be sufficiently warm, but never any warmer than is absolutely necessary to protect the child from chilliness. The lightest covering which will secure this object is the best. Perhaps there is nothing in use that, with so little weight, secures so much heat as what are called "comfortables."

The clothes should not be "tucked up" at the sides and foot of the bed with too much care and exactness. For when the bed is once warmed thoroughly with the child's body, the admission of a little fresh air into it, when he elevates or otherwise moves his limbs, can do no harm, but may do much of good, in the way of ventilation. I deem it important, moreover, to inure children very early to little partial exposures of this kind.

Those mothers who, from over-tenderness, and want of correct information on the subject, pursue a contrary course, and consider it as almost certain death to have a particle of fresh air reach the bodies of their infants during their slumbers, are generally sure to outwit themselves, and defeat their very intentions. For by being thus tender of their children, it often turns out that whenever the mother is ill, or when on any other account she ceases to watch over them—and such times must, in general, sooner or later come—they are much more liable to take cold or sustain other injury, should they be exposed, than if they had been treated more rationally.