Two wash cloths;

Four ounces of crystal boracic acid, a saturated solution of which is used for cleansing baby's eyes and mouth;

One pound of good absorbent cotton;

A flexible tube of white vaseline;

A bath thermometer;

A package of sterile gauze;

A half dozen baby towels, good quality;

A soft, white, good blanket,--one and one-half yards square;

One pair small blunt pointed scissors;

A package of the best safety pins;

Three or four dozen bird's-eye cotton diapers. First size, eighteen inches square. Second size, twenty-five inches square;

One yard of soft white flannel for belly bands; each band should be five inches wide, by twenty-four inches long.

Two silk and wool shirts;

Three flannel shirts (all shirts should be high necked, long sleeved, and open down the front);

Three Eiderdown wrappers;

Three Cashmere sacques;

Three pads for crib;

Six dresses;

Six petticoats (they should be thirty-three inches long from neck to hem; they should be turned up at the bottom for about four inches and should b.u.t.ton there to keep the feet warm; if it is desired to use pinning blankets for the first two months in place of the petticoats, they should be made of soft white flannel with cotton bands);

Six night slips;

Six pair socks;

Two cloaks;

Two hoods;

One dozen bibs.

Simplicity, warmth, and freedom are the essentials in latter-day baby clothes. It is cheaper to make the clothes than to buy them. Excellent and accurate paper patterns can be obtained, giving the quant.i.ty of material necessary and suggesting the kind and quality best suited for the purpose. These patterns may be obtained from the b.u.t.terick Publishing Company in New York City.

CARE OF THE NEWLY-BORN BABY.--After the nurse has completed her duties with the mother after the confinement, she will prepare to give baby its first bath.

The bath should be given in a warm room. This is a matter that should receive more consideration than has been given it. Nurses do not as a rule attach much importance to this duty, while in reality it is a most important one. I have seen trained nurses make ready to give baby its first bath in rooms, during the night, that were not heated adequately.

I am convinced that many babies have been victims of this careless habit to the extent of grafting on them the tendency to catarrhal colds and bronchitis because of undue exposure at this critical period. If one will remember that a baby has just been removed from an environment where the temperature was suitable and constant, to one in which it needs a large degree of artificial heat until such time as it may become accustomed to the change, one may appreciate the risk taken in exposing the child for even a short time. The mother should therefore warn the nurse not to undertake the baby's first bath until the temperature and other conditions are favorable. Many nurses and other individuals have the impression, without knowing why, that the baby should be cleansed and bathed immediately after birth. This is not at all necessary. If the conditions are not favorable, it would be far better to wrap the baby snugly in a warm blanket--first having put a diaper on--and place it in its crib with a hot water bottle near it and defer the bathing until the following forenoon. By that time the baby will be adapted to its new surroundings; its lungs will have become accustomed to the air which it is breathing for the first time; the mother will have been rendered comfortable; in other words, the conditions and the environment will be favorable for the baby and for a better performance of the duty.

The next important feature of the first bath is that it should be done in the quickest time consistent with efficient service. Only the necessary exposure should be indulged in. It is not necessary that the baby should be exposed to the admiring inspection of every member of the household--there will be plenty of time for that without risking the health of the child. A pan of water at a temperature of 100 F. should be placed on a stool in front of the nurse. The nurse should have on a rubber ap.r.o.n, and on top of this, an ordinary ap.r.o.n and a warm bath towel laid over her knees. The child should be gently rubbed with warm sweet oil to remove the _vernix caseosa_ (the greasy substance which is on all babies when born to a lesser or greater extent). Particular attention is to be given to all folds of the skin, as under the arms, in the fold of the neck, in the groin, behind the ears, etc., because in these parts the substance is thickest and if not carefully removed it will cake, and cause painful eruptions and sores, which may bleed and render the infant extremely uncomfortable. It is not necessary to expose the whole body at one time while applying the oil. The lower half may be covered with a warm soft towel while the nurse is oiling the upper part, and vice versa. After the body has been thoroughly oiled it should be cleansed with water at the proper temperature, in which pure castile soap has been dissolved. Absorbent cotton only should be used to wash the baby. All the washing is done with the baby on the nurse's knee; it is not put into the water.

The baby should be mopped dry with sterile gauze, or with a soft sterile towel, the cord dressed and the flannel band adjusted. It should then be completely dressed and put to the nipple and later to sleep.

DRESSING THE CORD.--The cord should be covered with powder and sterile gauze. The powder to use should be plain subnitrate of bis.m.u.th. If there is any reason to use another powder the physician will write a prescription for it according to indications. The subnitrate of bis.m.u.th will be found much better than any ordinary talc.u.m or toilet powder, many of which do not make good dressing powders.

Very few nurses know how to dress the cord. It seems to be impossible to impress them with the need of frequent attention to the cord. Fresh powder should be put on every time the diaper is removed, every time the infant urinates, and at other times during the day. The cord should be kept absolutely dry. Putting on powder twice daily will not keep the cord dry and many nurses are too lazy to bother to do it oftener. You cannot make a mistake in putting on too much powder, you can make a serious mistake by not putting on enough. Every time the cord is powdered it should be lifted up, away from the skin of the abdomen, and the powder put below it. The cord should be slightly drawn out and the powder applied round its base where it meets the skin. Many nurses are afraid to touch or handle the cord--they find it easier to neglect it.

The mother should see that the nurse dresses the cord at least five times every day.

APPLYING THE STERILE GAUZE TO THE CORD.--A piece of gauze, six inches square is taken, a hole is cut the size of a ten-cent piece out of the center, the cord is drawn through the hole, the gauze folded lengthwise over the cord and then sidewise, and this is held in place by the binder. This piece of gauze will adhere to the cord and will most likely be removed with the cord on the fifth day. If it should fall off, another piece may be put on in the same way.

If the cord does not fall off until very late it is because it has not been attended to rightly or because it was a very thick cord.

TREATMENT AFTER THE CORD FALLS OFF.--The stump of the cord should be powdered with the same powder used on the cord; a pad two inches square of sterile gauze and quite thick should be held over the stump for a number of days by the abdominal binder. This is used to prevent a possible rupture. After a week the size of the pad may be reduced, but a small pad should be used over the stump of the cord for a month or more.

A POUTING NAVEL.--If the stump of the cord should protrude, a piece of strong pasteboard, the size of a fifty-cent piece, should be wrapped in soft gauze and placed over the navel, over this a gauze pad, and if necessary this should be held in place by a strip of adhesive plaster, though the binder is usually sufficient if it is put on carefully. If this pad is held properly and worn for a month the tendency to protrusion or rupture will have pa.s.sed away. These pads may of course, be removed when the baby is being bathed and put back again before the binder is applied.

BATHING BABY.--A baby should not be put into water for a bath until after the cord has been off for forty-eight hours.

During the first few months the temperature of the water should be 98 F. The temperature of the water should be taken with a bath thermometer; it should not be guessed at. A bath thermometer is an inexpensive commodity and it will be in daily use in many ways in a home where there is a baby--it should therefore be procured wherever possible. The room should be warm; there should be no draughts. The mother or nurse should cultivate the habit of bathing baby quickly and with system. Everything should be ready and at hand. A little salt in the water will tend to strengthen the skin; it will also relieve any superficial rashes or excoriations which may be on the skin. Four tablespoonfuls to a gallon of water will be sufficient. The sea salt sold in the stores may be used in lesser quant.i.ties.

By the end of the fifth month the temperature of the water may be reduced to 95 F., and by the end of the first year to 90 F. After the first year the mother should accustom the child to a quick sponge with cool water on the chest and spine immediately after the bath. This simple means, if kept up, will often prevent the development of colds and bronchial troubles so common to children in temperate lat.i.tudes.

The best time to give the warm bath is at night. In the morning a cold sponge bath is desirable. This should be given as described in the chapter on cold sponge or shower baths.

In certain children bathing seems to depress their entire system. They do not react well even to a warm bath. They remain blue or pale around the mouth and eyes; bathing should therefore be carefully undertaken with these children until such time as they acquire strength.

CLOTHING OF BABY.--The baby should wear a woolen shirt, with a high neck and long sleeves. The abdominal binder may be worn for the first three months. It is not necessary after that time. If worn longer the habit is acquired and chronic indigestion may ensue when it is ultimately taken off. If the baby is very thin it may be wise to leave it on, simply for its warming effect, for a few months longer. If the child is normal and healthy the binder should be left off permanently after three months.

The band for the first four weeks should be made of plain flannel; after this period a knitted band with shoulder straps is the better article.

All petticoats and skirts should be supported from the shoulders.

Stockinet is a good material for diapers; it is soft, warm, and pliable.

Baby's feet should be warm always. Cold feet are frequently responsible for colic and gastro-intestinal troubles. A hot water bottle should be placed in the carriage if the weather is cold, but care should be taken to see that it does not touch the feet, otherwise it may burn them. The same measure may be adopted in the baby's crib if the feet are cold.

During the summer the outer clothing should be made of the thinnest quality of material possible, and the underclothing of the finest flannel or gauze. Body heat may be maintained during changes of temperature by extra outer wraps--not by dressing the baby in clothes that keep it too hot and uncomfortable all the time.

The main object to be attained in clothing the baby is to ensure a sufficient protection, but the clothing must be light, warm, loose, and non-irritating. Don't bundle up the arms and legs so that they cannot be moved; don't pin them so tight that the child cannot breathe properly and don't put the band on so that the child is in torture all the time from inability to move the abdomen.

BABY'S NIGHT CLOTHES.--The night clothing should be the same as that worn during the day, but it should be loose and of the lightest flannel material. For older children a thin woolen shirt (not the one worn during the day) and a suit of union clothing with feet is best.

The mistake must not be made to cover children too warmly at night. They can do with relatively less than adults. Too much covering will render the sleep restless, will encourage nightmare, and in older children will engender bad habits. Delicate children especially must not be over-covered at night.

For the first few months children should sleep in a darkened room.

CARE OF THE EYES.--The eyes should be cleansed for the first few days with a saturated solution of boracic acid. They should be protected from the direct light for two or three weeks after birth.